BARRIERS AND FACILITATORS IN THE IMPLEMENTATION OF UNIVERSAL HEALTH COVERAGE HEALTH VOUCHER MECHANISM AT TIKO DISTRICT HOSPITAL, CAMEROON

Background: The Universal Health Coverage (UHC) Health Voucher Mechanism was introduced in Cameroon to reduce financial barriers to maternal and child health services. Despite its implementation, factors affecting its operational effectiveness at facility level remain inadequately documented. Objective: This study assessed the barriers, facilitators, and strategies for strengthening implementation of the UHC Health Voucher Mechanism at Tiko District Hospital. Methods: A mixed-methods cross-sectional study was conducted among 57 health workers and 40 beneficiaries selected through census and consecutive sampling respectively. Data were collected using structured questionnaires and a facility observation checklist and analyzed using SPSS version 20. Findings were presented in tables and charts. Results: Implementation barriers were reported by all health workers (100%) and 92.5% of beneficiaries. Among health workers, delayed reimbursement (93.0%), high workload (68.4%), poor beneficiary understanding (52.6%), and inadequate training (47.4%) were predominant. Among beneficiaries, drug stock-outs (47.5%), administrative delays (47.5%), and poor explanation of procedures (45.0%) were leading challenges. Key facilitators included availability of trained staff (87.7%), supportive hospital management (77.2%), reduced cost of care (97.5%), and easy access to services (82.5%). Conclusion: The UHC Health Voucher Mechanism was perceived favorably by most beneficiaries, although its implementation remains constrained by financial, workforce, logistical, and communication challenges. Strengthening reimbursement timelines, staff training, drug supply, and beneficiary awareness is essential to improve program effectiveness and advance Cameroon's progress toward Universal Health Coverage.