Collaboration intersectorielle en faveur de l’intégration des objectifs de santé dans les politiques d’habitat urbain à Yaoundé et Douala : enjeux, logiques et pratiques d’acteurs

Abstract

This thesis arises from the observation that, contrary to certain development policy approaches adopted and implemented by the State of Cameroon, there emerges a low level of appropriation by the public authorities of the intersectoral collaboration approach, in favoring the integration of health objectives into all policies. In other words, despite the adoption of this holistic and inclusive approach by Cameroon and the calls from international organizations promoting health objectives, like the World Health Organization in favor of its appropriation, it emerges paradoxically a low level of appropriation of this strategy in urban housing policies in Yaoundé and Douala. The question arising from this observation was to know: what are the logics and practices which underlie the implementation of this approach in the human settlements sector of Douala and Yaoundé. In response, it appears that although the integration of this approach into human settlements policies leads to socio-economic, political and environmental benefits for the general well-being of urban populations, its implementation remains limited or weakened by bottlenecks. strangulation of socio-economic, political and environmental orders in these two cities. This favors the development of superficial, mixed, temporary and difficult collaborations between those involved in promoting urban health issues in said cities. This hypothesis was supported by a triple theoretical foundation: the theory of conflicts and powers, the theory of coalitions and the sociocritical approach. Just as in certain countries of the North and South having successfully adopted the HiAP, its appropriation has proven to be important for the reduction of inequalities and the promotion of health equality in the urban housing sector of economic and political capitals. from Cameroon. This new paradigm of transversal governance allows actors to effectively address the diversity and complexity of general health determinants, within the framework of intersectoral collaboration with a view to efficiently and effectively reducing urban health problems. The advantage of establishing this approach also lies in the fact that it makes it possible to increase the effectiveness and efficiency of health policies collectively, by bringing together expertise and energy for the promotion of issues of general well-being in human settlements. To this end, the use of this approach represents a preferred option to respond effectively to the multifaceted and complex determinants of health, in the face of which the efforts of the MINSANTE sector alone have proven to be limited. However, the appropriation of this approach in the urban housing sector of Yaoundé and Douala remains hampered, among other things, by bottlenecks such as the selfishness of the actors, conflicts of interest and power, the incivism of the populations. , the laxity of certain competent authorities, the ignorance of the intersectoral approach by the actors, the insufficiency of financial, material and human resources intended for this purpose. The weak appropriation of the HiAP in the Cameroonian urban context reflects the failure of the actions carried out by the public authorities for this purpose in a context of decentralization. To facilitate its appropriation in the Cameroonian urban housing sector, the different actors involved must take into account the realities, specificities and urban context of each city.