Emergency medicine systems are key players in the global healthcare architecture, saving lives and minimizing long-term disabilities. Their core function is to deliver urgent, time-critical medical care designed to significantly improve a patient’s chances of recovery without lasting impairment [1,2]. It culminates in the immediate provision of life-saving emergency care upon arrival at the hospital, often within hours, minutes mere seconds, or of symptom onset [3]. Globally there is still a high proportion of people dying in emergency department of many healthcare settings. In 2019, emergency and/or operative conditions accounted for 514.09 deaths per 100,000 population and 18,113.00 Disability-adjusted life year (DALYs) per 100,000 population worldwide [4]. For emergency conditions, the per capita burden of deaths and DALYs is greatest for low-income countries [5].

In Cameroon, the life expectancy at birth (61 years in 2020) is still lower than that of several developed countries [6]. The maternal mortality ratio in 2023 is 250/100,000 live births, reflecting a high risk of women dying while giving birth [7]. A significant proportion of these deaths occur in emergency situations such as hemorrhage due to road traffic accidents or post-partum hemorrhage for women [8,9]. To properly address such health emergencies, a rapid pooling of health human resources, an adequate and high-quality technical platform, and financial resources are required. In a context of limited resources, mobilizing these resources for some families to save the life of their relatives might be challenging to ensure the optimal management of the patient.

In countries like Cameroon, domestic public health spending, at a mere 0.6% of gross domestic product, ranks as the third-lowest in sub-Saharan Africa [10]. Cameroon also faces the fourth-highest household out-of-pocket expenditure in the region, with approximately 475 billion XAF annually, representing 70% of total health expenditure [10,11]. In this context, where roughly 4 in 10 Cameroonians live below the national poverty line, health issues, especially emergency situations, might lead to death due to delays in patient management [12]. Additionally, the utilization of healthcare services (0.41 per 10,000 population) is still very low compared to the WHO target (5 per 10,000 population). This leads to delayed seeking care during illness, which worsens the patient’s condition and reduces the chances of recovery [6].

To prevent these deaths resulting from limited financial resources and poor utilization of healthcare services, the implementation of universal health coverage (UHC) in the country is one possible solution to increase access to quality healthcare [13,14]. Since April 2022, Cameroon has engaged in a significant UHC health system reform, aiming to ensure fair access to high-quality, affordable healthcare for all its citizens, with a special focus on the nation’s most vulnerable groups [15].

However, the packages offered in this initial phase primarily covered healthcare for specific groups within the Cameroonian population [16].This package includes several interventions ranging from prevention to care and treatment services for pregnant women, children under 5 years, patients on dialysis, and those diagnosed with tuberculosis, as well as human immunodeficiency virus (HIV)-related health services for people living with HIV [17].

In order to benefit from medical coverage, other population groups not covered by this UHC must subscribe to one of the health insurance schemes available in the country. Such medical insurance options include community-based health insurance, private health insurance offered by some traditional insurance and bank companies, and other medical coverages offered by the government to civil servants [14,18].

To sustainably run the UHC public policy in the country, households will be required to contribute financially to the program. Study reports identified significant factors associated with willingness to pay for UHC. Such factors include sociodemographic and economic characteristics, healthcare utilization, and policy perception [15].

On the other hand, a study conducted in Cameroon revealed six primary barriers to health insurance uptake and utilization, affecting both subscribers and non-subscribers. These included distrust in current health insurance policies, insufficient awareness of available schemes, high subscription costs, lengthy and complex bureaucratic procedures, infrequent healthcare utilization, and the common practice of self-medication [14].

To better inform decision-makers, there’s a clear need for data on the implementation of healthcare coverage in Cameroon as perceived by the general population. This information would help national and international stakeholders to develop targeted strategies to improve access to quality healthcare, reduce out-of-pocket (OOP) expenses, and prevent avoidable deaths due to financial constraints. This study aimed to provide a comprehensive national overview of how healthcare coverage is implemented in Cameroon. Specifically, we need to map the distribution of medical coverage across the country, identify the factors that determine its uptake, reveal the most prevalent types of insurance, understand the behaviors of both insured and uninsured individuals, and assess the level of satisfaction among beneficiaries.