Exploring Healthcare Providers' Experience of Communication Barriers with Official Language Non-Proficient Patients in Cameroon: Evidence from Multilingual Health Centers in the Far North of Cameroon
DOI:
https://doi.org/10.53103/cjlls.v6i1.258Keywords:
Communicative Barriers, Healthcare Provision, Official Language Illiterate Patients, Linguistic PolicyAbstract
Communication barriers between health care providers and official language non-proficient patients (OLNPP) in the Far North of Cameroon have disastrous consequences for the quality of health care provided to this underprivileged population. These barriers are due to the complete lack of communication skills of patients in the official languages, the high level of illiteracy in this part of the country, the training of health care providers that does not take into account the multilingual and multicultural complexity of the country (health care providers in the country have been trained exclusively in French and/or English, the exoglossic languages that have been adopted as the official languages of the country). Moreover, the lack of a governmental language policy in the health sector in general and for patients who are non-proficient in the official languages in particular contributes to some extent to maintaining or widening this communicative gap. From the perspective of health care providers, this paper therefore aims at investigating the significance (health care providers' estimated proportion and frequency) of patients' official language illiteracy in Far North Cameroon health centers, the current strategies used by health care providers in these health centers to overcome these barriers, make some suggestions to overcome communication barriers in Far North Cameroon health centers, investigate the consequences of communication barriers on health care provision in Far North Cameroon health centers and propose a language policy for Cameroon health centers. Data were collected through questionnaires completed by 487 health care providers selected by simple random sampling from 45 health centers (government and private) in the region. Quantitative analysis was carried out using the Statistical Package for the Social Sciences (SPSS), while qualitative analysis followed a thematic approach. The work is discussed from the perspective of the Cultural Competency Model (Brach and Fraser 2000). The results show that 98 per cent of health care providers in health centers in the Far North region face language barriers in their daily practice, and the situation is more common in rural than in urban health centers. Furthermore, the estimated proportion and frequency of health care providers encountering patients who are non-proficient in the official language is very significant. Despite the fact that some healthcare providers and OLNPP patients share some home languages in their verbal repertoire, the proportion of healthcare providers who communicate with patients through these home languages is very insignificant. Various strategies are proposed to improve the current linguistic practices used by healthcare providers to overcome communication barriers. The paper proposes an exo-endonormative approach to language policy in health centers in Cameroon.
References
Akumbu, P. W., & Di Carlo, P. (2020). Multilingualism: The language of health in Cameroon. In Pius W. Akumbu; Justine Germo Nzweundji (eds). Responding to disease outbreak in Cameroon: Lessons from COVID-19., Rüdiger Köppe Verlag, pp.1-17, 2021, 978-3-89645-855-1. ffhal-03691704f
Ali, P.A., & Watson, R. (2018). Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses' perspectives. Journal of Clinical Nursing, 27 (5-6). e1152-e1160. ISSN 0962-1067 https://doi.org/10.1111/jocn.14204.
Amery, R. (2017). Recognising the communication gap in Indigenous health care. The Medical Journal of Australia. 207(1), 13-15.
Albrecht, U.V., Behrends, M., Schmeer, R., Matthies, H.K., & von Jan, U. (2013). Usage of multilingual mobile translation applications in clinical settings. JMIR Mhealth Uhealth. 2013 Apr 23;1(1):e4. doi: 10.2196/mhealth.2268. http://mhealth.jmir.org/2013/1/e4/ v1i1e4
American Institutes for Research (2005). A patient-centered guide to implementing language Access services in healthcare organizations. Document of the Office of Minority Health, U.S. Department of Health and Human Services. https://minorityhealth.hhs.gov/Assets/pdf/Checked/HC-LSIG.pdf
Banque Africaine de Developpement (2011). Cameroun : projet de réduction de la pauvreté et actions en faveur des femmes dans l’Extrême Nord (prepafen). Document of the banque africaine de développement, Département de l’évaluation des opérations division de l’évaluation des projets et programmes (opev.1)
Beh, T.H., & Canty D.J. (2015). English and Mandarin translation using Google Translate software for pre-anaesthetic consultation. Anaesth Intensive Care. 43(6):792-3.
Bowen, S. (2015). The impact of language barriers on patient safety and quality of care. Final Report Prepared for the Société Santé en français. pp. 1-47. http://www.santefrancais.ca/wp-content/uploads/2018/11/SSF-Bowen-S.-Language-Barriers-Study-1.pdf
Brach, C., & Fraser, I. (2000). Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev. ;57 Suppl 1(Suppl 1):181-217. doi: 10.1177/1077558700057001S09.
Chie, E. P., & Chenwi, A. J. (2021). Challenges of Language Barrier on the Health Services in Multilingual Cameroon: The Case of the North West Region. The International Journal of African Language and Media Studies (IJALMS). pp.5- 16
CMC (Center for Medicare and Medicaid services) (2017). How healthcare providers meet patient language needs: highlights of medscape provider surveys. pp. 1-22. https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Issue-Brief-How-Healthcare-Providers-Meet-Patient-Language-Needs.pdf
Commission Nationale pour l’UNESCO (2008). tendances récentes et situation actuelle de l’éducation et de la formation des adultes (EdFoA).) Rapport National de la République du Cameroun Par la Commission Nationale pour l’UNESCO. Document of the UNESCO National Commission.
Cox, A., &, Li, S. (2020). The medical consultation through the lenses of language and social interaction theory. Adv Health Sci Educ Theory Pract. 25(1):241-257. doi: 10.1007/s10459-018-09873-2.
De Moissac, D., & Sarah, B. (2019). Impact of language barriers on quality of care and patient safety for official language minority francophones in Canada. Journal of Patient Experience. Vol. 6(1) 24-32. https://doi.org/10.1177/2374373518769008.
DuBard, C.A., Garrett, J, &Gizlice, Z. (2006). Effect of language on heart attack and stroke awareness among U.S. Hispanics. Am J Prev Med. 2006 Mar;30(3):189-96. https://doi.org/10.1016/j.amepre.2005.10.024.
Good, J. (2017). Language choice and health communication in multilingual Africa A case study of Lower Fungom, Cameroon. Global Health Equity(https://www.buffalo.edu/globalhealthequity/Resources/research-posters.host.html/content/shared/www/globalhealthequity/research-posters/language-choice-and-health-communication-in-multilingual-africa--a-case-study-of-lower-fungom--cameroon.detail.html
Hunter-Adams, J., Rother, H.A. (2017). A Qualitative study of language barriers between South African health care providers and cross-border migrants. BMC Health Serv Res 17, 97. https://doi.org/10.1186/s12913-017-2042-5
Jaiteh, M., Cormi C., Hannetel, L., Mir JP., Leaune E., & Sanchez, S. (2022). Perception of the use of a telephone interpreting service during primary care consultations: A qualitative study with allophone migrants. PLoS One.;17(3):e0264832. https://doi.org/10.1371/journal.pone.0264832.
Kaliyadan, F., & Gopinathan, P.S. (2010). The use of Google language tools as an interpretation aid in cross-cultural doctor-patient interaction: a pilot study. Inform Prim Care, 18(2), 141-143. http://hijournal.bcs.org/index.php/jhi/article/view/764 .
Karliner, L.S., Jacobs, E.A. Chen, A. H., & Mutha, S. (2007). Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature Health Serv. Res., 42 (2), 727-754. https://doi.org/10.1111/j.1475-6773.2006.00629
Kayum, Fokoue C. (2013). Language use and communication of MDGs(Millennium Development Goals (MDGs): The health sector in Cameroon. Saarbrucken: LAP LAMBERT Academic Publishing
Khander, A., Farag, S., & Chen, K.T. (2018). Identification and Evaluation of Medical Translator Mobile Applications Using an Adapted APPLICATIONS Scoring System. Telemed J E Health.; 24(8), 594-603.
https://doi.org/ 10.1089/tmj.2017.0150.
Langendijk-van den Berg, I., Verdonk, P., & Abma, T. (2014). De professionele tolk verdwijnt: kwaliteit onder druk [The professional interpreter disappears: quality is jeopardized]. Ned Tijdschr Geneeskd.;158:A7702. Dutch. PMID: 25052355.
Li, Chieh., Noora, Addulkerim., Cara A. Jordan., & Christine Ga Eun (2017). Overcoming communication barriers to healthcare for culturally and linguistically diverse patients. North American Journal of Medicine and Science, 10(3), 103-109.
Margaret, M., &Van Wyk, J. (2016). Speaking the language of the patient: indigenous language policy and practice. South African Family Practice 2016; 58(1):30–31. http://dx.doi.org/10.1080/20786190.2015.1083718.
Matthews, M., & Van Wyk, J. V. (2016). Speaking the language of the patient: indigenous language policy and practice. South African Family Practice, 58, 30-31.
Meutem Kamtchueng, L.M. (2026) Healthcare providers' experiences of the practice of French/English home language interpretation for patients who are not proficient in the official language in Far-North postcolonial multilingual Cameroon. (Forthcoming)
Meuter, R.F., Gallois, C., Segalowitz, N.S., Ryder, A.G., & Hocking, J. (2015). Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC Health Services Research, pp.1-5.
https://doi.org/10.1186/s12913-015-1024-8.
Ministry of Basic Education (2015). Rapport d’analyse des données du recensement scolaire 2014-2015 du Ministère de l’Education de Base. Document of the Ministry of Basic Education.
Narayan, L. (2013). Addressing language barriers to healthcare in India. Natl Med J India. 26(4), 236-8.
Nguyen-Lu, N., Reide, P., Yentis, S.M. (2010) Do you have a stick in your mouth? -use of Google Translate as an aid to anaesthetic pre-assessment. Anaesthesia. 65(1), 96–97.
https://doi.org/10.1111/j.1365-2044.2009.06184_4.x.
Patil, S., & Davies, P. (2014). Use of Google Translate in medical communication: evaluation of accuracy. BMJ.;349:g7392. https://doi.org/10.1136/bmj.g7392.
Qanbar A.W., & Saqer, A.O. (2019). Language miscommunication in the healthcare sector: A case report. Journal of Patient Safety and Quality Improvement. 7(1): 33-35. https://doi.org/10.22038/PSJ.2019.36761.119
Republic of Cameroon (1996). Law No. 96-6 of 18 January 1996 to amend the Constitution of 2 June, 1972.
Republic of Cameroon & United Nations Development Programme (2002). Conditions de vie des ménages et profil de pauvreté à l'extrème-nord Cameroun en 2001. Yaoundé: République du Cameroun, Ministère des affaires économiques, de la programmation et de l'aménagement du territoire.
Röysky, M. (2015). Overcoming language barriers in health care services in the medical tourism context: Health care companies' perspective. Master’s thesis, School of Business, Aalto University.
Tadadjeu, M., & Sadembouo, E. (1984). General alphabet of Cameroon languages. Yaoundé: University of Yaoundé, Faculty of Letters and Social Sciences, Dept. of African Languages and Linguistics.
Unesco Institute for Lifelong Learning (2014). The Study Groups and Literacy Programme, Cameroon. https://uil.unesco.org/case-study/effective-practices-database-litbase-0/study-groups-and-literacy-programme cameroon#:~:text=The%20proportion%20of%20the%20population,in%20the%20Far%20North%20Province).
Van den Berg, V.L. (2016). Still lost in translation: language barriers in South African health care remain. South African Family Practice, 58, 6, 229-231. https://doi.org/10.1080/20786190.2016.1223795.
Van Rosse, F., de Bruijne, M., Suurmond, J., Essink-Bot, M.L., & Wagner, C. (2015). Language barriers and patient safety risks in hospital care. A mixed methods study. International Journal of Nursing Studies, 54:45-53. https://doi.org/10.1016/j.ijnurstu.2015.03.012.
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