REPUBLIC OF CAMEROON REPUBLIQUE DU CAMEROUN

Peace – Work – Fatherland Paix – Travail – Patrie

NATIONAL INSTITUTE OF INSTITUT NATIONAL DE

STATISTICS LA STATISTIQUE

WORLD POPULATION DAY

11 July 2022

Theme :
Theme: A World of 8 billion: Towards a Resilient Future
for All- Harnessing Opportunities and Ensuring Rights
and Choices For All

Demographic Growth and Resilience in Cameroon:

The Case of Education, Health and Decent Work

CONTACT :
P.O.Box: 134 Yaounde-Cameroon
Tel: (237) 222.22.04.45 / Fax: (237) 222.23.24.37
www.statistics-cameroon.cm
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Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work
1  
 

FOREWORD

The National Institute of Statistics (NIS) is pleased to present to you, on the

occasion of the 2022 World Population Day (2022 WPD), this brochure related to
the theme of the day, so as to enable to assess the effects of demographic
variables on education and health systems. The aim of this document is to raise
awareness among policymakers about the urgent need to use population data to
guide public policy and development planning. As a matter of fact, faced with the
rapid population growth, the availability and use of quality data enable to anticipate
the potentially negative effects and to exploit the opportunities of the demographic
dividend
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Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work
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INTRODUCTION
The world population will reach 8 billion in November 2022. Africa’s share of this
population is now experiencing a brutal growth since the current United Nations
(UN) projections show that this share will grow from less than one-tenth to one-
quarter in a century. Demography is in this regard, the great challenge for Africa in
the 21st century. As a matter of fact, the rapid population increase is reflected,
among other things, by a rapid urbanization, a sudden increase in the number of
people to be educated, cared for and integrated into the labour market.
Demographic resilience is about countries “anticipating and understanding how
their populations change…” and to “develop unique data-based responses that
can help mitigate the potentially negative impacts and fully exploit the
opportunities that also accompany demographic changes...”1
Demographic resilience thus underlines the importance of anticipating and
planning for demographic changes and investing in education, health, access to
decent work and gender equality. It also focuses on the use of statistical data to
guide public policy and development planning.

While there is a consensus in the

international community about the “Everyone has the right to life... Everyone
crucial role of education, health, has the right to education… Everyone has
decent work and gender equality in the right to work... on fair and satisfactory
the development process, it must working conditions... Everyone has the right
also be recognized that education, to a standard of living adequate for the
health, decent work are human health and well-being of himself and of his
family...” (Extracts from the Universal
rights issues.
Declaration of Human Rights, United
In this brochure, we aim to analyse Nations, 1948).
the impact of population growth in
Cameroon on access to education, health care and decent work. Issues of gender
equality will be tackled in a cross-cutting way. Data come from a set of socio-
demographic studies carried out in Cameroon.

                                                                                                                                   
1
Extracts from World Population Day Circular - 11 July 2022
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3 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

I-   Overview of the evolution of population, GDP and budgets

of education and health systems in Cameroon

According to the results of the Third General Population and Housing Census (3rd
GPHC), the population of Cameroon in 2005 was 17,463,836 and the average
inter-census population growth rate (1987 to 2005) was estimated at 2.9%.
Population projections place Cameroon’s population at 27,419,137 inhabitants in
2022. By 2025, Cameroon’s population will be about 30,000,000 inhabitants
(Figure 1). The level of fertility (measured by the Total Fertility Rate (TFR) is
estimated at 4.8, that is to say nearly 5 children per woman, on average 2.
Figure 1: Evolution of the population from 1912 to 2025

30 000 000

25 000 000

20 000 000

15 000 000

10 000 000

5 000 000

0
1912 1954 1965 1976 1987 2005 2011 2016 2022 2025

Source: BUCREP, National Report on the State of the Population of Cameroon – 2011 Edition; NIS,
Population projections and estimates of priority targets for various health programs and interventions,
2016

Moreover, it should be noted that the population of Cameroon, like other African
countries, is extremely young. In 2022, 43% of Cameroon’s population is under
the age of 15.
The role of human capital is crucial in the development process. This role is
strengthened in the new information and knowledge economy where the
                                                                                                                                   
2
2018 CDHS V
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4 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

emphasis is on skills and abilities, or capabilities (Sen, 1999). Capital is linked to

investment. Investment in human capital is concentrated in all expenditure on the
major axes of education and health.
Figure 2 : Evolution of GDP growth rates (1961-2021)

23
18
13
11,2
8 8,1
5,7
3 3,1 2,9 3,8 2,2 2,9 3,5
1,2 2
-­‐2 -­‐2
-­‐7 -­‐6,1
-­‐12
1961 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2021

GDP  growth  rate

Source : BM (https://donnees.banquemondiale.org/indicator/NY.GDP.MKTP.KD.ZG?locations=CM)

Over the past decade (2012-2021), GDP growth was averagely 4.0% per year.
Over the same period, the annual average rate of population growth was 2.6%.
The gap between the GDP growth rate and the annual average population growth
rate over this period is 1.4 percentage points, which is less than the 1.9 percentage
point gap projected in the GESP, for a reduction of poverty to 28.7% in 2020.
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5 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

Figure 3 : Evolution of budgets (billion CFA francs) allocated to basic education

and health in Cameroon from 2011 to 2022

250
244  
236   235   233  
230 226  
222   217  
210 207   206   208   211   208   208  
201  
190 189  
170 171   175   175  
161 162   166  
150 152 151
142
130
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Basic  education  budget Public  health  budget

Source : Finance Laws of the Republic of Cameroon (for fiscal years 2013 to 2021)

Budgetary resources in the basic education sector have steadily increased to

reach 244 billion in 2022. As for the budget allocated to health, it increased
successively from 2012 to 2016, then decreased considerably between 2016 and
2018, before increasing again but without reaching its 2016 level.
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6 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

II-   Effects of demographic variables on school and health

systems
Along with social, economic, political and cultural variables, demographic
variables play a central role in explaining the dynamics of education and health
systems. These systems, reciprocally, act on demographic variables.
This section presents the effects of demographic variables on school3 and health
systems in Cameroon.

Effects of demographic variables on school system

In Cameroon, there has been significant progress on indicators of school
enrolment (school enrolment rates and gender parity index), although there are
disparities according to regions. This progress is obviously to be compared with
the figures, in absolute numbers, of the evolution of the de la population at school
age.
Figure 4 : Evolution of the primary school enrolment rates

125
117.7
115 110.9
108.8
105

95

85

75
72.5
65 68.  2

55
1991 1998 2004 2011 2018

Sources: CDHS-I 1991, CDHS -II 1998, CDHS -III 2004, CDHS -MICS 2011 and CDHS -V 2018

                                                                                                                                   
3
We will limit ourselves to the primary cycle which is compulsory for children at school age
(6-11 years).
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7 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

Figure 5 : Evolution the gender parity index at the primary

0,92
0.91
0,91
0,90
0.90 0.90
0,89
0,88
0.87
0,87
0,86
0,85
0.84
0,84
0,83
1991 1998 2004 2011 2018

Source: CDHS-I 1991, CDHS -II 1998, CDHS -III 2004, CDHS -MICS 2011 and CDHS-V 2018

The base of the age pyramid is very broad for African countries that have not yet
started their demographic transition. It is estimated that the population of primary
school age (6-11 years) in Africa is three times that of industrialized countries with
an age pyramid getting closer by a column (Figure 6). In Cameroon, the
dependency rate between the population at school age and the adult population
is about 0.34 (that is, 100 children of school age for every 30 adults). According to
HUGON (2007), the gross school enrolment rate, or ratio, for a year, between
school enrolments at a level (cycle) and the population at school age, can be used
to analyze the interdependence between the school system and demographic
variables. So, the gross enrolment rate (ts) can be defined in financial terms as the
ratio between the actual expenditure on education for a given cycle and the
expenditure that would have been required if the whole population of school age
had been enrolled. It is written as follows:

                                                                                                                                   
4
NIS, Population projections and estimates of priority targets for various health programs and
interventions, 2016
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8 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

ts = aj/mj.bj (1 + hj). tj (1)

with aj : share of cycle j expenditure on GDP (or macroeconomic variable) ; mj :
teacher/student ratio (or pedagogical variable) ; bj : weighting of the teacher’s
salary in relation to the GDP per capita (or social variable) ; hj : ratio of non-salary
expenditures to salary expenditures; tj: the ratio of population at school age to the
total population (or demographic variable).
The two determining variables are, on the one hand, the difference between
teachers' salaries and per capita income (bj) and, on the other hand, the
demographic variable (tj) which is a function of the age pyramid. On the basis of
the relationship (1), considering the age structure of the population (thus the
dependency of the population at school age to the total population) and the
differences in remuneration (salaries have an incentive effect on teachers), at the
same rate of primary school enrolment (ts), the relative financial effort (relative to
GDP) in Africa (in Cameroon in particular) is much greater than that of industrialized
countries.

Figure 6 : Comparison of age pyramids of populations in Africa and industrialized

countries
Age pyramid of Cameroon Population Age pyramid of France population in
in 2018 2018

Répartition  (en  %)  de  la  population  des  ménages

Âge
80+
75-­79
70-­74
65-­69
60-­64
55-­59 Men   Women  
50-­54 Hommes Femmes
45-­49
40-­44
35-­39
30-­34
25-­29
Men   Women  
20-­24
15-­19
10-­14
5-­9
<5
10 6 2 2 6 10

Percentage Thousands
Source : NIS/CDHS-V, 2018
Source :
https://www.insee.fr/fr/statistiques/3312958
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9 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

In Africa, the population of school age generally grows more often than the general
population. In the case of Cameroon, the superiority of the growth rate for the
population of school age is not clear (Figure 7). This presents an opportunity to
capture the demographic dividend (school dividend in this case) by maintaining
an investment with a constant rate of growth. As a matter of fact, to maintain a
constant school enrolment rate, it is necessary to welcome each year more
students, with an increase of more than 3 % (Figure 7).
Figure 7 : Evolution of the annual growth rate of the population at primary school
age and the annual growth rate of the general population.

8%
7%
6%
5%
4%
3%
2%
1%
0%
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024 Annual  growth  rate  of  the  general  population
Annual  growth  rate  of  primary  school  age  population  (6-­‐11  years)

Source: NIS, Population projections and estimates of priority targets for various health programs and
interventions, 2016

If for example, universal primary education by 2025 must be reached, given the
current lag5 and the increase of the population of school age in Cameroon, the
number of primary school pupils must move from 3,345,735 in 2022 to 4,552,034
in 2025, that is an average annual growth rate of 12%. If not, primary education
for all will remain a mirage that shifts as we think we are getting closer to it.
                                                                                                                                   
5
The net primary school enrolment rate is 77.5% (CDHS V, 2018). With 4,317,077 children of
primary school age in 2022, it is deduced that 3,345,735 children are enrolled in primary school
in 2022.
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10 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

From the teacher student ratio (teacher/pupil ratio), the number of teachers
needed to cope with the increase in the population of school age at a time t + n
can be known. Then, from the teacher stock loss rate, the number of teachers to
be recruited yearly to avoid discordant effects can be known. For a teacher/pupil
ratio of 1/50, not only should the number of teachers in primary education be
maintained above 91,041 until 2025, but their loss should be avoided if a
widespread primary school enrolment is to be carried out.

Table 1 : Distribution of teaching staff in the Primary by Order (2017/2018 school

year)
Order of teaching Men Women Total
Public 29 831 26 555 56 386
Private 14 104 22 518 36 622
Community-based 214 501 715
Total 44 149 49574 93 723
Source :MINEDUB (http://www.minedub.cm/index.php?id=71)

Table 2 : Evolution of the population of primary school aged from 2005 to 2025
Year 2005 2006 2007 2008 2009 2010 2011
Number at school age 2825995 3 023229 3 021708 3147234 3189377 3278930 3374443
(Primary)

Year 2012 2013 2014 2015 2016 2017 2018

Number at school age 3383253 3460659 3547037 3654484 3739804 3820577 3945645
(Primary)

Year 2019 2020 2021 2022 2023 2024 2025

Number at school age 4059336 4161476 4244550 4 317077 4390045 4 466836 4552034
(Primary)
Source : NIS, Population projections and estimates of priority targets for various health programs and
interventions, 2016

Effects of demographic variables on the health system

Demographic variables also have an impact on the health care system. Health
issues are also to be compared with population figures, in absolute numbers, in
order to assess the magnitude of health phenomena on the population.
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11 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

The issues of public health, food safety, water quality, sanitation and the
environment are at the heart of population’s health. Access to care and medicines
is also essential.
The sanitary environment, especially water and sanitation, is crucial for
population’s health. Drinking water is vital. Target 6.1 of SDG Goal 6 aims to
achieve universal and equitable access to safe drinking water at an affordable cost
by 2030. Globally, there is a trend towards increasing access of Cameroon’s
populations to drinking water from an improved source6, from 42% in 2004 to 69%
in 2011 and 75% in 2018. It is estimated that at this rate, in Cameroon, in 2022,
about 7 million persons do not have access to safe drinking water. In addition,
SDG 6 Target 6.2 aims by 2030 to ensure equal access to adequate sanitation
and hygiene services for all, and to end open defecation, with particular attention
to the needs of women and girls and persons in vulnerable situations. For
improved sanitation facilities7, from 2011 to 2018, the percentage of the population
using improved sanitation facilities increased from 40% to 58%. This indicates
that in absolute terms, everything else equals, nearly 16 million people do not have
access to adequate facilities in Cameroon, in 2022.
The infant and child age group (less than 5 years or 0-59 months) and women of
reproductive age (15-49 years) are generally considered to be groups at risk due
to the weight of infectious 8 and reproductive diseases. Children under 5 are the
target of nutrition monitoring, vaccination, malaria and tuberculosis programmes.
This target represents at least 15% of the total population over several decades
(Table 3). Considering the demographic weight and the vulnerability of the
population of this age group, its contribution to the overall burden of disease is
noticed. A large part of the funding of the health system is therefore directed
towards this category of the population which, moreover, benefits from a policy of
gratuity within the framework of the priority programmes (free malaria treatment
for children under five and pregnant women, etc.)

                                                                                                                                   
6
Improved drinking water supplies include tap water, pump or drill wells, protected dug wells,
bottled water, protected spring water, and rainwater.
7
Improved sanitary facilities include flush toilets (manual flushing where water flushes urine,
human excrement and wastewater in pipes connected to the sewer system, a septic tank, a toilet
system, etc.), a ventilated improved pit toilet, a pit toilet with slab, or composting toile
8
According to the WHO, worldwide, infectious diseases, including pneumonia, diarrhea and
malaria, as well as premature births, asphyxiation at birth, injuries, and birth defects remain the
leading causes of death in children under 5 years.
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12 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

As with education, the age pyramid can be linked to the care structures. This
pyramid clearly shows an over-representation of the infant and child (see Figure
6). If we differentiate by age and gender the populations to benefit from health care
(infant, child, adult, senile), most of the resources of health care concerns the
infant, child and female populations
Children aged 0-11 months and pregnant women are target of the routine
vaccination. A 0-11 month old child is considered fully vaccinated when he has
received all doses of the planned vaccines while observing the minimum interval
between doses. According to the results of the 2018 Fifth Cameroon Demographic
and Health Survey (CDHS-V), 52% of children aged 12-23 months received all
basic vaccines. This means that out of 797,907 children in this age group, 382,995
are not fully vaccinated in 2018.
To fill the gap, both data on the current level of vaccination and the growth rate of
the target population must be taken into account. The pattern of trends in the
annual growth rate of the target population of 0-11 months suggests a declining
rate of growth. Over the past decade, the annual population growth rate of 0-11
months has been close to 2% (Figure 8).

Table 3 : Health Programs Priority Targets

Pregnant women
0-11 months 12-23 months 0-59 months
expected
percentage

percentage

percentage

percentage
population

population

population

population
population

population

population

population
Target in

Target in

Target in

Target in

Year
of total

of total

of total

of total
Target

Target

Target

Target
size

size

size

size

2016 817510 3.5 766851 3.2 3738441 15.8 869745 3.7

2017 840654 3.5 776308 3.2 3814004 15.7 892970 3.7
2018 857962 3.5 797907 3.2 3885338 15.6 912408 3.7
2019 874840 3.4 814714 3.2 3951283 15.5 933071 3.7
2020 888916 3.4 831280 3.2 4028776 15.4 938566 3.6
2021 904194 3.4 845591 3.2 4110877 15.4 964219 3.6
2022 920610 3.4 859363 3.1 4187861 15.3 980986 3.6
2023 936955 3.3 875897 3.1 4265114 15.2 998295 3.6
2024 961049 3.3 891906 3.1 4347751 15.1 1026983 3.6
2025 947531 3.2 890263 3.0 4309832 14.6 1004803 3.4
Source :INS, Population projections and estimates of priority targets for various health programs and
interventions, 2016
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13 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

Figure 8 : Evolution of the annual growth rate of routine vaccination target and the
annual growth rate of the general population

6%

3%

2%

1%

0%
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
Annual  growth  rate  of  the  general  population
Annual  growth  rate  of  population  aged  0-­‐11  months

III-   Employment dynamics in Cameroon

As part of the fight against poverty, the Government has given priority to
employment issues, with the aim of increasing the offer of decent jobs, matching
employment offer and demand and improving the efficiency of the labour market.
In Cameroon, according to the results of EESI 2, the employment rate was 66.4%
in 2010 against 68.3% in 2005. The average age of the active occupied population
is 33 years and it is 52.2% male and 47.8% female. The average duration in the
employment is 9.1 years.
The wage rate, defined as the ratio of the number of wage-earners to the active
occupied population, is an indicator to measure decent work. The national wage
rate is 20.3% in 2010 against 18.0% in 2005. This rate is lower in rural areas (9.4%)
than in urban areas (41.4%).
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14 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

CONCLUSION
In conclusion, there are clear links between education, health and demographic
variables. Access to education, access to health and access to decent work must
be seen as objectives in their own if human capital and human rights are to be
increased.
The leitmotiv of the demographic resilience approach is linked to the fact that,
when data are sufficiently taken into account in public policy making, high
population growth should not make development impossible, notably through
efficient planning of universal education and access to health care for all.
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15 Demographic Growth and Resilience in Cameroon: The Case of Education, Health and Decent Work  
 

REFERENCES

Philippe HUGON.Variables démographiques et développement : Le cas de

l'éducation et de la santé en Afrique, P. 155-190.

CAILLETEAU François, « Le défi démographique africain », Revue internationale

et stratégique, 2015/3 (N° 99), p. 52-61. DOI : 10.3917/ris.099.0052. URL :
https://www.cairn.info/revue-internationale-et-strategique-2015-3-page-52.htm

National Institute of Statistics (2016). Population projections and estimates of

priority targets for various health programs and interventions, 2016

Institut National de la Statistique (2016). Rapport de l’évaluation rapide des besoins

en soins obstétricaux et néonatals d’urgence au Cameroun.
Institut National de la Statistique (2020).Document de travail : Autonomisation des
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Institut National de la Statistique (INS), et ICF (2019). Enquête Démographique et
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Institut National de la Statistique (INS) et ORC Macro (2011). Enquête
Démographique et de Santé et à indicateurs Multiples du Cameroun 2011.
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Institut National de la Statistique (INS) et ORC Macro (2004).Enquête
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Institut National de la Statistique (INS), Rapport principal, Phase 1 : enquête sur
l’emploi, Deuxième enquête sur l’emploi et le secteur informel au Cameroun (EESI
2), 2011
Ministère de la Santé Publique. Stratégie Sectorielle de la Santé 2016-2027
Ministère de la Santé Publique (MINSANTE). 2018. Normes et Standards du
Programme Elargi de Vaccination – PEV/Cameroun. Yaoundé.