Women as agents of social protection through health insurance in the Kom ethnic community of Cameroon

In Cameroon, poverty and out-of-pocket payments limit healthcare access, disproportionately burdening women who often serve as primary caregivers. Community-based health insurance schemes like the Boyo Mutual Health Organization aim to mitigate these challenges, yet women’s extensive contributions remain unacknowledged within formal insurance systems. Guided by a feminist framework, this qualitative study examined women’s roles in health insurance delivery in the Fundong Health District. Fieldwork was conducted from March to December 2021, using in-depth interviews and focus group discussions with 35 purposively selected participants. Analysis focused on gendered, cultural, and economic dynamics shaping healthcare engagement. Findings reveal that Kom women sustain households and community health through caregiving, financial mobilization, logistical management, and informal education. They bathed the ill, maintained sanitation, prepared meals, accompanied patients to clinics, ensured proper use of insurance cards, and encouraged community enrollment—often compensating for men’s absence or non-contribution. Despite this indispensable labor, women’s contributions are marginalized by patriarchal norms and institutional structures that privilege formal, male-dominated work. These unequal arrangements imposed disproportionate burdens on women while excluding them from decision-making power and financial authority, thereby reinforcing a gendered social order where care is feminized, undervalued, and detached from formal recognition. Formally integrating women’s caregiving, financial, and educational roles into health insurance frameworks is both an equity and efficiency imperative. Drawing on Fraser’s critique of the “male breadwinner” model and Acker’s theory of gendered hierarchies, this study underscores the need for feminist-informed, culturally grounded policies that validate women’s lived experiences, address structural barriers, and bridge traditional and biomedical knowledge. In the Kom context and beyond, gender-responsive reforms that recognize and support women’s indispensable labor are critical not only for advancing equity but also for achieving universal health coverage.