Harmonizing the Training and Certification of Nurses, Midwives, and Health Technicians in Cameroon: A Policy Analysis

Background: Fragmentation in the education, credentialing, and professional regulation of nurses, midwives, and health technicians (NMHTs) remains a critical governance constraint on health-system performance in Cameroon. Although multiple reforms have expanded training opportunities, parallel pathways and contested licensure rules continue to generate uncertainty for graduates, employers, and regulators. Objective: This study analyzed how policy content, context, actors, and processes interact to reproduce the lack of harmonization in NMHT training and certification, and to identify policy options that are institutionally feasible within Cameroon’s current governance architecture. Methods: A qualitative health policy analysis was conducted using Walt and Gilson’s policy triangle. An explicit document review protocol was applied to legal instruments, national strategy documents, and interministerial reform texts relevant to NMHT education, equivalence, and professional registration. Documents were selected using predefined inclusion and exclusion criteria, examined through iterative two-cycle coding, and appraised for internal coherence, operational clarity, and implementability. Results: The analysis shows that Cameroon’s harmonization deficit is sustained by four mutually reinforcing mechanisms: overlapping ministerial mandates, incomplete equivalence across qualification pathways, transitional certification arrangements that can reproduce inequity when weakly competency-mapped, and insufficient regulatory infrastructure for accreditation, registration, and continuing competence. The 2024 MINESUP–MINSANTE resolutions represent an important political opening, but they do not yet provide the procedural and regulatory architecture required for durable harmonization. Conclusions: The central policy problem is not a lack of reform activity, but the absence of integrated governance and enforceable national standards. The study’s distinctive contribution is to demonstrate that harmonization in Cameroon is fundamentally a governance-integration problem rather than a purely technical curriculum problem. Sustainable reform will require a joint standard-setting and accreditation platform, competency-based equivalence rules, a unified licensure and registration pathway, and time-bounded transition arrangements anchored in transparent implementation procedures.