Healthcare inequities and human rights violations: Examining hospital detention practices in Cameroon

Hospital detention-the confinement of patients after discharge or the withholding of deceased bodies for unpaid medical bills-is a pervasive yet understudied phenomenon in low-resource health systems. In Cameroon, it remains normalized, yet little is known about how patients experience and navigate this coercive practice. This study applies a Structural Justice Framework to ethnographic research in two faith-based hospitals in the Funding Health District of the Northwest Region. Data were collected through interviews, focus groups, and participant observation with patients, healthcare workers, and community members, and analyzed thematically to link lived experiences to structural and institutional inequities. Findings reveal that detained patients adopt diverse survival strategies- including begging, informal labor, installment payments, reliance on family or community networks, and escape-that illuminate vulnerabilities across Fraser’s three dimensions: redistribution, in inequitable allocation of healthcare resources; recognition, in the systematic disregard for patient dignity; and representation, in the exclusion of marginalized voices from health governance. These strategies reflect the entanglement of economic precarity, institutional imperatives, and systemic injustice. The study concludes that hospital detention constitutes a multidimensional violation of rights to health, 20 dignity, and equitable treatment. Addressing this practice requires coordinated reforms, including legal protections, strengthened regulation of healthcare facilities, expansion of social health protection, and the pursuit of universal health coverage. Such measures are essential for dismantling structural inequities and advancing justice for vulnerable populations.