Indigenous peoples' health: Culturally grounded evidence from the Baka, Southeastern Cameroon

Indigenous Peoples are exposed to the impacts of the climatic, ecological and socioeconomic changes, yet there is a need for a better understanding of their health and higher involvement of Indigenous Peoples in health promotion design and implementation. Our study brings empirical data on the healthcare system of the Baka, forager-horticulturalists from Cameroon. Using a mixed methods approach, we explored the health issues they encounter, the emic determinants of health and healthcare system, and the different threats towards their healthcare system. We conducted focus group discussions, interviews with experts, and self-reported health recalls with 302 individuals living in two settlements from southeastern Cameroon during two fieldwork periods between June and November 2022. Our insights highlight the prevalence of respiratory and children's digestive issues, and the occurrence of illnesses implying a combination of symptoms that would deserve further Western biomedical attention. The Baka's healthcare relies on medicinal plants, knowledge experts, and on the social cohesion of the community, all largely affected by the local social-ecological impacts of global change. Exposure to the market and health facilities does not seem to relate to Baka's health state and practices but might affect their perception of health. Deforestation, poor water quality, and alcohol (ab)use were reported and observed threats to the Baka's health and healthcare system. Our work supplies empirical evidence for a better understanding of Baka's health and healthcare system, helpful in designing health prevention and policies adapted to their reality and culture. Further research and interventions on health should consider the current threats to Baka's local ecosystems and cultural knowledge. These insights contribute to a higher recognition of the Baka's, and most broadly, the Indigenous Peoples' emic perspective on health, and on culturally grounded indicators of the resilience of their healthcare system to current and future challenges.