In order to provide affordable healthcare services to its population, the Government of Cameroon has engaged to reform its health sector toward SWAp mechanism to ensure District development by supporting both supply and demand sides. A recent study points that less than 1% of the total population is covered by a CBHI scheme and out-of-pockets expenses still constitute the main purchasing mechanism for healthcare. To increase the enrolment in Mutuelle de santé (French Acronyne for CBHI), governance, financial and delivery arrangements tailored to the national context need to be considered.