Cameroon

Cameroon, unique among African nations for being both French- and English-speaking, shares with its neighbors rising HIV prevalence, as well as poor maternal health outcomes. Among adults, 6.9% are living with HIV, a figure three-times as high for girls and young women aged 15 to 24.  As one of 21 nations participating in EngenderHealth’s AWARE-RH program, our work in Cameroon addressed these health issues by:

• Promoting maternal and infant health
• Expanding contraceptive options
• Addressing the HIV and AIDS epidemic with integrated health care
• Reducing health care costs

 
Promoting Maternal and Infant Health
Each year in Cameroon, pregnancy-related complications cause 730 maternal deaths for every 100,000 live births. Moreover, for each maternal death that occurs, 20 to 30 women suffer from pregnancy-related disabilities. While most maternal deaths are preventable, maternal and neonatal health programs remain severely under-funded.  EngenderHealth addressed maternal health needs in two key ways:

• Using an advocacy model called “REDUCE,” EngenderHealth worked with local partners to:
  • Analyze the economic impact created by maternal and infant death and disability; 
  • Demonstrate how maternal and infant death and disability has negative economic consequences for Cameroon;
  • Advocate for increased government funding to improve maternal and infant health care.

• Collaborated with the United Nations Children’s Fund (UNICEF) to improve maternal and infant health in by:
  • Mobilizing community participation in health care and encouraging families to better prepare for routine births;
  • Improving provider skills in basic and emergency obstetric care;
  • Upgrading equipment at health facilities at clinics in N’gaoundere district.

 
Expanding Contraceptive Options
In Cameroon, EngenderHealth worked with the Ministry of Health to develop national plans to better manage family planning programs, including ensuring the availability of family planning and reproductive health supplies.

 
Addressing the HIV and AIDS Epidemic with Integrated Health Care
EngenderHealth also worked to integrate treatment for HIV with other reproductive health services.  These included:

• Creating a regional training center in Mutengene where health care workers learn skills for preventing mother to child transmission of HIV;
• Leading training programs for health care workers designed to ensure that they have the skills to family planning services to pregnant and postpartum women;
• Introducing COPE® and facilitative supervision—two quality improvement tools that help health care staff identify and resolve problems on their own;
• Encouraging men to seek testing for HIV and counseling for prevention and/or treatment. Improvements have been made in the prevention of mother to child transmission of HIV in Cameroon, and women increasingly seek testing. But their male partners are often left out of the process. EngenderHealth encourages men to come to sites for counseling and testing, either with their partners or alone.

 
Reducing Health Care Costs
Even where quality health care exists, many people in Cameroon cannot afford to use it.  To help make services more accessible, with local partners EngenderHealth launched community-based health financing schemes, known as mutual health organizations (MHOs). These nonprofit, voluntary schemes pool community savings to help members pay for medical care.  MHOs also may negotiate a care package with local providers for their members that can include both preventive and curative care. More than 3,300 members of three MHOs in Bafoussam and N’gaoundere districts now have access to reproductive health and child health services at a reduced cost; efforts are underway to expand MHOs throughout Cameroon.