Improving the Quality of Frontline Health Facilities and Services to Support the Most Vulnerable

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The Challenge

Despite its lower-middle-income status, Cameroon still suffers from poor basic health outcomes and widespread inequalities. Cameroon’s maternal and child mortality remains high and is mismatched to the country’s economic status and relatively high per-capita health spending ($138 in 2014). Additionally, Cameroon suffers regional disparities in health and nutrition outcomes, with the three northern regions and the East region performing considerably worse than the national averages.  

The GFF Partnership Response  

With support from the GFF, the government of Cameroon led a consultative process with key partners to promote partner alignment and articulate priorities in the investment case. The investment case focuses on shifting more public health resources toward primary and secondary care and concentrating them on the four most underserved regions of the country. Using a performance-based approach, and health care vouchers, additional resources are improving the quality of frontline health facilities, stimulating demand for health services, and making care affordable for the poorest families. The GFF is also supporting country leadership in financing and managing reforms in Cameroon’s Global Strategy for Women's, Children’s, and Adolescents’ Health and prioritizing efforts to improve maternal and child health to achieve tangible results. Cameroon’s priorities are financed by the Bill & Melinda Gates Foundation, European Civil Protection and Humanitarian Aid Operations (ECHO), Gavi, the Vaccine Alliance, the Global Fund, Islamic Development Bank, UNFPA, UNICEF, Unitaid, WHO, and the governments of France (AFD) and Germany (BMZ, KfW.

The Result 

The GFF process provides the analytical underpinnings for health sector reforms, including a trigger that commits the Government to increase the health budget allocation to the primary and secondary levels from a baseline of eight percent in 2017 to 20 percent by 2020. The investment case helped inform the dialogue between the ministries of Health and of Finance. From 2018 to 2019, the increase in budget share for health went from 3.9 to 3.97 percent, and the share of health budget going to primary and secondary care went from eight percent in 2017 to 21 percent in 2019. Coverage in Performance-Based Financing has substantially increased, from 78 districts in 2017 to 172/189 districts in 2019. However, important delays were experienced in issuing payments to health facilities; arrear payments for 2018 and 2019 are ongoing, thus accelerating service delivery. Additionally, mobilization of the Development Impact Bond for Kangaroo Mother Care (KMC) started in January 2019. Initially, six out of 10 hospitals started delivering KMC, collecting data and building capacity of their staff to deliver the highest quality of care, and more than 380 babies were enrolled for KMC across these six hospitals in the first year. Implementation of the impact bond has ramped up with further results.  

See the latest GFF Annual Report to learn how Cameroon is making progress towards these goals.