Health programme – fight against maternal mortality
Project description
Title: Health programme/Fight against maternal mortality (PASaR-II)
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Cameroon
Lead executing agency: Ministry of Public Health (MINSANTE)
Overall term: 2015 to 2016
Context
The development of Cameroon’s health system is stagnating at a low level. Children and women in particular have only limited access to medical care. The area of reproductive health, including family planning, appropriate health care for women during pregnancy and childbirth and access to contraceptives, is insufficiently developed. Only 16 per cent of the population use modern contraceptives. The reasons include socio-cultural barriers, the shortage of contraceptives, the inaccessibility of health facilities and the poor quality of services.
Care during childbirth is inadequate, not least because there are only around two hundred qualified midwives nationwide. The first intake of students to the midwifery schools has now entered the labour market. Nevertheless, there are still diverse challenges to overcome, such as the integration of midwives as a new occupational group in the public service sector. The strategy of establishing regional health funds is promoting the participation of the municipalities in health care. The sale of essential medicines creates profits for the funds, which flow into the financing of community-based health activities.
Objective
The provision of reproductive health services to the population has improved. The majority of the population has access to modern contraceptives. Functioning midwifery schools operate in three of the country's regions and the graduates are integrated into the national labour market. Regional funds support community-based work in the area of reproductive health in five regions.
Approach
The programme dovetails its measures with activities that are being carried out within the framework of German financial cooperation and with those of other actors. Family planning services are available in a growing number of public and private health facilities. A high level of quality in the services is achieved through several interlinked measures. These include the continuous training of staff, the availability of contraceptives and other materials, the strengthening of health administration management capacities and the participation of the municipalities in the activities.
The programme is also continuing to support the midwifery schools: it supplies them with modern teaching materials, offers advice to teachers and school administrations and promotes practice-based training. Advice is provided to the personnel department of the Ministry of Public Health on integrating the trained midwives into the national labour market.
The regional funds receive organisational advice on establishing and consolidating their structures and processes. The programme promotes efforts to use the profits from the sale of medicines to finance community-based activities that are beneficial to reproductive health. It also provides technical and organisational support with the training of the municipal committees.
Results
The use of modern contraceptives has increased more than threefold in recent years. Factors that have contributed to this success include the stable supply of contraceptives, the improved skills of the health service staff, the expansion of the service to over 500 health centres and socio-culturally adapted educational work in rural areas.
The norms and standards developed for midwifery training have been checked for the first time in an audit. The first intake, which comprised 175 student midwives, successfully completed their training at the end of last year. They will soon be joining the public service sector.
The strategy of establishing regional funds, which support community-based activities from their surpluses, has been officially recognised by the Ministry of Public Health. The programme is involved in efforts to consolidate this approach and roll it out nationwide.