Cameroon

Lack of Funds Puts Cameroon Off Track to Reduce Infant, Mother Deaths

Publication Date

Lack of Funds Puts Cameroon Off Track to Reduce Infant, Mother Deaths

Publication Date

BAMENDA, CAMEROON – Ngwa Amos is now a widow after his wife died in labor on a recent morning at Bamenda General Hospital in northwestern Cameroon.

“We arrived [at] the hospital at 4 a.m. yesterday morning, and my wife got into the labor room,” he says. “Since then I have not set eyes on her. However, I could hear her voice as she groaned about three hours ago.”  

He says the hospital staff asked him to go and bring money for his wife to be operated on because she needed a Caesarian section. He says he spent two hours searching for money to borrow for the operation.

“When I returned, she was no longer groaning,” he says. “I thought the baby had been born. I am shocked to be informed now that she and the baby passed away 30 minutes ago.”

Amos says that he can’t explain the cause of his wife’s and baby’s deaths.

The midwife in charge of the delivery says the baby couldn’t be born normally but that the couple couldn’t afford a Caesarian section. The baby was breech – when the feet enters the birth canal first instead of the head – but the couple wasn’t aware because they couldn’t afford antenatal care for the last three months of the pregnancy.

Bih Sylvia, a nurse at the hospital, says the hospital has incurred enormous losses in the past for taking on emergency cases without payment so patients are obliged to pay upfront.

Amos, who earns a living by using his motorbike to taxi people from town to town, is now a single father of four children. Outside the maternity ward, his wife’s family members are in agony and accuse Amos of using their daughter as a sacrifice for money.

While the family cries, a taxi stops nearby and a teenage girl is supported out of the vehicle and into the labor room. With each step she takes, blood drips from her body.

Observers say the girl attempted to perform an abortion on herself, but the hospital staff has refused to attend to her until she confesses. If she dies, she will be the second woman to die in an hour in the hospital because of pregnancy-related complications.

Sylvia says she’s not sure what happened in this case, as it’s neither ethical nor hospital protocol to leave suspected abortion cases untreated.

A lack of funds, skilled birth attendants and health centers across Cameroon means that mothers don’t receive the care they need during pregnancy and childbirth. Others say a lack of family planning contributes to the high rate of maternal mortality here. The African Union, AU, government and nongovernmental organizations, NGOs, have pledged to reduce maternal deaths in the region, but a lack of funding continues to derail Cameroon from meeting the 2015 global goal.

Cameroon is off track to reduce maternal deaths by 75 percent by 2015 – goal five of the Millennium Development Goals, MDGs, a U.N. initiative agreed to by governments around the world. There are currently 1,000 maternal deaths per 100,000 births in Cameroon, according to the United Nations. About 9,000 women die during childbirth every year in Cameroon, the Ministry of Public Health reported in 2010.  

According to UNICEF, 80 percent of maternal deaths are preventable and could be avoided with access to essential maternity and basic health care services. Indeed, the Ministry of Public has attributed Cameroon’s maternal mortality rate to the absence of adequate maternal care before, during and after pregnancy.

One reason for this absence is poverty, as many families can’t afford to pay for the care they need. More than 30 percent of the population lives below the international poverty line of $1.25 per day, according to UNICEF.

Another reason is the lack of skilled birth attendants. A global forum earlier this year named the critical shortage of skilled health personnel in the world a major obstacle to meeting the MDGs by 2015.

About 63 percent of births are assisted by skilled attendants in Cameroon, according to UNICEF. An official at the North West Regional Delegation of Public Health, the regional representative of the Ministry of Public Health, says this percentage is high compared with other countries. But the official, who requested anonymity for job security reasons, says Cameroon also has a high maternal mortality rate, which he attributes to a lack of frontline tools and poor pay packages for health workers.

Reports indicate that doctors often leave Cameroon to work in countries where conditions and wages are better. Meanwhile, some say many traditional birth attendants are retired or dying out.

Another reason for the absence in care is a lack of health centers in rural areas. Pregnant women here are forced to trek long distances before reaching the nearest health center. As a result, it is not uncommon for babies to be born on the side of the road.

Janine Ngum, 23, says this happened to her.

“I had my first baby by the roadside as I was trekking to the health center, and the second was almost born the same way,” she says.

Now pregnant with her third child, Ngum says she is determined to deliver in a health center.

“For this third baby, I plan to go the health center three days before the due date and wait.”

Ngum says she goes for antenatal consultation every last Wednesday of the month at the Akum Health Centre. It is the closest one to her village, Alatening, yet is still two hours away. To reach the health center by 9 a.m. for her appointments, she says she has to wake up at 5 a.m. to fetch water for her household, cook the day’s meal, prepare the children for school and start the two-hour trek to the clinic at 7 a.m.

“It is very strenuous for me, but I must attend [the] clinic so that I will have no problem when I want to deliver my baby,” she says.

Others say the poor use of family planning in the country is to blame for maternal deaths.

Fomuso Mary, a retired family planning expert at Bamenda General Hospital, says very few married women use family planning methods.

“Most of the women are still very skeptical about the idea, and so child spacing continues to pose a challenge to childbearing women,” she says.

Less than 30 percent of women in unions ages 14 to 49 use contraceptives, according to UNICEF’s latest statistics.

Ministry of Public Health officials say they are determined to curb the number of women who die during childbirth before 2015. They say the government is training and employing more health personnel and improving the working conditions of those already working in the industry in order to meet this goal.

The AU launched in 2009 the Campaign on Accelerated Reduction of Maternal Mortality in Africa, which Cameroon’s government launched on a national scale last year.

Last year, the Ministry of Public Health also initiated the Cameroon Maternal and Child Health Handbook Pilot Project. The handbook aims to standardize maternal and child care across Cameroon and to improve record keeping, according to a project newsletter. The project is currently in phase two of testing the handbook, which was adopted from the Japanese health system, in two health districts in the country.


Cameroon has also increased its budgetary allocation to health care to about 5.6 percent, but it’s still far below the 15-percent minimum agreed to by AU members in 2001 in the Abuja Declaration, according to the World Health Organization.

But the North West Regional Delegation of Public Health official says the government doesn’t spend enough on health. He estimates that it dedicates just 4.9 percent of the annual budget to health – a fraction of which goes toward fighting maternal mortality.

Dr. Patrick Mbah Okwen, health adviser for SNV Netherlands Development Organization, a nonprofit international development organization, says that NGOs in Cameroon have the will to curb maternal mortality but that the problem is funding. He says they receive minimal funding – just 2 percent – from international donors in the health domain to address maternal mortality.

“NGOs have therefore focused on capacity development, which is more sustainable,” he says.

He says this means they focus more on training gynecologists and midwives and providing them with necessary equipment, especially in the area of echography, or ultrasound technology.