An innovation in Cameroon: a prepaid health voucher that gives mothers-to-be and their children access to quality prenatal and postnatal healthcare. By influencing behaviours and encouraging mothers to consult medical professionals, the programme helped bring about a fivefold reduction in maternal mortality and a twofold reduction in infant mortality. 

Overcoming financial barriers to accessing obstetric and neonatal care is something that CIDR Pamiga has been working on since 2013 in three regions in northern Cameroon, some of the poorest regions in the country. Partnering with AFD, the Cameroonian health ministry and NGO Care, the organization created and rolled out a system unlike anything elsewhere: the health voucher.

Distributed to mothers-to-be, the prepaid vouchers give them access to regular care before and after the birth of their child. It’s an innovative project that’s making a big impact.

“We’re seeing a fivefold cut in the number of mothers dying, and a twofold cut in the number of infant deaths,” says Renée Chao-Béroff, Managing Director of CIDR Pamiga.

Better quality of care

There has been a major shift in behaviours, with women becoming much more aware of the importance of giving birth under good conditions, notably in terms of cleanliness, and, more broadly, of the need to consult medical professionals.

A knock-on effect has been a significant increase in the number of people attending local clinics and maternity units. “People are making more use of these rural health facilities, which in turn makes them more profitable and increases the quality of care available,” Renée Chao-Béroff explains. “It’s a minor innovation that triggers massive changes in behaviours among beneficiaries and healthcare providers.” Another positive spin-off of the use of prepaid vouchers is a fall in the number of under-the-counter transactions at healthcare facilities. 

Changing people’s perceptions

Project funding came via AFD debt relief, in full collaboration with local authorities and the health ministry, both of which are involved in governance. And there were many challenges to overcome. “We had to reassure people and persuade them to trust public health facilities. That took a very long time,” explains Renée Chao-Béroff. 

During this process, CIDR Pamiga collaborated with a network of local NGOs that were already working closely with women. They acted as intermediaries to help pass on the health awareness messages and distribute vouchers.

The project, designed as a long-term mechanism to be rolled out across the country, is now reaching its final phase as skills are being transferred to local bodies.

The project in figures

Beneficiaries (as of the end of September 2019)

Health districts covered


Take-up rate in rural areas

The other projects