In December 2018, the Cameroon Ministry of Public Health, Global Financing Facility for Women, Children and Adolescents (GFF), World Bank (WB), Grand Challenges Canada, Nutrition International and the Fondation Kangourou Cameroun, with the support of the Fundación Canguro Colombia, launched the Cameroon Kangaroo Mother Care (KMC) development impact bond (DIB).
Programme delivery started in February 2019 with the DIB aiming to reduce morbidity and mortality among premature and low birth weight infants in five regions of Cameroon by rolling out quality KMC in 10 hospitals. DIB design, performance management and sustainability support were provided by Social Finance.
The DIB supported KMC delivery in 10 hospitals across Cameroon with DIB-funded training and support to public clinicians provided by the Fondation Kangourou Cameroun. Contractual programme objectives, linked to outcome payments, focused on three areas:
- The number of hospitals appropriately equipped and trained to deliver quality KMC.
- The number of babies receiving quality KMC at programme hospitals.
- The number of KMC babies with appropriate nutrition and weight gain at 40 weeks gestational age.
The programme also aimed to embed KMC expertise within the public health system through the certification of three additional hospitals as KMC Centres of Excellence and the creation of a pool of qualified KMC trainers among public sector clinicians in Cameroon.
The challenge: Improving neonatal survival in Cameroon
- 23,000 neonatal deaths each year in Cameroon.
- Almost 1 in 2 low-birth-weight and preterm infant dies after birth in Cameroon.
- A Cochrane review of 21 studies including 3,042 infants has found that, at discharge or at 40 to 41-week gestational age, KMC was associated with a statistically significant reduction in neonatal mortality rate.
The DIB successfully equipped 10 hospitals to deliver quality KMC, trained 47 neonatal clinicians and 121 community health workers to support mothers in delivery of KMC to low-birth-weight babies. As a result, 1,221 babies received quality KMC, 28% percent above the DIB target of 951 babies. Furthermore 80% of babies were exclusively breastfed at point of discharge from hospital and 80% percent of babies returning for check-ups had appropriate weight gain at 40 weeks gestational age.
The Cameroon Ministry of Public Health is now working to embed national roll-out of KMC in their strategy for Maternal and Newborn health.