Félicité Tchibindat, UNICEF Resident Representative for Cameroon, explains why her organisation and UNFPA are sponsoring the innovative Performance-based Financing health project .

What explains the decision by UNFPA and UNICEF to work together to curb infant and maternal mortality in Cameroon?

UNICEF and UNFPA support the health systems in many countries. In Cameroon, we have been doing a lot to reduce maternal, neonatal and infant mortality because we have a common framework. We discovered that the quality of healthcare was not so good. This is why healthcare delivery is not translated into reduction in mortality and morbidity rates. We decided to join the Support Programme for Investments in the Health Sector, PAISS Project of the Ministry of Public Health by bringing in our own funding.

This is a very good project with results that can be confirmed on the ground. UNICEF and UNFPA are adding nutrition and reproductive health components respectively to this Performance-based Financing project that has been tried in other regions before. We intend to expand the project to areas with the least progress in health indicators such as the Far North, North, Adamawa and East Regions.

UNFPA and UNICEF are concerned about the slow progress in health indicators in the country. None of the health-related Millennium Development Goals has been achieved at a time when the world is preparing to move on to Sustainable Development Goals. This is the reason for our support to the PAISS Project.

So, you are only joining an ongoing project?

Yes, the project was already going on with good results to show. Our support is intended to strengthen the project by adding new intervention activities and increasing the coverage area.

Why is the PAISS Project so peculiar?    

Getting health workers motivated has always been a major problem. People have a lukewarm attitude to work, knowing that despite output, they will still receive their salaries. The PAISS Project is different in that we want people to be motivated or compensated based on their output. Experience shows that such a method works as it improves the quality of healthcare.

If people visit a health centre and are not well received or treated, they will not come back. Through this new approach, we hope to reverse the trend and improve Cameroon’s health indicators.

Does this mean there will be financial reward for health workers who produce good results?

Yes! For example, if more pregnant women come for antenatal care in an area, the local health workers get additional money. This will encourage them to look for pregnant women who are not yet coming for antenatal care.

What are the expected outcomes of this project?

We expect more efficiency in healthcare delivery and improvements in the lives of women. We hope that as the project expands, the Ministry of Public Health will continue to be as serious as it was before. We would also like to see government take ownership of the project like it has already started doing by investing more domestic funds. Our objective is to see every Cameroonian woman and child reached with healthcare services. This will help in reducing disparities in healthcare delivery.

Why was the East Region selected for the pilot of phase of UN funding for this project?

The Far North, North, Adamawa and East Regions have the worst health indicators in the country. With time, we will cover all these regions. We are starting with the East Region because it is host to thousands of refugees from the Central African Republic. This is an added burden to the health system. So, we thought we should begin from there before extending to the other three regions.