In Cameroon, Phase I of Universal Health Coverage (UHC) is marked by major achievements: more than 5.2 million beneficiaries enrolled, millions of free pediatric consultations and access to dialysis reduced to 15,000 CFA francs per year.
Officially launched on 12 April 2023 in Mandjou, in the East Region, Phase I of Universal Health Coverage (UHC) is emerging as a central pillar of Cameroon’s public health policy. Led by the Ministry of Public Health through the National Technical UHC Unit, this structural reform is reporting significant quantitative indicators that reflect strong public uptake and the direct impact of state investment. A total of 5,248,296 people have already been enrolled, against an overall target of 5,807,886 by December 2026, representing a 90% achievement rate. This is complemented by enrollment rates of 72% among children aged 0 to 5, 93% among people living with HIV, and 100% among people suffering from tuberculosis, patients undergoing dialysis, and pregnant women in areas covered by the Health Voucher scheme.
An interim assessment strongly supported by figures
An assessment of the implementation of Phase I of UHC reveals considerable progress across the country’s 10 regions, particularly in maternal and child health. Nearly 3 million children aged 0 to 5 (2,974,598) have benefited from free consultations, alongside 618,564 children treated free of charge for uncomplicated malaria and 771,295 for severe malaria. Meanwhile, 2,576,722 antenatal care consultations were carried out for a single contribution of 6,000 CFA francs, including 848,457 first antenatal visits, 718,548 second visits, 583,685 third visits and 431,961 fourth visits. These services contributed to 463,732 deliveries and 21,181 caesarean sections since 2023, with patients reporting perceived financial gains of 90% and 95%, respectively.
The financial impact is also reflected in dialysis care. Thanks to the reduction in the annual cost from 520,000 CFA francs to 15,000 CFA francs, 1,630 patients regularly receive two dialysis sessions per week, totaling more than 250,000 sessions, with a perceived financial gain of 98%. Meanwhile, the HIV and tuberculosis component has enabled 475,966 people to receive antiretroviral treatment free of charge, supported by 998,205 viral load tests, while 96,485 tuberculosis patients have received treatment at no cost.
These efforts are reinforced by a broad prevention and health promotion component, including the administration of vitamin A to 2,461,802 infants aged 0 to 11 months and 7,777,607 children aged 12 to 59 months; the distribution of mebendazole to 4,480,631 children; early breastfeeding initiation for 1,273,141 newborns; iron supplementation for 1,978,612 pregnant women; 946,636 intermittent preventive treatments for malaria; as well as 7,674,206 home visits carried out by Community Health Workers for the benefit of 928,675 households, including the distribution of insecticide-treated mosquito nets and the immunization of 3,043,167 children with BCG and 3,880,546 with measles-rubella vaccine. “With my twins, every trip to the hospital used to be an uphill battle before UHC. Today, free pediatric consultations and malaria treatment have taken a huge burden off my shoulders. I can finally treat my children without fearing that I will empty my last pockets,” says Chantal M., a mother in Yaoundé. Jean-Paul N., a dialysis patient in Douala, shares a similar sense of relief: “At 520,000 CFA francs a year, my dialysis sessions had become a financial sentence that my family could no longer afford. Thanks to the reduction to 15,000 CFA francs, I can breathe, follow my treatment regularly and continue to be there for my loved ones. It is a true miracle of survival.” Regarding maternal care, Aissatou D., a young mother in Ngaoundéré, adds: “For my last delivery, the Health Voucher scheme and the antenatal consultations at a fixed rate gave me quality medical care without the pressure of unexpected bills. Knowing that the State supports pregnant women in this way gives us confidence renewed and dignity.”
The strengths of the model and the conditions for expansion
The success of this first phase is based on a pragmatic approach and the establishment of a robust ecosystem. Despite cash-flow pressures and challenges related to compliance with disbursement schedules by the Ministry of Finance, just under 30 billion CFA francs have already been transferred to health facilities. A weekly monitoring system and rapid redeployment mechanism have also been put in place to address shortages of medical supplies.
At the same time, the State continues to advocate for the upcoming enactment of the UHC law in order to make the reform sustainable over several decades, strengthen national solidarity and expand the healthcare benefits package to include new health conditions such as viral hepatitis and childhood diabetes.
