Plan Stratégique National de la Santé de la Reproduction, Maternelle, Néonatale, Infanto-Juvénile, de l’Adolescent et de la Nutrition (PSN-SRMNIA-Nut) 2024-2030

Objectives

Cameroon’s 2024–2030 National Strategic Plan for Sexual, Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition seeks to minimise maternal, neonatal and child mortality and reproductive-health-related morbidity among adolescents, young people, women, men and older people, with particular attention to vulnerable and disadvantaged populations. Its mission is to promote universal sexual and reproductive health and rights and contribute to Sustainable Development Goal progress on maternal and child mortality, HIV/AIDS, universal sexual and reproductive health and reproductive rights.[1]The plan aims to reduce the socioeconomic burden of sexual, reproductive, maternal, neonatal, infant, adolescent and nutrition-related illness and death by expanding equitable coverage of promotional, preventive and curative interventions.[2]

• Extend high-impact, evidence-based interventions for mothers, newborns, children, adolescents, young people, women, men and older people across the continuum of care.[1][3]
• Improve service coverage and quality, including targets by 2030 of 95% quality antenatal-care coverage, 80% quality postnatal-care coverage, 80% facility-based births and 35% contraceptive prevalence among women of reproductive age.[3]
• Strengthen newborn and child survival through quality newborn services in 80% of selected facilities, prevention of mother-to-child transmission of HIV, syphilis and hepatitis B, maternal tetanus vaccination, immunisation, nutrition and other high-impact child-health interventions.[4]
• Improve adolescent and youth health by reducing risky sexual behaviour, expanding sexually transmitted infection and HIV prevention and management, providing youth-friendly services in 80% of administrative departments, increasing modern contraceptive prevalence to at least 30%, and improving nutrition.[4]
• Address obstetric fistula, infertility, sexual dysfunction, reproductive cancers, hepatitis, HIV and poor nutrition among pregnant and breastfeeding women, alongside reproductive-health needs of older women and men.[3][4][5]
• Reduce gender-based violence, female genital mutilation and child marriage through changes in community attitudes, better evidence, survivor care, and stronger institutional and legal action.[5]
• Strengthen health-system pillars and the enabling environment, including infrastructure, equipment, qualified staff, medicines, community activities, information use and removal of financial, cultural and geographical barriers.[1][6]
• Increase the availability of quality services by equipping at least 80% of facilities in targeted districts, ensuring quality medicines and essential products in at least 90% of facilities, reducing qualified human-resource deficits by 30%, and expanding delivery of the Community Activities Package.[6]
• Improve equity by enabling affordable access for at least 50% of the most vulnerable target groups and reducing cultural and geographical barriers by 50% in targeted districts.[6]

Implementation

Implementation is patient-centred and guided by quality, availability, equity, accessibility, non-discrimination, human rights and multisectoral collaboration.[1][7]The plan combines fixed-facility and mobile delivery of preventive, curative and psychological services, supported by national standards, trained personnel, reliable medicines and products, adequate infrastructure, water, electricity, referral transport and demand-generation measures such as communication, health vouchers, obstetric kits and income-generating activities for disadvantaged groups.[8][2]

• Coordinate implementation through the Ministry of Public Health, led technically by the Directorate of Family Health and supported by the Multisectoral Programme to Combat Maternal and Child Mortality, national committees, thematic working groups and competent units in participating ministries.[9]
• Deliver services through the health-system pyramid, from communities and health facilities to district, regional and central hospitals, while engaging decentralised local authorities, civil society, faith-based and community organisations, private providers, traditional and religious leaders, professional associations and the media.[10][3]
• Assign regional health delegations, reproductive-health focal points and District Health Management Teams responsibility for field coordination, supervision, indicator follow-up, technical support and dissemination of the plan.[9]
• Integrate interventions into district, facility, commune and partner-ministry plans and budgets; health facilities are expected to provide quality care, maintain supplies and equipment, manage data, monitor staff performance and collaborate with communities.[11]
• Strengthen supply systems through regulation, timely procurement, distribution and management of medicines, reagents and essential commodities, coordinated by the Directorate of Pharmacy, Medicines and Laboratories with the Directorate of Family Health.[12]
• Build capacity by developing or updating technical guides, standards, protocols, training manuals and communication materials; training clinical, public-health, community, education, media and partner-sector personnel; and improving data-management skills.[8][13]
• Monitor implementation through routine health-information and community data, supervision, data review, operational research, annual joint reviews, mid-term and final evaluations, inspections and corrective action.[12][14]
• Track quantified performance across facility readiness, staffing, supplies, service use, referrals, access barriers, community activities, stakeholder engagement, quality assurance, research, civil registration and emergency preparedness; detailed indicator definitions and reporting responsibilities are not fully specified in the supplied summaries.[6][15][16]
• Prepare regional emergency response plans, train facility staff in resilience, conduct simulation exercises and maintain essential services during public-health emergencies.[17]
• Mobilise resources through government, decentralised authorities, communities and partners, including a stated objective to increase financing for plan interventions by at least 5% by 2030.[6][18]The estimated overall implementation budget is 308,553,646,283 CFA francs for 2024–2030, with 58% allocated to high-impact interventions, 40% to health-system strengthening and 2% to emergency resilience.[19][20]

Monitoring & Evaluation

The plan establishes a performance, monitoring and evaluation architecture intended to track service coverage, health outcomes, equity, implementation quality and emergency resilience. It combines routine health-information reporting, supervision, reviews, operational research, surveys and accountability functions at central, regional, district, facility and community levels.[15][9][21][14]

• Monitor impact through maternal, neonatal and under-five mortality, obstetric fistula incidence, mortality from reproductive cancers and cervical-cancer incidence.[22]
• Track service-coverage targets for 2030, including 95% quality antenatal care, 80% quality postnatal care, 80% facility births, 35% contraceptive prevalence, 90% tetanus vaccination among pregnant women attending antenatal care, and adolescent- and youth-friendly services in 80% of administrative departments.[3][4]
• Measure health-system performance through facility readiness, qualified staffing, medicine and commodity availability, stock-outs, service use, referrals, emergency transport, quality assurance, management capacity, stakeholder engagement and implementation ownership.[6][21][17]
• Use the national health information system and District Health Information Software 2 to collect, process, analyse and visualise indicators, supported by monthly activity reports, disaggregated regional and district data, data validation and feedback to facilities.[23][24][25]
• Strengthen routine-data completeness, coherence, promptness and use for local decision-making, as important gaps remain in reporting, including incomplete notification and registration of deaths and causes of death.[24][26][27]
• Maintain maternal and perinatal death surveillance and response, death reviews and follow-up of corrective recommendations, while extending review of maternal, neonatal and infant deaths to public and private facilities and communities.[28][29][11]
• Address information gaps, including weak reporting on community-directed interventions, poor documentation of health-district performance, insufficient disaggregation of indicators for vulnerable groups, and limited data on infertility, sexual dysfunction, female genital mutilation and cancer care.[30][31][32][33][34]
• Conduct annual joint reviews, indicator reviews, field monitoring, inspections and controls, with a mid-term evaluation after three years and a final evaluation at the end of the plan period.[14][35][36]
• Apply quarterly coordination, data-review and formative-supervision mechanisms at regional, district and health-area levels; undertake regional inspections semi-annually or on request and district inspections quarterly or on request.[35][36][20]
• Assign monitoring responsibilities to the Directorate of Family Health, the Health Information Unit, regional public-health delegates, reproductive-health focal points, District Health Management Teams, facilities and community structures.[9][12]
• Promote transparency by making information on the design, delivery, implementation and evaluation of reproductive-health services and programmes accessible, and recognise access to remedies where responsible actors fail to meet relevant obligations.[10]

Costing & Financing

The 2024–2030 plan is explicitly costed, with an overall implementation budget reported at approximately 308.6 billion CFA francs. Costing is based on operational activities and unit-cost estimates prepared by the Ministry of Public Health and technical and financial partners.[19][20]Financing priorities include increasing allocations for sexual, reproductive, maternal, newborn, child, adolescent and nutrition health, mobilising innovative financing for vulnerable populations, integrating interventions into ministerial and commune budgets, and reducing dependence on external partners.[37][2][9][11]

• Allocate 58% of the plan budget to expanding high-impact interventions for direct beneficiaries, 40% to strengthening health-system pillars and 2% to emergency resilience.[20]
• Cost activities including technical meetings, workshops, training, missions, campaigns, studies, surveys, communications, information-technology equipment, vehicles, fuel, maintenance, salaries, operating expenditure and investment expenditure.[20]
• Increase financing for SRMNIA-Nut interventions by at least 5% by 2030, although the source does not provide a detailed funding-gap estimate or allocations by activity.[6]
• Integrate strategic-plan interventions into the Ministry of Public Health programme budget and partner-ministry budgets, while ensuring inclusion of relevant activities in commune budgets.[12][11]
• Address under-financing, which contributed to weak implementation of the 2014–2020 plan, whose activity execution rate was below 30%.[38][39]
• Recognise household financing as the main health-financing source, contributing approximately 71% of total health expenditure in 2018 and 2019; total health expenditure rose from 821 billion FCFA to 874 billion FCFA over this period.[40]
• Use targeted subsidies, free services, health vouchers, obstetric kits and the country compact for reproductive-health commodities to reduce financial barriers, particularly for vulnerable populations.[25][27][41][7]
• Address reliance on external financing for subsidised medicines and commodities, as supply continuity may be threatened if external support ends.[42]
• Note affordability barriers, including reported charges of 15,260 CFA francs for normal delivery, 32,813 CFA francs for episiotomy and approximately 30,000 CFA francs for surgical procedures in the northern region.[25]
• Recognise wider economic constraints, including inflation, supply-chain disruption, dependence on external aid and projected average real gross domestic product growth of 4.2% during 2023–2025.[43][44]