"Many women give birth at home because of fear—fear of insecurity. Displaced people are terrified when they encounter armed men. If a woman goes into labour at night, she would rather deliver at home than risk going to the hospital," says Yeza Aoudi, a matron in the region. As one of the nine matrons trained and supported by MSF, Yeza helps in raising awareness about maternal health, vaccinations follow-up, and guiding women toward the needed medical care.
In 2023, just 49 per cent of deliveries occurred in hospitals across Cameroon , while the Far North region saw 18,720 home births. Maternal and neonatal deaths remain shockingly high in both settings, with 595 deaths in communities nearly equal to the 631 deaths in hospitals.
In the Mora health district, where MSF is present, maternal and child mortality persists due to limited access to healthcare, economic instability, and the consequences of a long-lasting regional conflict. In 2024, the localities of Kourgui, Amchidé, Kolofata, and Limani recorded 1,266 home deliveries, compared to just 885 at the Kourgui health centre supported by MSF.
In response, MSF has launched an innovative community outreach strategy. Matrons and mother leaders living in community are key intermediaries in ensuring people can access healthcare and in breaking down barriers between community members and medical services.
"In the past, matrons were elderly women who delivered babies at home. Today, their role has evolved. They no longer run home births but identify pregnant women needing care and refer them to the health centres,"
── Danielle Zouyane, a midwife supervisor
Mother leaders, meanwhile, play a key role in raising awareness about eating habits and encouraging pregnant and breastfeeding women to visit health centres. They also organize cooking demonstrations using local, affordable foods to fight malnutrition, a dangerous health issues in the region.
"Every week, we visit different neighborhoods to raise awareness. The main challenge for families with ill children is the distance between them and health centres. But thanks to our efforts, more women are seeking consultations," says Neche Maïzena, a mother leader.
In 2024, mother leaders and matrons reached close to 36,500 people and referred more than 1,100 patients for various conditions, including antenatal and postnatal care, assisted deliveries, vaccinations, malnutrition, and sexual violence. Of those, 1,025 (91 per cent) arrived at the Kourgui integrated health center, a 40 per cent increase over 2023.
The capacity-building efforts for matrons and mother leaders have led to tangible improvements. Since the matron strategy was introduced in 2023, the rate of women attending antenatal consultations in the first trimester and referred by matrons has increased to almost 10 per cent, up from just over 6.5 per cent the previous year. Although the figures are still low, this marks a significant leap in improving access to care.
"Women often hide their pregnancies in the first few months, but with the help of the matrons, we can detect early signs and encourage them to go to the hospital. We explain the benefits of antenatal care for their baby," adds Yeza Aoudi, matron.
In 2024, MSF provided about 14,500 sexual and reproductive health consultations at the Kourgui health centre and 1 380 deliveries.
The ongoing crisis in the Lake Chad Basin, has worsened humanitarian conditions in the Far North, making access to healthcare even more critical for both people who are displaced and host communities. Since 2015, MSF has been delivering essential medical and humanitarian aid, including emergency surgery, treatment for malaria and diarrhea, and nutrition and reproductive health services.
Despite significant progress, the challenges remain immense. However, the dedication of local women proves that lasting solutions are possible—even in the most challenging environments.
