Since 2023, Doctors Without Borders/Médecins Sans Frontières (MSF) has been working with influential local women in Cameroon's Far North region, where insecurity and community practices can severely affect access to critical health care. These women, known locally as matrons and mother leaders, are tackling threats including infant mortality and malnutrition—and they are saving lives amid an alarming humanitarian crisis.
"Many women give birth at home because of fear—fear of insecurity,” said Yeza Aoudi, a matron in the region. “Displaced people are terrified when they encounter armed men. If a woman goes into labor at night, she would rather deliver at home than risk going to the hospital.”
As one of nine matrons trained and supported by MSF, Yeza helps raise awareness about maternal health, vaccination follow-up, and guiding women toward the medical care they need.
In 2023, just 49 percent 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 that occurred in hospitals.
A community approach to improving access to health care
In the Mora health district, where MSF is present, maternal and child mortality persists due to limited access to health care, economic instability, and the consequences of a long-lasting regional conflict.
In response, MSF has launched an innovative community outreach strategy in which matrons and mother leaders living in the community are key intermediaries in breaking down barriers between community members and medical services, ensuring people can access health care.
"In the past, matrons were elderly women who delivered babies at home,” said Danielle Zouyane, a midwife supervisor. “Today, their role has evolved. They no longer run home births but identify pregnant women who need care and refer them to the health centers."
Cameroon 2025 © Vanessa Fodjo/MSF
Mother leaders, meanwhile, play a key role in raising awareness about eating habits and encouraging pregnant and breastfeeding women to visit health centers. They also organize cooking demonstrations using local, affordable foods to fight malnutrition, a dangerous health issue in the region.
"Every week, we visit different neighborhoods to raise awareness,” said Neche Maïzena, a mother leader. “The main challenge for families with ill children is the distance between them and health centers. But thanks to our efforts, more women are seeking consultations."
In 2024, mother leaders and matrons reached close to 36,500 people and referred more than 1,100 patients for various conditions, including prenatal and postnatal care, assisted deliveries, vaccinations, malnutrition, and sexual violence. Of those, 1,025 (91 percent) arrived at the Kourgui Integrated Health Center, a 40 percent increase from 2023.
The measurable impact on communities
The capacity-building efforts for matrons and mother leaders have led to tangible improvements. Since the matron referral strategy was introduced in 2023, the rate of women attending prenatal consultations in the first trimester increased to almost 10 percent, up from just over 6.5 percent 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,” said Yeza Aoudi, a matron. “We explain the benefits of prenatal care for their baby."
In 2024, MSF provided about 14,500 sexual and reproductive health consultations at the Kourgui Integrated Health Center, and 1,380 deliveries.
A humanitarian crisis with growing needs
The ongoing crisis in the Lake Chad basin has worsened humanitarian conditions in the Far North, making access to health care 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.
