Health Savings Funds in Eastern Cameroon

In the districts of Ketté and Ndélélé, access to healthcare is a real struggle. For thousands of families from host and refugee communities, the financial barrier remains the main obstacle. In a context where universal health coverage is still struggling to materialise and economic insecurity is weakening households, a happy event such as a birth can quickly become an ordeal. 

This is the reality experienced by Nziki Sidonie, a 30-year-old woman living in Bédobo with her husband and their three children. Two of their children are in school, which is already a heavy burden for the couple. To support her family, Nziki practises small-scale subsistence farming, while her husband does odd jobs to earn a little money. Despite their efforts, their income remains insufficient to cover all essential expenses, particularly healthcare costs.

A community response led by women 

Faced with these challenges, Action Against Hunger, through the SOLID project funded by the European Union, has implemented an innovative community-based solution: Health Savings Funds (HSFs). Much more than a one-off aid package, this mechanism empowers communities by enabling them to organize their own social safety net. 

In the five supported health areas, 31 HSF have been created, mobilizing 676 households. Mainly run and managed by women, these funds are based on regular contributions from members, enabling the creation of a solidarity fund that can be mobilized in the event of a medical emergency. 

Membership of a HSF is voluntary and benefits the whole household. Each group is governed by a clear set of rules, ensuring transparency and good governance. In the Kpambeta HSF, set up in March 2025 in the Bédobo health area, members contribute 500 CFA francs each per week. This common fund provides assistance to any member facing unexpected and urgent health expenses. The 30 members of this group are all from the host population, and four people have already benefited from health assistance since June 2025. 

The day everything changed for Nziki Sidonie 

An active member of HSF Kpambeta since March 2025, Nziki’s life was turned upside down on 26 May 2025. 

On that day, when she went into labour, she was taken to the Bédobo Integrated Health Centre, where she gave birth to a healthy baby girl. However, her relief gave way to concern: how would she pay the medical bills, given that the health cheque system was not yet operational in this health facility? 

That’s when the solidarity of the group came into its own. Informed of the situation, the president of HSF Kpambeta quickly mobilized the common fund to help her. Thanks to this support, Nziki was able to pay all the costs and return home peacefully with her newborn baby. 

“As my due date approached, I was extremely worried. My husband was struggling financially and I hadn’t yet been able to raise all the money I needed. When the chair of our group told me that I would receive assistance from the HSF, I was deeply moved. This gesture enabled me to pay off my medical bills and focus on my baby’s health. This support came as a breath of fresh air at just the right time. I would like to thank my colleagues at HSF Kpambeta and Action Against Hunger for making this possible,” says Nziki. 

“Since setting up our Health Savings Fund in March 2025, we have already helped four members of our group deal with medical emergencies. This system has truly changed the way we experience solidarity. We are proud of this, because it proves that when the community comes together, it can overcome its own difficulties. We see that women are particularly committed and play an essential role in the smooth running of these funds,” comments Ms Martine, chair of the Kpambeta Health Savings Fund. 

A collective and lasting impact 

Health savings banks strengthen community solidarity, encourage participatory management and reduce the use of home births, thereby contributing to improve maternal, neonatal and child health. 

By strengthening community solidarity, encouraging participatory management and promoting a culture of mutual aid, Health Savings Funds directly contribute to reducing maternal and infant mortality. They restore dignity and confidence to families, while strengthening the link between communities and health structures. 

Today, the 31 active HSF are entirely managed by the communities themselves, bringing together 676 households, including 545 women and 131 men. This inclusive model forges strong bonds of solidarity between host and refugee communities, strengthening local cohesion and resilience.