‘No Single Hospital Has Sufficient Incubators in the Country’: Inside Cameroon’s Incubator Crisis
By Hans Ngala
On January 22, 2025, Nancy who was nearly 7 months pregnant, went into labour at her home in the coastal city of Douala in Cameroon’s Littoral Region. The clock on the wall read “11:55 p.m.” Nancy’s husband knocked on a neighbour’s door who owns a motorbike and she was rushed to hospital on the bike while her husband later joined them, running on foot, as fast as he could. She was rushed to the nearby Logbaba District Hospital.
“I don’t even want to talk about it” a visibly distraught Nancy told CNA. “I lost my three little angels” Nancy sobbed as she wiped her tears with the edge of the loincloth tied around her waist. “Please, I don’t want to talk about it” the woman in her early 30s wept. A close relative who opted to speak with us later, said that Nancy had given birth that night to triplets – two boys and one girl – but because the Logbaba District Hospital only had one incubator, the babies could not properly be taken care of. With an estimated population of 5 million, the city has scores of hospitals but even its best-equipped – the Laquantinie Hospital and the Douala General Hospital – do not have enough incubators for the hundreds of babies that need them monthly.
This results in nearly 10,000 babies dying every year in Cameroon from a shortage or complete lack of incubators in the country’s hospitals.
It is the same story in the Northwest of the country where the Anglophone Crisis (a secessionist conflict rooted in attempts to break away from the rest of the country) has had a devastating effect on healthcare infrastructure. On July 25th, was at the Bamenda Regional Hospital, a government-run hospital where our reporter saw firsthand, the problem of incubator shortages. A medical staff member was wheeling out an incubator that had broken down and was in need of repairs. As of January 2024, the Bamenda Regional Hospital only had six incubators. This is grossly below the number required for a hospital of this scale. The six incubators were expected to serve 19 babies delivered at the hospital at the time. This number of incubators often proves insufficient.
Attempts by CNA to get more information from the hospital regarding the precise, current number of incubators, maintenance and related details all proved futile as hospital authorities were unwilling to cooperate. However, when CNA spoke to Dr. Gwanyama Noela who was in charge of the hospital’s neonatal unit in January 2024, She said that the hospital was not only dealing with a shortage of incubators, but also a shortage of pediatric experts with just one pediatrician in the entire hospital. She added that most of the pre-term babies often had infections, asphyxia and neonatal jaundice – heightening the risk of these conditions being passed on to other babies when incubators have to be shared by two babies.
At Mbingo Baptist Hospital (MBH), a mission-run hospital owned by the Cameroon Baptist Convention (CBC) Health Services, the situation is similar. The referral hospital and one of Cameroon’s most prestigious hospitals, only has 4 incubators as of the time of writing this report in August 2025. Using data from the hospital’s own records, we noticed a pattern that showed that with its 4 incubators, the hospital’s neonatal unit often had to deal with high pre-term births (seven to eight) on average in 2015. Overall deliveries stood at 61 and 73 for November and December 2015 respectively. This was prior to the separatist conflict now rocking this part of the country and which has in turn had an adverse effect on the overall patient turn-out.
By November 2020, just five years later, the combined effects of COVID-19 and the Anglophone Conflict, saw overall deliveries plummet to 23 with just 2 pre-term deliveries. This was because the COVID-induced shutdowns and the insecurity resulting from the Anglophone Crisis, caused movement to be impeded, medical staff are sometimes targeted and Mbingo is a village at the heart of the Anglophone separatist struggle.
In January and February 2025, Mbingo recorded 27 and 17 deliveries respectively.
This shortage of incubators has real adverse consequences on neonatal health. According to Grace Tadzong-Awasum and Nkengafac Priscilla Kungang in a study they conducted at a hospital in the capital city of Yaounde, “In Cameroon, nearly 90,000 babies are born each year with a weight of less than 2,500 g and before the theoretical term of 37 weeks and nearly 10,000 die from preventable causes”.
“Sub-Saharan Africa continues to bear the world’s highest burden of under-five mortality” a World Health Organization (WHO) report states. According to the global health organization, Africa’s under-5 mortality rate remains at approximately 74 deaths per 1,000 live births – significantly higher than any other global region, reflecting profound gaps in pediatric healthcare access, quality, and infrastructure.
In Cameroon, the situation is particularly dire. While recent estimates vary, UNICEF data indicates that Cameroon’s under-five mortality rate is about 67.2 deaths per 1,000 live births – again, well above global averages.
Dr. Atem Erica, a pediatrician serving at Etoug-Ebe Baptist Hospital in the capital city, Yaoundé, says common medical conditions that affect neonates in Cameroon include malaria, gastroenteritis, chest infections, benign sickle cell disease and malnutrition.
Speaking on the importance of incubators for pre-term neonates, Atem says “Incubators are crucial in the survival of preterm babies because they keep these babies in conditions that mimic the uterine environment, thereby increasing their chances of survival”, adding that a pediatrician and incubators have a crucial relationship as “a pediatrician is a specialist responsible for monitoring and treating children – including pre-term babies – because these babies often need to be in an incubator” she explained. “The incubator is a medical tool or device, but it’s the pediatrician’s expertise that ensures it’s used correctly to ensure the babies proper health and survival”.
Maternal health expert and infection prevention nurse, Nkwan Jacob explained that “There is actually no single hospital that has sufficient incubators in the country”. Nkwan was a nurse with the Cameroon Baptist Convention (CBC) Health Services for nearly 30 years and now works as an Infection Prevention Consultant with the Infection Control Africa Network , training medical staff across Africa on infection prevention.
Nkwan says that this shortage in incubators reflects a broader issue: “The Abuja Declaration stipulated that 15 percent of the national budget of AU member states should be allocated to health but many African countries are not able to allocate even more than 5% percent” he regretted. Speaking further, the medical expert said “Cameroon’s health budget always rotates at roughly 4 percent” and this is part of the issue that then translates to a lack of incubators he clarified.
Can Structured Health Financing Help?
This is the question we put to a Member of Parliament (MP), Honourable Peter Njume. Seeing the shortage in funding in Cameroon’s health sector, Njume decided to create the Parliamentary Caucus on Health Financing(PCHF). “I noticed that our health sector is under-funded and we rely on international partners for more than 50 percent of our health budget. This is not right,” Njume told CNA. He went on to add that “While my initial focus for creating the Parliamentary Caucus on Health Financing was to tackle financing for malaria treatment in particular, this will also be beneficial to the entire health sector in Cameroon once it works and we can provide more incubators for our hospitals, better pay for doctors and nurses inter alia”.
Njume said that following the global aid cuts by the U.S. government which were announced in January, Cameroon’s PCHF was already in talks with the Prime Minister, the Minister of Finance and the Minister of Health to see to it that Cameroon’s health budget – which falls way below the required Abuja Declaration minimum of 15 percent – is increased and can help improve especially the areas of maternal health and malaria treatment. “We have to now fund our healthcare ourselves” he said.
The financial issue is quite significant when it comes to the shortage of incubators but Nkwan Jacob says “I do not believe that incubators are too expensive. An imported incubator costs about 6 million CFA (about 10,600 USD) per incubator while locally made ones cost 2.8 million CFA (or about 4,900USD) so I don’t think that cost is a hindrance”. He says “Politicians are able to prioritize non-crucial sectors and spend lavishly on cars so I believe incubators can be afforded with the right leadership approach”.
Nkwan said Cameroon has 380 health districts and ideally, each district hospital needs about 10 incubators while regional hospitals should have 15 incubators. However, current numbers sadly fall far below this threshold; with most hospitals operating without any incubators at all, putting the lives of pre-term babies at risk. Many do not survive beyond six weeks after birth.
A Shortage of Incubators – and Pediatricians
The shortage of incubators is just one aspect of the equation as maternal health also requires pediatricians. Dr. Atem told CNA that “Each year, we have about ten to 15 Cameroonian pediatricians who graduate from residency but (the) majority of them end up leaving the country”. She says that “Most of them leave because they want better pay and better working conditions which are lacking in Cameroon at the moment”.
The average monthly salary for Cameroonian GPs and specialists like pediatricians, stands at 300,000 CFA (530 USD) but Atem believes that an ideal salary would be 500,000 CFA (880 USD) to 600,000 CFA (1,000 USD) for a start, given the amount of time and money that doctors put into medical school.
The Cameroon Society of Pediatricians, better known by its French-language acronym SOCAPED was founded in 1980 to try and address issues affecting pediatricians in the country.
“We don’t only have pediatricians as members” the organization’s Secretary General, Prof. David Chelo told CNA, “We have just about 200 pediatricians in the country for 15 million kids and you can see how that is a problem Chelo says. “Most of them leave Cameroon every year, seeking better pay and opportunities abroad, but we need at least 2,000 pediatricians to be able to meet the country’s shortage”.
Dr. Atem who has practiced for two years now, says that even with the shortage in pediatricians nationwide, most of them are concentrated in towns and cities due to the relatively better standards of living in these places. However, this results in remote or rural areas being disproportionately affected as they are left with even fewer or no pediatricians at all. This results in hospitals and clinics in towns getting overburdened.
Cameroon currently has no pediatric hospital where specialized neonatal or maternal health services are offered. However, Professor Pius Tih, former Director of the CBC Health Services is working with some partners and trying to bridge this gap. A respected public health expert and scholar, Tih led the CBC Health Services for over 30 years and was at the fore of many nationally-adopted health programs; from promoting the inclusion of persons with disabilities to advocating the treatment of HIV, clubfeet and cleft lips. He is currently working with US-based Cameroonian partners to see to it that Cameroon gets its first-ever pediatric hospital.
Speaking to CNA, Tih said “Increasing infant mortality compounded by conflict in the Northwest and Southwest regions—often referred to as the “Anglophone regions”—nearly 18 percent of health facilities have been forced to close due to ongoing insecurity, the deterioration of the immunization infrastructure is especially acute. By late 2019, we saw that facility-based immunization coverage had dropped by more than 50 percent in the Northwest and 30 percent in the Southwest, primarily due to health facility closures, looting, and the flight of health workers”
“Against this backdrop, the African Children’s Healthcare Fund (ACHF)—a U.S.-registered nonprofit—is uniquely positioned to make transformative impact. We are working with Dr. Daniel Gwan-Nulla, a Cameroon-born surgeon based in the U.S. Along with his wife Dr. Meesha Gwan-Nulla, they are responding directly to the realities Dr. Gwan-Nulla witnessed during several surgical missions he undertook across Africa where he noticed children dying after routine procedures because of the absence of pediatric-specific equipment and specialized care” Tih explained.
ACHF’s mission is to bridge critical pediatric healthcare gaps by building a state-of-the-art, full-service children’s hospital in Cameroon, in partnership with the Cameroon Baptist Convention (CBC) Health Services. “This facility will be equipped with incubators and pediatric specialists to provide comprehensive, specialized pediatric care, accessible to all children, regardless of their families’ ability to pay. It will be one of only a few nonprofit general and specialized children’s hospitals in Sub-Saharan Africaand the first in Cameroon, focusing on equity and excellence” Tih said.
He added that in Cameroon, children account for almost 49 percent of the national population—a demographic reality that underscores the urgency of scaling up child health services. “By delivering high-quality, accessible pediatric care, this pediatric hospital will not only save lives but also lay the foundation for long-term health and socioeconomic stability” the former CBC Health Services director explained.
Cameroon has committed to achieving universal health coverage by 2030, with specific targets on maternal, infant, adolescent, and child health and Tih sees the proposed children’s hospital as a cornerstone in this effort but he says it is just the first step in the right direction.
Nancy is a pseudonym that has been used to protect her real identity given the sensitive nature of this report.
This investigative report was produced as a result of a grant provided by the Wits Centre for Journalism’s African Investigative Journalism Conference
