The Cameroon Cataract Bond, launched in 2018 as a new way of funding health care by bringing together public and private investors, health donors and eye care delivery experts, has completed the first year, screening more than 50,000 patients and completing more than 2,300 cataract surgeries in Cameroon
It is a pay-for-performance loan (also known as a development impact bond or DIB) which is supporting the Magrabi ICO Cameroon Eye Institute (MICEI) to provide as many as 18,000 cataract surgeries in Cameroon over five years. The loan means that low-income patients can receive sight-saving surgery for free or at a subsidised fee. The fund will also help the hospital to become self-sufficient in five years.
In its first year, the hospital conducted 103 outreach camps screening 11,284 patients and screened a further 42,899 patients in the hospital.
Staff throughout the hospital received training and mentoring from the Magrabi Hospital Group and Aravind Eye Care System. Two ophthalmologists completed Manual Small Incision Cataract Surgery training and nurses received refraction training. Training will continue throughout the project to expand the capacity to deliver eye care services in Cameroon.
The quality of surgeries exceeded the World Health Organization (WHO) standards with around 70 per cent of surgeries achieving a good visual outcome on the day after surgery. For those people who returned to the hospital for a follow up four weeks after surgery, 92 per cent achieved a good visual outcome, while 2.8 per cent had a poor outcome.
Financially the hospital is performing better than anticipated after its first year and is on track to become financially sustainable within five years.
The project aims to provide 40 per cent of all surgeries for the people in the poorest two groups of the national population. This target is hard to reach because the catchment area of the hospital is the capital city and surrounds, while more of the poorest people live outside urban areas.
Already 29 per cent of all patients were from the bottom two groups based on national poverty thresholds, and 45 per cent based on urban poverty thresholds. The project is working to better understand the barriers people face and develop strategies to increase access for the poorest.
The primary donor and founder of the hospital, Dr Akef El-Maghraby, internationally renowned ophthalmologist and Chairman of the Magrabi Hospital Group said, “My goal is to make high-quality eye care accessible to the people of Cameroon regardless of their ability to pay. We are grateful to our stakeholders for supporting the hospital’s path to sustainability so that we can continue to deliver on our promise. MICEI is the first project for the Africa Eye Foundation, and lays the foundation for a network of integrated and self-sustainable eye hospitals the organisation plans to build across Africa.”
“We are encouraged by the progress made so far towards the goal of building greater eye care capacity for Cameroon and for the region,” said Peter Laugharn, president and CEO of the Conrad N. Hilton Foundation, the main financial contributor to the outcome funding pool.
“We look forward to the continued partnership represented by this innovative financing mechanism to help support the sustainability of MICEI’s operations,” Laugharn added.