Patients wait for consultations at Ouadda Health Centre in the Central African Republic, where health workers provide essential services to communities in need. Photo: UNOCHA/Regis Maloundou
After eight years of displacement, Amne Izadid returned to Ouadda, in north-eastern Central African Republic, in 2024. Coming home brought relief, but also uncertainty.
Ouadda is one of the country’s highest–severity humanitarian hotspots. Around 6,000 people urgently need health assistance in the area, where isolation, displacement and limited access to basic services continue to deepen humanitarian needs.
The situation is compounded by a weak health system. Only one functioning health facility serves Ouadda, with limited staff, equipment and medicines. Children under five are also severely affected by acute malnutrition, while shortages of nutrition supplies are made worse by poor road access, long distances and funding cuts.
Amne during a consultation at the Ouadda Health Center. Photo: UNOCHA/Maxime Nama
Free healthcare that protects families
For Amne, the strengthening of services at the town’s only functioning health facility, the Ouadda Health Centre, made returning home feel more possible. With support from the OCHA-managed Central African Republic Humanitarian Fund, thousands of people now have access to life-saving health and nutrition services.
“As medicines are free, it allows us to use money for other needs, such as buying seeds to plant or raising goats to support my family,” said Amne.
The Fund’s support has enabled the non-governmental organization Community Humanitarian Emergency Board and its national partner Assistance d’urgence et développement communautaire to deliver integrated health and nutrition services based on priorities identified by communities themselves.
For families in Ouadda, free access to health services is a critical lifeline. It helps reduce the impossible choices many households face between treatment and other basic needs. Before this support, many households returning from years of displacement were forced to sell productive assets, take on debt, or reduce spending on food and their children’s education just to pay for essential healthcare. By removing this financial burden, the project has given families the stability and breathing space they need to rebuild their lives, restore their livelihoods, and look toward the future with renewed confidence and hope.
Patients collect prescribed medication from the pharmacy after consultations. Photo: UNOCHA/Maxime Nama
Tania Monique, who is pregnant, continues her antenatal consultations at the same facility. She says the support has given her confidence that this pregnancy journey will be safer than her first.
“During my first pregnancy, the hospital barely existed and there was no midwife,” she said. “I went there once and returned home to give birth on the floor.”
“It was very risky for me and for the child, as I did not receive appropriate care. Today, I am not afraid because Fatou and Liliane, the midwives, take good care of me and medicines are available for free.”
Health indicators in the Central African Republic remain alarming. Under-five mortality remains among the highest in the world, at 90 deaths per 1,000 live births, while maternal mortality stands at 835 deaths per 100,000 live births. Only about 40 per cent of births are attended by skilled health personnel.
Tania attends a prenatal consultation at the Ouadda Health Center. Photo: UNOCHA/Regis Maloundou
Treating malnutrition
At the same facility, two-year-old Gervais is gradually regaining weight after being admitted to a nutrition programme.
“Sometimes he could not stand and had severe diarrhoea, even developing complications,” said his mother, Laurène Madena. “Since I learned how to cook nutritious meals and he receives therapeutic food, he can now stand and is improving.”
Like Amne, Gervais and Tania, more than 9,000 people are benefiting from the project’s services, including through mobile clinics. The centre has received medicines, medical equipment and additional staff, including the town’s only doctor, two midwives, two nutritionists and two psychologists.
The project has also strengthened local capacity by training health workers, while two additional health facilities in the nearby villages of Boungou and Mouka have received similar support.
Laurène holds her son, Gervais, as he eats ready-to-use therapeutic food as part of his nutrition treatment. Photo: UNOCHA/Maxime Nama
Health workers measure a child as part of screenings to detect malnutrition. Photo: UNOCHA/Regis Maloundou
A child is screened for malnutrition. Photo: UNOCHA/Regis Maloundou
Communities shaping the response
The project follows an area-based financing approach that places communities at the centre of decision-making. Before the project was designed, humanitarian partners consulted residents to understand their priorities and preferences.
“I felt listened to and respected,” said Alphonse Doungoussa, who took part in the consultations. “The humanitarian organizations took our community’s concerns and preferences into account when designing assistance, and this made us feel genuinely involved in decisions that affect our lives.”
Humanitarian actors are also returning to communities to discuss how programmes are being implemented and collect feedback.
At the national level, nearly 600,000 people – most of them women and girls – participated in consultation and feedback mechanisms in 2025 under Central African Republic Humanitarian Fund allocations.
Community members take part in consultations helping humanitarian partners understand local priorities and shape assistance around people’s needs and preferences. Photo: UNOCHA/Maxime Nama
Hope despite persistent challenges
Despite progress, needs remain high. Poor road access, long travel distances and limited health system capacity continue to constrain service coverage in and around Ouadda.
Sustained humanitarian funding is essential to preserve the gains already made and expand services to the most-at-risk people.
For families in Ouadda, access to health care no longer means a journey measured in days or a choice between treatment and survival. With continued support, communities can access the care they need while rebuilding healthier and more resilient futures.
