A health system you can count on in the Central African Republic

“Give to your baby one tablet in the morning, one in the evening, for three days, beginning today. Please, don’t forget. Is it clear mama?”

Chief Pharmacist Andre Ngouayiri patiently explains to mother Agnese Yassimea how to dispense the anti-malaria tablets to her six-month-old baby Vivianne, pointing at each pill. He is the pharmacist at the health centre of Bornou, a sprawling neighbourhood of the Central African town of Bria. Last night, the child started developing a fever and without losing any time, Agnese brought her to the dispensary. 

Agnese came to the health centre at eight in the morning. Forty minutes later, she walked back home with the anti-malarial drugs. She didn’t pay anything. She was the first patient of the day. By the time she left, eight other people were waiting to be consulted.

“Every day, I dispense free drugs to an average of 25 patients who qualify for this programme,” says Andre. “This means that at the end of the month, quite a lot of people have benefitted of the gratuity of essential drugs. It is an achievement for a health centre like ours, with an estimated population of 10,700 in our area of responsibility.”

Since last year, several hundred refugees from Sudan who live in a site three kilometres away also have the Bornou dispensary as their health centre of reference.

No sooner had Agnese arrived than she met the nursing assistant. She explained the case to him, and after checking little Vivianne’s temperature, he took a blood sample and did the malaria test, which turned out to be positive. Her weight was also checked: seven kilos. He appears to be reasonably well nourished.

Then dispensary head, Christiana, came in to discuss the baby’s health. “She is a ‘child mother’, only 13 years old, and she needs a lot of advice and support. She has told me that at her home they don’t sleep under a mosquito net, and I have told her that she must begin using one religiously if she wants to protect her baby and herself from catching malaria.”

Christiana writes the prescription and accompanies Agnese and little Vivianne to the pharmacy where she can go and receive the drugs. Andre is there, waiting to serve the patients.

After Agnese leaves, Andre takes some time to unpack five boxes of medicines that were delivered three days earlier and place them carefully on the storeroom shelves. A constant supply guarantees that no patient shall be left unattended. Since 2023, UNICEF has been supporting the Ministry of Health and Population to improve basic health services for people, by guaranteeing free and accessible medicines for children under five and pregnant mothers thanks to the financial support of the European Union. In 2024, UNICEF delivered more than 12,500 tons of medical and nutritional supplies across the country under the programme.

Seven health districts have been benefitting: Bimbo, Boda, Bossangoa, Bangassou, Ouango-Gambo, Haute Kotto and Vakaga. In addition to the supply of medicines, in 2023 the referral hospitals from these seven districts received 35 motorcycles to facilitate the distribution of drugs to local health centres. This year, a set of moto-tricycles equipped with a refrigerated car were delivered to also reinforce deliveries.

Under the programme, nearly 200,000 children and pregnant women received appropriate care in 2024, 27 per cent above the programme annual target of 157,000. Health centres report much fewer stock-outs. The number deaths of under 5 children dropped from 670 in 2023 to 234 in 2024. In the first half of 2025 just 27 child deaths were reported.

Bornou is Bria’s largest neighbourhood. Since the start of the most recent civil conflict in 2013, the town was largely occupied by different armed groups. In 2021, after fierce confrontations, Bria came under control of the central government and today, with a growing economy, it offers a semblance of normality. Many people who used to live in displacement camps are now trying to resettle in their former neighbourhoods and start a new, peaceful life.

“Those were very tough years, when armed groups could even come and bully us inside the health centre,” remembers Andre, “but fortunately this is now a thing of the past.”

As he continues to place in order the boxes of essential drugs, he explains that he feels happy to know that they shall help many women and children to be in good health.

“I have been doing this in Bornou since 2016 and all I can say is that I love my work. Our people need help to enjoy good health.”