Geographic Accessibility of Neonatal Incubators in Cameroon: Current and Prospective Modelling using Cost-Distance Analysis towards the African Union Agenda 2063

Abstract

Neonatal incubators are essential tracer equipment for newborn survival, yet in much of sub-Saharan Africa their benefit is limited less by their number than by how far a newborn must travel to reach one. This study analysed the geographic accessibility of neonatal incubators across Cameroon's 210 health districts using a raster-based cost-distance analysis implemented in AccessMod 5, which models travel time to the nearest incubator-equipped facility while accounting for road network, land cover, terrain, and hydrographic barriers. Population coverage was estimated at four travel-time thresholds (½, 1, 1½, 2 hours) for the current situation (2024) and for two prospective scenarios projected to the African Union's Agenda 2063 horizon: a Catastrophic trajectory of infrastructure degradation and high population growth, and a Desirable trajectory combining road investment and targeted facility capacity-strengthening. Under the current, Status Quo situation, only 53.60% of the population was covered within half an hour, rising to 77.15% within 2 hours, 2.85 percentage points short of the WHO/Lancet Commission's 80% benchmark, with 42.86% of districts more than two hours' travel from care and marked disparity concentrated in the North-West, South-West, Far North and East regions. Under the Catastrophic scenario, 2-hour coverage was projected to fall to 67.14%, whereas the Desirable scenario raised it to 89.40%, lifting the number of WHO-compliant districts from 115 in Status Quo to 152 of 210 under that scenario. These findings show that Cameroon's neonatal incubator accessibility gap is severe but not fixed, and that targeted, spatially-informed investment in roads and facility capacity could close it well within the Agenda 2063 horizon.

Keywords: neonatal incubator, geographic accessibility, cost-distance analysis, AccessMod, Agenda 2063.

Received Date: June 19, 2026

Accepted Date: July 10, 2026

Published Date: August 01, 2026

Available Online at: https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/812