Community Based Approach to Malaria Prevention among Pregnant Women and Children Less Than Five Years of Age in Cameroon

Abstract

Malaria is a major public health concern in Cameroon which for a long time has remained the second leading cause of morbidity and mortality after HIV/AIDS, and the most widespread endemic disease in the country. Cameroon, historically has been implementing malaria prevention programs through a community based strategy from the pre-colonial era, through the independence to the post-independence period till date. Despite the adoption and implementation of the CBA in the fight against the scourge in the country which has yielded results in many countries like Cape Verte, the Mauritius Island and Algeria, malaria prevalence rate remains high especially among pregnant women and under five children. This is a proof that the CBA faces enormous challenges in effectively tackling malaria in the country. This qualitative study has as objective to analyze the barriers/challenges that are faced in implementing the CBA in the country and how these challenges can be overcome to ensure that preventive measures are effective. This study used two types of data; primary data collected using structured interview guides sectioned into themes having as indicators; health educational programs, community participation/engagement, environmental/larval source management and recruiting, training, equipping and using community health workers. A total of 233 key informants were interviewed; 40 community health workers, 70 community leaders, 75 Pregnant women, 24 health care providers, and 24 care givers through purposive sampling. Secondary data was collected through reading documents; textbooks, research reports, journal articles, conference papers, workshop papers, theses, seminar reports and dissertations on malaria prevention among the vulnerable populations through the CBA. Data from the interview guides were analyzed using the NVIVO software. Findings revealed that factors such as community apathy, language barriers, resource constraints, poor use of media and cultural beliefs are challenges faced by health education. the lack of interest/motivation among community members, geographic barriers, overburdened community, cultural norms, unfamiliarity with the importance of participation, lack of acknowledgment for community contributions were identified to be challenges community participation faced. Environmental degradation, low community participation and awareness, resistance to change, fluctuating mosquito populations were identified as barriers faced by LSM and. logistic challenges, training quality variability, workload stressors, high turnover, resource limitations, cultural barriers were noted to be hurdles encountered by CHW in the fight against through the CBA strategy in Cameroon.