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Epidemic preparedness and response in Cameroon, Sep 2021

Highlights of a technical brief from the Institute of Development Studies

With high ethnic diversity, low investment in health and several ongoing humanitarian crises, Cameroon faces important challenges in epidemic response and preparedness.

Tackling deadly diseases in Africa (TDDA) works with Cameroon to improve health security and save lives. Integrating social science perspectives into TDDA’s technical assistance work provides important benefits. It strengthens our understanding of the contexts in which we operate and informs the support we give. It can also help to shape emergency response systems so that they are more effective, adaptive, evidence-based, and planned in consultation with affected and at-risk communities.

The Institute of Development Studies is a valued resource partner to TDDA. With our support, they have recently produced a series of technical briefs, detailing the key political, economic, cultural and social issues facing each of the countries we work with. Here is a snapshot of their findings for Cameroon.

Key considerations and recommendations in Cameroon – summary

Assessing vulnerability and adapting preparedness and response: Key vulnerable populations in Cameroon include: women, who have limited representation in decision making at all levels and face disease risk through their caring roles; children, who are most susceptible to disease and under-immunized; elderly and disabled people; displaced and conflict-affected people; historically marginalised groups such as the Baka and Bororo; and prisoners. It is important to ensure vulnerable groups are included in preparedness and response activities and specific efforts are needed to engage communities through appropriate, targeted communications channels.

Culturally appropriate, clear communication: Cameroon is highly culturally and linguistically diverse, with low rates of literacy among older people, particularly women. This means there is an onus to use the dialects and languages preferred by some communities, as well as targeted channels and visual media. Community dialogues can be more effective than top-down messaging, enabling responses to be adapted to people’s priorities and understandings, avoiding potential confusion and the proliferation of rumours and conspiracy theories.

Incorporating local knowledge and health practices: Cameroonians may very often attribute illness to social forces (e.g. witchcraft, transgression of norms) which affects how they seek health. Financial constraints lead some people to self-medicate and many only go to formal health facilities when their conditions are advanced. It is important to identify and respectfully acknowledge how local people understand and seek help for outbreak-prone diseases. By working with trusted health actors, both formal and informal, Cameroon can strengthen surveillance and response.

Ongoing conflicts and displaced peoples: Insecurity is a major factor in health, which makes it vital to support vulnerable people’s multiple needs. There are well over a million displaced Cameroonians and regional refugees living in the bush, in camps, or in host communities. Populations in conflict-affected areas are also highly vulnerable and may be difficult to reach. When dealing with disease outbreaks, it is therefore essential to incorporate decentralized, community-based surveillance and response, engaging local community health workers or trained volunteers already embedded in these areas.

Locally embedded response to build trust: It is vital to identify locally trusted leaders and networks, recognising that this may vary according to the local context. Religious leaders (e.g. priests, ministers, pastors, and imams) are influential in many communities.

Health system strengthening: Cameroon’s public health system is severely under-resourced and northern regions are disproportionately underserved. To mitigate this, disease-specific activities need to be integrated into routine health services so that critical activities such as antenatal care and routine immunizations are not adversely affected during an epidemic response. Greater empowerment and autonomy for local health workers, and collaboration between different health system actors is critical as, together, they reach many more people, and can complement and learn from one another in ways that improve epidemic response.

The IDS technical brief for Cameroon was prepared by Tabitha Hrynick, Deffo Modeste and Kelley Sams.

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