The first forum on primary care and the institutionalization of community health
The first National Forum on Primary Health Care and the Institutionalisation of Community Health is being held in Yaoundé from 19 to 21 November 2024.
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Challenges
UNICEF played a key role in organising the first National Forum on Primary Health Care (PHC) and Community Health, which attracted 3,576 participants, three times more than the initial target of 1,300.
The Health Sector Strategy 2020-2030 reveals health indicators that remain low in Cameroon despite consistent efforts deployed on several levels by public authorities for several decades. Indeed, in recent years, despite notable progress in the health sector in general thanks to the Government’s efforts, certain indicators remain worrying, including those for maternal, neonatal and infant/child health, jeopardizing the achievement of the Millennium Development Goals (MDGs). Faced with this situation, “primary health care” is a promising way forward, strongly based on prevention and the implementation of health actions via community participation of populations, to improve and mobilize the people and local means available.
Today, thanks to the combined efforts of the State and partners including UNICEF, the Global Fund (GF), the Presidential Malaria Initiative (PMI), etc., the Community- Directed Interventions (CDI) approach, which uses multipurpose community health workers, is effective in 138 (68%) of the 205 health districts. A total of 9,932 multi-purpose community health workers out of a projected 25,000 work in these health districts, representing a coverage rate of 39.7%.
Despite these advances, the involvement of communities in the provision of health services continues to face a number of problems, including: the absence of a definition of the legal status of multi-purpose community health workers; the non-involvement of decentralized local authorities in health management, as provided for by the 2004 law; and finally, the under-funding of community health, including for the care of multi-purpose community health workers.
Investing in multi-purpose community health workers means recognizing both the crucial role they play and the primordial importance of Community Health, which is deployed as close as possible to families, villages and communities.
Highlights from the forum
Multi-purpose health workers: Heroes on the frontline
Sandrine is 38 years old and has five children. She has been a community health worker for 4 years in Bertoua, in the ENIA 2 district.
It all started on a market day. Her husband called and told her that two health care workers wanted to meet her at the health centre. They offered her the opportunity to become a community health worker and explained what that job was.
“I didn’t hesitate and became a multi-purpose health worker. I started my training the following month.”
Birth registration, whatever the obstacle! Adamou, a volunteer, travels through the flooded areas of Cameroon's Far North to give each newborn baby an identity.
In the Gado refugee camp, in the Bertoua district, Ibrahim and other community health workers trained with UNICEF support, carry out follow-up visits to households targeting families benefiting from the kangaroo method, to ensure that babies are systematically provided with this method, and that they (he or she) are properly fed, vaccinated and registered. Families are also reminded of the date of their next hospital checkup and referred immediately to a specialist if the infant’s condition is unstable.
Ruth, 37, is one of 21 multi-purpose community health workers attached to Ngong Integrated health center in the North region. Highly committed, she sometimes uses her money to travel to remote villages to sensitize families - among others - to the need to consult and give birth in health centers. She has encouraged many
pregnant women to visit the Ngong Integrated health center, helping to reduce the number.
The village of Ngamboula, in the Mandjou commune in eastern Cameroon, has been designated a 'child-friendly village' for 2024. This is thanks to the daily work of the community's multi-skilled health workers. Bienvenu Ndongmoui Ndibili has been a multi-purpose community health worker for 27 years. He has helped to stop 7 child marriages and to register the births of several children. He also carries out home visits to identify pregnant women, cases of malnutrition, malaria, violence and under- or unvaccinated children. Bienvenu also helps identify vulnerable families and cash transfer recipients. He is an excellent link between the health units, child protection services, registry offices and his community.
The Yaoundé Declaration
Through strategic advocacy, UNICEF influenced the adoption of the Yaoundé Declaration, committing stakeholders to institutionalise community health, strengthen financing and improve coordination. UNICEF's advocacy focused on equity, including the voices of marginalised groups, religious leaders and community health workers, ensuring that the Declaration reflected inclusive priorities. This milestone illustrates UNICEF's success in creating transformative policy change. It is a crucial step in ensuring sustainable support for primary health care.