Introduction. Malaria continues to be the number one killer disease in Cameroon. It accounts for 40 to 45% of medical consultations, 40% of households’ annual expenditure on health, 50% morbidity and 40% mortality particularly amongst the under five years-old children and 30-40% of deaths in health facilities.. It equally represents 57% of hospitalization days and 26% of sick leaves. At least two million cases of malaria are reported yearly from health facilities in Cameroon.
Since 2005, Plan Cameroon in collaboration with the ministry of health and Natexis bank-France are implementing a 3-year malaria control project in Akonolinga health district targeting 23 667 children under five and pregnant women through free distribution of long lasting insecticide treated nets, environmental cleanliness and intermittent preventive of malaria in pregnancy. The main vectors of change were youth groups and community-based organizations.
Goals of project: To reduce by 50% morbidity and mortality attributable to malaria using long lasting insecticide treated nets.
Objectives of the project by 2008 were;
- To raise awareness in 350 communities on the causes of malaria,
- To ease both financial and geographical access to long lasting insecticide treated nets to at least 60% of children under-5 years old and pregnant women;
- To promote effective use of LLITNs by at least 60% of children under-5 years old and pregnant women;
- To make 350 youth groups actors of malaria control in Akonolinga health district
- To build the capacity of 350 CBOs to continue sensitization of the local community on malaria control.
Activities and strategies of the project
Youth groups and CBOs were actors of malaria control through:
- plays, sketches, theaters and health talks on malaria control during public ceremonies;
- conduct regular home visits to ensure effective use of bed nets;
- organize cleanup campaigns to drain stagnant water, fill up pot holes and clear bushes;
- organize exchange visits to learn from good performing youth groups on malaria control;
- free distribution of long lasting insecticide treated nets to under-5 children and pregnant women.

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Dear Ephraim,

Thanks for sharing these facts about Cameroon. I was wondering: are you aware of the existence of the process on Malaria Competence? You can read more on this website: http://www.malariacompetence.org.
If I understood it right, Malaria Competence will be introduced (if it hasn't started yet) in Cameroon with support of the Global Fund. It is the Cameroon Coalition against Malaria that will initiate the process.

According to you, what is the key to stimulate communities to take ownership of the issue of malaria?
Is there something about community responses that you would like to learn from us or members from around the world?

Cheers,

Laurence
Hello Laurence
As I said Cameroon will be implementing Global Fund R9 malaria component and one of the approaches to be used in the malaria competence approach which will be handled by Plan Cameroon ( My organization) and the Cameroon coalition aganist malaria.
For communities to have ownership of malaria control in a more sustainable way, the malaria competence approach seems the best option.
Presently, I have had a few trainings on the malaria competence and will like to be included on the list of facilitators so that I can also share the cameroonian experience with others.
Best regards
Ephraim
Dear Ephraim,

Great to hear that you are going to use Malaria Competence approach. I'm looking forward to hear the stories from communities and what they think about it.

What will be your strategy to reach '23 667 children under five and pregnant women' ? Is Plan Cameroon going to go to every village or are you going to train facilitation teams in every district, or something else? How do the facilitation teams make sure they respond to all invitations? Are they managing their team independently or is Plan supporting the management of the teams?

We have a similar challenge in DR-Congo on HIV. We aim to reach 60% of the whole population in this huge country. Our strategy is to work with local or international NGOs who will be trained in our approach. These NGOs then transfer our approach to local associations or NGOs who will be facilitating in the field. The first NGOs support the smaller NGOs in the management and coordination of their team.

Thanks for your answer!

Laurence
Dear Laurence
Thanks once more. children under 5 and pregnant women will be reached easily throughyouth groups trained on the malaria competence approach using the self assessment framework. These youth groups conduct household census in their respective communities, knowing who is under-5 and pregnant. During bed net distribution these two most vulnerable groups are given net first.
To ensure that these nets are installed and used, youth groups conduct regular home visits to check the use of these nets.
other opportunities used to give nets to these two groups are during antenatal visits by pregnant and under-5s and vaccination campaigns in health facilities.
Best regards
Ephraim
Hi Laurence.
Plan Cameroon will not reach every village but will have facilitation teams first in the ten regions of the country, then in the 174 health districts too. At the health district level, Community based organizations will be trained on the malaria competence appproach. These CBOs will conduct household census in thier respective communities, distribute nets, monitor their use during home visits, collect community health data, analyze and take decision, then forward their data to the health district.
At the health district, the data is consolidated, analyzed and decision taken. The various health districts then forward their data now through the regions to the central level where the general picture concerning malaria control in the country will be looked into and some policy formulated.
Thus, the malaria competence approach will really empower communities to take up malaria control as their own problem and not that of the health personnel only as it was in the past
Best regards
Ephraim
Dear Ephraim,

Greetings! Thanks for this wonderful sharing.

I had a few queries. I assume youth will take the forefront in the process. Which other CBOs are you planning to involve? What is the time line of the project? Will you be doing a base line data collection? Which organisation in Cameroon is the PR for this funding?

Look forward to hearing from you. Best wishes for the project.

Wam regards,

Rituu
Thanks Rituu
The project is Global Fund funded and will last for 5 years. The project is to scale malaria control in cameroon for impact. Distributing LLITNs, IPT, and appropriate case management both in health facilities and in communities using CBOs. We are planning to identify existing women's groups in all the commnuities in Cameroon who will serve as CBOs. A self assessment of the malaria competence approach will be done and a plan of action for the fight against malaria put in place, These CBOs will then continue to distribute nets, monitor their use and colect data. A baseline survey will not be conducted because this was done during the round 5 project implementation.
Plan Cameroon is one of the PRs alongisde with the ministry of health.
Best regards
Ephraim
Laurence,
Thanks for sharing the great effort of our colleagues in Cameroon. As a contribution, I will suggest that our Cameroon colleagues to adapt the competence approach to achieve their objectives including the one on raising awareness in 350 communities on the causes of malaria.

Also, it is great to see the inclusion of exchange visits which I hope will target communities.

Hope my contribution will be of help to your project.
Joseph
Thanks Joseph.
I was great having your contribution.
Best wishes 2010

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