Cameroon

Background

Photo: Anna Wang / MMV

Over the period 2015–2021, a reduction in mortality was recorded, while with regard to morbidity, the downward trend in prevalence contrasts with the increase in incidence. The contributing factors to the drop in prevalence and mortality were among others the improvement in the level of education of women, improving the use of mosquito nets in households by the most vulnerable (children under 5 years of age), implementation of the seasonal malaria chemoprevention in the North and Far North regions, improvement of home hygiene limiting exposure to mosquitoes. The increase in incidence over the period could be explained by the improvement in the following aspects: (i) the routine epidemiological surveillance system; (ii) parasitological diagnosis; and (iv) the contribution of community health workers in the collection of data on malaria cases.

Areas eligible for SMC and areas where SMC is implemented

Photo: Cameroon SMC map

Cameroon

# of children targeted

# of children reached

Coverage

Cycle 1

1,941,722

1,877,838

97%

Cycle 2

1,964,568

1,888,436

96%

Cycle 3

2003510

1947069

97%

Cycle 4

2025604

1922419

95%

Data from the NMCP of Cameroon

Monitoring for coverage and compliance

Monitoring for coverage completeness

  • In Cameroon, the results of CPS coverage are reported in DHIS2.
  • The DHIS2 data are compared with the results of the external monitoring that is carried out at each cycle.
  • The method used is the Lot Quality Assurance Sampling (LQAS).
  • A coverage survey is performed every year.

Monitoring for compliance

  • LQAS is used to monitor compliance.

Measuring effectiveness

  • Efficacy is not monitored yet.

 

 

Successes, action steps, challenges and solutions

Succeses

  • Member of chosen household leader to sensitize 5 neighboring households for the administration of second and third dose in two health areas.

 

Challenges

  • The change in timing with delay in finalizing strategies due to waiting for WHO guidelines.
  • Delay in the delivery of COVID-19 prevention equipment as they were not initially planned and budgeted for
  • Reduction in number of national supervisors to reduce risk of COVID-19 transmission
  • Substantial Increase in the budget
  • Insufficient domestic resources for SMC
  • Delay in procurement of SMC tools due to delay of the validation of tools
  • Lack of budget for pharmacovigilance activities
  • Inaccessibility of some areas during rains due to flooding
  • Limitation of mobile payment partner (network, coverage, hours, etc?)


Proposed solutions

  • The NMCP with its partners decided to push back slightly the start of the SMC to allow for good preparation.
  • The NMCP and PMI submitted a request to the Global Fund on SMC PPE kits. In the meantime, some kits were borrowed from other MOH services for the start-up of the SMC campaign
  • Increase in local and regional supervisors
  • Resources mobilization from other the government and other partners such as GF
  • Advocacy by the resource mobilization committee
  • Early validation of tools right after the validation of the strategy
  • Diversification of funding sources for 2021 SMC campaign
  • Organization of catch-up distribution in flooded areas
  • Diversification of payment mechanism in the upcoming SMC campaigns

Research priorities for 2020

  • Identify barriers to the implementation of SMC at the community level;
  • Identify areas not, or poorly, covered and catch-up with missed children;
  • Evaluate compliance of the SMC strategy by mobilizers-distributors;
  • Assess the coverage of target children with the three doses of treatment;
  • Access the feasibility and success of pilot approaches(leader-managed and electronic data collection)