Roles and Challenges of Community Health Workers in Epidemiological Surveillance: A Qualitative Study in Cameroon
Rôles et Défis des Agents de Santé Communautaire dans la Surveillance Épidémiologique : Une Étude Qualitative au Cameroun
DOI:
https://doi.org/10.5281/hra.v3i2.6464Keywords:
Community health workers, epidemiological surveillance, Cameroon, qualitative researchAbstract
ABSTRACT
Introduction. Community Health Workers (CHWs) are key community and health system liasons. Their closeness and acceptance by their community give them an important role to play concerning early detection in community-based surveillance (CBS). To sort out the role, strengths, and challenges of CHWs in their epidemiologic surveillance activities since the implementation of CBS in Cameroon, an evaluation has been conducted in 2023. Methodology. This exploratory qualitative study was based on semi-structured interviews with CHWs who are involved in surveillance activities in each of the ten regions of Cameroon. Twenty CHWs were recruited through a purpose sampling. Results. The CHWs reported engaged in many roles such as health promotion, detection and notification of suspected cases or signals which can lead to a public health event, response to outbreaks, community awareness and community engagement. Their integration in the community, the love for their community were highlighted as important factors of their activities. Nevertheless, they faced some challenges such as absence of legal mandate, distrust of the community, exposition to public health threats and lack of resources. They proposed to focus on improvement of their status and financial incentives, recruitment of more CHWs for representative purpose, and providing trainings, personal protective equipment and documentation to enhance their skills to successfully address these challenges. Conclusion. Findings in this study, support that CHWs contribute not only to the primary health care process but also to public health surveillance. However, they encountered some difficulties in undertaking confidently their activities. Legal mandate, sustainable resources and capacity building are needed to strengthen CBS.
RÉSUMÉ
Introduction. Les agents de santé communautaire (ASC) jouent un rôle clé en tant qu'intermédiaires entre la communauté et le système de santé. Leur proximité et l'acceptation dont ils bénéficient au sein de leur communauté leur confèrent un rôle important dans la détection précoce dans le cadre de la surveillance communautaire (SC). Afin de mieux comprendre le rôle, les forces et les défis des ASC dans leurs activités de surveillance épidémiologique depuis la mise en place de la SC au Cameroun, une évaluation a été réalisée en 2023. Méthodologie. Cette étude qualitative exploratoire s’est basée sur des entretiens semi-structurés avec des ASC impliqués dans les activités de surveillance dans chacune des dix régions du Cameroun. Vingt ASC ont été recrutés par un échantillonnage raisonné. Résultats. Les ASC ont rapporté plusieurs rôles dans lesquels ils sont impliqués, tels que la promotion de la santé, la détection et la notification de cas suspects ou de signaux pouvant mener à un événement de santé publique, la réponse aux épidémies, la sensibilisation de la communauté et l'engagement communautaire. Leur intégration au sein de la communauté et l'amour qu'ils portent à celle-ci ont été soulignés comme des facteurs importants dans l'accomplissement de leurs activités. Cependant, ils ont également rencontré certains défis tels que l'absence de mandat légal, la méfiance de la communauté, l'exposition aux menaces pour la santé publique et le manque de ressources. Les ASC ont proposé plusieurs solutions, notamment l’amélioration de leur statut et de leurs incitations financières, le recrutement de davantage d’ASC pour une meilleure représentation, ainsi que la fourniture de formations, de matériel de protection individuelle et de documentation afin de renforcer leurs compétences et relever ces défis avec succès. Conclusion. Les résultats de cette étude montrent que les ASC contribuent non seulement à la prise en charge de la santé primaire, mais également à la surveillance en santé publique. Toutefois, ils rencontrent des difficultés à réaliser leurs activités de manière confiante. Un mandat légal, des ressources durables et le renforcement des capacités sont nécessaires pour consolider la surveillance communautaire (SC).
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