preprint · medRxiv
Yellow fever remains an ongoing public health concern in Cameroon, particularly within conflict-affected settings where surveillance systems encounter operational difficulties. Under the Integrated Disease Surveillance and Response framework, community health workers are essential for early detection and rapid response. A qualitative investigation conducted across two health districts in the Northwest region examined the perspectives of health personnel and community health workers through focus groups and interviews. The findings reveal that while these workers are embedded and trusted within their localities, their efforts are hampered by significant emotional and professional strains. Additional challenges include mixed community awareness, cultural and spiritual factors, gender-related barriers, and an absence of adequate supervision and operational feedback. Strengthening health worker support is necessary to enhance disease surveillance outcomes in fragile environments.
Controlling disease outbreaks in fragile and conflict-affected zones depends heavily on frontline personnel. By identifying the direct challenges experienced by community health workers, health authorities can design more effective support structures, enhance disease reporting, and address community-level barriers to contain infectious diseases like yellow fever more reliably.
This qualitative research does not present a direct commercial product, but its insights can guide public health organisations, digital health developers, and non-governmental programmes in designing targeted workflow tools, training programmes, and communication platforms for frontline health workers. The work represents applied field research that could directly inform operational strategies in fragile health settings.
AI-generated from the published abstract. Always read the original work before citing.
Abstract Background Yellow fever remains a public health threat in Cameroon, especially in conflict-affected regions where surveillance systems face contextual challenges. Community Health Workers (CHWs) are crucial in early detection and response under the Integrated Disease Surveillance and Response (IDSR) framework. Understanding their perceptions is essential to improve performance. Methods This qualitative study explored CHWs’ and health personnel’s perspectives on yellow fever surveillance in two districts of Northwest Cameroon. Data were collected through seven focus group discussions and fifteen in-depth interviews. Thematic analysis followed Braun and Clarke’s framework using MAXQDA 2022. Results Six themes emerged: (1) mixed understanding of yellow fever among communities; (2) trust in CHWs shaped by social embeddedness; (3) emotional and professional burdens; (4) limited feedback and supervision; (5) cultural and spiritual barriers; and (6) gender-specific experiences. CHWs were central to surveillance yet often under-recognized. Conclusions CHWs are vital but under-supported in yellow fever surveillance. Although trusted by communities, their work is hindered by limited training, weak feedback systems, and sociocultural dynamics. Strengthening support, integrating gender-sensitive strategies, and engaging with local beliefs are necessary to improve IDSR outcomes in fragile health settings.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1101/2025.08.28.25334621
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
