Community perceptions and barriers to brain health and dementia care in rural communities in Cameroon: a qualitative study

Abstract

Community perceptions of brain health and dementia can significantly influence health-seeking behaviors. Context-specific data on community perceptions of dementia and brain health in rural communities in Cameroon is vital for the development of context-relevant interventions and policies to promote brain health and reduce the burden of dementia. This study aimed to explore community perceptions of dementia and brain health, as well as the barriers to optimal brain health and dementia care in some rural communities in Cameroon. We conducted a qualitative study using semi-structured interviews with healthcare workers, participants with dementia and their caregivers, and individuals without dementia from three rural communities in Cameroon. Data analysis was done thematically based on grounded theory. The study included seven healthcare workers, five participants with dementia and their caregivers, and 10 persons without dementia. Emerging themes in community perceptions of dementia were spiritual/supernatural, bewitchment, generational curse, infection, madness, and normal aging. For community perceptions of brain health, emerging themes included mental sharpness, healthy mind, the absence of brain disease, an intact brain, the importance of brain health, lifestyle, environment, systemic conditions, and socioeconomic and cultural factors. Barriers to dementia care were stigma, lack of public awareness, lack of specialist services, insufficient healthcare worker training, cultural practices, limited therapeutic options, lack of diagnostic tools, lack of social support, and financial constraints. Barriers to brain health were substance abuse, unhealthy lifestyles, economic constraints, low public awareness, cultural practices, and low access to health facilities. Community misperceptions about dementia and brain health are common, and multiple barriers to brain health and dementia care exist in rural communities. A multipronged intervention is warranted.