Effectiveness of Community-Directed Intervention in the Roll-Back Malaria among the Under-Five Population of the Ndop Health District in North West Cameroon

Community-directed Intervention (CDI) is an intervention approach in which communities themselves direct and execute the planning and implementation of a health intervention. The success of this approach for the intervention of Onchocerciasis led to the extension of the strategy for the intervention of the other diseases in Africa. Community Health Workers (CHWs) working under the CDI of malaria program play a vital role in primary health care of the community. Local health services and partners initially introduce the intervention and explain the community-directed approach and how it can be planned, run and controlled by the community. This project was aimed at assessing the effectiveness of the implementation of the CDI in the roll-back of malaria among under-five children in the Ndop Health District, with special emphasis of the home management of malaria (HMM) by the Community Health Workers (CHWs). Among the CHW involved in the study, 94.7% of them accepted to receive monetary incentive for their services as CHW. Up to 39.8% of them had no other source of income. Furthermore, 74.3% of the participants reported that they have regular monthly meetings with their supervisor while 25.6% of them had either irregularly-scheduled meetings or none. While 76.1% of respondents accepted to have had at least one refresher course since working under the CDI of malaria program, 23.9% reported to have never had one. While 43.3% of the respondents found their workload okay, 8.9% of them reported they were overworked. A majority (47.8%) of the respondents reported that they found their workload as community health workers manageable. While majority of the respondents reported irregularity in the supply of both antimalarial drugs (64.6%) and RDT kits (73.5%), a majority of them said the supply of registers for records and the provision of transportation means were regular (71.7% and 69% respectively).