Cameroon - Communication Consultants Report

Geographical situation

• Country of Central Africa situated just above the Gulf of Guinea
• Surface: 475,000 km2, density of 3 inhabitants per km2
• Bordered on the: North by Republic of Chad, South by Republic of Congo, Gabon and Equatorial Guinea, East by CAR, Chad, and West by Nigeria.

Population

• 17,000,000 in 2004, rate of growth: 2.9%
• 46.3% live in urban zone
• More than 50% are young
• Children of 0 to 11 months = 4% (approx.)
• Children of 0 to 59 months = 18% (approx.)

Administrative situation

• Divided country in 10 administrative, sanitary provinces, subdivided in 159 districts of health 1145 sanitary formations.

Main epidemiological data:

• 1 case of AFP in Bafang in July 2004
• 1 case in Makari (extreme-North, border of Chad) in August 2004
• 1 confirmed case in Kolofata (extreme north, border with Nigéria) in October 2004
• Vaccinal coverage ratio accumulated of OPV3 (of January to August 2004) is of 70.3%; 36% of the health districts have an OPV3 coverage lower than 80%.
• The quality of the surveillance doesn't stop deteriorating in spite of decentralisation

Population-target of the National Immunisation Days (NIDs) 2004

• 3,954,460 for the OPV
• 395,446 children of 6 to 11 months, 3,163,568 children of 12 to 59 months.

Main sociological data:

• Bilingual country of 10 provinces with (8 French-speaking provinces and 2 English-speaking provinces)
• System of patriarchal traditional chiefs
• Traditional leaders, political and religious leaders all have strong influence.
• Abundance of associations and NGO, flight of the health services being a matter for the casual sector because of the economic crisis and the resulting global pauperisation.
• Diverse ethnicity, 236 ethnic groups and languages, presence of Pygmy groups
• Social and political stability

Dates of the NIDs

• First passage: Friday 19 to Tuesday November 23 2004
• Second passage: Friday 17 to Tuesday December 21, 2004.
• Processed weekends.

Strategies Adopted:

• Door-to-door
• Stationary to the tolls
• Stationary points at border crossings

List of the "Zones to high risk" and "Zones of difficult access":

• Districts having notified cases of AFP: Kousséri, Lagdo, Makary, Bafang
• Border districts with those that notify cases of AFP in Cameroon and in the neighbouring countries: Nigeria, Chad, RCA
• Districts with weak vaccine cover less than 80% during the previous editions of the NID
• Zones of difficult access: Mudemba, Polite, Mbalam, Makary, Fontem, Alati, Lagdo, insular zones of Tignère, Islands of the Chad lake, Islands of Bonassama, of Mouanko

Strategies for the "Zones to high risk" and "Zones of difficult access":

• Implication of the leaders of opinions responsible for the traditional practitioners associations
• Cartography
• Backing Supervision
• Fast investigations
• Use of the logistical means appropriated

General objective



To convince all parents of children of 0 to 5 years to make vaccinate their children counterparts the NIDs, including those of the special populations and/or difficult access.

Communication Objectives:

• All parents will have vaccinated all their children aged of 0-59 months
• All parents of the children aged of 0-59 months have been convinced of the advantages of the NIDs
• The adherence of the leaders of opinions and the communal relays in the activities of the NIDs will have been increased

Local Communication Committees

Committees were struck at all district health levels.

Weaknesses

• Not all are functional

Area Communication

Strengths

• Partnerships for communication have been developed with NGOs, associations, and traditional leaders.

Weaknesses

• The mobilisers are not always reliable and cannot provide steady commitment.

Action Points

• To reinforce the holding of the follow-up meetings and active coordination
• To organise a meeting with the Scouts/Guides, Red Cross and to involve them in the mobilisation

NGO Partnerships


Strengths

• Engagement of the leaders of the women’s NGOs (UFAC, OFCA)
• Collaboration with Scouts, Guides and Red Cross to contribute human capital to the mobilisation

Action Points

• To continue to recruitment and follow-up activities with NGO leaders: UFAC, OFCA, Scouts, Guides and Red Cross

Media

Strengths

• Communal and farming media and the national radio network and CRTV in every province have been involved
• The national television station covers nearly the whole country but is very expensive
• There has been some limited use of the traditional medias such as griots, Tom-tom, and storytellers

Weaknesses

• Total overall coverage of mass media remains relatively weak

Interpersonal Communication Module Development

(For vaccinators, supervisors, mobilizers)

Strengths

• Interpersonal communication modules have been developed for the management of the rumours, and to explain the role of social mobilisation

Decentralisation



Strengths

• Activity occurring at the district health level and a preparatory meeting has been made to the central level

Weaknesses

• Some districts have not finalised their microplan maps and cartography activities
• Social mobilisation has not been implied in all briefings
• Every district didn't elaborate its communication plan

Action Points

• To finalise the cartography activities by the 2nd week of November
• Every health district must finalise its plan before the end of October 2004

Involvement of all partners



Strengths

*Involvement of the chiefs of health centre and members of the social mobilisation boards (NGOs, associations, administrative, religious, and traditional sectors.)

Weaknesses

• Contributions and commitment are not always effective

Local Resource Usage



Strengths

• Use of local vehicles and material is foreseen

Weaknesses

• There is a weak contribution level from communities

Financial Allocation to Micro planning Activities

Contribution of the partners and the state

• Total budget: 1,469,507,386 F CFAS
• Social Mobilisation: 147,728,008 F CFAS
• Social Mobilisation GAP: 68,669,845 F CFAS
• Social Mobilisation remains the under-funded component of the campaign

External Level (Coordination between UNICEF national partners)



Strengths

• Regular meetings with the GTC-PEV, the WHO and the other partners in the setting of the CCIA
• CCIA meetings are held regularly under the presidency of the health minister

Implementation

Message Diffusion Characteristics

• Period and length of the message diffusion prior to the NIDs = 18 days, during = 5 days
• A special strategy has been put in place around the border areas with Nigeria and the 1st NID in Cameroon corresponds with the 2nd round in Nigeria

Evaluation and Monitoring

Fast Assessment System

• This activity is foreseen and some local consultants have been recruited to this effect

Budget

• The total budget for the NIDs is valued at 1,469,507,386 FCFA, but there has been a lack of contribution from local economic operators (businesses)

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