Rural development NGOs and service delivery to the very poor: An empirical analysis of a training center in rural Cameroon

Child malnutrition is an obstacle to human capital and a deprivation of capabilities. In Cameroon, malnutrition is a public health problem and rural areas suffer more from child malnutrition than the urban areas. The objective of this study is to identify the factors that explain inequality in the distribution of child malnutrition between urban and rural areas in Cameroon. The methodology used is based on the Oaxaca-Blinder decomposition. The data used is from the Demographic and Health Survey organized in 2011 by the National Institute of Statistics. Differences in endowments of children and mothers explain 75% of the weight difference of children under 5 years between urban and rural areas. We specifically find that a paid job for the mother reduces by approximately 2.56 % the differences in the weights of children of less than 5 years between urban and rural areas. Also, the education of the mother reduces the difference in weight between the rural and urban children by 2.44% for primary education, 5.48% for secondary education and 3.54% for higher education. Lastly, the difference in weight between the children of rural and urban areas increases when the households are poor. The reduction inequalities of child malnutrition between urban and rural areas in Cameroon thus passes through the improvement of the education of the mother, the strengthening of the economic capacities of women in rural areas and the improvement of the living conditions of rural households.

Knowledge, attitude, and practice (KAP) studies have recently been suggested as a useful tool to understand the specificity of the population related to a disease. However, in Cameroon, there is a lack of information based on KAP studies regarding obesity. This study has been designed to collect basic indicators on the KAP of the populations regarding overweight and obesity in urban and rural areas in Cameroon (Douala and Manjo). For this purpose, an epidemiological community-based cross-sectional descriptive study was conducted in these two areas using a well-structured questionnaire. Sociodemographic and medical characteristics and KAP information were assessed. For the quantification of KAP, a score varying from 0 (poor knowledge, attitude, or practices) to 100 (good knowledge, attitude, or practices) was attributed for each question. Correlations between knowledge, attitude, and practice were determined using inferential statistics tests which were χ2 test, independent Student t-test, ANOVA (followed by Tukey's post hoc test), and Pearson correlation coefficient. Results reveal that living in a rural area (Manjo), being overweight or obese, having complete secondary education, and being married increase the knowledge and the practice score. There is a strong and positive correlation between knowledge and practice score. However, there is no association between attitude and practice and between attitude and knowledge. Reducing the disparities between knowledge, attitude, and practices constitutes a serious track in a holistic strategy for the management of obesity in these areas.

Background: Child malnutrition is highest in Sub-Saharan Africa. Over 45% of children in Cameroon die each year from malnutrition-related causes, most of which are preventable. Exclusive breastfeeding is a well-acknowledged and cost-effective intervention against malnutrition-related illnesses in children. However, the practice remains low in Cameroon. This study explored perceptions of mothers, care givers and key informants on infant feeding in Cameroon, and barriers to exclusive breastfeeding. Methods: A qualitative methodology was used, comprising key informant interviews and focus group discussions with nursing mothers, grandmothers and health workers; in one urban and one rural area in Cameroon. Participants were selected using convenience, purposive and snowball sampling methods. Data were analysed using thematic analysis. Results: Cameroonian mothers were supportive of breastfeeding. However, knowledge of exclusive breastfeeding and its benefits was poor. Mothers expressed doubts about its feasibility and showed concerns about satisfying their babies’ feeding and health needs. Barriers included factors which either affected women’s abilities to breastfeed or their babies’ satisfaction, family influences, other responsibilities, cultural and societal factors, and lack of support from the healthcare system. Conclusions: This study highlighted a sizeable gap between mothers’ lived experiences and infant feeding recommendations. Living in rural areas was an added disadvantage. Developing effective strategies to increase exclusive breastfeeding rates requires that mothers’ needs be understood and that influencing factors be addressed. Supportive environments are also required to promote and protect the rights and abilities of mothers to breastfeed exclusively.

Malnutrition greatly increases the risk of infant mortality and vulnerability to various diseases later in the long run. It has been shown that children's malnutrition is the result of low household income. Rural areas in Cameroon are mainly made up of poor families. This guided the present research to analyze some socioeconomic factors and their impact on the nutritional status of pupils. Using a simple random sampling technique, 300 pupils were recruited. About 66.33% of pupils were from poor families. Obesity was more prevalent in the category of rich pupils (09.52%) compared to poor (06.53%). The height and weight of pupils studied were lower than the reference (P < 0.001). This study carried out in a single council is proven to be limited for a better understanding of the epidemiology of malnutrition among students, and large-scale studies would be adequate to better prevent and control malnutrition in rural areas.

The paper reports on an investigation of factors militating against adherence to highly active anti-retroviral therapy in a rural area in Cameroon: A pre-tested interviewer-administered questionnaire was administered to 108 HIV positive patients on treatment with antiretrovirals. Adherence was evaluated on the following drug combinations Nevirapine /Lamivudine/ Stavudine (Triomune); Efavirenz/Lamivudine/ Zidovudine and Indinavir/ Lamivudine /Stavudine. The correlation of factors like income, educational level, age, gender, medication type and adherence was evaluated. The effect of ascertained factors such as drug type, finance, medication side effects, forgetting to take medication, difficulty in fitting drug schedule with daily activities, shame to get refills and level of conviction on efficacy of drug on adherence are discussed herein. (Key Words: HIV/AIDS, Treatment, Anti-retroviral, Adherence. Sahel Medical Journal Vol.7(4) 2004: 119-124

OBJECTIVETo determine the main clinical indications for surgical removal of the eye in rural areas in Cameroon.DESIGNRetrospective non-comparative case series.PARTICIPANTSA total of 253 patients presenting to the Manna eye clinic Nkongsamba who underwent destructive eye surgery (DES) between January 2006 and December 2010 were reviewed.MAIN OUTCOME MEASUREAge, gender, occupation, prior medication, visual acuity, operation indications, and type of operation.RESULTSThere were 58.10% (n = 147) men and 41.90% (n = 106) women. Median age was 29 years (interquartile range: 14–69 years); age ranged from 10 to 88 years. A total of 67.19% (n = 170) of participants were farmers and lived in rural zones. In all, 79.05% (n = 200) confessed to have trying a medication before the presentation. Surgical indications included infective causes (perforated corneal ulcer 33.20% (n = 84) and endophthalmitis 18.20% (n = 46)), trauma 17.40% (n = 44), painful blind eyes 11.50% (n = 29), malignancy 10.70% (n = 27), and others 9.10% (n = 23).CONCLUSIONThe most common causes of DES in this series could be avoided. Therefore, preventive measures including extensive health education of the public and traditional healers on the risks linked to the use of traditional medicines in ophthalmology and the late presentation of eye disease, quality control of the campaigns that offer free cataract operations in the country.

This study examines the variations in household violence and maternal autonomy in rural and urban areas and their effect on child health in Cameroon. Using data from Cameron Demographic Health Survey (CDHS, 2018), a mixed-method approach (Ordinary Lease Square Regression and the Oaxaca-Blinder decomposition method) was used for the analysis. The study found that household violence had an insignificant negative effect on child health while maternal autonomy exhibited a very significant positive effect on child health globally, in rural and in urban areas in Cameroon. Also, the rates of household violence and maternal autonomy are significantly higher in urban areas than in rural areas in Cameroon. Policy recommendations includes raising awareness, providing educational and economic opportunities for women, improving health care services and strengthening legal framework to combat violence while strengthening maternal autonomy through educational and economic initiatives which improves their own and child health in both rural and urban settings in Cameroon.

A Comparison of Assertive Community Treatment and Intensive Case Management for Patients in Rural Areas

This paper analyzes the determinants of income and the urban-rural income gap to highlight the urban-rural inequality problem in Cameroon. It concurrently uses the OLS regression, the conditional quantile regression as well as the Blinder-Oaxaca decomposition techniques to achieve this objective. The findings of OLS estimations show that human resources and social as well as physical capital play a major role in the improvement of welfare. Household size reduces the consumption expenditures both in rural and urban areas. The regions where the households reside also affect consumption expenditures. Household heads who work in the services sector and trade are better-off than those working in the other sectors of the economy. However, quantile regressions results show that households headed by the old people enjoy a higher level of welfare in the upper quintiles of the distribution of consumption. Household heads who work in the industrial sector have a negative relationship with consumption at the 10th quintile of the distribution of household expenditures in the urban area. In the rural area, household heads working in the services sector have a positive relationship with consumption only at the 50th and 90th percentiles of the distribution of expenditures, whereas those belonging to the 10th quintile have a negative relationship with consumption. In the rural area, the average time span spent to reach an asphalted road has a stronger positive impact on the consumption of households belonging to the 90th percentile of the distribution of expenditures. Being a member of an association has a significant positive effect only on the consumption of households belonging to the 10th quintile of the expenditures distribution. The study results derived with the help of the Oaxaca-Blinder decomposition method show that 59 percent of the welfare gap between urban and rural areas may be explained by differences in the characteristics, and most particularly in physical assets and education. The remaining 41 percent of the welfare gap is explained by discrimination.

Solutions for rural Mental Health Services.

The western China, especially near the Wenchuan region witnessed a terrible earthquake in the year 2008, which led to some severe damage in the country. Several interviews and studies are conducted to explain the impact of this Sichuan earthquake on the development of the various grass-root associations present in the country.

In Cameroon, the 1980s were marked by the economic crisis (falling export revenues) with the direct consequences of unemployment. Thus many were retrenched from the public service, private companies and graduated students engaged in small- income generating activities which later became small businesses. It is in this context that the village palm grove started to bloom as an economic branch and contributes remarkably to the development of business activities in rural areas in Cameroon. Despite, the poorly organized activities small-scale producers deserve a framework that will allow a diffusion of entrepreneurial spirit that will promote the development of rural areas and economic development as well. This article shows how villagers in Cameroon deal with entrepreneurship activities in agricultural business, especially in the business of palm oil. The article aims at introducing the palm grove activity branch as an elevator of entrepreneurship in rural areas; it stresses the characteristics of entrepreneurial actors in this branch of activity, the motivations of small-scale producers towards the production of palm oil and the challenges of the palm grove activity branch. This study show how the business of palm oil is source of main income and contributes to the social welfare of small-scale producers.

Along with the process of urbanization in China, the country has clearly put forward The National New-Style Urbanization Plan to promote the integration of urban and rural development, allow all of the people living in rural areas to participate in China’s modernization and share the achievements of development. Meanwhile, the country has launched lots of policies to promote rural stability, agricultural development and farmers’ income. In 2013, China launched the Beautiful Countryside program to strengthen rural ecology, environmental protection and comprehensive improvement, and strive to build a beautiful countryside. This policy is quite flexible and involves more than aesthetics. It can support rural infrastructure construction, industrial and economic development, improvement of living environments, social and cultural development, and protection of natural, historical, and cultural resources as well as beautification projects. In accordance with the policy requirements, all provinces in China have worked out the implementation plans. Guizhou province is located in South Central China, most of the province’s land (92.5%) consists of mountains and hills, water resources are limited. As a poor province, Guizhou has proposed many policies to promote the development of rural areas over the years, and some of them have made great impact. In 2013, the Provincial Government issued a policy document titled “Promote the Development of The Countryside and Build a Beautiful Countryside—Six Point Action Plan Program for Rural Infrastructure”, which emphasizes improving living conditions in rural areas by promoting roads, drinking water and irrigation, electricity, telecommunications, housing, and the environment. This paper will study the policy and focus on the formulation of the policy implementation and management. The research group at Shanghai Tongji Urban Planning & Design Institute’s China Rural Planning and Construction Research Center launched an investigation of the implementation of Guizhou’s Six Point Action Plan in 2015, they conducted an investigation of the planning and implementation process in 10 administrative villages representative of the variety of villages in Guizhou Province, and obtained a set of comprehensive data. On this basis, this paper firstly introduces the policy objectives and the key projects. Then, it introduces the governance and plan implementation in detail. In the end, the paper summarizes the experience of policy implementation, including breaking down and refining policy goals, paying attention to organization and project management, involving civil society and individuals in projects, providing multiple funding channels, promoting citizen participation and so on.

ObjectiveAdolescent pregnancies are high risk and deliveries in this age group are usually associated with adverse outcomes. The perception that multiparous adolescents have better delivery outcomes than primiparous counterparts is not uncommon. We sought to determine if multiparous adolescents were precluded from having adverse delivery outcomes when compared to primiparous adolescents. The data used for the analysis is a side product from a published project aimed at mapping the epidemiology of adolescent deliveries in the Oku health district.ResultsFrom an 8-year (2009–2016) retrospective register analysis of data from two primary healthcare facilities in the Oku health district—a rural area in Cameroon, the prevalence of multiparous adolescent deliveries was 21.5% (78/363). After multivariable analyses, and adjusting for age, sex of baby, gestational age, marital status and HIV status, primiparous adolescents were more likely to have low birth weight infants (LBW) (OR: 3.2; 95% CI 1.1, 9.7; p = 0.04) when compared with multiparous adolescents. Though primiparous adolescents were more likely to have LBW infants than multiparous adolescents, this group of mothers are generally ill-equipped to handle pregnancies and adolescent-friendly programs are necessary to decrease the associated burden.

The COVID-19 pandemic rapidly evolved in December 2019 and to prevent its spread, effective vaccines were produced and made available to the population. Despite their availability so far in Cameroon, the vaccination coverage remains low. This study aimed at describing the epidemiology of the acceptance of vaccines against COVID-19 in some urban and rural areas of Cameroon. A cross-sectional, descriptive and analytical survey was conducted from March 2021 to August 2021 targeting unvaccinated individuals from urban and rural area. After receiving appropriate administrative authorizations and an ethical clearance from the Institutional Review Board (or Ethics Committee) of Douala University (N° 3070CEI-Udo/05/2022/M), a cluster sampling at many degrees was performed and a language-adapted questionnaire was completed by each consenting participant. Data were analyzed using Epi info version 7.2.2.6 software and for p-values < 0.05, the difference was considered as statistically significant. Out of 1053 individuals, 58.02% (611/1053) participants were residing in urban and 41.98% (442/1053) in rural areas. Good knowledge relative to COVID-19 was significantly higher in urban areas as compared to rural areas (97.55% vs. 85.07, p < 0.000). The proportion of respondents who intended to accept the anti COVID-19 vaccine was significantly higher in urban areas than rural areas (42.55% vs. 33.26, p = 0.0047). Conversely, the proportion of anti COVID-19 reluctant respondents thinking that the vaccine can induce a disease was significantly higher in rural areas than urban areas (54 (35.07 vs. 8.84, p < 0.0001). The significant determinants of anti-COVID-19 acceptance were the level of education (p = 0.0001) and profession in the rural areas (p ≤ 0.0001), and only the profession (p = 0.0046) in the urban areas. This study globally showed that anti-COVID-19 vaccination remains a major challenge in urban as well as rural areas in Cameroon. We should continue sensitizing and educating the population about vaccine importance in preventing the COVID-19 spread.