The Approach of Community-Directed Treatment with Ivermectin in the Participation of Communities in the Fight against Onchocerciasis: The Resignation of Community Distributors

Abstract

Objective: The aim of this article is to analyze the factors behind the resignation of Community Distributors. Methodology: The qualitative method was used to collect data through individual interviews and focus groups in the health districts of Kouoptamo, Foumbot and Massangam in the West region of Cameroon. Between 2020 and 2022, these interviews were conducted with Beneficiaries, Community Distributors, managers of district health services and health facilities, and also town hall managers. The data collected was analyzed using the content analysis technique and interpreted using Michel Crozier's Systemic Analysis. Results: The methodological procedures used led to a number of results, including the low or non-existent coverage of CDs, the choice of CDs, the lack of community ownership, the discrepancy between actual and official data, and the diversion and sale of medicines, the main consequence of which is the misuse of Mectizan. Furthermore, faced with a lack of support, community distributors are showing a lack of interest in distributing this product and are resigning. To alleviate this problem, health professionals are trying to replace them with health auxiliaries, nurses and trainees, who unfortunately have no knowledge of their area of activity. Conclusion: As the Community Distributor is the key to Ivermectin Treatment under the Community Directive, it is important to review its status on the scale of actors and to consider strategies for its funding in order to revitalize the CDTI strategy for the elimination of onchocerciasis.