Politiques de santé et lutte contre le cholera au Cameroun : cas de la ville de douala (distrit de sante de deido)

Abstract

The present research is focused on the fight against cholera in Cameroon and in Douala in particular. This dissertation poses the problem of the weakening of public health policies in the fight against cholera in the Douala context. The objective was to understand the dynamics of the implementation of cholera control policies in the city of Douala. How does the experience of the fight against cholera help to understand the implementation of public health policies in Cameroon? This is the research question that served as a guideline for this study. The main hypothesis was put forward according to which the experience of the fight against cholera reveals that the more urgent public health policies previously formulated by the WHO are implemented without taking into account the socio-cultural community realities in conflict with the universal rules enacted. Two theories were mobilized, namely: the systemic approach to analyze the dynamics of the health system in the implementation of national guidelines for the fight against cholera in Douala; and the Health Belief Model (HBM), to analyze the socio-cultural determinants of the weakening of government measures to combat cholera and the persistence of epidemics in the city. The results presented were obtained from direct observations, semi-structured interviews, the administration of questionnaires, documentary research and unscheduled discussions. On the basis of a joint survey carried out among actors in the fight against cholera in the Deido Health District, communities and religious leaders, it emerges from the analysis of the results that the weakening of public health policies in the fight against cholera, is due to the persistence of socio-cultural determinants (individual perceptions and beliefs relating to cholera, unhealthy behaviors and practices of populations) proof of the failure of health socialization despite the COVID pandemic context -19. This weakening is also due to the lack of commitment of the public authorities, almost all of whose activities remain theoretical and ineffective on the ground. The promotion of the intersectoral approach to health, which engages the others public sectors, could make it possible to effectively attack the direct determinants of cholera and possibly achieve the objective of eliminating cholera in Cameroonian territory by 2030 as foreseen the Health Sector Strategy and in the WHO GTFCC roadmap for the African region.