Cameroon: Using Local Maps to Promote Community Diagnosis and Action

More than 83,000 children die each year in Cameroon from preventable illness. Lack of child health information and access to quality care hampers efforts to address the prevention and treatment of malaria, malnutrition, diarrheal disease, and pneumonia. Since 2005, Plan Cameroon (an international, humanitarian, private organization) and the MOH are implementing an USAID-funded child survival project in 11 health districts benefiting 211,473 under-five children and 481,441 women of reproductive age.

One of the important project components is to promote community action through a better identification of local problems and solutions. In this regard, the project spearheaded the use of community behavior mapping. In this approach, community members (with the assistance of project staff) drew up poster-size maps of their communities to represent all the households and landmarks. The households in these maps were then split into groups of 10 to 15 households, each group assigned to two to three community members for home visits, direct support and monitoring of healthy behaviors. The household's fulfillment of four to six healthy behaviors (i.e. handwashing with soap) were tracked on the maps by colored thumbtacks placed besides each household to show the compliance (or non-compliance) to the chosen behavior, each color representing a given behavior. For example, the house with all its members sleeping under an insecticide-treated network merited a blue thumbtack in the map. With little support from a project staff, the community volunteers consolidated all the bloc maps during monthly meetings, where data analysis, interpretation and decisions were taken in an action plan for the next month. By the third year of the project (September 2008), behavior mapping was being implemented in 762 communities. Indicators at year 3 had improved over the baseline: ITN use among under-five children was 60.7% up from 11.8%; ITN use among pregnant women was 43.2% up from 15.7%; IPT completion in pregnancy was 51.4% up from 18.5%; exclusive breastfeeding 63.1% up from 50.8% and timely care seeking behavior for suspected malaria to 51% up from 37.4%.

A simple and community-owned visual health information system can go a long way to boost community behavior change interventions in a sustainable manner leading to improved maternal and child health.