CHWs’ and Health Personnel Perspectives in Yellow Fever Surveillance: A Qualitative Study in Two Health Districts of the Northwest Region of Cameroon

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Abstract

Background

Yellow fever remains a public health threat in Cameroon, especially in conflict-affected regions where surveillance systems face contextual challenges. Community Health Workers (CHWs) are crucial in early detection and response under the Integrated Disease Surveillance and Response (IDSR) framework. Understanding their perceptions is essential to improve performance.

Methods

This qualitative study explored CHWs’ and health personnel’s perspectives on yellow fever surveillance in two districts of Northwest Cameroon. Data were collected through seven focus group discussions and fifteen in-depth interviews. Thematic analysis followed Braun and Clarke’s framework using MAXQDA 2022.

Results

Six themes emerged: (1) mixed understanding of yellow fever among communities; (2) trust in CHWs shaped by social embeddedness; (3) emotional and professional burdens; (4) limited feedback and supervision; (5) cultural and spiritual barriers; and (6) gender-specific experiences. CHWs were central to surveillance yet often under-recognized.

Conclusions

CHWs are vital but under-supported in yellow fever surveillance. Although trusted by communities, their work is hindered by limited training, weak feedback systems, and sociocultural dynamics. Strengthening support, integrating gender-sensitive strategies, and engaging with local beliefs are necessary to improve IDSR outcomes in fragile health settings.

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