Clan Strategies: A Relevant Alternative for the Fight against Neglected Tropical Diseases in the Western Region of Cameroon

Objective:

This article aims to analyze the relevance of clan strategies in the fight against Neglected Tropical Diseases (NTDs) in the Western region of Cameroon. Introduction: The abrupt cessation of mass distribution of Ivermectin for onchocerciasis control, due to the suspension of international funding in Cameroon, risks prolonging or undoing efforts made since the 2000s to eliminate onchocerciasis as a public health issue. To mitigate this, a strategy referred to as the "clan strategy" has been implemented. This strategy aims to empower families to manage their health issues, which have severe consequences on vision and skin.

Methodology:

This article is based on a descriptive and analytical study with a mixed approach (quantitative and qualitative), conducted from June to August 2025 in the health districts of Foumbot, Bamendjou, and Bangourain in the Western Region of Cameroon. Data collection for the analysis of performance indicators of the program was carried out using an Excel spreadsheet for the quantitative aspect, and semi-structured interviews and Focus Group Discussions (FGDs) for the qualitative part. The study was conducted in communities where this strategy has been implemented, involving District Health Chiefs, Health Area Chiefs, clan distributors, and 81 clan members (clan leaders, community representatives), as well as household heads in the communities. The aim was to assess their knowledge, participation, and perceptions regarding NTD-related activities.

Results:

Motivational challenges faced by distributors, treatment delays, absenteeism, and refusals were reduced due to the strong community ownership of the onchocerciasis control efforts, particularly in rural areas. The post-distribution coverage survey shows that 85% of the areas were adequately covered. The implementation of the clan strategy in the mass distribution of Ivermectin for onchocerciasis control serves as a viable alternative to the cessation of international funding for NTDs in Cameroon. This strategy involves the empowerment of large families in managing public health issues.

Discussion:

The study highlights the high community acceptability of the project. The gradual reduction in treatment costs and the enhanced community ownership are expected to contribute to its sustainability. Performance indicators reveal a decrease in absenteeism and refusals due to the proximity of clan distributors who are familiar with the movements of clan members.

Conclusion:

In the context of reduced funding, the clan strategy will facilitate the continuation of mass distribution efforts to achieve the elimination of onchocerciasis as a public health problem. A progressive institutional integration of the clans, accompanied by capacity-building in communication and health leadership, is essential to achieving the WHO's NTD elimination goals by 2030.