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

Background: Community Health Workers (CHWs) play a vital role in disease detection and response at the community level. However, their effectiveness within the Integrated Disease Surveillance and Response (IDSR) program in Cameroon is hindered by multiple barriers that remain poorly understood. Objective:This study aimed to identify key barriers faced by CHWs in engaging communities under the IDSR program in the Bali and Bamenda health districts, Northwest Region of Cameroon. It also assessed resource and training gaps, community misconceptions, and feedback and integration challenges affecting surveillance effectiveness. Methods: A cross-sectional study design was employed using both quantitative and qualitative data collection methods. A total of 288 participants were surveyed, including CHWs, healthcare workers, and community members involved in IDSR activities. Data were analyzed to evaluate frequencies, correlations, and thematic insights related to CHW engagement and system performance. Results:A majority of CHWs (86.8) reported facing barriers to effective community engagement. The most frequently cited challenges included limited resources (76.4), insufficient training (62.8), and inadequate community involvement (57.5). Only 11.7 of participants had received formal training in IDSR, and this was significantly associated with increased confidence in surveillance activities (p < 0.01). Conclusion: CHWs face substantial barriers in executing their roles within the IDSR program in Cameroon. Addressing gaps in training, resource allocation, and community integration is critical to improving surveillance effectiveness and public health outcomes. Strengthened coordination and targeted support are urgently needed to empower CHWs and enhance disease response at the grassroots level.