Community engagement: a critical accelerator for onchocerciasis elimination in Cameroon

This policy brief examines how community engagement influences progress toward onchocerciasis elimination in Cameroon and assesses policy-relevant barriers affecting Community-Directed Treatment with Ivermectin (CDTI). It draws on qualitative research conducted in 32 communities across four regions, including 145 in-depth interviews and 27 focus group discussions with community members and drug distributors, health workers, and local authorities. Findings highlight persistent challenges: limited disease knowledge, fear of adverse events, alcohol-related concerns, low motivation among community drug distributors, and increasing MDA fatigue. Evidence indicates that participation improves when trust, communication, and local ownership are strengthened. The brief positions community engagement as a core elimination strategy and recommends strengthening culturally adapted communication, adverse event management, incentives for community drug distributors, surveillance feedback, and multi-level coordination to advance national elimination goals.