Community Investigators on Health Care Delivery Holds in Bonaberi

By James Achanyi Fontem, camlinknews

The Health District of Bonassama was the focus of a two-day workshop on the investigation of the level of quality health care within the different health areas of the district. The workshop took place on November 16 and 17, 2018 grouping some 72 participants chosen from 18 Local Community Associations. The training was facilitated by Nkeng Eric and Ngouh Emannuel from the Agency for Contractualisation and Verification (ACV) The agency is involved in financing based on performance. The participants were later sent to the different health areas to conduct a survey and meet patients selected who hasd received treatment in the health facilities who signed contracts with the Agency of Contractualisation and Verification (ACV°. The contracts signed were financing based on performance. The ministry of public health encourages proximity health at low cost and these facilities are paid motivation allowances every three months after a survey. The activity is coordinated by the Regional Fund for the Promotion of Health. During the investigation, the local associations verify the data produced by the health facilities through comparative analysis of the declarations made by the patients treated. The level of satisfaction of the health care delivered to the patient from the bebnficiary populations is compared with the policy for health care put in place by the Cameroon government. This aims at getting the community to appropriate the services received as a means of encouraging quality and quantitative health care for all. Addressing the issue of the project site and target groups, the facilitator Nkeng said the activity is conducted quarterly in 16 Health Districts of Littoral region, notably: Cite des Palmiers, Bangue, Edea, Loum, Njombe-Penja, Yabassi, Nylon, Deido, Nkongsamba, Mbanga, Manjo, Boko, Bonassama, Japom, Logbaba and New Bell.

The target group zre payients declared to have been received in health facilities in the above districts. During a period of three months. Following the community investigation by the Agency for Financing based on performance ‘ACV) The task of the investigator resides on visiting the homes of patients declared to have been trearted in the health facilities. The result is to find out whether the patient really exists and received treatment as declared by the health facilities. THE INVESTIGATION IS CARRIED OUT WITH A QUESTIONNAIRE INDICATING THE FACILITY visited, the period, the reason for the visit, health test test done in the facility and whether the staff was welcoming. The time spent in the health facility, the drugs available and the cost of health care are registered. For reasons of transparency the patient indicates who received payment for the care in the facility. The patient closes the questionnaire by expressing his opinion on areas that need to be improved. PARTICIPANTS WERE DURING THE TRAINING GUIDED ON THE TECHNIQUE CONDUCTING INTERVIEWS? TH QUALITIES OF A GOOD INVESTIGATOR? WHICH INCLUDE SOCIALIBILTY;

30ème journée mondiale contre le Sida

Par camlinknews

30ème journée mondiale contre le Sida; déjà 16 ans que Synergies Africaines mène le combat Novembre est le mois camerounais contre le Sida : l’appui de Synergies Africaines aux associations et établissements scolaires a été au centre des évènements du mois. SYNERGIES AFRICAINES a offert du matériel de sensibilisation à une centaine d’associations et établissements scolaires au cours d’une cérémonie présidée par M. Jean Stéphane BIATCHA, Secrétaire Exécutif de l’ONG Panafricaine, le mercredi 14 novembre 2018. Cette cérémonie s’inscrit dans le cadre d’une série d’activités que SYNERGIES AFRICAINES organise dans le cadre de la 3ème édition du Mois Camerounais contre le Sida.

Proven Benefits and Uses of Tea Tree Oil (Melaleuca Oil) – Science Based

By Jenny Hills, Nutritionist and Medical Writer

Tea tree oil has been used for centuries due to its amazing medicinal and therapeutic properties. The antimicrobial compounds in tea tree oil have many uses and benefits. You can use tea tree oil to cure fungal infections, help cuts to heal quickly, get rid of dandruff, and treat nail infections. To use tea tree oil on your skin, scalp, or feet, you can add it to a carrier oil and apply to your body. On small areas of skin, tea tree oil can be used as a spot treatment on acne pimples or to disinfect small cuts. You can even add a few drops of tea tree oil to your shampoo if you want to use tea tree oil to soothe an itchy scalp. In this article, you will learn about the many uses of tea tree oil and why it is one of the best antimicrobial essential oils you can use. At the end of the article, you can find out about precautions to take when using tea tree oil for medicinal purposes. What is Tea Tree Oil (Melaleuca Oil) and Where It Comes From Tea tree oil (also called “melaleuca oil”) comes from extracting oil from the leaves of the tree Melaleuca alternifolia that grows in Australia. The tea tree plant looks like a tall shrub but can grow into a moderate sized tree. The journal Clinical Microbiology Reviews reports that tea tree oil contains a number of medicinal compounds. The most prominent antimicrobial compound in tea tree oil is terpinen-4-ol. To use tea tree oil for its therapeutic benefits, tea tree oil should contain at least 30% terpinen-4-ol. (1) According to research published in 2018, recent scientific studies have confirmed many of the medicinal uses and benefits of tea tree oil. Research has shown that tea tree oil can be used for its antibacterial, antifungal, antiviral, and antioxidant properties. (2) Some scientists have found that tea tree oil is even powerful enough to be effective against many drug-resistant strains of fungi and bacteria. (1, 3) What is Tea Tree Oil Good For? The powerful healing compounds of tea tree oil mean that it is useful in addressing a number of health concerns. As well as containing terpinen-4-ol, researchers have identified a number of other beneficial chemicals in tea tree oil. These include 1,8 cineole, limonene, linalool, and terpineol. How can you use tea tree oil to treat many ailments? Because tea tree oil is antifungal and antibacterial (4), tea tree oil is good for treating acne pimples, nail fungus, itchy skin, and dandruff. Tea tree oil is also an effective antiseptic solution that has uses and benefits for treating cuts, healing wounds, and reducing skin inflammation. You can also add tea tree oil to natural anti-deodorants to prevent underarm odor. The Benefits of Using Tea Tree Oil Let’s look in more detail about the many benefits and uses of tea tree oil if you want to help keep your skin free from germs, bacteria, and microbes. Tea Tree Oil Is Good for Fighting Acne You can use tea tree oil to eliminate blackheads, inflamed pimples, and bacteria from skin that can cause acne. A scientific study on the uses of tea tree oil found that 5% tea tree oil cream was just as effective as benzoyl peroxide in reducing the number of acne pimples. The benefit of using tea tree oil was that there were fewer side effects. (5) Benzoyl peroxide is a pharmaceutical cream used in the treatment of acne but can cause itching, burning, or swelling. (6) Research from Australia in 2017 found that tea tree oil gel and tea tree oil face wash can be used to treat mild to moderate acne. Over a 12-week period, the anti-acne tea tree oil remedies helped to reduce the number of lesions. (7) How to use tea tree oil for acne: To make a natural facial cleanser with tea tree oil, mix 1 part tea tree oil to 9 parts water. Shake well and with a cotton ball, apply the tea tree oil solution to your acne-prone skin. Leave for 15 minutes before rinsing off. Another option is to dilute 3-4 drops of tea tree oil in a tablespoon of carrier oil of your choice and apply to the affected skin. If you have just one or two pimples on your face, you can apply undiluted tea tree oil to the spot using a cotton swab. Find out more information and suggestions on how to use tea tree oil for treating acne outbreaks and how to use it in homemade acne face masks. Tea Tree Oil Helps to Disinfect Cuts and Grazes The antiseptic compounds in melaleuca oil mean that tea tree oil can be used to remove germs from minor skin wounds. A 2017 review of essential oils that promote skin health found that terpinen-4-ol in tea tree oil can be used as an antiseptic. Applying a 5% solution of tea tree oil and water helped to kill off bacteria and other microbes that could potentially infect the cut. (8) Other studies have found that tea tree oil is an antibacterial agent that can kill off methicillin-resistant Staphylococcus aureus strains of bacteria. These bacteria are often responsible for skin infections. (9) How to use tea tree oil to disinfect minor cuts: First, thoroughly clean the affected area with warm water and soap. Mix one or two drops of tea tree oil with a teaspoon of coconut oil or other carrier oil. Apply to your cut and cover with a bandage. Change the bandage daily, applying more tea tree oil disinfectant ointment each time. Tea Tree Oil Promotes Healthy Wound Healing Another use for tea tree oil is to apply some drops of tea tree oil to a wound dressing to help wounds heal quicker. Tea tree oil helps to overcome one of the obstacles of treating wounds successfully – microbial resistance to standard antibiotic treatments. Studies into the benefits of tea tree oil have found that tea tree oil is an effective remedy for treating wounds. Clinical trials have shown that tea tree oil can kill off strains of Staphylococcus aureus bacteria. Tea tree oil has proven efficacy against methicillin-resistant and methicillin-sensitive strains of bacteria. (10) One small study showed that adding tea tree oil to a wound dressing helps wounds heal quicker than traditional methods. (11) Using tea tree oil for wound healing: Put 2 or 3 drops on the dressing allow to soak into the dressing. Apply the dressing to the wound with the tea tree oil side against the damaged skin tissue. Add some drops of tea tree oil every time you change the dressing to help prevent infection. Learn about other natural remedies you can use to help wounds heal faster. Tea Tree Oil Is Useful for Psoriasis and Other Inflammatory Skin Conditions The anti-inflammatory properties of tea tree oil mean that it is useful for treating a number of skin conditions, including psoriasis. Research into the uses and benefits of tea tree oil has found that its terpinen-4-ol helps to reduce skin inflammation. Scientists found that this has a potential use in treating psoriasis symptoms such as inflamed red skin patches, scaling, and cracked dry skin. (12) The fact that tea tree oil is antibacterial also helps prevent secondary skin infections from developing. (12) Some evidence also points to the fact that skin treatments containing tea tree oil can help to treat contact dermatitis. In fact, tea tree oil was more effective than zinc oxide when treating eczema. Zinc oxide is a popular anti-eczema cream. (13) There are also other scientific studies showing that tea tree oil can help reduce skin inflammation that is due to allergic reactions. In the study, scientists used 100% tea tree oil on the inflamed skin to reduce swelling and redness. (14) You can also use tea tree oil for treating sunburn, rashes, burns, insect bites, and blisters. (15) Use tea tree oil for dermatitis and psoriasis: To help reduce skin inflammation, add 3 or 4 drops of tea tree oil to a tablespoon of extra virgin oil. Mix well and apply to your patches of inflamed skin 2 times a day to reduce redness, itchiness, dry skin, and swelling. You can use the same tea tree oil remedy to help treat other types of skin inflammation. Before using tea tree oil for treating skin inflammation, do a small patch test first as tea tree oil can cause skin irritation in some people. (16) Further reading: Find other natural treatments for eczema, or if you suffer from psoriasis try these natural remedies. Tea Tree Oil Treat Fungal Skin Infections Tea tree oil is also very useful to help treat infections such as ringworm, jock itch, and other types of fungal infections on the skin. Fungal skin infections are characterized by patches of red itchy skin around the genitals, in the armpits, or in between your toes. (17) The European Medicines Agency reports that melaleuca oil is an effective natural treatment for fungal infections. For example, tea tree oil is a good remedy to use for tinea cruris (jock itch). (18) You can also benefit from using tea tree oil if you have ringworm. Dermatophytes are a type of mold that results in ringworm infections. The journal Phytomedicine reported that a solution of 25% tea tree oil and sweet almond oil helped to reduce symptoms of ringworm. (19) Another study found that, in a 4-week period, tea tree oil helped to cure ringworm infections in over 60% of persons using the natural antifungal cream. (20) Use tea tree oil as an anti-fungal cream: Add 3-4 drops of tea tree oil to one tablespoon of virgin coconut oil or extra virgin olive oil (or other carrier oil) and apply to the affected skin areas twice a day until the fungal infection clears. Learn about other natural ingredients that you can use to rid yourself of itchy, fungal skin problems, including ringworm and jock itch. Tea Tree Oil is Useful for Treating Scabies and Mites Scabies is a contagious skin disease caused by tiny mites that bury under your skin. The anti-parasitic and antibacterial properties of tea tree oil make it a great natural remedy to use for scabies. The American Journal of Tropical Medicine and Hygiene reports that tea tree oil helps kill off mites as well as to reduce itching, inflammation, and infection. Tea tree oil can even be used when conventional scabies treatments don’t work. (21) Some studies have shown that a 10% solution of tea tree oil can kill 100% of dust mites. Also, undiluted tea tree oil was effective at eliminating face mites. (21) How to use tea tree oil for killing mites: Mix 3 drops tea tree oil, 3 drops lavender oil, and 5 drops neem oil with one tablespoon of carrier oil such as virgin coconut oil. Apply the tea tree oil anti-parasitic remedy to your affected skin 2 times a day until the scabies infection has gone. Find out more about the anti-parasite activity of neem oil and how you can use it to treat all types of mite bites naturally. Tea Tree Oil is Antiviral and Can Help Cure Cold Sores (Fever Blisters) You can even use a drop or two of tea tree oil on symptoms of the herpes simplex virus type 1 (HSV-1). The HSV-1 is responsible for painful cold sore outbreaks on your lips, under your nose, and inside your mouth. Researchers have found that the antiviral properties of tea tree oil can be used to eliminate herpes viruses. A 50% solution of tea tree oil was enough to help cure cold sores and prevent further outbreaks. (22) Practical way to use tea tree oil for fever blisters: Mix 3 drops of tea tree oil with a tablespoon of carrier oil. Apply at the first sign of a cold sore and use 3 or 4 times a day to prevent or get rid of your cold sore. Tea Tree Oil is Antifungal and Treats the Causes of Athlete’s Foot Another great use for tea tree oil is to eradicate the fungal infection that causes athlete’s foot. Athlete’s foot (tinea pedis) causes itching, broken skin, and a burning sensation between your toes. The infection can spread to other parts of your feet and to other people. Research has shown that a 10% solution of tea tree oil is as effective as antifungal pharmaceuticals in eliminating athlete’s foot. (23) How to use tea tree oil for athlete’s foot: Put a few drops of sweet almond oil or other carrier oil on a cotton ball and add 2 drops of tea tree oil. Apply the antifungal tea tree remedy to relieve itching, burning, and inflammation between your toes. Use Tea Tree Oil to Combat Fungal Nail Infections Fungal infections in your feet can also cause dry, thick, and flaky nails that are systematic of a nail fungal infection. One of the many popular uses and benefits of pure tea tree oil is to cure fungal infections that attack the bed of your nail (onychomycosis). Scientific research has shown that tea tree oil can be just as effective as antifungal creams in clearing nail infections. One study found that undiluted tea tree oil was just as good at treating onychomycosis as clotrimazole (a popular antifungal treatment for nail fungus). After 6 months of treatment, 60% of patients in both groups showed significant signs of improvement. (24) How to use pure tea tree oil for fungal nail infections: Cut away as much of the damaged nail as possible. Using a cotton swab containing a few drops of undiluted tea tree oil, apply the oil to the infected nails. Continue applying twice a day until the nail infection is completely resolved. Further reading: Try these other natural treatments for toenail fungus. Tea Tree Oil Helps Get Rid of Dandruff and an Itchy Scalp If you are bothered by flaky bits of skin in your hair due to dandruff or a dry scalp, you can use some tea tree oil to the underlying cause of your symptoms. Dandruff and scalp itching are often the result of a fungal infection in your scalp. Dermatologists have found that applying a tea tree solution to your scalp regularly can help to treat dandruff. One study found that 40% of people using an antifungal shampoo with tea tree oil showed significant improvements. (25) Tea tree oil helped to soothe scalp itching, reduce scalp flaking, and improve the appearance of oily hair. (25) How to use tea tree oil for dandruff: Add 8-10 drops of tea tree oil for every 1 oz. (30 ml) of shampoo. Use as normal shampoo but leave the shampoo for 5 minutes in your hair before rinsing out to make sure and kill off fungal strains on your scalp Tea Tree Oil to Eliminate Head Lice In my article about effective home remedies for lice I’ve mentioned tea tree oil as one of the effective natural ingredients to eliminate head lice. A study published in the journal BioMed Central Dermatology found that a mixture of tea tree oil and lavender oil killed 97% of lice when applied 3 times a week and was more effective than pyrethrins-based products. (30) Coconut oil has also been shown to be effective in treating lice. (31) To use tea tree oil to treat lice, you should mix 15 drops of tea tree oil and 5 drops of lavender oil with 2 oz. of carrier oil such as coconut oil. Apply to the scalp and hair, avoiding the face and eyes. Put the hair in a shower cap and then wrap with a towel and leave for an hour. Comb through all the hair with a nit comb and wash the hair to remove all the oil. Repeat this 3 times a week. Remember that it is always important to use a lice comb to remove all the lice. You can also eliminate head lice using this simple home remedy. Tea Tree Oil for Healthy Hair There have been some claims that tea tree oil can aid hair growth. Although there haven’t been any studies which conclusively prove that tea tree oil can help hair regrow, there is an evidence from research to show that it promotes the growth of healthy hair. For example, some hair loss can be the result of hair follicles becoming clogged or inflamed or because other scalp inflammation. An interesting study from 2013 into tea tree oil and hair loss showed that it can help traditional hair re-growth remedies work more effectively. In the study, tea tree oil was mixed with minoxidil, which is a drug used to promote hair regrowth, and an anti-inflammatory drug called diclofenac. It was found that the combination of tea tree oil, diclofenac, and minoxidil was far more effective than just minoxidil alone. (31) Find out more interesting ways you can use tea tree oil as a natural hair conditioner and in hair masks in my article “Tea Tree Oil for Hair and Scalp – The Complete Guide“. Tea Tree Oil is Antibacterial and You Can Use it as a Natural Deodorant Due to its powerful antibacterial properties, tea tree oil can also be used as a natural and safe deodorant to kill off armpit odor. Find out how to incorporate tea tree oil with other natural ingredients to create your own underarm deodorant. Tea Tree Oil Can Kill Off Vaginal Yeast Infections The powerful antifungal properties of Melaleuca alternifolia mean that tea tree oil is excellent to use for genital yeast infections. Research published in 2015 found that tea tree oil can help to eliminate many strains of Candida albicans. The study found that tea tree oil’s antifungal compound terpinen-4-ol boosted the effectiveness of conventional candidiasis treatments such as fluconazole. (26) Another study found that tea tree oil vaginal suppositories helped to kill off 20 strains of Candida species that are common in vaginal yeast infections. (27) How to use tea tree oil for candidiasis: Add 2 or 3 drops of tea tree oil to a tablespoon of warmed coconut oil (so that it is in liquid form) and mix well. Soak a tampon in the tea tree oil remedy and insert into your vagina for 2 hours to help kill off the Candida infection naturally. Learn how to spot signs if you have a candida infection and find out other effective home remedies for candidiasis. Tea Tree Oil Inhalation for Sinusitis, Colds and Coughs The anti-inflammatory effect of tea tree oil can help to reduce swelling, irritation, and mucus in your sinuses. Tea tree oil also has natural antiseptic properties that can also kill off germs that cause your sinuses to become inflamed and swollen. The journal Clinical Microbiology Reviews reported that tea tree oil is a natural remedy for many inflammatory conditions caused by infections. Compounds in tea tree oil have been used to treat coughs and colds. The review stated that vaporized tea tree oil can kill off various Strep. strains of bacteria when inhaled. (32). Tea tree oil can be added to most home remedies for sinusitis to boost the antimicrobial effect of other essential oils. To use steam inhalation for sinus relief and get rid of congestion, this is what you can do: Fill a bowl with hot water and add 5 drops of eucalyptus oil, 5 drops of tea tree oil, and 5 drops of any other essential oil from the list of the top 10 essential oils for sinus infections such as peppermint oil, rosemary oil or oregano oil. Put your head over the bowl, cover it with a towel and breathe deeply. Continue breathing deeply for 10 – 15 minutes to help relieve sinus congestion. Where to Buy Tea Tree Oil To get the many benefits of using tea tree oil, it is important to choose the best quality product. You should always ensure that any tea tree oil you use is 100% pure tea tree essential oil. This means that it hasn’t been diluted with less-inferior oils. Make sure that the only ingredient listed is Melaleuca alternifolia. It also always best to purchase organic tea tree oil to guarantee that you get a high-quality product without any risk of pesticides or other toxins. You can buy tea tree oil in many supermarkets, pharmacies, health stores or online. Side Effects and Precautions of Using Tea Tree Oil Tea tree oil is used by many people and is well tolerated. Doctors from the Mayo Clinic reports that using tea tree oil topically is generally safe and good for treating skin infections. (28) However, you should never ingest tea tree oil as it is toxic when swallowed. Before applying tea tree oil to your skin, you should dilute it with a carrier oil to prevent skin irritation. If your skin shows any kind of allergic reaction to tea tree oil such as irritation, a rash, or burning, you should avoid using it or dilute it with more carrier oil. If you are interested to learn more about essential oils you can find useful information in my e-book Magical Aromatherapy. This e-book will help you to discover the power of essential oils and the most effective ways to use them. Other Home Uses for Tea Tree Oil Air Freshener Add a few drops to your diffuser and diffuse throughout the day, or soak cotton balls in tea tree oil and keep them stored in an open container to freshen the air. You can also create tea tree oil spray and spray around the house. Just fill an 8oz spray bottle with 15-20 drops of essential oils such as tea tree, lavender, lemon, rosemary or eucalyptus. Shake well and mist around your home. Find more ways to make your home smell fantastic with essential oils in this article. Carpet cleaning You can put a few drops of tea tree oil on the vacuum cleaner bag or filter for extra cleaning power and for additional great scent. Flea collar for dogs Make a flea collar by putting a few drops of diluted tea tree oil on the dog’s collar on a weekly basis. There are several caution notes you must be aware of: Never use essential oils on cats. If you decide to put tea tree oil on your dog’s collar, always use lower concentration oil (1% or less) and always dilute it with a carrier oil. Use very small amount on the collar, and don’t use it directly on the skin. Find here more ways to get rid of fleas from your home, garden and pets. Household Cleaning Tea tree oil can be added to your own homemade cleaners to get rid of germs and to sanitize surfaces. You can make a tea tree cleaner by mixing two teaspoons of tea tree oil with two cups of water in a spray bottle. Shake vigorously to mix it up and use for household cleaning. This solution works especially well in bathrooms and toilets. Tea tree oil is just one effective alternative to bleach to help disinfect surfaces in your home. Insect Repellent Add 15 drops of tea tree oil to 1/2 cup of water, shake well and spray over the body as an insect repellent. Mildew and Mold Remover Combine two teaspoons of tea tree oil with two cups of water to create an all-purpose cleaner to treat mold and mildew. Shake bottle well before use. Spray on the affected surface and let it dry. Don’t rinse. Pest Control Household bugs, such as ants and spiders don’t like tea tree oil, so putting several drops or spraying tea tree oil spray at the doorway can act as a deterrent. Combine water and oil to create a solution which can be used to clean cupboards and keep pests away. Related articles: How to Use Tea Tree Oil for Acne: The Ultimate Guide Tea Tree Oil for Hair and Scalp – The Complete Guide The Best 17 Essential Oils for Acne (Backed by Scientific Research)

CAMLINK ENGAGE DANS LE CADRE DE LA MISE EN ŒUVRE DES ISDC AU CAMEROUN

Par calinknews

Cameroon Link a démarré les activités dans le cadre du projet ISDC/NFM2. Elle est a sa quatrième année avec les communautes rurale du district de santé d'ABO après avoir passe trois ans dans le district de sante de Dibombari, dans la region du Littoral du Cameroun.Avec l'appui d'IRESCO? CAMEROON lINK FAIT ACTIVITES SUR L4INFORMATION? EDUCATION ET COMMUNICATION DANS LE DISTRICT DE SANTE D'ABO sur la prévention du paludisme, la tuberculose et les VIH/sida.La nouvelle phase des activites de Cameroon Link avec le le Groupe Technique Régionale du SIDA dans le Littoral. Elle est engagé dans la dispensation des anti-rétroviraux en milieu commuataire avec l'appui de l’Hôpital Général de Douala. Dans le cadre du Nouveau Model de Financement (NMF) du Fonds Mondial, le Cameroun bénéficie d’une subvention portant sur les trois maladies à savoir le VIH, la Tuberculose et le Paludisme. Cette subvention vient à la suite de l’évaluation de la subvention précédente qui a été implémentée avec succès au Cameroun entre Janvier 2015 et Décembre 2017. Cette subvention qui s’inscrit dans la continuation des stratégies est mise en œuvre par le MINSANTE qui est le récipiendaire principal (PR) et le Groupement Plan-MCCAM-IRESCO en qualité de sous récipiendaire (SR). Le besoin d’intervenants communautaires est exprimé par les programmes du MINSANTE pour augmenter la demande de service au sein des communautés afin que 80% de la population adopte des pratiques favorables à la promotion des comportements sains, à la prévention et à la prise en charge intégrée des maladies (Paludisme, Infections Respiratoires Aigües, Diarrhées, Tuberculose, VIH/SIDA, Malnutrition, Onchocercose, maladies évitables par la vaccination …) au niveau communautaire. Dans la région du Littoral, l’activité communautaire sera mise en œuvre prioritairement dans 07 districts de santé, 56 Aires de santé par plusieurs acteurs parmi lesquels on peut citer 07 Organisation de la Société Civile de District (OSCD) et 430 Agents de Santé Communautaire (ASC).. La stratégie communautaire est une traduction opérationnelle de la politique des interventions sous directives communautaires (ISDC) élaborée par la Direction de l’Organisation des Soins et de la Technologie Sanitaire (DOSTS) en 2012. Ce processus a conduit à l’élaboration de la stratégie intégrée de mise en œuvre des activités sous directives communautaires, en juillet 2016. Les principaux acteurs de mise en œuvre de cette stratégie que sont les ASC ont été formé entre Décembre 2016 et Janvier 2017. A la suite de ces formations les ASC ont reçu les outils, matériels et intrants pour la mise en œuvre de ces activités communautaires. La mise en œuvre des activités communautaires est continu depuis le début de 2017, cependant il y a eu des moments de faible suivi des ASC essentiellement pendant le processus de sélection du SR pour la deuxième phase du NFM. A la suite des différentes revues et évaluations des activités communautaires, certains goulots d’étranglement qui empêchaient la mise en œuvre optimale des activités ont été identifiés parmi lesquels le faible suivi des ASC. C’est ainsi que dans le cadre de la continuation du programme pour la période 2018-2020, la supervision des ASC par les OSCD sera accentuée. Cette fiche technique définit la stratégie et les livrables attendus au terme de cette activité de supervision qui sera conduite dans les aires de santé du district de santé de Melong par l’équipe de l’OSCD CAMLINK du DS d’Abo pour le compte du trimestre Avril-Mai-Juin 2018.

II. Objectifs A. Objectif général : Apporter un appui aux acteurs communautaires (ASC, COSA, leaders communautaires, chefs d’aires de santé…) pour améliorer la qualité de la mise en œuvre des ISDC dans les communautés. B. Objectif spécifique  Faire le suivi de la mise en œuvre des recommandations de la dernière supervision ;  Distribution du matériel  S’assurer que les acteurs principaux des activités communautaires (ASC & chefs d’aire) ont une bonne compréhension de leur cahier de charge ;  S’assurer que le protocole de prise en charge des maladies au niveau communautaire est respecté par les ASC ;  Vérifier la disponibilité et la conservation des intrants (médicaments, TDR, boite à image, registre…) par les ASC;  Assister l’ASC dans le remplissage des registres ;  S’assurer de la qualité des activités menées par les ASC (VAD, causeries éducatives, pratique des TDR et leur interprétation….) ;  Revoir la qualité et validité les données et rapports produits par les ASC ;  Aider à la résolution des conflits en relation avec les ISDC identifiés au sein de la communauté. III. Résultats attendus  Les ASC et les chefs d’aire ont une meilleure compréhension des ISDC et maitrisent leur cahier de charge ;  Le protocole de prise en charge des maladies au niveau communautaire est respecté par les ASC ;  l’approvisionnement des ASC en intrants et leurs utilisation sont améliorés ;  Les registres des ASC sont mieux remplis ;  La qualité des activités menées par les ASC est améliorée ;  Les données collectées par les ASC sont validées et les rapports produits cohérents et facilement exploitables ;  Les conflits identifiés en communauté en relation avec les ISDC sont résolus. IV. Méthodologies 1. Avant la supervision Avant la supervision le coordonnateur de l’OSCD doit informer les personnes à rencontrer pendant sa supervision de la date de visite et les principales articulations de la supervision. Le superviseur doit s’assurer de la disponibilité des grilles de supervision et du formulaire à signer par les personnes rencontrées lors de la descente sur le terrain. Le coordonnateur élabore les TDR de sa supervision et les transmets au RFS pour validation. 2. Pendant la supervision La séance de travail proprement dite débutera par une brève présentation des TDR de supervision. Ensuite le superviseur devra rappeler les grandes lignes des ISDC et surtout le cahier de charge des ASC. La suite de la supervision portera sur l’administration de la grille de supervision de l’ASC avec feedback immédiat et la résolution des conflits identifiés au niveau communautaire. C’est pendant cette étape que les problèmes spécifiques à chaque ASC sont identifiés et les solutions sont recherchées de manière participative. Chaque OSCD supervise trois ASC par jour de supervision ; ainsi le nombre total de jours de supervision par trimestre est le quotient du nombre d’ASC par trois. 3. Après la supervision Au terme de la supervision le superviseur doit rédiger un rapport de supervision qu’il transmettra au niveau régional du SR (RFS) pour approbation. Ce rapport intègre les trouvailles de la supervision et en annexe la liste de personnes rencontrées. La justification des frais de subsistance de l’OSCD pendant la supervision des ASC se fait par la soumission des TDR approuvés, du rapport de supervision approuvé, de la liste des personnes rencontrées et de l’ordre de mission dument signé et présentant l’itinéraire de supervision. 4. Matériel à emporter sur le terrain par le superviseur • L’ordre de mission • La grille de supervision de l’ASC (une grille par ASC à superviser) • La liste des personnes à rencontrer (noms, contact téléphonique, localisation…) • La copie des précédents rapports de chaque ASC à rencontrer • La cartographie des ASC à compléter • Le stylo, crayon, gomme, chemises plastique… • La fiche de suivi des indicateurs au niveau de l’ASC • Les fiches de validation de la prime (fixe et variable) des ASC pour la période de mise en œuvre concernée (Avril à juin 2018) et pour chaque aire de santé. 5. Matériel à ramener du terrain par le superviseur • Les Ordre de mission signé • Les grilles de supervision remplis et signées par le superviseur et les supervisés • La fiche des personnes rencontrées (noms, résidence, qualité/fonction, téléphone…) • La cartographie complète des ASC • Les rapports des ASC pour la période concernée (visés par le chef de l’aire) • La fiche de synthèse des activités au niveau de l’aire de santé (la quantité dépend du nombre d’aire de santé du district) • Les notes de remplacement de tous les ASC n’ayant pas suivi la formation au même moment que les autres • La fiche renseignant sur le coût réel du transport de chaque ASC de sa résidence au district de santé • La fiche de suivi des indicateurs au niveau de l’ASC • Les fiches de validation de la prime (fixe et variable) des ASC signées par les chefs d’aires pour la période de mise en œuvre concernée (Avril à juin 2018) et pour chaque aire de santé • Le rapport de supervision selon le canevas établi.

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CNLS officials visits Cameroon Link

By James Achanyi-Fontem, camlinknews

A delegation of three officials of the Littoral Technical Group visited the office of Cameroon Link on the 2nd October 2018 to evaluate the site for take off of dispensation of anti-retroviral drug in the community. The visit was a follow up of the protocol convention signed between the Technical Group of CNLS in the Littoral and Cameroon Link on 16 July 2018. Dr. YONGUI NTAMACK, Regional Coordinator, endorsed the protocol agreement on behalf of CNLS/GTR-Lt and James ACHANYI-FONTEM, President of Cameroon Link signed on behalf of the Civil Society Organisation. This protocol falls within the frame work of a World Bank subvention for the fight against AIDS, Tuberculosis and Malaria in Cameroon. The dispensation of anti-retroviral drugs within the community by a non-medical structure by a staff living within the community is to facilitate access to treatment by patients and the Cameroon Link is now charged with undertaking the following activities: - Explaining the the population what dispensation fo anti-retroviral therapies with the community entails, who can benefit i from the service, the advantages of dispensation of anti-retroviral drugs within the community, in which case should the patient return to the health facility, what are the services to be offered by Cameroon Link, counseling and organization of educative talks with the community. - In effect any person that has been diagnosed can benefit from the services at Cameroon Link Support groups of persons living with HIV, well structured community therapy groups constituted within the community are eligible. - These groups will benefit from the renewal of their prescription, biological follow-up, coaching on poor hygienic and sanitation. - HIV patients will benefit from cordial attention, availibity of Cameroon Link staff, confidentiality and the reduction of delays for reception of and answers to the queries of patients.

GENERALITIES ON HIV

By James Achanyi-Fontem, camlinknews

As we dispense anti-retroviral drugs, we need to eucate the population on HIV prevention. This article give a global view of the generalities of HIV. HIV is a Sexually Transmitted Infection(STI) :. This is any disease contracted through unprotected sex. HIV: Human Immunodeficiency Virus. This virus attacks the body's immune system, weakens it, and exposes it to opportunistic infections. This virus is responsible for AIDS. There are 2 types of viruses: Type 1, which is the most widespread, the most contagious, the most virulent; and type 2, which is less widespread, less virulent and rare in Central Africa. A person can have both types of viruses. AIDS: Acquired immune deficiency syndrome. This is the advanced stage of the disease. It is at this stage that the PLHIV has opportunistic infections. PLHIV: Person Living with HIV .Opportunistic infection: It is a disease that takes advantage of the weakness of the human body's immune system to install itself. It can be an infection (Cryptococcus’s, tuberculosis ...) or cancer (Kaposi ...). Viral load (VL): It is the amount of virus per millilitre of blood present in the body and determining the degree of infectivity. A person who has an undetectable viral load has a very low risk of transmitting HIV. CD4 lymphocyte: This is a type of white blood cell that helps the body to fight against diseases. It is this defence cell that HIV primarily attacks and destroys. Accidental Exposure Biological Fluids (AEBF) : It is any accidental contact of a mucosa or damaged skin with body fluids (blood, sperm, vaginal secretions, etc. ...) or tissues likely to be infected. Antiretroviral treatment (ART): Any drug capable of preventing the proliferation of HIV. It can be used for preventive purposes (prevention of mother-to-child transmission of HIV (PMTCT), post-exposure prophylaxis (PEP)) or curative (HIV infected persons). EPIDEMIOLOGY  Situation in the world in 2016: - 36.9 million people are living with HIV worldwide. - 17.1 million people are not aware they were HIV carriers. - 2 million people were newly infected with HIV, that is 5600 new infections per day, a third of which are young people between 15 and 24 years old. - 15.8 million people with HIV had access to antiretroviral therapy. However, 22 million still do not have access to ARVs.Situation in Cameroon - The Republic of Cameroon has a generalized HIV epidemic with an estimated prevalence of 4.3% in the general population (15-49 years) in 2011. - This epidemic affects more women (5.6% in women against 2.9% in men) and a peak in the 35-39 years (8.1%). It is more urban (4.8%) than rural (3.8%) with a great disparity between regions ranging from 1.2% in the Far North region to 7.2% in the South region. In the two big cities Yaounde and Douala, it is respectively 6.3% and 4.6%1. Prevalence among adolescents aged 15 to 19 years is 1.2% (2.2% for girls and 0.4% for boys). Situation in Cameroon - The Republic of Cameroon has a generalized HIV epidemic with an estimated prevalence of 4.3% in the general population (15-49 years) in 2011. - This epidemic affects more women (5.6% in women against 2.9% in men) and a peak in the 35-39 years (8.1%). It is more urban (4.8%) than rural (3.8%) with a great disparity between regions ranging from 1.2% in the Far North region to 7.2% in the South region. In the two big cities Yaounde and Douala, it is respectively 6.3% and 4.6%1. Prevalence among adolescents aged 15 to 19 years is 1.2% (2.2% for girls and 0.4% for boys). In Cameroon PLHIV were estimated at 612,445 in 20142. According to the 2014 UNAIDS report, 45,000 (39,000 - 55,000) new HIV infections occurred in 2013, including 9,500 in children below 15 years of age. The rate of MTCT was estimated at 25% in 2013, compared to 33% in 2009. - The epidemic affects the key populations more, notably sex workers (SW) with 36.7% prevalence in 2014 and a national prevalence of 24% among men having sex with men (MSM) , with a peak of 44% prevalence for MSM in Yaounde and Douala in 2014. - 205382 patients were on ART as at late December 2016 (ARV coverage of 37%). TRANSMISSION MODES OF HIV AND MEANS OF PREVENTION . Localization of the virus in the body: The virus is found in all fluids of the body, but not all are contaminating. HIV is not spread through saliva and sweat. . Localization of the virus in the body: The virus is found in all fluids of the body, but not all are contaminating. HIV is not spread through saliva and sweat.There are three (3) modes of HIV transmission : • There are three (3) modes of HIV transmission : Sexual route, Blood transfusion and vertical transmission SEXUAL ROUTE Contamination by genital secretions (presence of HIV in sperm and vaginal secretions) : • From man to woman • From woman to man • From Man to Man (MSM) Risk factors are : • Risky sexual practices (Behaviour, type of sexual acts, etc.) • Absence of the use or misuse of condoms • Presence of ulcerative STIs in any of the partners UNSAFE BLOOD Contamination by blood or blood derivatives through: • Direct contact with infected blood or blood derivative (transfusion, AEBFs, etc.) • Object stained with infected blood (syringes of drug addicts, acupuncture needles, tattoo needles etc.) Risk factors - Manipulation (use) of contaminated soiled objects without protection - Accidental direct contact with blood or blood derivatives - Untested blood transfusion VERTICAL TRANSMISSION  It is the transmission of HIV from a mother to her child during: • Pregnancy, • Childbirth • Breastfeeding RISK FACTORS - STI in the mother - Ignorance of the status of the mother - Absence of ANC - Nutritional factors (breastfeeding) - Practices during childbirth - Placental pathologies NON-TRANSMISSION ROUTES Saliva, urine, tears etc. are non-contaminating probably due to the low virus concentration in these milieus or the presence of neutralizing factors. MEANS OF PREVENTION Purpose of prevention: Avoid contamination Application of the AGC rule of safer sex:  A: Abstinence B: Good fidelity C: Condom  Voluntary testing  Application of infection prevention standards and protocols (health workers and individuals) Early Management of Blood Exposure Accidents (BEAs)  Diagnosis and treatment of STIs  Blood transfusion with tested blood  Prevention of mother-to-ch

Dispensation of anti-retroviral by Community Based Organisations

By James Achanyi-Fontem, camlinknews

Cameroon Link has been engaged as one of the civil society organisations in Cameroon to dispense anti retroviral drugs to HIV carriers. The was a follow up of the training received in Mbalmayo on the subject. During the training the training T the first module was on the generalities of HIV/AIDs and the concept of logistic. Paticipans defined what HIV means, the different types of drugs used to fight the virus and what a treatment protocole means. A video was projected to show how the virus affects the body and its consequencies. It was noted that the treatment with the anti-retroviral only reduces the effect of the virus in the body and does not eliminate it. It clears the viral load in the blood, especially when it is non-detectable. The anti-retroviral re-establishes and preserve the immunological functions, which is the CD4 in the blood stream. This helps to improve the well-being of the patient and reduces mortality. The standard anti-retroviral protocol is the mono or bi-therapy tablets for treatment and these results to rapid recovery by increasing resistance to the multiplication of the effects of the virus in the body. The treatment is composed of the following: INTI + 1 INNTI :or any of the four combinations associated Zidovudine + Lamivudine+ Efavirenz Zidovudine + Lamivudine + Névirapine Ténofovir + Lamivudine + Efavirenz Ténofovir + Lamivudine + Névirapine The above drugs have principal side effects which need to be taken into consideration: ZIDOVUDINE (AZT) may lead to severeanemia Anémie, neutropénie, nausées, vomissements, myalgie, fatigue, insomnie, hyper pigmentation (ongles, langue), gynécomastie.In this case it is advised to contrôl NFS for research of the cause ofanémia and/orneutropénie. LAMIVUDINE (3TC) may lead to Céphalées/insomnie, diarrhée, with some rare cases of neuropathiepériphérique. In this case, toleration is generally recommended. Using TENOFOVIR (TDF) may lead to Diarrhées, nausées, flatulences, tubulopathieproximale, néphrotoxicitéSD de Fanconi and it is advised to evalulate the patient ; renal function,,andadapte the posology with créatinine< 50ml/mn. NEVIRAPINE (NVP) will lead to rashes cutané that could evaluate towards a syndrome of Stevens-Johnson et Lyell. reactions very frequent in women with CD4totaling>250 cell/mm3 and>400 cell/mm3 in men.With this, the following effects have been recorded and it is advised to always administer half the dose in the first six months. In case of effects, within 7 days,return patient to clinic of observation of CD4 count. Aaaaaaaaaaaaaaaaaaaaaaaaaaaaaacd4 count isgenerally 250 for women and 400 for men. EFAVIRENZ (EFV) will show the following effects: T neuropsychiquesroubles,dowsiness, insomnie, somnolence, hallucination, possible toxicity cutanée et hépatique. In this case, take medicine to reduce effects in pregnant women and patient suffering fromantécédentspsychiatriquesand convulsions. When in difficulties, contact your care-giver and doctor.

Cameroon Link Youth Network Strategy

By James Achanyi-Fonte, camlinknews

Cameroon Link Youth Network Strategy aims a promoting gender equality from from the base. In this article we outline how this can be achieved by the youths for the youths through a network.Goal Develop and sustain young persons to promote, protect and support environmental protection, promote food sufficiency through farming and promote good health through nutrition for well being. Foreword Cameroon Link Youth Network Strategy has been developed to guide the network towards achieving the organisation’s goals. This strategy provides the strategic framework, and focus that Cameroon Link intends to pursue in regard to attaining optimal health and nutrition for the youth in Cameroon. It is anchored on the Youth frameworks and platforms of the African Union (AU) and other regional and international youth charters meant to improve and achieve overall goals and deliverables of Cameroon Link and the host country government and sectors. This strategy has three sections: 1. Provide a background, situation analysis and the emerging issues. 2. Highlights the actual objectives and focus 3. Outlines how the strategy will be implemented defining the key issues, structures and processes. This Strategy is intended for use by all members of the network including and not limited to managers, staff and other affiliate Organisations within the Youths network. Further, it is intended to inform our partners of the principles, philosophy and belief in promoting, protecting and supporting optimal maternal, infant and young child health and nutrition interventions which are core drivers of the ministry of public health. The target beneficiaries of the strategy are young people of reproductive age, youths in and out of schools, and all other categories of people who fall within the age bracket of the youth. Cameroon Link is thus declaring her direction towards the youth for the next five years. Our sincere hope is that more partners of good will shall join hands and support Cameroon Link to drive the agenda forward by supporting and committing resources to invest in tthe Strategy. Executive Summary Cameroon Link Youth Network Strategy has been developed to guide the organisation towards achieving the organization’s goals. This strategy provides the strategic framework, and focus that Cameroon intends to pursue in regard to attaining optimal health and nutrition for the youth in Cameroon. It is anchored on the Youth frameworks and platforms of the AU and other regional organizations. Limited data hinder the measurement of the wellbeing of Cameroon youth, but the available data suggest that the youth population is large and growing, and has high educational attainment and unemployment rates—with adverse consequences: • The lack of a universal definition of “youth” makes measuring the youth problem difficult and the comparison of data across Cameroon less reliable. • The youth population in Cameroon is large (about 6 million, which is 30percent of its population of more than 20 million). • Cameroon’s relatively young population (about 30percent of its population in 2012 was estimated to be below 15 years of age), combined with the country’s high fertility rate, is likely to magnify the so-called youth budget. This trend could have positive consequences for Cameroon’s development, if properly channeled. • Youth, especially in Southern Cameroon and especially males, have higher educational attainment. However, there are large variations in educational attainment across Cameroon and its regions. • Youth unemployment rates are relatively high, with significant regional differences and adverse consequences such as poverty, migration and diseases. Femalesparticularly face extremely high unemployment rates. 2. Policies and actions for youth have not successfully addressed these challenges: • Effective youth policies require dealing with challenges facing youth that include, but are not limited to, the lack of access to a high-quality and relevant education, high rates of persistent unemployment, a high incidence of chronic poverty, political disengagement and poor environmental health. • Information on the development and implementation of youth policies in Cameroon are hard to find, but anecdotal evidence suggests that various regions are at different stages of the process. • Youth policies potentially have several challenges, and the assessment of problems facing young people is complicated by data limitations. These limitations include a lack of reliable and accurate data; a lack of comparable data across regions; a lack of pro-jobs and pro-youth economic growth agendas; a lack of comprehensive youth policies that are integrated into national development plans; a lack of broad macroeconomic policies and the need to mainstream youth policies; the fact that the costs of programs and sources for funding are not fully known; and the fact that the government lacks the capacity to undertake comprehensive monitoring and evaluative processes. 3. The key recommendations arising focus on harnessing the potential of Cameroon youth to foster economic development through their participation in the labour market and strategies to improve their living standards generally. The main strategies proposed include: • Improving the investment climate by reducing the cost of doing business so as to create jobs for youth; • Expanding infrastructure, especially in rural areas, to boost employment opportunities for youth; • Harnessing innovation, which has the potential to increase skill formation, enhance productivity and create youth employment opportunities; • Building institutional quality so that individuals and organizations are effective in responding to the needs of the youth. Definition of Key Terms Youth Empowerment: Young people are empowered when they realize that they have or can create choices in life, are aware of the implications of those choices, make informed decisions freely, take action based on those decisions and accept responsibility for the consequences of their actions. Empowerment also means having the ability for supporting enabling conditions under which young people can act on their own behalf, and on their own terms, rather than at the direction of others. These enabling conditions fall into major categories such as an economic and social base; political will, access to knowledge, information and skills, adequate resource allocation and supportive legal and administrative frameworks; a stable environment of equality, peace democracy and positive value system. Youth Development: ….the ongoing growth Processes in which, youth are engaged in attempting to: 1. meet their basic personal and social needs to be safe, feel cared for, be valued, be useful, and be spiritually grounded, and 2. build skills and competencies that allow them to function and contribute in their daily lives." (Pittman, 1993)… A process which prepares young people to meet the challenges of adolescence and adulthood through a coordinated, progressive series of activities and experiences which help them to become socially, morally, emotionally, physically, and cognitively competent. Positive youth development addresses the broader developmental needs of youth, in contrast to deficit-based models which focus solely on youth problems. “Information”refers to ideas or thoughts that individuals contribute, seek, or obtain from informal or formal discussion, investigation, or study. “Access”refers to the breaking of long-standing information barriers, bringing to a wide diversity of opinion and opportunity. The digital environment may facilitate or inhibit access. “Connectivity”refers to the sense of community or construction of social worlds that emerge from changing perspectives and expanded associations in the real world or in resources. “Interactivity”refers to dynamic, user-controlled, nonlinear, non-sequential, complex information behaviour and representation. “ICT” is an umbrella term that includes any communication device or application. It encompasses radio, television, cellular/mobile phones, computer and network hardware and software, satellite systems, and so on, as well as the various services and applications associated with them. Section 1: Description of the Health and Nutrition context of Youth in Cameroon 1. Background The outcomes include: CAMLINK guiding the health and nutrition investments by the government and other stake holders (public and private) towards attainment of the Organisation’s goals and objectives and also putting into effect the strategy and focus areas of the plan of action of the Cameroon Youth Charter. This strategy is meant to: 1. Provide continuity in terms of strategic planning for Youths in Cameroon. 2. Capture critical lessons in implementation to guide strategic focus and investments for youth in the medium and long term, and consolidated investment targeting youth socio-economic empowerment; 3. Align the network priorities with organizational, regional and government policies and strategies in terms of health and nutrition for youth; 4. Ensure rights-based approach to youth development through meaningful participation and representation; and 5. Mainstream youth perspective in the efforts to achieve broad development goals and priorities Introduction: Population, demographics, administrative factors, Cameroon development plan One of the greatest challenges facing the government and policymakers in Cameroon today is how to provide opportunities for the country’s more than 6 million youth so that they can have decent lives and contribute to the economic development of Cameroon. According to the United Nations (2012), Africa’s 2011 population was estimated at 1.05 billion and was expected to double by 2050. Africa is the youngest continent in the world with about 70percent of its population 30 years of age or younger. In 2011, youth, who are defined here as those between 15 and 24 years of age, constituted 21 percent of the more than 1 billion people in Africa, whereas another 42percent was less than 15 years old. Slightly more than half of the Cameroonian youth population is female, and there are more rural dwellers than urban dwellers. With such a large proportion under 15 years of age, Cameroon’s youth population is expected to grow in the years to come while the youth population in other parts of the world shrinks. Undoubtedly, the challenges for youth that are central to Cameroon’s economic development are numerous and varied - they include employment, health, nutrition, and socio-political participation. These issues differ among groups within regions (by gender, education level, ethnicity and health status). Conversely, the size, energy, enthusiasm, innovation and dynamism of youth are assets that can be harnessed for Cameroon’s development with appropriate policies that deal adequately with the issues facing them. The challenge to Cameroonian policymakers is how to harness young people’s desire for change that has the potential to translate into positive outcomes. Description of the Cameroon Youth Network National health systems, health service delivery The process to develop the network and the youth programme under CAMLINK Y4D was launched during the 2012 Cameroon Link General Assembly after realization that there was need to build a team of young advocates to fill the gap of supporting breastfeeding in a seemingly inevitable changing environment. At this forum it was officially declared that Cameroon Link was to have a slot for a youth representative to the Federation of Cameroon Breastfeeding Promotion Associations (FECABPA) and issues of the youth were to be officially coordinated by an undersigned officer. Since then there has been considerable development and improvement including funding to ensure that the youth groups, individuals and organisations thrive and take root in the work of promotion, protection and support for optimal maternal, infant and young child health and nutrition in Cameroon. A number of youth related documents were drawn and revised to guide implementation and support to the country groups in effecting projects and programmes of the youth network; however these also had their gaps. There was limited clarity and direction when it came to youth programmes and interventions by then and in most cases they were implemented as smaller components under the umbrella organisations. This greatly affected and hindered growth of frontline effectiveness of young people’s involvement in the breastfeeding movement work. However with the opportunity of representation on the Board and the Organisation’s partners in full support of youth interventions, this strategy has been developed. The strategy places emphasis on support to efforts that ensure network growth into a visible force at country and international level, in contributing towards the attainment of Cameroon’s goals on nutrition. The objectives are aimed not only at attainment of full potential and growth of infants and young children, but also the attainment of a quality of health and nutrition that ensures young parents are able to bring forth a generation that is lively and healthy. 2. Situation Analysis There is no universal definition of the youth population. “Youth” is traditionally defined as a period of transition from childhood to adulthood. In the African Youth Report 2009 (hereafter, the UNECA 2009), “youth” are defined as people between 15 and 39 years of age. However, several African countries define their youth population differently. For example, Ghana, Tanzania and South Africa define the youth population as those between 15 and 35 years of age; Cameroon,Nigeria and Swaziland define it as those between 12 and 30 years; and Botswana and Mauritius define it as those between 14 and 25 years. These varying definitions of the youth population make it difficult to effectively discuss issues affecting youth in Africa generally and to compare information across countries. The available data suggest that the youth population is large and growing, but there are limited data on gender and rural/urban distribution. The youth population in Africa is relatively large and is growing very fast. As shown in the figure, youth constitute about 20 percent of Africa’s population. Thus, the absolute size of the continent’s youth population is slightly above 200 million (in 2011, Africa’s total population was estimated at about 1.05 billion). Although Asia has the largest youth population in the world because of its large total population, Africa is the region with the highest youth population relative to its entire population. Because Africa’s population is relatively young (about 42 percent of Africa’s population in 2010 was estimated to be below 15 years of age) and has a high fertility rate, the youth population in Africa is projected to grow very fast and is likely to remain high for a long period of time. Sexual and Reproductive Rights and Health Article 16 of the African Youth Charter focuses on the health of young people and stipulates that “every young person shall have the right to enjoy the best attainable state of physical, mental and spiritual health”. Our focus below is on the health status of young people in Africa, with particular reference to their reproductive health, mortality, maternal and child health. Although sub-Saharan Africa is experiencing an overall decline in the number of births per woman, adolescent birth rates remain high in many countries including Cameroon. Each year, births to adolescent girls aged 15 to 19 accounts for 16 per cent of all births in sub-Saharan Africa. The youngest mothers are the most likely to experience complications or death due to pregnancy and childbearing. And sexually active young women often face obstacles to accessing contraceptives and health services, increasing the risk of unintended pregnancy and unsafely performed abortions. Young men also need information and services so they can be partners in preventing unintended pregnancies. Fertility The high adolescent fertility in sub-Saharan Africa means that young women contribute to the high maternal morbidity and mortality in the region. By the same token, young people in affected areas also share in the impact of communicable diseases such as tuberculosis and malaria. Age at First Sex An indicator used to determine the average age at which young people become sexually active and provides some insight into when most young people are exposed to risks related to pregnancy and sexually transmitted infections(STI). Adolescents rarely use protection when having sex for the first time and younger adolescents face a greater risk than older adolescents of acquiring sexually transmitted infections, including HIV. In most countries with available data, the median age of first sexual experience for young women is between ages 16 and 18. The average age at first sex in some countries - including Cameroon, Niger, Sierra Leone, Liberia, Guinea and Uganda - is younger than 17. In these countries adolescents under the age of 18 are at a higher risk for sexually transmitted infections and poor reproductive health outcomes due to pregnancy and early childbearing. For young men, the median age at first sex is between ages 17 and 20. The majority of countries - 14 out of the 22 countries with available data - the average age of first sex is 18 or older. Gender differences between age at first sex are most pronounced in several West and Central African countries, such as Niger, Mali and Sierra Leone reflecting the early age at marriage for girls. Adolescent Birth Rates Although there has been a slight decline in adolescent birth rates in developing countries over the last two decades, sub Saharan Africa continues to have some of the highest rates of adolescent fertility in the world, showing almost no decline since 1990. Among the 14.3 million adolescent girls that gave birth in 2008, one of every three was from sub-Saharan Africa. Often, early childbearing is the result of child marriage with its associated negative consequences. But unmarried adolescents are also at risk for unintended pregnancy if they do not have access to comprehensive sex education and family planning services. Nearly half of the countries with available data have an adolescent fertility rate of more than 100 births per 1,000 adolescent girls. Niger, the Democratic Republic of the Congo and Mali are particularly high, with 192, 168 and 167 births per 1,000 adolescent girls, respectively. And high rates of adolescent childbearing are not limited to any one region in sub-Saharan Africa; the 10 countries with the highest adolescent fertility rates include countries from West Africa, Central Africa, East Africa and Southern Africa. Approximately one-quarter of the countries with available data have an adolescent fertility rate of less than 60 births per 1,000 adolescent girls. Countries like Botswana, Rwanda, Mauritius and Burundi stand out as countries with the lowest rates of adolescent childbearing across the continent. A later and healthier start to childbearing produces important gains in maternal and child health outcomes and breaks cycles of poor health. It is well documented that adolescent pregnancies carry risk to the mother as well as to the newborn. Across the globe, pregnancy and childbearing is the leading cause of death for adolescent girls. In developing countries, the risk of dying during childbirth is twice as high for women aged 15 to 19 as it is for women in their 20s and five times greater for girls under the age of 15. And the risk of maternal death is aggravated by unsafely performed abortions. Ensuring that adolescent girls have access to information and services to prevent unintended pregnancies and delay that first birth will help reduce the burden of maternal death and disability in sub-Saharan Africa. Status Report on Adolescents and Young People in Sub-Saharan Africa: Opportunities and Challenges, Alexandra Hervish and Donna Clifton, Population Reference Bureau Access to reproductive health care and services is especially important for the youth as this is the life stage in which people develop secondary sexual characteristics and typically make their sexual debut – and may start having children (Richter and Panday, 2005; UNICEF, 2011). The table below shows selected reproductive health indicators for youth in Africa. Despite its decline, adolescent fertility in sub-Saharan Africa remains the highest in the world. The proportion of women aged 20-24 years who gave birth before age 18 is also higher than elsewhere in the world. These figures are a major concern, given that teenage pregnancies have negative repercussions for the development of the young mothers, with the most important implications including dropping out of school, curtailed personal development and increased vulnerability to exploitative sexual relationships. Additionally, because of the youth of the mother the child is particularly vulnerable to perinatal mortality, and the young mother – who may not be physically mature herself – is vulnerable to prolonged labour and increased risk of fistula. Children of teenage mothers are also usually caught in a vicious circle of poverty, malnutrition, poor health and disadvantage. High levels of teenage pregnancy further reflect a pattern of sexual activity that puts teenagers at risk of HIV and other sexually transmitted infections (Swartz, 2003; Cooper et al., 2004) Modern Contraceptive Use To a large extent the high adolescent pregnancy rates in sub-Saharan Africa can be attributed to low contraceptive prevalence among young people in the region. The United Nations Population Fund (UNFPA) has shown that the use of modern contraceptive methods has changed little in the recent past throughout much of sub-Saharan Africa. Although it increased from 12.2percent to 20percent between 1990 and 2000, the 2007 figure was only 21.5percent; in many countries of the region it is less than 10percent. By contrast, the contraceptive prevalence in North Africa was 60.3percent in 2007, up from 58.8percent in 2000 and 44percent in 1990 (UNFPA, 2010). Overall, rates of contraceptive use remain very low in all regions in sub-Saharan Africa among 15-to-19-year-old and 20-to-24-year-old married women. Nearly all the countries with available data for married women aged 15 to 19 have less than 30 per cent are using modern contraception. Among married women aged 20 to 24, Namibia and Zimbabwe stand out as the only countries, with more than half of all women using a modern method of contraception. Among the countries with available data, the lowest rates of modern contraceptive use are in West Africa and Central Africa. Among 15-to-19-year-old married women, contraceptive use in Cameroon, Sierra Leone, Niger, Nigeria and Benin ranges from 1 per cent to 3 per cent. And while some countries in Eastern and Southern Africa have higher rates of contraceptive use - Rwanda at 31 per cent, Zimbabwe at 35 per cent, Namibia at 39 per cent and Swaziland at 43 per cent - more than half of all married adolescents are not using any contraception. The reasons for this range from lack of knowledge about contraception, health concerns, high costs and limited supplies, to cultural or personal objections to the use of contraception (Bulatao, 1998) Child Marriage In addition to low contraceptive use, the high prevalence of early marriage in many parts of sub-Saharan Africa partly explains the high adolescent fertility rates in the sub region. Although most African countries have declared 18 years as the minimum legal age of marriage, a 2006 UNICEF report stated that 42percent of young girls in the region were married before turning 18 years (UNICEF, 2006). While the practice has decreased, it is still commonplace, especially in rural areas. Overall, early marriage is generally more prevalent in Central and West Africa where it affects at least 40percent of girls under 19 years. It is relatively less common in East Africa and Southern Africa. Notably, however, even though fewer girls in Southern Africa marry in their teens, cohabitation is relatively common in this region (Mokomane, 2004). Maternal Mortality Given that a high proportion of young people start giving birth during their adolescent years, the issue of maternal mortality – death resulting from the complications of pregnancy and/or childbirth – is relevant for this age group. Available evidence shows that the maternal mortality ratio (MMR) in Africa remains the highest in the world and the continent contributes about 47percent of global maternal mortality. As in other developing regions, the leading causes of maternal mortality in Africa are hemorrhage and hypertension (UN, 2010). Major Causes of Death for Cameroon Youth According to UNECA (2009), the main cause of death among Cameroon youth is HIV and AIDS, accounting for over 53percent; followed by maternal conditions at 16.7percent, tuberculosis at 4.5percent, sexually transmitted diseases other than HIV and AIDS at 1.7percent, and malaria at 1.5percent. Abuja declaration, policies, Regional Initiatives, public private partnerships in health service delivery, infrastructure, progress on MDGs The range of health services delivered in Africa varies with the level of care, from the basic package at the lower level centers to specialist services at the referral hospitals located within the provinces or at national level. Nutrition Adequate nutrition is an essential prerequisite for maintaining the health status. Malnutrition is a major health problem in Africa, affecting millions of the continents citizens, especially women, children, and infants. The most common nutrition-related problems especially in sub-Saharan Africa include high rates of chronic malnutrition and micronutrient deficiencies, specifically of Vitamin A and iron. Under-nutrition in Cameroon effects … Hunger and Poverty Access to productive and decent employment is one of the challenges confronting Cameroonian youth in their transition to adulthood. Poverty, in turn, has far-reaching consequences for the development of young people as it is related to the timing and ordering of transitions into adulthood. Although the value of individualism as a defining aspect of independence and adulthood tends to be associated with Western cultures (Arnett, 2001), while interdependence defines the African way of life, there is no doubt that youth poverty undermines the sequencing of the transition considered a norm in societies (the school–formal employment–marriage–family progression). Young males may delay leaving home to assume independent living and start a family because they feel they lack the capacity to support a family materially, and girls may be pushed to assume new roles as mothers because of unplanned pregnancy or as spouses where poor families may organize their child’s marriage as a livelihood strategy. Curtain (2003) showed that 15 of the 19 poorest countries in the world are in sub-Saharan Africa, and concluded that the 51 million youth in these countries accounted for 37percent of all young people in the region. It has been argued that reducing hunger is a necessary condition for the elimination of poverty, as better nutrition improves the capacity of people to produce a sustainable livelihood. Although the incidence of hunger in Africa decreased in the 1990s – early 2000s, this may have been reversed by the recent global economic downturn and sharp increases in the price of staple foods, civil conflicts, wars and migration at their highest. HIV and AIDS HIV is one of the most serious public health and development challenges in Cameroon and practically all the sectors of the society have been affected. Available evidence also shows that HIV prevalence among young people in sub-Saharan Africa is the highest of all major world regions. Among other things, the epidemic has left many young Africans orphaned and vulnerable to risky behaviours that include engagement in unprotected sex, substance abuse and crime. Cameroonian youth also have inadequate participation in decision making and social dialogue at local, national and regional levels. In Cameroon, changes in sexual behaviour patterns among young people—such as waiting longer to become sexually active, having fewer multiple partners and increasing condom use—have resulted in reductions in HIV prevalence. High-burden countries such as Côte d’Ivoire, Ethiopia, Kenya, Malawi, Namibia, South Africa, Tanzania, Zambia and Zimbabwe achieved a significant decline of more than 25percent in HIV prevalence among young people. Burundi, Lesotho and Rwanda also reduced HIV prevalence among young people by one quarter. These declines are essential for curbing the AIDS epidemic in sub-Saharan Africa. Although HIV prevalence has declined among young people in many high-burden countries, young people, especially young women, are still disproportionately affected by the epidemic. Twenty countries in sub-Saharan Africa accounted for nearly 70percent of the world’s new HIV infections among young people in 2009. Among the countries with available data, Swaziland, Lesotho, Botswana, South Africa and Zambia have the highest HIV prevalence rates for both males and females aged 15 to 24. However, rates of infection among females are more than double that of males. In addition, HIV prevalence is higher in the 20-to-24-year-old age group (both male and female) compared to the 15-to-19-yearold age group, suggesting that more efforts are needed to strengthen HIV prevention for young adults, their partners and their children. HIV status is fundamental to the uptake of HIV services, treatment and care. Data from selected countries show that most young people do not know their HIV status. Among young women aged 15 to 24, nearly three-quarters of countries with available data have less than 30percent of women tested for HIV. Among young men aged 15 to 24, Malawi, Rwanda and Uganda stand out as the only countries that are not highly affected. In some of the countries, particularly from Eastern and Southern Africa, young women are more likely to have been tested for HIV and received the results from their tests. However, this trend may be linked to their use of antenatal services where HIV testing and counseling are offered more regularly. Intersection of HIV infection and maternal death HIV is an increasing contributor to direct and indirect causes of maternal deaths in Cameroon. Ensuring that young women receive appropriate HIV diagnosis and treatment, including access to antiretroviral drugs, is crucial to manage HIV infection in young, pregnant women as well as women who have just given birth and to reduce the number of maternal deaths. This set of interventions is particularly important in Central, Eastern and Southern Africa, where HIV prevalence rates are higher.. Recognize that cross-generational sex puts girls at risk for HIV Cross-generational sex between an unmarried adolescent girl and a man 10 or more years older is not unusual in Cameroon. These relationships are often driven by economic need and expose young women to HIV. Many researchers have found that girls and young women are less able to negotiate condom use in cross-generational sexual relations due to an imbalance in power and a girl’s lack of control in decision making. Consider other health-related behaviours that put young people at-risk for HIV infection Many people have their first experience with tobacco, alcohol and drugs during adolescence and youth. These are risky behaviours that have negative impact on young people’s wellbeing and also lead to poor sexual and reproductive health outcomes. For example, alcohol use often contributes to risky sexual behaviour, such as multiple sex partners, inconsistent condom use and transactional sex. In addition, young people who sell or use drugs are at higher risk for HIV infection. They may not have access to information, sterile injecting equipment and services such as HIV testing and counseling. Consequences for Adolescents and Youth Among young people living with HIV, some contracted the virus through vertical transmission from the mother to the child. Although there has been significant progress in reducing pediatric AIDS infections, sub-Saharan Africa continues to have the highest rate in the world. The future course of the AIDS epidemic in Cameroon depends on a number of factors including HIV and AIDS-related knowledge, degree of social stigmatization, risky behaviour, access to high-quality services for sexually transmitted infections (STIs), provision and uptake of HIV counselling and testing services, and access to antiretroviral therapy (ART). Reaching young people with sexual and reproductive health and family planning information and services to prevent maternal HIV infection in the first place is also necessary. Since adolescents remain a high-risk group (both for HIV infection and pregnancy), HIV prevention programmes must address their specific sexual and reproductive health needs. Young people—especially young women—need access to family planning services and comprehensive sex education so they have a full understanding of how to prevent HIV and can gain competence in negotiating condom use. Technology and Behavior Change (Africa’s Mobile Youth) Recent marketing research indicates that 80percent of youth own three or more personal media devices, 96percent go online daily, and for 78percent of youth, cell phones are the most popular method of remote communication. Young people are much more likely to jointly experience events, not in someone’s living room, but rather via text messages, My Space, Twitter, blogs, or instant messaging. Mobile technology has been a game changer for Africa. The World Bank and African Development Bank report there are 650 million mobile users in Africa, surpassing the number in the United States or Europe. In some African countries more people have access to a mobile phone than to clean water, a bank account or electricity, the agencies add. Youth are using mobile phones for everything: communicating, listening to the radio, transferring money, shopping, mingling on social media and more. Furthermore, the industry has transcended divides between urban and rural, rich and poor. Cheap Chinese handsets are readily available, with some going for as little as USD20. Africa has a history of inflating taxes for mobile consumers and operators, but countries like Kenya, recognizing that handset prices represent a barrier to development, removed their 16% general sales tax in 2009, increasing sales by more than 200percent, the Global Mobile Tax Review reports. Mobile phone penetration in Africa has therefore increased rapidly in the past 12 years, going from 1percent in 2000 to 54percent in 2012, as stated in Deloitte’s report by The Sub-Saharan Africa Mobile Observatory. Young people are the largest group using cell phones and their software applications, says SimthandileMgushelo on his blog Voices of the World. In his country, South Africa, 72percent of those between the ages of 15 and 24 have cell phones, according to the UN Children’s Fund, UNICEF. Internet prices are coming down and speed is up, writes J. M. Ledgard in Intelligent Life magazine, thanks to fibre-optic submarine cables running along the East African coast and connecting several African countries, including Cameroon, South Africa, Mozambique, Madagascar, Tanzania, Kenya, Somalia, Djibouti, Sudan and the Comoros. Other fibre-optic cables run along Africa’s west and central coast. Ledgard predicted that by 2014, 69percent of mobiles would have Internet access. In response to the burgeoning demand, markets are transitioning slowly from so-called feature phones with limited data access to low-cost Smartphones with access to the Internet. Facebook splits costs with the network operators and phone manufacturers and Google has followed and is providing free Internet access and also eliminating language barriers by becoming multilingual. Face-to-face conversations are out, texting is in. Hangouts are no longer the craze for youth. Texting or SMS (short message service) has overtaken speaking on a mobile phone. Even when young people are physically in the same space, they will secretly text each other. “Often, we’ll SMS something we don’t want to say out loud.” Just a few years ago most people considered this kind of behaviour rude; now it’s so frequent, it’s grudgingly tolerated (Africa Renewal). Even during social events like weddings, funerals and religious services, it’s typical to see teens and young adults hunched over, peering into a small screen, thumb and forefinger poised ready to fly over the tiny keyboard to send a text message. It’s no longer a fad; it’s ingrained in the culture. Emerging Issues and Recommendations The most critical actions to be taken to harness the potential of young people today as well as future generations include: Sexual and reproductive health and rights: All young people have a need for comprehensive, age-appropriate and accurate sexuality education. Effective sex education programmes have been shown to reduce misinformation, increase the use of contraception to prevent unintended pregnancies and sexually transmitted infections and promote positive attitudes and behaviours. HIV/AIDS Integrate reproductive health and HIV/AIDS services. Linking these two services is a cost-effective strategy to meet the needs of young people. Youth-friendly, integrated services are needed throughout the region, providing convenience, privacy and low-cost or free services, including HIV testing and counseling and male circumcision where necessary for young people. Particular attention should be given to young people who engage in intergenerational and transactional sex as well as adolescents who are exploited in sex work. Social Networking The increasing use of the Internet and mobile phones in Cameroon has been accompanied by increased and widespread use of web-based social network sites. These sites allow users to share ideas, activities, events and interests within their individual networks. Among the positive impacts of social networking is the opportunity they offer young people to connect with others who share similar interests and activities across political, economic and geographic borders. These sites are also increasingly being used in education, medicine, finance and legal applications. Studies show that policies to address the challenges facing youth have not resulted in a great deal of success. These failures are attributable to a number of factors including the inadequacy of information about youth that is necessary in the design of policy, weak coordination amongst government agencies, donors, regional organizations, and the failure to design specific policies that are suited to deal with the problems of Cameroon youth. • The AYR indicates that African governments have responded to the challenges of youth, but these challenges still persist. There is a need to foster youth involvement in the process of policy formulation and to consider youth issues within a general framework that incorporates regional and global responses. Specific policy recommendations are provided in the AYR, from the United Nations Economic Commission for Africa (UNECA). Although the reports recognize the need for African countries to take further steps to develop and implement their national plans and to fully assess their progress, no study has been done to evaluate the aspects of youth policies. • Several African countries have made progress in developing youth policies, as embodied in the African Youth Charter, a regional framework for youth development, as well as in other reports. The existence of a national youth policy does not necessarily mean that it is being implemented – or that it is particularly good for young people. But overall, the progress seems to have been slow, and the available policies or actions do not adequately meet the challenges presenting to the youth. • Computers and other mobile gadgets are a viable way to deliver prevention information and promote skill development. While psychological science has established the dangers of these new media (e.g., Internet, video games) such as increased violence and addiction, we must also consider the potential strengths of these strategies and employ them appropriately - this is not only possible, but sometimes preferable to adolescents. Section 2 Strategic Direction/Background and Context of the Strategy Thematic Areas covered by Strategy Cameroon Link Youth Network exists as a component of IBFAN Africa and like the mother Organisation works through the existing government and non government structures within the network regions. The Organisation has been key in providing guidance and support in the areas of Policy analysis and formulation; Strategic planning and programme cycle management; Setting standards and quality assurance. Cameroon Link also provides technical support to regional groups and ministry of public health on nutrition and food security related issues, including capacity development and technical support supervision; interventions on nutrition emergency preparedness and response; nutrition and health related operational research as well as monitoring and evaluation of the overall nutrition, food security and health related interventions with specific emphasis on maternal, infant and young child feeding and related programmes. The Y4DA Network implements through Cameroon Link structure how it utilizes the approach of integration to include aspects of the youth and youth-friendly service delivery to reach to the young men and women within the communities in the country. The key intervention areas are listed below: Section 3 Strategic Interventions The achievement of the objectives outlined above will among others, entail the pursuance and implementation of the following strategic interventions. Programme Management Outcome 1 Improved programme quality, governance, accountability and competence Objective: To ensure Cameroon Link functions at the highest level of organisational accountability, effectiveness and efficiency Specific Objectives 1. To increase the visibility of CAMLINK vision, purpose, brand and safe guard the reputation of the organisation. 2. To strengthen organisational infrastructure and operations; 3. To ensure effective succession planning and democratic decision making at governance and management levels; and 4. To develop a stable, highly qualified and motivated workforce that actively delivers the organisation’s mission. Programme Strategies 1. Analyse impact of Camlink Youth Network programmes and strengthen outreach services to attain an effective response to priority advocacy areas; 2. Strengthen the Organisation’s infrastructure and operations to ensure a healthy and responsive organisation; 3. Resource global governance to enhance the collective power of the Organisation and increase the commitment to the vision and purpose; 4. Investigate the major opportunities and barriers of integration; 5. Support program implementation by members through provision of technical support for community development; 6. Enhance a participatory approach through pilot projects and sharing of best practices; 7. Conduct baseline assessment, create and use indicators that add value to programme interventions; and 8. Strengthen the monitoring, quality improvement and evaluation including promotion of evidence based practices. Desired impact • A flexible and responsive Organisation with effective governance and management at all levels, clear delegation of powers, as well as strengthened cooperation, coordination and support mechanisms Service Delivery Outcome 2: Enhanced Delivery of Quality Services Social Marketing Programs - Peer Education Peer education is a common approach for helping youth to adopt responsible behaviours, but reaching large numbers of youth effectively remains a challenge for many programs. Although large diverse audiences can be ideal for raising awareness of reproductive health issues, they are not always suitable for intensive interpersonal activities. Working with small groups of youth Participatory techniques designed to encourage audience members to personalize information, gain confidence, and practice new behavioural skills are most effective when used with a small number of participants who share common demographic and socioeconomic characteristics. Small homogenous groups allow peer educators to cover more material, engage participants more fully, tailor messages appropriately, and effectively address concerns and questions. Using structured participatory approaches Social learning theory asserts that young people learn by observing and imitating a behaviour and receiving support to maintain the behaviour. Based on this scientifically tested theory, peer education activities should avoid didactic presentation and instead aim to motivate participants to internalize risks and make the commitment to practice healthy behaviour. Reaching the most vulnerable youth Out-of-school youth, orphans, street youth, and commercial sex workers are more likely to engage in high-risk behaviours, and therefore have a greater need for peer education services. Reaching sufficient numbers of youth face-to-face on a repeated basis requires collaboration among many organizations. One option for expanding coverage is to use experienced peer educators as trainers and supervisors of a wider network of volunteer peer educators linked to schools, youth clubs, and other organizations. Practical tools such as standardized guidelines for peer education sessions can reduce variability, maximize audience participation, and ensure emphasis on key messages. Recruitment and training In order to be credible, youth peer educators must be true peers - similar age range, sex, marital status, and sexual experience - to the program’s target audiences. This should emphasize the ability to listen, guide discussions, and talk about sensitive topics. A major challenge is to recruit and train peer educators who are poised and self assured and, at the same time, comfortable deferring to experts when appropriate. David Wilson, “PSI Youth Sexual Health Programme: Cameroon, Rwanda, Madagascar,” unpublished report, April 25, 2002. Program design focusing on environmental and contextual factors An effective way to deal with health issues is to take a holistic approach that considers not only youths’ physical and mental well-being but also their social, economic and cultural environment. Well developed commercial infrastructure allows programs to deliver products, information, and services to youth conveniently and affordably. Improving the accessibility and quality of reproductive health care for youth Youth-friendly service provision, Integrating health programs with opportunities for personal development can attract females to youth centers Cooperation from parents and other influential adults to achieve program results It is important distinction between soliciting support from adults and basing youth programs on the perceptions and values of adults. More information is needed about the extent to which parents and other adults influence adolescent behaviour, and how to most effectively promote dialogue between adults and adolescents on reproductive health. Standard guidelines for program design, marketing, and research Behaviour-change programs that are evidence-based need staff with the ability to direct and analyze research, convey complex behavioural concepts to research and advertising agencies, and apply best practices in youth programming. These specialized skills are not widely available in Cameroon and thus future programs should devote resources to build local capacity in this area. Collaboration, Coordination and Networking Outcome 3 Enhanced collaborative, Information sharing, coordination and networking with stakeholders, members and the development partners Cross Cutting: Gender, Environmental Conservation, Monitoring & Evaluation Outcome 4 Gender mainstreamed at all stages of planning and implementation Objective: To ensure that gender issues are streamlined into all Camlink Y4DA work. Strategies 1. Observe gender equity and equality in recruitment, leadership, networking, and in all coordination processes (i.e.: planning, implementation, M&E); and 2. Lobby and advocate for improved basic health services provided to youth, men, women and children by members and partner organizations. Strengthening Institutional Capacity and mobilizing resources Supervision, monitoring and review of services Outcome 5: Mechanisms for monitoring and evaluation strengthened and institutionalized Framework for monitoring and reporting, indicators, supervision and monitoring of progress, interpretation of progress Resource Mobilisation Outcome 6: Increased investments in youth development and empowerment Article 16 of the African Youth Charter calls for provision of technical and financial support to build the institutional capacity of youth organisations to address public health concerns including issues concerning youth with disabilities and young people married at an early age. Financing of services Outcome 7: Capacity and resources for implementation consolidated Coordination and monitoring of progress enhanced and consolidated at the levels of Cameroon, youth networks and youth servicing organizations. ;"