Maroua 3, one of the three health districts (HDs) in the city of Maroua, has a worrying malaria situation.

Despite the extent of malaria, the rate of community care in Maroua 3 remains low. This is mainly due to the low take-up of health services by the population, who rarely turn to the community relays for first aid or rapid diagnosis.

This context fully justifies the inclusion of Maroua 3 as a priority district in the implementation of the project. Équité Accès Palu, which aims to improve access to care and strengthen community involvement in the fight against malaria. The active presence of the OSC CADELCO, a well-established local partner in the Maroua 3 local development area, is a strategic asset for the deployment of the project's activities, particularly in terms of communication, awareness-raising and community mobilisation.

The health district (DS) of Mokolo, capital of the Mayo-Tsanaga department in Cameroon's Far North region, is facing a particularly critical malaria situation.

Mokolo is home to a mixed population: indigenous populations (notably the Mafa), internally displaced people fleeing conflicts in the region, and above all a large number of Central African and Nigerian refugees, grouped together in the Minawao camp, the largest refugee camp in Cameroon.

At community level, although 12,185 suspected cases were identified by community health workers (CHWs), only 8,883 were tested, revealing a problem of access to essential inputs, in particular rapid diagnostic tests (RDTs). This logistical shortfall is severely limiting the response capacity at community level.

In this context, civil society plays a crucial role. The AJERED-MT CSO, which is active in the Mokolo district, works with vulnerable populations (refugees, IDPs, nomads, orphans, etc.). It supports community-based interventions such as seasonal chemoprevention (SPC), distribution of LLINs, ISDCs, behaviour change communication (BCC) and local advocacy. Thanks to its proximity to communities, AJERED-MT strengthens the link between public health services and hard-to-reach populations.

The Doume Health District, located in the Haut-Nyong department (East region), will have a population of 54,512 in 2023, the majority of whom are indigenous Maka and Baka people. Malaria is one of the main causes of mortality and morbidity.

Children under 5 and pregnant women remain the most vulnerable, and remote populations such as the Baka have difficulty accessing care. Despite the commitment of CHWs, community care remains sub-optimal.

Doume was chosen as the district in which to implement the Équité Accès Palu project because of : Its worrying health situation, the high vulnerability of its population, the existence of isolated areas that are difficult to access and the presence of dynamic community organisations.

It is for this reason that the CSO ADES has been chosen to implement the community activities of the Équité Accès Palu project in this district. The project aims to improve access to healthcare, particularly for marginalised and neglected groups such as Baka pygmies.

Bafoussam, capital of the Mifi department in the West region, is a semi-urban town divided into three arrondissements

However, the lack of trained Community Health Workers (CHWs) severely limits community care. Specific groups such as orphans, IDPs and hard-to-reach populations remain largely excluded from malaria control services.

Despite the efforts of the NMCP (distribution of LLINs, hospital care, awareness-raising), there are still major gaps, particularly at community level.

This is why the Equitable Access to Malaria project has been deployed in this district, in order to : Strengthen community capacity, improve equitable access to care, and reduce the impact of malaria on vulnerable populations, the project activities there are being implemented by the MoJe Foundation, an experienced civil society organisation with a long-standing commitment to fighting malaria and other diseases at community level, the absence of multi-skilled community health workers (CHWs) limits access to care, particularly for vulnerable groups such as orphans and hard-to-reach populations. Despite NMCP interventions such as the distribution of LLINs and hospital-based care, challenges remain. The contribution of NMCP partners and civil society is essential to improving malaria control indicators. In this context, the MoJe Foundation is implementing the project activities, drawing on its experience in the fight against malaria at community level.