The intervention, called Scaling up healthy nutrition intervention in adolescents and pregnancy (WDF22-1902) aims to accelerate the prevention of non-communicable diseases (NCDs) through a holistic multi-sectoral approach.
As primary prevention efforts need a long-term perspective and a strong partnership framework to make an impact, the project brought Cameroonian municipalities on board as active partners and advocates for institutional change supporting the NCD agenda.
The main goal of this collaborative effort is to roll out an innovative multi-setting nutritional intervention by creating health-promoting environments for adolescents and pregnant women. This is also the first attempt to operationalize WDF’s new approach to primary prevention which prioritises context-relevant interventions.
'It is a much more ambitious project because of its comprehensive approach to prevention', explains Elsa Morandat, Senior Programme Manager at WDF.
'Previous projects focused on schools only – now, we aim for multi-setting interventions in schools, health facilities and at a community level. We need to embrace a holistic approach considering all levels to ensure the potential impact on people’s wellbeing.'
With this common purpose, civil society, the government, health care providers, academic institutions, and other partners are now collaborating to foster an environment at a systemic level that supports such interventions in school and health facility settings.
The project builds on the success of a previous programme, Early NCD Prevention in Cameroon Schools, which aimed to improve secondary school students' dietary habits and physical activity.
Cameroonian municipalities met in Yaoundé for the second edition of the International Economic Days of Municipalities (JEICOM23) - June 2023
Healthy pregnancy in focus
Sustaining health-promoting interventions and advocating for systemic changes to prevent diabetes and obesity are actions needed in a country facing the triple burden of malnutrition: undernutrition, micronutrient deficiency and overnutrition (TBM).
As a result, the project seeks to empower health decision-makers in Cameroon to advocate for changing the narrative of undernutrition to include all forms of malnutrition and commit to more sustainable health interventions to prevent the risks of TBM.
Undernutrition and micronutrient deficiencies are still urgent health issues at a national level. More than 40% of women of reproductive age suffer from anaemia , while more than 37% of adult women fit the overweight/obesity categories in 2018 and one in three had hypertension [2, 3]. This affected diabetes prevalence too, which increased from 2% in 1998 to 6% in 2018 [4, 5].
Due to high rates of malnutrition, the prevalence of hyperglycaemia in pregnancy (HIP) is also likely to be high, with a 5% to 17% prevalence of gestational diabetes . Rapid urbanisation and adoption of unhealthy dietary habits worsened the situation, with children and pregnant women being more vulnerable to NCD risks.
To prevent the risk of NCDs among the next generations, a key priority of the WDF project is to implement a nutritional education programme in antenatal care (ANC) clinics and monitoring of women with HIP – a valuable opportunity to provide preventive services for women and children visiting health facilities.
This is highly relevant as women account for half of the Cameroonian population and from a cultural standpoint are also the family decision-makers in terms of nutrition .
Students of secondary school point towards one of the health promotion materials created in the previous project (WDF16-1434).
Thriving environments for adolescents
The project’s multi-sectoral approach also involves scaling up nutritional education for all students attending secondary school in the country and involves training national school inspectors as trainers in nutritional education and introducing a nutrition curriculum into the distance learning platform owned by MoE among other actions.
Based on a lasting collaboration between the RSD Institute, WDF’s long-term local partner, and the Ministry of Health (MoH) and Ministry of Education (MoE), the project builds on the success of past local interventions (WDF16-1434).
The latter led to legislative change by making training in healthy cooking compulsory for food vendors in schools and launching a digital app presenting Cameroonian meals and their nutritional values. This food atlas represents the first attempt to produce nutritional information on local food and meals consumed in Cameroon.
Local ownership with national ambitions
One novel element in the project’s approach is supporting mayors and representatives from eight selected local councils to work with their communities for the same purpose.
'Municipalities play a key role in creating health-promoting environments', Elsa adds.
Having local decision-makers, healthcare professionals, and schools convening to discuss what is needed in their municipality means they would roll out only those interventions that could meet those exact needs'.
Going beyond simply educating to co-developing locally acceptable and sustainable interventions – access to community gardens, tax incentives for vegetable vendors, food labelling regulations, or water points and health clubs in schools, to name a few – makes it easier for pregnant women and adolescents and the general population as well to adopt healthier behaviours and prevent the risks of NCDs for generations to come.
For an overview of the project’s activities and expected results, read more here.