ArticleConflict and health2025
Community-based surveillance programs in Cameroon, Chad, Niger and the DRC: a comparative assessment of integration in humanitarian crisis contexts.
Article in Conflict and health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIncreasing community involvement to anticipate and organize a rapid response to epidemics remains a major challenge. From 2022 to 2025, the French Red Cross, together with host national Red Cross Societies, supported the Ministries of Health in Cameroon, Chad, Niger and the Democratic Republic of Congo (DRC) in setting up community-based epidemiological surveillance (CBS). On the basis of prevention, early detection and notification of suspected cases, these programs mobilize community players trained in early warning. This article aims to contribute to the limited evidence on CBS effectiveness in humanitarian crises by describing and evaluating the implementation of community-based surveillance in these countries.
methodsThe evaluation of CBS systems followed a mixed retrospective-observational multicentred approach, combining quantitative indicators (responsiveness, verification and sensitivity) and qualitative indicators (simplicity, adaptability, acceptability and perceived usefulness) collected from key stakeholders.
resultsA total of 186 stakeholders involved in the CBS program were interviewed. Combined with quantitative epidemiological data, these findings seem to confirm the advantages of the CBS: its responsiveness, perceived usefulness by the stakeholders involved, simplicity, adaptability, acceptability and proximity to the community. 82% of alerts were verified within 24 h, and 76% of these alerts were validated by a supervisor or health center manager. Apart from the DRC, very few biological samples have been taken; however, the stability of the system cannot be accurately assessed. The sustainability of the CBS, while desired by most stakeholders, remains subject to the question of how it will be financed.
conclusionThis evaluation confirms the usefulness of the CBS in various humanitarian contexts but highlights areas for improvement, including logistical support, human resources, community player training, healthcare access (especially for women), and microbiological testing. The long-term viability of CBS depends on securing sustainable funding and strengthening healthcare systems to empower local communities to manage future epidemics.
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