Assessment of the availability, accessibility, and quality of sexual and reproductive health services for young people in conflict affected zones of Cameroon: a mixed method study.

INTRODUCTION: Despite ongoing programs to improve young people's Sexual and Reproductive Health Services (SRHS) in the conflict plagued North West and South West Regions of Cameroon, there is limited evidence-based information evaluating SRHS. This study, therefore, aims to investigate the availability, accessibility, and quality of SRHS provided to young people in the North West and South West Regions of Cameroon. METHOD: This is a cross-sectional mixed-methods sequential explanatory study conducted among healthcare providers and young people between 10 and 24 years in 6 selected urban and rural areas in North West and South West regions. Data was collected between December 2021 and September 2022 using an adopted checklist. A descriptive analysis was conducted for quantitative data. An inductive analysis was conducted for the qualitative data to construct themes. The findings from the quantitative and qualitative responses were triangulated. RESULTS: There were 114 participants, 28 healthcare providers and 86 young people. Most provider participants were nurses (n = 18, 64.3%), working in religious facilities (n = 14, 50.0%), with diplomas as state registered nurses (n = 9, 32.1%). Also, more than half of young people (51.2%) were less than 20 years old, while there were more male young people (51.2%) than female young people (48.8%). Most respondents agreed that SRHS services were available, though they think they are not designed for young people and have limited awareness campaigns about the services. Reasons such as limited use of written guidelines, affected quality of SRHS. Participants revealed shyness, resistance from religious groups and families, insecurities from political instability, and inadequate training, among others, as barriers to SRH accessibility. CONCLUSION: The study shows that SRHS are available but are not specifically designed for young people. Inadequate publicity for these services, coupled with the political crises and the ongoing COVID-19 pandemic, has increased young people's inaccessibility to SRHS. Young people usually have to finance the cost of most of the SRHS. The quality of service delivery in the facilities is inadequate and must therefore be improved by developing safe, youth-friendly centers staffed with well-trained service providers.

Best practices and lessons learned from implementing a massive Ebola vaccination program: Summarizing UMURINZI team experience.

Background and Aims: The unified Rwandan initiative for national ZEBOVAC immunization (UMURINZI) program's community engagement component was enacted to mobilize and vaccinate high-risk community members. This article describes best practices and lessons learned from the implementation of UMURINZI, a large-scale Ebola vaccination program. Methods: The population deemed to be at risk for EVD consisted of people who frequently cross Rwanda and the Democratic Republic of Congo (DRC) borders including those coming from Kigali City, potential first responders who have not previously been vaccinated against EVD, as well as people who reside in high-risk border-proximate areas of the Rubavu and Rusizi districts in the Western Province of Rwanda. These districts were selected because of their proximity to high-traffic borders linking Rwanda to DRC's cities near an active Ebola outbreak. Volunteers of this program were adults, adolescents, and children aged 2 years or above who resided in the selected communities. Recruitment at the sites was conducted in close collaboration with each health area's Community Health Workers (CHWs). Volunteers were informed that the program involved being fully vaccinated (two doses of Ebola vaccines) within 2 months apart in the allocated vaccination sites. Results: Lessons learned were categorized into four pillars: infrastructure, leadership, myths, and partnership with respect. The best practices that were used during the implementation of the UMURINZI program were the results of a collaboration among CHWs, the involvement of national and local leaders, the use of a comprehensive engagement plan, and training. The study also had limitations. Conclusion: We described best practices and lessons learned during the implementation of the UMURINZI program in Rwanda. These practices and lessons learned represent promising options that could contribute to better community members' participation in mass vaccination programs. Hence, we demonstrated that rigorously designed community awareness and sensitization programs are effective for the implementation of similar programs in resource-limited settings.