Drawing on a decolonial lens to Explore Stakeholders Perceptions, Opportunities, and Challenges in the Expanded Programme on Immunisation in Cameroon: A Critical Qualitative Case Study Analysis
1
Expanded Programme on Immunisation, Ministry of Public Health, Cameroon, Ministry of Public Health, Cameroon, Buea, Southwest region, Cameroon
2
Global Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Introduction. The Expanded Programme on Immunisation (EPI) has contributed to a decline in morbidity of vaccine-preventable diseases in Cameroon1; however, the programme faces significant challenges, including vaccine hesitancy rooted in the historical legacy of fostering colonial practices2. Furthermore, EPI's heavy reliance on funding from global north organisations limits local stakeholder representation in decision-making, undermining local ownership and the effectiveness of vaccination interventions3. This study examined stakeholders' perceptions of decolonising the EPI, using a qualitative approach informed by decolonial theory. Methods. The study sample comprised 15 purposively selected stakeholders, with consideration of gender and years of immunisation experience. Semi-structured interviews were conducted in English via Microsoft Teams, lasting 45–90 minutes. Data was analysed inductively using Braun and Clarke’s six-phase thematic analysis, with researcher reflexivity informing the interpretive process.
RESULTS:
Stakeholders identified enduring colonial practices within the EPI, linking current systemic awareness to Cameroon’s colonial history. Financial dependence on Global North health organisations was viewed as a primary tool for Western control over decision-making within the programme. Systemic inequities were highlighted, specifically preferential treatment and higher compensation for international actors compared to local staff. Structural challenges to local ownership included government under-investment in health, centralised administration, outdated colonial-era curricula, and a lack of domestic vaccine manufacturing facilities. To decolonise the programme, stakeholders advocated systemic reforms: integrating local knowledge and traditional medicine into curricula, investing in local vaccine manufacturing, and adopting participatory, human-centred design. Furthermore, Universal Health Coverage (UHC) and the formal recognition of local philanthropy were identified as critical levers for local ownership.
CONCLUSIONS:
Decolonising the EPI is an ongoing, multi-stakeholder process essential for reclaiming local ownership and optimising EPI performance in Cameroon.
Introduction. The Expanded Programme on Immunisation (EPI) has contributed to a decline in morbidity of vaccine-preventable diseases in Cameroon1; however, the programme faces significant challenges, including vaccine hesitancy rooted in the historical legacy of fostering colonial practices2. Furthermore, EPI's heavy reliance on funding from global north organisations limits local stakeholder representation in decision-making, undermining local ownership and the effectiveness of vaccination interventions3. This study examined stakeholders' perceptions of decolonising the EPI, using a qualitative approach informed by decolonial theory. Methods. The study sample comprised 15 purposively selected stakeholders, with consideration of gender and years of immunisation experience. Semi-structured interviews were conducted in English via Microsoft Teams, lasting 45–90 minutes. Data was analysed inductively using Braun and Clarke’s six-phase thematic analysis, with researcher reflexivity informing the interpretive process.
RESULTS:
Stakeholders identified enduring colonial practices within the EPI, linking current systemic awareness to Cameroon’s colonial history. Financial dependence on Global North health organisations was viewed as a primary tool for Western control over decision-making within the programme. Systemic inequities were highlighted, specifically preferential treatment and higher compensation for international actors compared to local staff. Structural challenges to local ownership included government under-investment in health, centralised administration, outdated colonial-era curricula, and a lack of domestic vaccine manufacturing facilities. To decolonise the programme, stakeholders advocated systemic reforms: integrating local knowledge and traditional medicine into curricula, investing in local vaccine manufacturing, and adopting participatory, human-centred design. Furthermore, Universal Health Coverage (UHC) and the formal recognition of local philanthropy were identified as critical levers for local ownership.
CONCLUSIONS:
Decolonising the EPI is an ongoing, multi-stakeholder process essential for reclaiming local ownership and optimising EPI performance in Cameroon.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
