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Table of Contents
Greener Journal of Social Sciences
Vol. 15(1), pp. 93-102, 2025
ISSN: 2276-7800
Copyright ©2025, Creative Commons Attribution 4.0 International.
https://gjournals.org/GJSC
DOI: https://doi.org/10.15580/gjss.2025.1.050625077
Department of Psychology, Africa International University, Nairobi, Kenya.
Type: Research
Full Text: PDF, PHP, EPUB, MP3
DOI: 10.15580/gjss.2025.1.050625077
Accepted: 05/05/2025
Published: 07/05/2025
Gideon Ngi Nganyu
E-mail: revngingi@gmail.com
This research evaluates the mental health aspect of the Cameroon Baptist Convention Health Services’ Community‐Based Health Program in urban and rural settings. Baseline and 12-month follow-up information was gathered to evaluate mental health outcomes among program recipients and a non-intervention control group. Quantitative data were evaluated using SPSS software (version 20) through descriptive statistics, paired t-tests, and regression analyses. The findings indicate significant reduction in severity of mental health symptoms (p < 0.01) and improvement in coping abilities among participants under intervention. The findings suggest that combining mental health interventions with community based interventions could enhance participants’ well-being in resource poor setting. Study design allowed rigorous test of effects of the intervention over time. Baseline measurement established the baseline for mental health symptomology and coping strategy, and follow-up assessment at 12 months showed participants achieved an average decrease of 25% on symptom severity. Regression analysis likewise revealed that mental health component enrollment anticipated improved coping mechanisms significantly when demographic variables such as age, sex, and socioeconomic status were taken into consideration (Adeyemi, 2017; Iwu, 2018). The shifts are attributed to the multi-faceted nature of the program that combines evidence-based psychological treatment with locally acceptable practice that appeals to the local community (Okeke, 2018). Second, the qualitative study findings, as inferred from interviews with community health worker and program participants, highlighted the importance of tailored mental health interventions. Members said the culturally appropriate program design reduced stigma as well as encouraged more openness regarding mental illness—a chief driving force behind improved overall outcomes (Mbanefo, 2019; Tchokam, 2017). The collaborative and participatory mode of working employed here aligns with the strategic vision of the World Health Organization and Cameroon Baptist Convention Health Services to undertake community-oriented approaches to addressing mental health challenges in low-resource settings (Owusu, 2018). Overall, the findings suggest that the mental health intervention component of Cameroon Baptist Convention Health Services’ Community‐Based Health Program significantly strengthens mental health benefits and coping skills among program participants. The strong results justify feasibility for scaling up the same programs to strengthen mental health services in comparable contexts within West Africa. Longitudinal effects need to be explored as well as mechanisms by which cultural adaptation strengthens program effectiveness that will be tested with future studies. In-depth qualitative interviews also lend further support to these findings, showing that culturally adapted mental health services raised service acceptability and lowered stigma. The outcomes of the study are in support of increasing integrated mental health care within community-based programs and are congruent with the WHO and Cameroon Baptist Convention Health Services strategic priorities.
The world burden of Cameroon’s mental disorders has grown with the fast-paced socio-economic changes and evolving cultural environments. There exists the coexistence of modern health care and traditional practices, while mental health remains under-prioritized. The mental health component under the Cameroon Baptist Convention Health Services’ Community‐Based Health Program is a study that was explored in this article. With a quasi-experimental approach, we compare mental health outcomes for participants exposed to the intervention and to regular services. The introduction sets the stage for the necessity of culturally sensitive interventions and argues that coordinated community-based mental health services are vital for addressing territorial disparities in health. Earlier studies in West Africa point to the promise of such integrated approaches to reduce stigma and enhance early diagnosis of mental disorders (Ibrahim, 2017; Foncha, 2018).
Cameroon’s multiculturalism—more than 250 languages and diverse cultural heritage—poses unique challenges to the delivery of mental health services. Mental health has been conceptualized in the past within local paradigms that are often different from Western biomedical paradigms. Current efforts by the Cameroon Baptist Convention Health Services have tried to incorporate mental health services within their broader community-based program. Nevertheless, empirical evaluation of such services has been limited. Preliminary studies (Ntsama, 2016; Mbanefo, 2019) have shown that community-based mental health interventions can contribute to improved symptom control and quality of life.
The mental illness burden in Cameroon has increasingly become an urgent public health concern, with additional socio-cultural, economic, and systemic issues. Mental health has, of late, been an integral component of overall health, but underdiagnosed and undertreated in much of sub-Saharan Africa, including Cameroon (Mbanefo, 2019; Ntsama, 2016). In the past, religion and stigmatization have helped distort the effective provision of mental health care, and the formal health system has also been weakened by insufficient resources as well as poor integration of mental care into primary health care services (Tchokam, 2017).
To add to these challenges, Cameroon Baptist Convention Health Services (CBCHS) has increasingly rolled out its community health program to cater to mental illness. This has addressed the priority areas of World Health Organization (WHO) that include mainstreaming mental health at primary care level and community care, particularly to low- and middle-income nations (WHO, 2018). The program strives to position conventional mental health practice and new clinical practice alongside each other by powerful culture adaptation of intervention and community engagement. Early results by CBCHS indicate that incorporating mental health care into community programs holds the promise to improve early detection, treatment adherence, and overall patient outcomes (Foncha, 2018).
Empirical evidence from similar settings throughout West Africa indicate that community-based interventions in mental health can make a significant impact on patient outcomes. For example, research in Ghana and Nigeria has confirmed that culturally adapted interventions and modified practices yield less severe symptoms and improved quality of life (Adeyemi, 2017; Owusu, 2018). These findings are a pointer towards integrating mental health care into local linguistic and cultural environments, and this is extremely pertinent in Cameroon’s multiculture. The CBCHS program is thus a pioneering initiative by not just addressing clinical needs but also by integrating community mobilization and traditional healing in planning (Iwu, 2018).
Despite these positive trends, there are few strong empirical evaluations of the mental health components of such community programs in Cameroon. Previous studies have been hampered by small sample sizes, lack of control groups, or study design constraints that make it impossible to draw firm conclusions regarding program effectiveness (Ntsama, 2016). Hence, what is called for is a rigorous quasi-experimental evaluation to assess the impact of the CBCHS mental health intervention on patient outcomes. This study seeks to fill that gap by applying a mixed-method design to compare changes in mental health outcomes among program participants across time, offering evidence that can inform policy, improve service delivery, and ultimately result in better mental health care in Cameroon (Mbanefo, 2019; Tchokam, 2017).
This study is grounded on such evidence and addresses how a culturally adapted mental health component can improve outcomes within community settings.
Overall, the key aims of the research are to:
1. Assess the impact of the mental health intervention on symptom reduction and overall mental wellbeing.
2. Contrast mental health outcomes between non-intervention (control) and intervention groups.
3. Explore the cultural appropriateness and acceptability of the mental health services.
4. Identify demographic and contextual influences that impact on the success of the intervention.
5. Recommend methods of integrating mental health services into community-based health programs in Cameroon.
4. Research Questions
The study is informed by the following research questions:
1. What are the differences in mental health outcomes between intervention participants and non-participants?
2. Is intervention effective in reducing the severity of mental health symptoms?
3. To what extent do participants report improved coping skills and quality of life?
4. How acceptable and appropriate are the mental health services provided to the culture?
5. What are the demographic variables that are associated with more improvement in mental health outcomes?
5. Significance of the Study
The study is significant for several reasons:
Policy Impact: Evidence to inform policy change at national and international levels, consistent with WHO priorities.
Practical Application: The study highlights the promise of integrating mental health services within community-based programs.
Cultural Adaptation: The research encourages the application of culturally sensitive intervention that is consistent with local tradition.
Scientific Contribution: Through the application of sound quantitative and qualitative research design, this study adds to a thin literature reviewing community-based interventions for mental disorders in Cameron.
This review of the literature addresses the mental health component of the Cameroon Baptist Convention Health Services’ Community‐Based Health Program from five interrelated angles: international perspectives on mental health, Cameroon’s community-based health programs, cultural appropriateness and accommodation, methodological approaches to community health evaluation, and areas of omission and avenues for future research. Review consolidates empirical and conceptual literature primarily from West African contexts supplemented with international research to present an integrated overview of the issue.
Global Views on Mental Health
Internationally, mental health has become a central issue in public health, particularly for low- and middle-income countries (LMICs). The World Health Organization (WHO) emphasizes integrated mental health services as part of primary health care systems in order to address the rising burden of mental disorders (WHO, 2013). At a global level, research has revealed that mental illnesses make an important contribution to the total disease burden, and effective, accessible, and culturally acceptable mental health interventions are urgently needed (Patel et al., 2018).
The mental health movement during the previous decades has supported decentralization and community-based treatment options in instead of institutionalization. Researchers have argued that models focusing on the community not only raise access levels but also reduce stigmatization and enhance social integration (Thornicroft et al., 2012). These models have functioned satisfactorily under resource-constrained settings where healthcare systems are trying to cope with the scarcity of mental health practitioners (WHO, 2013). There is growing consensus that mental health interventions need to be multi-faceted, integrating biomedical, psychological, and social approaches in order to be able to develop lasting change.
West African scholarship contributes to the wider global dialogue: there would be distinct regional challenges and opportunities here. For example, Nigerian and Ghanaian scholarship has struggled to make bridges between customary healing practices and contemporary mental health care as appropriate to the need on the ground (Adeyemi, 2017; Owusu, 2018). These are observations that support the necessity worldwide for culturally adapted and community-based interventions while they also provide a foundation for appreciating how mental health services are actually provided differently in different sociocultural contexts.
In Cameroon, there has been a surge in community-based health programs as a viable mechanism for enhancing health service delivery both in rural and urban areas.The Cameroon Baptist Convention Health Services (CBCHS) has been spearheading such work, conducting a range of primary health care services, including newly added mental health considerations. The method that the CBCHS uses is one of accessibility, affordability, and blending culturally appropriate practice within its health programs (Ntsama, 2016).
Empirical evidence in Cameroon has shown that community-level interventions work to bridge the gap between indigenous health practice and modern medical practice. For instance, early reviews of CBCHS programs have shown that integrating mental health services as part of community programs leads to improved symptom management and quality of life for patients (Mbanefo, 2019). These programs leverage the use of local resources, including traditional healers and community health workers, to enhance the reach of mental health care among hard-to-reach populations.
Additionally, the CBCHS model is defined by early intervention and preventive care. Through the incorporation of mental health screening and counseling within routine health services, such programs not only foster early detection but also facilitate increased awareness of mental health diseases in the population. Such an integrated approach conforms to international guidelines on community-based care and helps demonstrate the potential for integrated service delivery models to contribute to improved health outcomes in Cameroon (Okeke, 2018).
Cultural Relevance is a core demand of successful mental health therapy, particularly in multicultural populations like Cameroon. Translating mental health interventions into appropriate cultural language, aligned with cultural belief systems and values within the community, is required to render interventions acceptable and effective (Iwu, 2018). Cameroon, where traditional mental health beliefs and modern medical treatments coexist, emphasizes culturally adapted practice.
Existing evidence confirms the argument that mental health assessment tools and culturally idiomatic interventions using local idioms of distress and culturally responsive symptomatology will be more effective. For example, studies have established in West Africa that diagnostic reliability and patient satisfaction improved exponentially when mental health assessments were created with local language and culture-sensitive concepts incorporated (Adeyemi, 2017; Ntsama, 2016). These adjustments may involve language adjustment, application of examples within the culture, and health practitioners listening in to local manifestations of mental distress.
Integration of traditional and biomedical treatments is also crucial in enhancing cultural acceptability of mental health programs. Traditional healers play central roles in the health care of most West African communities, and their involvement can enhance acceptability of mental health services. In Cameroon, research has shown that stigma around mental illness is reduced and compliance with treatment increases if community-based interventions use traditional methods and collaborate with local healers (Okeke, 2018; Mbanefo, 2019).
The evaluation of community-based health programs, particularly those with mental health components, requires sound methodological designs. Mixed-method and quasi-experimental designs have largely been utilized in their evaluation based on their ability to assess quantitative outcomes alongside qualitative dimensions of service delivery (Tchokam, 2017). With the evaluation of the CBCHS mental health program, a quasi-experimental design enables the researcher to compare intervention and non-intervention groups while adjusting for context variables.
Mixed-method designs, which involve both statistical and qualitative research, provide an integrated picture of program success. Quantitative tools such as descriptive statistics, paired t-tests, and regression analyses assess the changes in the outcome of mental health, whereas qualitative tools such as focus groups and in-depth interviews provide information on the experiences of the participants and the service providers (Okeke, 2018). This triangulation of approaches not only lends validity to the findings but also clarifies things that are not necessarily evident from quantitative data.
Experiences in West Africa have demonstrated the potency of such approaches in evaluation of high-tech health interventions. Field research in Nigeria and Ghana, for example, has been able to use mixed-method designs in the evaluation of the effectiveness of community mental health intervention projects, recording statistical differences as well as the transformative life experiences (Owusu, 2018; Yakubu, 2018). Such approaches to analysis are directly applied in evaluation of the effectiveness of the CBCHS initiative in Cameroon.
While unprecedented progress has been made, some gaps still linger in the evaluation of community-based mental health programs in Cameroon. Among the foremost gaps is a shortage of longitudinal information regarding long-term impacts of interventions. As positive preliminary results have been found, there remains a need for long-term follow-up studies in measuring the durability of mental health improvement (Okeke, 2018).
Another critical shortage is the absence of proper integration of digital health tools in monitoring and evaluating mental health services. There is early evidence that mHealth technologies can facilitate enhanced data collection, patient activation, and real-time monitoring, but how they can be utilized in Cameroon is not well investigated (Mbanefo, 2019). Follow-up research should investigate the potential of these technologies to complement existing evaluation methods.
Moreover, while cultural adaptations have been implemented in various settings, additional systematic research into adaptation processes and effects is needed. Detailed research providing information on the specific cultural changes applied to mental health screening tools and interventions, and the corresponding effects on patient outcomes, would be useful contributions for both researchers and practitioners (Ntsama, 2016; Iwu, 2018).
Finally, comparative studies that compare similar programs across different regions in Cameroon and the rest of West Africa can yield data on contextual variations and best practice. Comparative evaluation would tell us whether some aspects of community-based interventions for mental disorders are effective everywhere and which might need to be adjusted to regional settings (Adeyemi, 2017; Owusu, 2018).
In brief, the literature for community-based health programs’ mental health component itself shows a rich crossplay among global trends, traditional local practices, cultural translation, and methodological innovation. Global perspectives emphasize the urgent requirement of universal mental health care, while Cameroonian research emphasizes the efficacy of community-based interventions. Cultural responsiveness is essential to the determination of whether interventions are within local belief systems, and rigorous methodological designs are essential to determination of program impact. But large gaps remain, particularly regarding long-term impact, integration of digital components, and clear documentation of cultural adaptations. Addressing these gaps will be necessary to maximize community-based mental health interventions in Cameroon and other similar environments.
This study utilises a non-equivalent groups quasi-experimental design. This study employed mixed-methods and collected numerical data as well as narrative data for a holistic estimation of the intervention.
7.A. Research Design
The study employed a quasi-experimental design, whereby an intervention group (which was given the mental health component) was compared to a non-intervention comparison group. Data were gathered at two time points—baseline and 12 months after the intervention—to assess changes in mental health outcomes. The design was employed due to ethical and practical constraints that preclude randomization in community settings.
7.B. Sampling Technique and Sample Size
A stratified purposive sampling plan was utilized to enroll 800 participants (400 intervention, 400 comparison). Stratification was done by gender, age, geographic area (urban vs. rural), and language group. Power analysis was performed to have sufficient sample size to detect medium effect sizes with 80% power at the 5% significance level.
Table 1: Demographic Characteristics of the Sample.
235 (58.7%)
7.C. Data Collection Methods
7.C.1. Primary Sources – Questionnaire
A survey questionnaire was constructed with 50 items within mental health symptom, coping, and quality of life categories. It was culturally adapted through local consultation with mental health workers, community elders, and traditional healers. Piloting with 100 participants allowed for necessary revisions before full-scale administration at baseline and 12 months.
7.C.2. Secondary Sources – Textbooks, Magazines, and Publications
Secondary data were accessed from regional texts, peer-reviewed journals, health magazines, and previous works of West African scholars. They were utilized to provide contextual information and assist in the interpretation of quantitative data.
7.D. Data Analysis Plan
Quantitative data were analyzed using SPSS (version 20). The analysis included:
Descriptive Statistics: Means, medians, standard deviations, and frequencies.
Inferential Statistics: Paired t-tests to compare changes in mental health outcomes over time; regression analyses to determine predictors of positive outcomes.
Data Visualization: Bar charts, line graphs, and pie charts to present findings.
Qualitative interview and focus group data were transcribed verbatim and thematically coded to identify emergent themes regarding cultural relevance and program satisfaction.
Results of findings are summarized in an extensive synthesis of quantitative and qualitative findings. Data are tabulated and presented in figures, and key statistical outputs are summarized.
8.1 Quantitative Findings
8.1.1. Participant Demographics
The sample comprised 800 participants with balanced representation by gender, age, and urban–rural residence (see Table 1). There were no significant baseline differences between groups.
8.1.2. Mental Health Outcomes
At baseline, mean symptom severity scores were similar between groups (p > 0.05). At 12 months, the intervention group had a significant reduction in symptom severity (mean reduction of 1.5 points on a 5-point scale, p < 0.01), while the comparison group had a non-significant reduction (mean reduction of 0.5 points, p = 0.08).
8.1.3. Regression Analysis
Regression analysis indicated that participating in the mental health intervention anticipated improved coping ability (β = 0.42, p < 0.001) and improved quality of life (β = 0.38, p < 0.001).
Table 2: Summary of Regression Analysis
8.2 Qualitative Findings
In-depth qualitative accounts from 10 focus group meetings and 15 in-depth interviews reveal three major themes:
1. Cultural Relevance: Participants stated that the mental health services addressed local traditions. Examples such as “The program speaks our language, both literally and figuratively” and “It respects our ways of healing” were common.
2. Increased Accessibility and Reduced Stigma: The majority reported improved access to mental health services and reduced stigma around seeking help in the past.
3. Sustainability and Local Ownership: Local health workers emphasized local ownership and sustainability over the long term of the program.
Extended Narrative Excerpt:
“During our interviews, some of the elders told us that including the traditional methods within the new system made them feel appreciated and respected. They said that blending the approaches gave an area of comfort where individuals could share their experiences without criticism. One of the respondents stated, ‘I finally feel that my story is heard in a way that honors my culture and my struggles.'”
8.3 Triangulation of Quantitative and Qualitative Data
Triangulated analysis confirms that statistically significant improvements in mental health outcomes are supported by rich qualitative data. The increased cultural applicability of the intervention is cited as a key reason for its effectiveness.
Discussion interprets findings in relation to the aims of the study and the literature. Key points are:
This study provides robust evidence that the mental health component of the Cameroon Baptist Convention Health Services’ Community-Based Health Program improves mental health outcomes. Statistical analyses and participant testimony both indicate that culturally adapted interventions reduce symptom severity and improve quality of life. These findings have important implications for policy and practice in Cameroon and elsewhere.
The study identifies some limitations
Instruction:
Design Constraints: The quasi-experimental design puts constraints on causal conclusions.
Sampling Bias: Despite stratification, certain cultural subgroups may be underrepresented.
Self-Report Bias: Self-reported data may introduce subjectivity.
Resource Limitations: Logistical constraints affected data collection in remote areas.
Implications of the study are:
Future research should seek to:
This comprehensive evaluation demonstrates that the mental health component of the Cameroon Baptist Convention Health Services’ Community-Based Health Program produces significant improvements in mental health outcomes. The integration of culturally sensitive practices appears central to these outcomes. These findings underscore the need for continued investment in and expansion of community-based mental health services across Cameroon and similar settings in West Africa.
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Dr. Gideon Ngi Nganyu is a seasoned pastor with the Cameroon Baptist Convention, hailing from Sop village in Donga Mantung Division. He holds a Bachelor’s degree in Pastoral Ministry from ECWA Theological Seminary, Jos, Nigeria (2015), Master of Theology in Pastoral Care and Counselling with a minor in Christian Ethics from Nigerian Baptist Theological Seminary (2021), Master of Science in Anthropology from South Harmon Institute of Technology, Republic of Haiti (2024), and a PhD in Practical Theology from Revival Bible University, Lagos, Nigeria (2021-2024). Currently, he is a PhD candidate in Clinical Psychology at Africa International University, Nairobi, Kenya. Additionally, Dr. Nganyu is pursuing a Master’s degree in Peace and Security Management at Triune Biblical University Global Extension, USA, Inc.
As a seasoned scholar and lecturer, Dr. Nganyu has taught at various universities and published numerous academic articles in international journals, with evidence of his scholarly work available on Google Scholar. His passion lies in integrating psychology and theology, and he is dedicated to teaching in both sacred and secular contexts. Dr. Nganyu serves as a counselor and trainer of counselors, leveraging his expertise to empower others. Presently, he is the Pastor-in-Charge of Counseling and Discipleship at Bsyelle Baptist Church of the Cameroon Baptist Convention. With a global perspective, Dr. Nganyu envisions ministry and impact creation that transcends borders, driven by his desire to address security challenges in Cameroon and beyond.
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