CHAPTER ONE

INTRODUCTION

This chapter includes different historical aspects starting from the background of the study, followed with this is the problem statement, specific research questions and objectives, the justification for the study, the significance and the scope of the study.

1.1 Background

Access to safe water and effective sanitation remains a fundamental determinant of human health and wellbeing globally. Despite strides in water technology and health education, billions of people worldwide continue to rely on unsafe water sources that facilitate the transmission of harmful pathogens (World Health Organization & UNICEF, 2025). Water‑borne diseases  illnesses caused predominantly by the ingestion of contaminated water harbouring bacteria, viruses, protozoa, or parasitic organisms have been linked to severe outcomes including diarrhoea, dehydration, typhoid, cholera, and dysentery, resulting in significant global morbidity and mortality, particularly in low‑income and rural settings (Les enjeux de santé liés à la qualité de l’eau de boisson, 2016). The burden of these diseases not only reflects environmental conditions but also underscores unequal access to water, sanitation and hygiene (WASH) infrastructure that underpins disease transmission dynamics.

Youth populations are notably vulnerable to water‑borne diseases due to behavioural patterns, immune system development, and frequent contact with communal surface water sources. Studies on water contact behaviours have demonstrated that younger age groups, particularly adolescents and children, are subject to increased risk when they engage in routine activities such as swimming, bathing, playing, or doing laundry in unprotected water bodies that serve multiple domestic purposes, exposing them to pathogens such as Schistosoma and other parasites (Sama, Oyono & Ratard, 2007). This vulnerability is exacerbated when knowledge about the risks associated with contaminated water does not translate into preventive behaviour; in some contexts, even individuals with awareness of schistosomiasis still engage in high‑risk water contact activities because of socio‑cultural practices or lack of practical alternatives (Sama et al., 2007).

Furthermore, research on the knowledge, attitudes, and practices (KAP) related to water‑borne disease prevention reveals that significant gaps persist in community understanding and preventive actions. In studies conducted within Cameroon, residents demonstrated poor overall knowledge of water‑borne diseases and suboptimal practices for prevention with residents often unable to identify more than one water‑related disease and relying on a mix of untreated water sources such as springs, wells, and rainwater without adequate safety measures (Fogang et al., 2020). Such inadequate knowledge and behaviours contribute to persistent disease transmission pathways and highlight the need to explore how knowledge levels correlate with prevention practices, particularly among youth who are often at the forefront of water collection and household chores in rural communities.

Infectious agents responsible for water‑borne diseases continue to be detected in various regions of Cameroon, with studies documenting pathogens such as Cryptosporidium species in diarrheic children, confirming active water‑borne transmission chains within the country (Prevalence and molecular characterization of Cryptosporidium species, 2025). Likewise, bacteraemia and intestinal parasitic infections feature prominently in epidemiological profiles where water quality is compromised, suggesting that water contamination directly influences disease prevalence across different age groups. Compounding these biological risks are socio‑environmental factors such as inadequate sanitation, open defecation and poor hygiene practises that perpetuate the cycle of contamination and infection.

Despite initiatives to improve water infrastructure and sanitation systems in Cameroon, challenges remain substantial. National data suggest that roughly half of rural populations lack consistent access to improved water sources and sanitation facilities, indicating that the mere presence of infrastructure does not always guarantee the safety of drinking water, especially when contamination and WASH deficits persist (Eau, assainissement et hygiène, 2026). Elevated rates of diarrhoeal mortality among children less than five years old reflect ongoing threats posed by water‑related diseases and the vulnerability of young populations to these conditions (UNICEF, 2026). Moreover, climate variability  including alternating cycles of drought and flooding further exacerbates the contamination of water sources and fuels outbreaks of diseases such as cholera, demonstrating the complex interplay between environmental change and public health (Choléra au Cameroun : quand le climat déchaîne les épidémies, 2025).

In Cameroon, water‑borne diseases remain a significant public health concern tied to both infrastructure deficits and behavioural determinants. Understanding the level of knowledge among youths in the Barombi Kang community regarding the effects and prevention of these diseases is therefore crucial. Youth are uniquely positioned at the intersection of household water use and community health practices, and their knowledge can shape not only personal health behaviours but also community norms. Without comprehensive insight into youths’ knowledge and preventive practices, efforts to reduce the burden of water‑borne diseases may fall short of meaningful impact. This makes it imperative to investigate how young people perceive and respond to water‑borne disease risks in Barombi Kang  information that can inform targeted health education, reinforce WASH interventions, and contribute to the broader goal of reducing preventable disease transmission within rural Cameroon.

1.2 STATEMENT OF THE PROBLEM

Access to safe water remains a critical challenge in many rural communities, including Barombi Kang in Kumba, where residents rely heavily on untreated water sources such as rivers, streams, and shallow wells. These unsafe water sources increase the risk of water‑borne diseases, which disproportionately affect youths due to their frequent contact with contaminated water through domestic chores, recreational activities, and poor hygiene practices. Despite the high vulnerability of youths, there is limited information on their knowledge of the causes, effects, and preventive measures of water‑borne diseases in the community. This knowledge gap undermines efforts to design effective health education interventions, perpetuating disease transmission and associated health risks among young people in Barombi Kang.

1.3 Objectives of the Study

The objectives of this study are divided into the main research objective and specific research objectives.

1.3.1 Main Research Objective

To assess the knowledge of youths in the Barombi Kang community, Kumba, on the effects and prevention of water‑borne diseases.

1.3.2 Specific Research Objectives

The specific objectives of this study are to:

1. identify the roles played by nurses in promoting healthy ageing among elderly people aged 60 years and above at the Regional Hospital Bamenda;
2. examine the health education and health promotion activities provided by nurses to elderly patients at the Regional Hospital Bamenda;
3. assess the role of nurses in the prevention and management of chronic diseases among elderly patients attending the Regional Hospital Bamenda;
4. identify the challenges faced by nurses in enhancing and promoting healthy ageing among elderly people at the Regional Hospital Bamenda.

1.4 Research Questions

The research questions are derived from the objectives of the study.

1.4.1 Main Research Question

What is the role of nurses in enhancing and promoting healthy ageing among elderly people aged 60 years and above attending the Regional Hospital Bamenda?

1.4.2 Specific Research Questions

1. What roles do nurses play in promoting healthy ageing among elderly people aged 60 years and above at the Regional Hospital Bamenda?
2. What health education and health promotion activities do nurses provide to elderly patients at the Regional Hospital Bamenda?
3. How do nurses contribute to the prevention and management of chronic diseases among elderly patients attending the Regional Hospital Bamenda?
4. What challenges do nurses face in enhancing and promoting healthy ageing among elderly people at the Regional Hospital Bamenda?