REPUBLIC DU CAMEROUN

REPUBLIC OF CAMEROON Paix - Travial – Patrie

Peace - Work – Fatherland ************
CENTRE REGION REGION DU CENTRE
********** ***********
MINISTRY OF HIGHER MINISTERE DU L`ENSEIGNEMENT
****88EDUCATION SUPERIEUR
*********** *******
HOLY INFANT HIGHER INSTITUTE INSTITUTE SUPERIEUR DES SCIENCES
OF DE LA SANTE HOLY INFANT, MELEN
HEALTH SCIENCES, MELEN YAOUNDE
YAOUNDE

Authorization No. 19- 10563/N/MINSUP/SG/DDES/ESUP/SDA/GA

COMMUNITY INTERNSHIP REPORT AT

CENTRE DE AKON SANGMALIMA
FROM 23RD DECEMBER 2024- 25TH JANUARY
2025

ACADEMIC SUPERVISOR:
MADAM AURELIA WETONDIE DJEUMAKO
CLINICAL SUPERVISOR:
MADAM AKUNO STEPHANE
(Principal State Registered Nurse)

ACADEMIC YEAR: 2024-2025

 NAMES OF STUDENTS
- AFESE PRISCA ESENWU
- AYUK IVODIA MANYI
- ACHEATI SHALOM
- LEIN MARGORIE NDONG
- DJOUKWO KUEPPO MICHELLE
- NCHAMUKONG LENORA
- LONTSI TIOSOP MAEVA
- NGAH EKEBENA SUZANNE
- PAULATE APONG
- MARINET WIYSAHNYUY
- TATAW BRANDY TAGEM

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 ACKNOWLEDGEMENTS
We would like to acknowledge the community and their community workers for providing us with the
opportunity to complete our community internship.

We thanked the chief of Center of the district hospital of Akon III for her guidance, support and
mentorship throughout the internship.

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 TABLE OF CONTENTS
ACKNOWLEDGEMENTS..........................................................................................................................i

INTRODUCTION.......................................................................................................................................v

CHAPTER ONE..........................................................................................................................................1

PRESENTATION OF THE COMMUNITY...............................................................................................1

1.1 BRIEF HISTORY OF THE COMMUNITY.....................................................................................1

1.2 ADMINISTRATIVE ORGANISATION..........................................................................................2

1.3 HEALTH AREA...............................................................................................................................2

1.4 PRESENTATION OF THE RECEIVING HEALTH FACILITY.....................................................3

HISTORY............................................................................................................................................3

PHILOSOPHY....................................................................................................................................3

HUMAN RESOURCES......................................................................................................................4

SERVICES..........................................................................................................................................4

CHAPTER TWO.........................................................................................................................................6

PROGRESS OF INTERNSHIP...................................................................................................................6

2.1 Hospital Based Activities..................................................................................................................6

2.2 Community based activities...............................................................................................................7

CHAPTER THREE...................................................................................................................................10

PRESENTATION OF A COMMUNITY CASE STUDY.........................................................................10

I. Definition of Teenage Pregnancy:.................................................................................................10

II. Epidemiology:...........................................................................................................................10

III. Risk Factors:..............................................................................................................................11

IV. Medical Diagnosis:....................................................................................................................11

V. Nursing Diagnosis:...........................................................................................................................12

VI. Management:...................................................................................................................................12

VII. Rational..........................................................................................................................................14

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 VIII. Conclusion of Case......................................................................................................................14

CHAPTER FOUR.....................................................................................................................................16

SWOT ANALYSIS...................................................................................................................................16

SUGGESTIONS....................................................................................................................................17

ANNEXES................................................................................................................................................18

GENERAL CONCLUSION......................................................................................................................23

REFERENCES..........................................................................................................................................24

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 INTRODUCTION
A community internship is a supervised, hands-on learning experience where students or individuals work
with community organizations, agencies, or institutions to address specific community needs or social
issues. This internship helps to;

 Practical experience: Gain practical skills and experience in a real-world setting.

 Community engagement: Develop an understanding of community needs and contribute to
addressing them.
 Professional development: Enhance career prospects and build professional networks.

At the end of the intern ship, the students have to be capable of acquiring Health

Center Skills, Community knowledge and aptitude in community health management.

Precisely, they have to be capable to;

1. ldentify the area of experience

a. Locate the health area within the Health District

b. Locate the Health Center within the Health area and other health providers

2. Describe the Health center and personnel, community and its origin

3. Team work with health staff to create a conducive environment for work to be done (co-management)

4. Draw a plan of action to be carried out for a specified period

5. Develop and implement a work plan, evaluate interventions strategies and

Modify plan accordingly

a. Health Center: MCH/FH, ANC, IWC, EPI

b. Community health: Home/compound visits, school health environmental sanitation, agriculture,

veterinary, bakeries, markets etc.

c. Visit to village heads (traditional and administrative leaders)

6. Analyze and demonstrated the role of a CHN in the community

7. Apply the concepts of community participation and empowerment when addressing out specific health
needs of the community

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8. Perform 20 home visit (provide health education based on assed need)

9. Conduct community assessment and diagnose including the identification of high risk groups)

10. Develop and implement action plan relevant to the community needs/ diagnosis

11. Evaluate interventions strategies and modify the management plan accordingly

12. Participate in field team activities at the primary health care and family health care

13. ldentify existing dialogue structures and the state of its functionality

14. Identify the role of pro-pharmacy in the provision of essential drugs

15. Write a health center and community experience report based on the objectives above

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 CHAPTER ONE

PRESENTATION OF THE COMMUNITY

1.1 BRIEF HISTORY OF THE COMMUNITY
 Origin

Sangmelima is a town located in the Dja-et-Lobo Division of the South Region of Cameroon.
The area has been inhabited by various ethnic groups for centuries, with the Bulu people being
the main inhabitants. According to oral tradition, the Bulu people migrated to the area from the
Congo River basin in the 18th century. They were attracted by the fertile soil, abundant forests,
and access to the Dja River.

 Culture

The Bulu people have a rich cultural heritage, with a strong emphasis on traditional music,
dance, and art. They are known for their expertise in woodcarving, basketry, and textiles. The
Bulu people also have a complex system of traditional governance, with a council of elders
playing a key role in decision-making. Christianity and traditional African religions coexist in the
area, with many residents practicing a syncretic form of worship.

 Climate

Sangmelima has a tropical rainforest climate, with high temperatures and high humidity levels throughout
the year. The area experiences a bimodal rainfall pattern, with two distinct wet seasons from March to
June and September to November. The dry seasons, which occur from July to August and December to
February, are characterized by relatively low humidity and moderate temperatures.

 Population

As of the 2005 census, the population of Sangmelima was approximately 36,000 people. The town has
experienced significant growth since then, driven by migration from rural areas and natural population
increase. The population is predominantly Bulu, but there are also smaller communities of other ethnic
groups, including the Eton, Ewondo, and Bassa.

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1.2 ADMINISTRATIVE ORGANISATION
 Hospital Director: Overall responsibility for hospital management
 Deputy Director: Assists the Hospital Director and oversees specific departments
 Administrative Secretary: Provides administrative support to the Hospital Director
and Deputy Director

1.3 HEALTH AREA

Description of the location

The integrated health center of Akon, Sangmelima is built in a 2000m 2 40km of land. The health center is
limited to the south by Akon market, to the west by the 3rd street Akon and to the east by the 6th street
Akon

HEALTH AREA AKON

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 Functions of dialogue structure

 Improving Communication: Dialogue structures facilitate open and transparent communication

among healthcare providers, patients, and communities, ensuring that everyone is informed and
heard.
 Building Trust: Regular dialogue helps build trust among stakeholders, fostering a sense of
collaboration and mutual respect.
 Enhancing Patient Engagement: Dialogue structures enable patients to take an active role in their
healthcare, expressing their needs, concerns, and preferences.
 Promoting Community Participation: Dialogue structures encourage community involvement in
health decision-making, ensuring that health services are responsive to local needs.
 Supporting Healthcare Provider Collaboration: Dialogue structures facilitate collaboration among
healthcare providers, promoting a team-based approach to patient care.

1.4 PRESENTATION OF THE RECEIVING HEALTH FACILITY

HISTORY
The integrated health center of Monaza was the first health Centre in Sangmelima created in the
year 2000.

In health center district of Sangmelima there are 11 health centers, 2 in Avebe-Esse, 5 in

Akomessing, 3 in Akon, and 3 in Meyomessi. There are also 9 Health training centers.

PHILOSOPHY

Vision Statement

To provide compassionate, quality healthcare services to the communities we serve, promoting

health, well-being, and dignity for all.

Mission Statement

To deliver patient-centered, accessible, and equitable healthcare services, fostering partnerships

with our communities, healthcare providers, and stakeholders to improve health outcomes and
quality of life.

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HUMAN RESOURCES
There are;

- 5 nurses
- 2 midwives
- 2 lab technician.

SERVICES
The hospital is made up of;

 Maternity unit
 Female ward
 Male ward
 Children ward
 Laboratory unit
 Vaccination room
 Pharmacy
 UPEC ( HIV/ TB unit)

ORGANIGRAMME

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 CHAPTER TWO

PROGRESS OF INTERNSHIP

2.1 Hospital Based Activities

At the health center of Akon, we were able to work in the various units of the hospital;

 Medical unit: in the medical unit, we were able to practice drug administration, wound
dressing, minor sutures patient monitoring( vital signs especially blood pressure).
 Laboratory unit: In the laboratory we were able to carry out various diagnostic methods
and procedures such as specimen collection( blood, urine, vagina swab both high and low
vagina swab, stool), specimen analysis such as fasting blood sugar, urinalysis, rapid
diagnostic test( HIV, malaria, syphilis, hepatitis B and C, Chlamydia), and thick blood
film. We also practice laboratory hygiene on a daily bases likewise in all the other units.
 Maternity unit: In the maternity, we basically only assisted in child birth and monitoring
of pregnant women during labor.
 Vaccination unit: In the vaccination unit, we assisted and carried out child vaccination,
giving rendez-vous for the next vaccination program, vaccination of pregnant women.
 Dialogue structures
In the hospital, we program dialogues based on the vaccination program of the
hospital which was structure for two days, Mondays and Fridays. Mondays were
for babies from birth to 3months 2weeks and we made it a point of contact to
encourage the mothers on exclusive feeding with only breast milk and ensuring
the sanitation and health hygiene of their babies environments, the importance of
following up on all their babies vaccines as this will help improve and keep their
babies healthy and out of risk of many diseases and we also encourage them on
the new malaria vaccine with the first dose 3months 2weeks. On Fridays,
vaccination was for babies 6months to 15months and even 9years for the Human
Papilloma Virus. We presented talks on baby winning , mixed feeding, the kind of
food to start with like artificial milk, water then gradually moving to solid food
like costard, pap, banana, eggs, oranges and others.

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2.2 Community based activities
 Visit to stakeholders: For this community internship, we were able to visit the
delegate of health for the Sangmelima health district who received us warmly and
gave us an overall knowledge on the Sangmelima health district and its
functioning and structure.
 Visit to school: We were able to visit two primary school, where we presented
talks on school hygiene and healthy environment, hand hygiene and hand washing
with soap and clean running water, common diseases like malaria and its
prevention encouraging the children to tell the parents to take them for the malaria
vaccines, we also encourage the children on the importance of going to the
hospital when feeling sick as early diagnosis could help better treatment and
prevent further complications. The children and teachers including the school
administrations were happy to have us and readily received our message.
 Visit to other gathering points: we were able to visit the market, where we gave
out talks on food hygiene and preservation( washing before selling, cover from
dust and contaminants like inserts, shielding from sun, buying quantities that can
be sold out before they become perishable), hand hygiene, STDs and prevention
including early diagnosis, clean drinking water and purification methods( aqua
tabs, use of filters, producing their own local filter with cotton and a container,
boiling and allowing to settle, charcoal treatment, chlorination by adding a few
drops of Javel into drinking water)
 Home visits: we were able to visit a total of 36 homes and give them talks on
STDs, good drinking water source, environmental hygiene and home hygiene
which helps in disease prevention and insect/vector control, food preparation and
preservation to avoid food borne diseases. We were as well encourage by some of
the adults to continue on the right path and practice what we are being thought
and not to take up the regular wrong practices some personels are into.

 Outreaches: we were able to go to other villages under the Akon health

jurisdiction such as Ngon and Nga, we encouraged them to follow-up their
vaccination during pregnancy, and also take the children for vaccination. We also

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 gave the village community health talks on STD’s, malaria and general hygiene
such hand washing, environmental hygiene and home hygiene. We were also able
to carry out hospital environmental cleaning and waste disposal by sorting and
incineration

2.3 Attainment of objectives

Objectives Attained Partially attained Not Attained

ldentify the area of 
experience
Describe the Health center 
and personnel, community
and its origin
Team work with health staff 
to create a conducive
environment for work to be
done (co-management)
Draw a plan of action to be 
carried out for a specified
period
Develop and implement a 
work plan, evaluate
interventions strategies and
Modify plan accordingly

Analyze and demonstrated 

the role of a CHN in the
community
Apply the concepts of 
community participation and
empowerment when
addressing out specific
health needs of the

7
community
Perform 20 home visit 
(provide health education
based on assed need)
Conduct community 
assessment and diagnose
including the identification
of high risk groups
Develop and implement 
action plan relevant to the
community needs/ diagnosis
Evaluate interventions 
strategies and modify the
management plan
accordingly

Participate in field team 

activities at the primary
health care and family health
care
Identify the role of pro- 
pharmacy in the provision of
essential drugs

ldentify existing dialogue 

structures and the state of its
functionality

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 CHAPTER THREE

PRESENTATION OF A COMMUNITY CASE STUDY

Patient Profile

Name: X

Age: 16 years old

Ethnicity: Bulu
Gravida/Para: G1P0 (First pregnancy, no previous births)
Gestational Age: 12 weeks by LMP (Last Menstrual Period)
Social History: High school student, lives with her mother and two younger siblings. Father is not
involved.
Medical History: No significant past medical history. Not currently taking any medications. No
known allergies.
Family History: Mother had her first child at age 17.

I. Definition of Teenage Pregnancy:

Teenage pregnancy is defined as pregnancy occurring in a female between the ages of 13 and 19.
It encompasses pregnancies conceived before the age of 20. Teenage pregnancies are often
considered high-risk pregnancies due to the physiological, psychological, and social challenges
faced by young mothers.

II. Epidemiology:

Global Perspective: The World Health Organization (WHO) recognizes adolescent pregnancy
as a significant global health issue, particularly in low- and middle-income countries. (WHO,
2020)
United States: While teenage pregnancy rates in the US have declined in recent decades, they
remain higher than in many other developed nations. The CDC reports on teen pregnancy rates in
the US, highlighting disparities across racial and ethnic groups. (CDC, 2023)

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III. Risk Factors:
 Socioeconomic status: Teens from disadvantaged backgrounds are at higher risk.
 Education level: Lower educational attainment is associated with increased risk.
 Family environment: Lack of parental supervision, family history of teenage pregnancy, and
unstable home environments increase the risk.
 Access to contraception: Limited access to and knowledge about contraception contribute to
higher rates.
 Peer influence: Peer pressure and norms related to sexual activity can play a role.
Impact: Teenage pregnancy is associated with:
 Increased health risks for both mother and child: The WHO highlights the increased risks
of preterm birth, low birth weight, pregnancy-related complications, and infant mortality in
adolescent pregnancies. (WHO, 2020)
 Educational attainment: Reduced educational opportunities for the mother.
 Economic challenges: Increased poverty and dependence on social welfare.
 Social stigma and isolation
 Increased risk of repeat pregnancies

IV. Medical Diagnosis:

 Presenting Complaint: She presents to the clinic stating she missed her period and has been
experiencing nausea and fatigue for the past few weeks.
Physical Examination:
 Vital signs: Within normal limits.
 Abdominal examination: Uterus palpable above the symphysis pubis.
 Pelvic examination: Cervix appears healthy.
Diagnostic Tests:
 Urine pregnancy test: Positive.
 Ultrasound: Confirms intrauterine pregnancy, estimates gestational age at 12 weeks, and
detects fetal heartbeat.
 Initial prenatal labs: Complete blood count (CBC), blood type and Rh factor, rubella
immunity, syphilis screening, HIV screening, hepatitis B surface antigen, urinalysis. All results
are pending.
The CDC emphasizes the importance of screening for syphilis, HIV and Hepatitis B in
pregnant women. (CDC, 2021)

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  STI Screening: Chlamydia and gonorrhea NAAT (Nucleic Acid Amplification Test), if not
done recently.
The CDC recommends screening for Chlamydia and Gonorrhea in all pregnant women, and
repeat screening for women at high risk. (CDC, 2021)

V. Nursing Diagnosis:
Based on the assessment, the following nursing diagnoses
 Risk for Imbalanced Nutrition: Less than Body Requirements: Related to morning sickness,
limited knowledge of proper nutrition during pregnancy, and financial constraints.
 Anxiety: Related to unintended pregnancy, concerns about the future, and lack of social support.
 Deficient Knowledge: Related to pregnancy, childbirth, newborn care, and parenting.
 Risk for Ineffective Coping: Related to emotional stress, limited support system, and
competing demands of school, work, and pregnancy.
 Risk for Interrupted Family Processes: Related to changes in family dynamics, potential
conflict, and role adjustments.

VI. Management:
The management plan for patient X involves a collaborative approach involving healthcare
providers, social workers, and other support services.

Medical Management:
 Prenatal Care: Regular prenatal visits to monitor patient X health and the baby’s development.
The WHO provides guidelines on antenatal care for a positive pregnancy experience. (WHO,
2016)
 Nutritional Counseling: Education on proper nutrition during pregnancy, including a balanced
diet rich in fruits, vegetables, whole grains, and lean protein. Consider WIC (Women, Infants,
and Children) application if eligible.
 Vitamin and Mineral Supplementation: Prescribe prenatal vitamins with folic acid to prevent
neural tube defects.
 Management of Morning Sickness: Provide guidance on managing nausea and vomiting through
dietary changes (small, frequent meals), rest, and medications if necessary (after careful
consideration).
 Screening for Gestational Diabetes: Perform a glucose challenge test at 24-28 weeks gestation.

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  Monitoring for Pregnancy Complications: Assess for signs and symptoms of preeclampsia,
preterm labor, and other complications.
 Labor and Delivery Planning: Discuss birth options, pain management, and delivery preparation.
Nursing Interventions:
 Education: Provide comprehensive education on all aspects of pregnancy, childbirth, newborn
care, and parenting skills.
 Counseling: Offer emotional support and counseling to address Patient X’s anxiety, fears, and
concerns.
 Referral to Social Services: Connect patient X with resources such as:
 Medicaid: To ensure access to healthcare services
 WIC: To provide nutritional support and education
 Teen parenting programs: To offer support, education, and peer interaction.
 Housing assistance: If needed.
Family Involvement: Encourage family involvement and provide education and support to
Patient X’s mother.
 School Support: Work with the school to ensure Maria can continue her education, either
through alternative schooling options or accommodations to attend regular classes.
 Contraceptive Counseling: Discuss options for contraception after delivery to prevent future
unintended pregnancies. The CDC provides resources on effective contraception methods.
(CDC, 2020)
 Psychosocial Support
 Individual therapy: To address emotional issues, build coping skills, and enhance self-esteem.
 Group therapy: To connect with other pregnant teens and share experiences.
 Parenting classes: To learn effective parenting techniques.
 Mentoring programs: To provide guidance and support from a positive role model.

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VII. Rational

1. Adolescent Development: Teenagers are still undergoing significant physical, emotional, and
social development. Pregnancy can introduce unique challenges that may affect both their health
and the health of the fetus.

2. Risks Associated with Teenage Pregnancy: Pregnant adolescents face higher risks for
complications such as preterm birth, low birth weight, and maternal health issues due to their
still-maturing bodies. Understanding these risks is crucial for providing appropriate prenatal
care.

3. Educational and Social Implications: Teenage pregnancy can disrupt education and career
opportunities. It is important to consider how the pregnancy may affect the patient’s future and
what support systems are in place to help her continue her education.

4. Family Dynamics: The patient’s living situation and family background can significantly
influence her experience of pregnancy. Support from family members, particularly from a parent,
can provide emotional and practical assistance.

5. Psychosocial Factors: Adolescents may face stigma or emotional challenges related to

pregnancy, including anxiety, fear of judgment, or feelings of isolation. Addressing these
psychosocial aspects is essential for comprehensive care.

6. Access to Healthcare: Young mothers may face barriers to accessing appropriate prenatal care,
including lack of knowledge, financial constraints, or transportation issues. Ensuring that she has
access to healthcare resources is vital for her health and the health of her fetus.

VIII. Conclusion of Case

Her case highlights the complex challenges faced by pregnant teenagers. By providing
comprehensive medical care, nursing support, psychosocial interventions, and access to
community resources, we can help patient X navigate her pregnancy, prepare for motherhood,
and achieve her educational and personal goals. It’s crucial to address the underlying social
determinants of health that contribute to teenage pregnancy and to promote prevention strategies
that empower young people to make informed decisions about their sexual health. Ongoing

13
support and encouragement are essential to ensure patient X’s well-being and the healthy
development of her child. The success of her pregnancy will be highly dependent on the
resources and education provided by the health team members and the extent to which the client
implements the information provided.

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 CHAPTER FOUR

SWOT ANALYSIS
STRENGTH WEAKNESS
- Bringing additional knowledge to the - Difficulties in organizing work among
members of the community and ourselves (poor organization)
effectively answering their questions and - Some of us had difficulties in speaking
worries. French

OPPORTUNITY THREATS
- We were opportune to have a health talk No threats encountered
with the primary pupil in different schools
- Opportune to directly talk to the pregnant
teenagers in the hospital

Table 1: SWOT Analysis

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 SUGGESTIONS
Here are some suggestions to address the high rates of malaria and teenage pregnancies in the
community:

Malaria Prevention

 Distribute insecticide-treated bed nets: Provide free or subsidized bed nets to community
members, especially pregnant women and children.
 Organize indoor residual spraying: Collaborate with local authorities to conduct regular indoor
residual spraying to kill mosquitoes.
 Promote mosquito breeding site elimination: Educate community members on how to eliminate
mosquito breeding sites, such as standing water and trash.
 Provide access to malaria testing and treatment: Ensure community members have access to rapid
diagnostic tests and effective treatment.

Teenage Pregnancy Prevention

 Implement comprehensive sex education: Provide age-appropriate sex education in schools and
community centers, focusing on pregnancy prevention, STIs, and healthy relationships.
 Promote access to family planning services: Ensure community members, especially adolescents,
have access to confidential family planning services, including contraception and counseling.
 Support girls' education: Encourage girls to stay in school, as education is a key factor in reducing
teenage pregnancy rates.
 Engage community leaders and parents: Educate community leaders and parents on the
importance of addressing teenage pregnancy and involve them in prevention efforts.
 Provide economic empowerment opportunities: Offer vocational training, mentorship, and
economic empowerment programs to help adolescents, especially girls, make informed choices
about their futures.

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 ANNEXES

Health talk at la Rosiere Bilingual Primary School

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Health talk in homes

18
Health talk in Akon market

Health talk in the street

Hospital cleaning

19
Health talk before vaccination

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 GENERAL CONCLUSION
In conclusion, the community internship experience at Akon, Sangmelima has helped us to broaden our
understanding of the community development, social issues and the important of community engagement.
Throughout this internship, we had the opportunity to apply theoretical concepts to real life situations,
develop new skills and foster relationships with community members.

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 REFERENCES

CDC (Centers for Disease Control and Prevention). (2020). Contraception.

https://www.cdc.gov/reproductivehealth/contraception/index.htm

CDC (Centers for Disease Control and Prevention). (2021). Sexually Transmitted Infections
Treatment Guidelines, 2021. https://www.cdc.gov/std/treatment-guidelines/pregnancy.htm

CDC (Centers for Disease Control and Prevention). (2023). Teen Pregnancy.
https://www.cdc.gov/teenpregnancy/about/index.htm

WHO (World Health Organization). (2016). WHO recommendations on antenatal care for a
positive pregnancy experience. https://www.who.int/publications/i/item/9789241549912

WHO (World Health Organization). (2020). Adolescent pregnancy. https://www.who.int/news-

room/fact-sheets/detail/adolescent-pregnancy

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