WHO Initiative on Urban Governance for Health and Well-being: city spotlight: Douala, Cameroon

Rapid urbanization, environmental degradation and persistent health inequities are increasing the need for participatory and multisectoral approaches to urban governance that place health and well-being at the centre of local development. This city spotlight, developed within the WHO Initiative on Urban Governance for Health and Well-being, examines how Douala, Cameroon’s economic capital and largest port city, is strengthening collaborative governance mechanisms to address urban health challenges linked to inadequate access to water and sanitation, infectious diseases, environmental risks and socio-economic inequalities. The publication outlines the city’s demographic, administrative and public health context, including the complexities associated with decentralized governance structures, rapid population growth and the influx of internally displaced populations resulting from humanitarian crises in other regions of the country. Particular attention is given to recurrent cholera outbreaks and to the central role of safe drinking water, sanitation and hygiene in protecting health and well-being in underserved neighbourhoods.

The document describes activities implemented during Phase 1 of the initiative between 2020 and 2024, including the development of a multisectoral Strategic Action Plan 2023–2025, establishment of a joint municipal coordination platform, Urbanlead leadership training and implementation of community-based water and sanitation initiatives in Douala’s 3rd Municipal District. It highlights participatory approaches involving municipal authorities, community leaders, civil society organizations and private-sector actors in the creation of Water Works Management Committees responsible for supervising and maintaining public water points and strengthening long-term community engagement in local decision-making. The publication also examines efforts to strengthen local leadership capacities, inter-municipal coordination and evidence-informed planning while promoting a Health-in-All-Policies approach to urban governance. Participation in regional and international city exchange platforms is presented as an additional mechanism for strengthening collaborative learning and dissemination of multisectoral urban health practices. Intended for policy-makers, urban planners, public health professionals and development partners, the report illustrates practical approaches for embedding health and well-being into inclusive, community-driven and multisectoral urban governance systems.