A Mixed Methods Study of Community Engagement in Medicinal Programmes in West Africa: An African Perspective

The practical implementation of community engagement within medicinal programmes in West Africa is poorly understood from a local perspective. A gap exists in literature that foregrounds African voices and experiences in the design and evaluation of such initiatives. This study explored the role of local communities in medicine-focused health programmes in West Africa. Its objectives were to describe current engagement practices, analyse community perceptions of their involvement, and identify barriers and facilitators to meaningful participation. A convergent parallel mixed methods design was employed. A cross-sectional survey was administered to 450 community members across three West African countries. Qualitatively, 24 in-depth interviews and six focus group discussions were conducted with community leaders, health workers, and programme beneficiaries. Thematic analysis was used for qualitative data, which was integrated with descriptive survey statistics. Survey data indicated that 68% of respondents felt their community was consulted only after key programme decisions had been made. Qualitative analysis revealed a central theme of ‘tokenistic inclusion’, where communities were informed rather than partnered with. A strong preference for engagement through respected local structures, such as women’s groups and traditional leadership, was consistently expressed. Current community engagement in medicinal programmes often remains superficial and fails to incorporate local knowledge systems effectively. This undermines programme relevance and sustainability from the perspective of the communities they are designed to serve. Programme planners should adopt a phased, culturally grounded approach to engagement that begins at the conception stage. Investment in building the capacity of existing community structures for sustained partnership is essential. Monitoring and evaluation frameworks must include community-defined indicators of meaningful engagement. community participation, public health, West Africa, medicinal programmes, mixed methods, health systems This study provides an empirical, African-centred perspective on community engagement, highlighting the dissonance between participatory rhetoric and the lived reality of tokenistic inclusion in medicinal programmes.