Agricultural Livelihoods, Rural Exposure and Childhood Malaria Incidence in Cameroon: Evidence from the Demographic and Health Survey

Abstract

Malaria continues to impose a substantial public health and economic burden across Sub-Saharan Africa despite decades of intensified control interventions, particularly among children under five years of age who remain the most vulnerable group. In Cameroon, where a large share of the population depends on agriculture and rural livelihoods, the interaction between agricultural practices, rural exposure, and malaria risk remains insufficiently understood. This study investigates the effect of agricultural livelihood dependence on childhood malaria incidence in Cameroon, with particular emphasis on rural-urban disparities. Using secondary data from the Demographic and Health Survey (DHS), the study employs a binary logistic regression model to examine the determinants of malaria incidence among children while controlling for socioeconomic, demographic, environmental, and regional factors. The findings reveal that children in agricultural and rural households exhibit higher exposure to malaria risk due to increased proximity to vector breeding environments, although improved household wealth, maternal education, and better housing conditions significantly reduce malaria incidence. The rural effect remains statistically significant even after controlling for confounding factors, highlighting persistent spatial inequalities in health outcomes. The study recommends integrated rural development policies that combine agricultural modernisation with environmental health interventions, improved housing infrastructure, and strengthened malaria prevention programmes.