With a population of 3 million, Douala, composed of six districts, is the largest city in the country, with 20% of the total urban population. The city is subject to various sources of pollution, as waste collection is hampered by the lack of motorized roads in disadvantaged neighbourhoods. Public services are insufficient, are often located at the city centre, and are provided by the private sector. Access to safe water remains a problem in many areas.

Under the leadership of the mayor, a multisectoral coordination committee was established to implement the City Action Plan 2023–2025. Douala 3rd district identified safe, good-quality water as an entry point for tackling health determinants, such as cholera, and, as a result of dialogue with the municipality, traditional rulers, civil society, community members, and the private sector, an intersectoral community committee for water management was established through a municipal act to improve access to safe water through community participation. Similar municipal acts for intersectoral community committees are expected to be passed in other municipalities of the city.