The effect of the anglophone crisis on youth sexual and reproductive health in the Northwest region of Cameroon: a qualitative study

Abstract

The ongoing armed conflict in the two English-speaking regions of Cameroon, named the “Anglophone crisis”, has had a deleterious impact on the health and wellbeing of the populations inhabiting these regions, especially adolescents and youth, but there is sparse evidence on the effect of the crisis on adolescent and youth sexual and reproductive health (SRH). This study aimed to describe the effects of the crisis on adolescent SRH and identify stakeholder recommendations for strategies to address the SRH of youth in their crisis-impacted communities. This was a secondary analysis of qualitative data collected during discussion forums with 316 community stakeholders, including parents (n=63), youths (n=81), religious leaders (29), neighborhood leaders (n=23), secondary school teachers (n=28), health professionals (n=37), pharmacists (n=5), local drug vendors (n=13), media representatives (n=12), and non-governmental organization representatives (n=29), in Bamenda, northwest region, Cameroon. A total of 12 homogenous discussion groups of 5 to 41 participants in each were conducted between May and July 2020. Session recordings were transcribed and then analyzed using Dedoose qualitative data management software and a text analysis approach. The results indicate that the crisis led to internal displacements and idleness among adolescent and youth, which increased their social and economic vulnerabilities, including to sexual violence and transactional sex. Resulting SRH effects were unplanned pregnancies, sexually transmitted Infections, unsafe abortions, maternal mortality, and psychosocial distress. Community stakeholders recommended that strategies to improve adolescent and youth SRH outcomes in these conflict-hit regions focus on spreading information about SRH, providing SRH services, and addressing issues of idleness. The armed conflict in the Northwest region of Cameroon has had consequences on adolescent and youth’s adverse SRH outcomes, such as unintended pregnancies, transactional sex, rapes, unsafe abortions, and maternal death. The findings of this study highlight the importance of raising awareness on SRH risks of adolescents and youth and the necessity of adopting a community approach in developing interventions and policies to improve adolescent and youth SRH in regions affected by armed conflicts.