Study Overview

EVIHDAF successfully completed the TRaC PASSR II study on the Use of Contraceptive Methods in Northern and Eastern Cameroon, a large-scale evidence generation initiative designed to assess knowledge, access, and use of contraceptive methods in Cameroon’s most vulnerable regions. Commissioned by Population Services International (PSI) Cameroon, EVIHDAF implemented this study in the Adamawa, East, North, and Far North regions of Cameroon, providing critical baseline evidence to guide the third phase of the PASSR (Programme d’Accès aux Services de la Santé de la Reproduction) project.

About the PASSR Project

Sponsored by KfW in partnership with the Government of Cameroon represented here by its Ministry of Public Health (MINSANTE), and implemented by PSI Cameroon and ACMS, the PASSR (Programme d’Accès aux Services de la Santé de la Reproduction) project responds to persistent challenges in sexual and reproductive health, including high maternal mortality, low contraceptive prevalence, and strong regional and gender disparities in access to family planning services. The project is currently stepping into its third phase.

Study Objectives

The TRaC PASSR II study aimed to:

• Establish baseline values of key impact and outcome indicators for PASSR II
• Identify population sub‑groups with heightened vulnerabilities, including women, men, and adolescents
• Analyze behavioral, psychosocial, partner‑related, and service‑related barriers to contraceptive use
• Generate operational recommendations to inform adaptive programming and policy design for PASSR III.

Methodology

A quantitative, cross-sectional household and individual survey was conducted between March and April 2026 using digital data collection tools like KoboCollect. Data were analyzed using R statistical software, ensuring weighted, regionally representative estimates. Targeted groups were Women (15-49 years); Men (15-59 years); and Adolescents (girls and boys aged 10-14 years). The study covered 1,955 households and surveyed 2,683 women; 1,135 men; 733 adolescent girls; and 397 adolescent boys. As usual, the study adhered to national and international ethical standards, with clearance obtained from Cameroon’s National Ethics Committee for Human Health Research (CNERSH).

Findings

Key Findings – Women

Among women aged 15-49 years who were sexually active and not pregnant, overall contraceptive prevalence was 22%, with 20.8% using modern methods, reflecting a decline compared to 2020. Injectable contraception remained the most commonly used method (12%), while use of long‑acting methods stayed low at 5.3%, with the highest levels observed in the East Region. Although most women had heard of at least one contraceptive method, knowledge levels declined notably over time. General knowledge dropped from 84.6% in 2020 to 71.7% in 2026, with decreases observed across regions and age groups. This erosion of knowledge highlights the vulnerability of past gains in contexts affected by social, security, and service‑delivery constraints. Non‑use of modern contraception was largely driven by desire for large families, fear of side effects, and limited autonomy in decision‑making. Many women who wished to space or limit births reported being constrained by partner or family opposition and persistent misconceptions about infertility, underscoring the importance of addressing gender and behavioral barriers alongside service availability.

Key Findings – Men

Among men aged 15-59 years, 22.2% reported contraceptive use, either personally or through their partners, with 19.5% using modern methods. While more than half of men (51.4%) expressed favorable attitudes toward modern contraception, only 18.9% reported an intention to use it in the future, revealing a clear gap between attitudes and behavior. Contraceptive use among men was higher among those who were more educated, unmarried, and living in urban areas. However, strong pronatalist norms, fear of side effects, and mistrust of contraceptive methods continued to limit uptake. The findings suggest that low contraceptive use cannot be explained by male opposition alone, but rather by deeper structural constraints, particularly women’s limited decision-making power.

Key Findings – Adolescents

Exposure to reproductive health communication was moderate among adolescents, with 49.9% of girls and 26.5% of boys reporting contact with interpersonal communication activities. Despite this exposure, utilization of youth friendly health services remained very low, indicating weak transitions from information to service use. Knowledge gaps were especially pronounced in menstrual health. Only 31.3% of girls demonstrated adequate knowledge of menstruation, and just 15.5% understood proper menstrual hygiene practices, while awareness among boys was minimal. These results highlight the need for earlier, age appropriate education and stronger adolescent focused reproductive health interventions.

In a nutshell, the TRaC PASSR II study highlights a regression in several key reproductive health indicators since 2020, despite ongoing programmatic efforts. Findings demonstrate that:

• Knowledge alone is insufficient without addressing behavioral and social norms
• Women’s limited autonomy remains a central structural barrier
• Adolescents represent a critical entry point for long term impact.

Strategic Recommendations

The study proposes five priority actions for PASSR III:

1. Strengthen behavior change communication targeting myths and pronatalist norms
2. Improve management of contraceptive side effects by providers and community health workers
3. Expand inclusive community dialogue, actively engaging men and religious leaders
4. Reduce financial barriers through synergies with health financing mechanisms
5. Prioritize Adamawa and adolescent focused interventions due to persistently weak indicators.

Dive deep into study report here