Nsashiyi Raïssa Shiyghan, Rahman Md Mizanur, Ndam Lawrence Monah, Hashizume Masahiro
Institute for Nature, Health, and Agricultural Research (INHAR), P.O Box 71, Buea, Southwest Region, Cameroon.
Hitotsubashi Institute for Advanced Study, University of Hitotsubashi, 2-1 Naka, Kunitachi, Tokyo, 186-8601, Japan.
BMC Glob Public Health. 2024 Jul 3;2(1):40. doi: 10.1186/s44263-024-00071-4.
Cameroon is among countries that have made notable investments nationwide in line with the Family Planning 2030 initiative. This study examines the progress made across the 10 regions and 58 divisions of the country, including potential impairments following COVID-19 and armed conflict.
In this time-series analysis, parameters were sourced from 5 Demographic and Health Surveys and 3 Multiple Indicator Cluster Surveys conducted between 1991 and 2018. The Family Planning Estimation Tool (FPET) was used to estimate key family planning indicators among married women of reproductive age. Data from official country reports and FPET results were incorporated into Bayesian models to assess how projections (from 2020 to 2030) would vary given varying contractions (i.e., 0%, 5%, 10%, and 25% annually) to services coverage.
Nationally, modern contraceptive prevalence rate (mCPR) and demand satisfied with modern (contraceptive) methods reached 16.8% (95% credible interval 12.0 to 23.0) and 37.6% (28.7 to 47.0), respectively; and unmet need for modern methods decreased to 27.9% (22.9 to 33.7) in 2022. Notable improvements were observed in the East region and Boumba et Ngoko division, with annual mCPR trends of 2.1 percentage points (%p) (- 0.2 to 4.2) and 7.0%p (4.5 to 9.3) from 2015-2020; and 2030 projections of 58.7% (41.3 to 74.0) and 79.1% (65.0 to 89.0), respectively. The least performing in terms of demand satisfied with modern methods include Adamawa at the regional and Boyo at the divisional level, with 2030 projections of 45.5% (26.5 to 65.1) and 0.4% (0.2 to 0.8), respectively. The northern regions (Adamawa, Far North, and North) recorded the lowest levels of unmet need for modern methods. To achieve ≥ 75% demand satisfied with modern methods in 2030, an additional 1.4 (0.6 to 2.2) million modern contraceptive users are required. Given large reductions (- 25% annually) in services coverage post-COVID-19/armed conflict (2020 to 2030), the South region could experience the most significant contraction in projected mCPR, with a decrease of - 9.2%.
Family planning outcomes vary significantly across subnational territories of Cameroon. While the East region shows notable success, greater attention is needed in the northern regions. Strategies must be adaptive to address unprecedented emergencies that may disrupt access to services.
喀麦隆是根据《2030年计划生育倡议》在全国范围内进行了显著投资的国家之一。本研究考察了该国10个地区和58个分区所取得的进展，包括新冠疫情和武装冲突后可能产生的不利影响。
在这项时间序列分析中，参数来源于1991年至2018年期间开展的5次人口与健康调查和3次多指标类集调查。使用计划生育估计工具（FPET）来估计育龄已婚妇女的关键计划生育指标。来自该国官方报告的数据和FPET结果被纳入贝叶斯模型，以评估在服务覆盖率出现不同程度下降（即每年0%、5%、10%和25%）的情况下，（2020年至2030年的）预测结果会如何变化。
在全国范围内，现代避孕普及率（mCPR）和现代（避孕）方法满足的需求分别达到16.8%（95%可信区间为12.0至23.0）和37.6%（28.7至47.0）；2022年现代方法的未满足需求降至27.9%（22.9至33.7）。在东部地区和邦巴和恩戈科分区观察到显著改善，2015 - 2020年的年度mCPR趋势分别为2.1个百分点（%p）（-0.（此处原文有误，推测应为-0.2）至4.2）和7.0%p（4.5至9.3）；2030年的预测分别为58.7%（41.3至74.0）和79.1%（65.0至89.0）。在现代方法满足需求方面表现最差的地区包括地区层面的阿达马瓦和分区层面的博约，2030年的预测分别为45.5%（26.5至65.1）和0.4%（0.2至0.8）。北部地区（阿达马瓦、极北和北部）现代方法的未满足需求水平最低。为了在2030年实现≥75%的现代方法满足需求，还需要额外增加140万（60万至220万）现代避孕使用者。鉴于新冠疫情/武装冲突后（2020年至2030年）服务覆盖率大幅下降（每年-25%），南部地区预计的mCPR可能出现最显著的下降，降幅为-9.2%。
喀麦隆各次国家级地区的计划生育成果差异显著。虽然东部地区取得了显著成功，但北部地区需要更多关注。必须制定适应性策略来应对可能扰乱服务获取的前所未有的紧急情况。
