Sexual and reproductive health and rights post-ICPD: promises, implementation gaps, and lessons from Cameroon for Francophone sub-Saharan Africa—an integrative review

Three decades after the 1994 International Conference on Population and Development, Cameroon's experience reflects Africa's broader struggle to turn global sexual and reproductive health and rights commitments into effective laws, policies and practices. This integrative critical policy review applied the Guttmacher–Lancet framework and complementary policy lenses to 156 peer-reviewed studies, 15 national policy documents, and key datasets. We identified a pattern of selective domestication, where trackable SRHR domains receiving sustained political attention and donor investment such as maternal health, HIV, and family planning, showed greater progress compared to politically contested domains. This systems-first, rights-second trajectory is sustained by constrained domestic financing, policy resistance from conservative religious actors, fragmented advocacy, and male-dominated governance structures in which institutionalised norms of masculinity systematically limit women's agency and control over their reproductive lives. Progress requires legal and social accountability reforms, embedding rights in universal health coverage, and empowering feminist and youth coalitions.