Pathways to Sexual and Reproductive Health Empowerment Among Adolescent Girls in a Resource-Constrained Setting: A Grounded Theory from Southwest Cameroon

Adolescents' journey toward Sexual and Reproductive Health Empowerment (SRHE) in many sub-Saharan African countries faces myriad hurdles.This study aimed to describe pathways to SRHE among Adolescent Girls in a resource-constrained setting in Cameroon's Southwest Region, which has been affected by a socio-political crisis since 2016.The study obtained ethical approval and used a concurrent triangulation and sequential exploratory mixed-methods design within a survey framework, combining quantitative and qualitative approaches.The study included 465 participants: adolescent girls, parents, health personnel, and key informants from traditional, educational, health, social, legal, women and gender empowerment, UN organizations, and civil society organizations.Researchers analyzed quantitative data using SPSS, while qualitative data underwent thematic analysis using ATLAS.tiand NVivo.The findings revealed that though adolescent girls were empowered, the impact was questionable as they still engaged in sex relatively early.Though they were generally aware and had access to either form of contraceptive methods, their willingness to use them was relatively low except for condoms.Among others, teenage pregnancy was relatively high.Critical predictors of early sex were the poverty / economic emancipation, the vulnerability of those with dead parents, from a single-mother home, or living with a friend, and the conflict and fragility context.To improve and sustain SRHE, stakeholders suggested early home-based education; comprehensive/intensified school-based education; intensified community-based education and awareness; and education through controlled mass media.SRH education mostly started in early adolescence.