A policy brief: improving access and utilization of adolescent sexual and reproductive health services in Southern Ethiopia.

Background: Adolescent sexual and reproductive health (ASRH) is fundamental to the overall wellbeing and development of young people. In Southern Ethiopia, adolescents face significant barriers to accessing and utilizing ASRH services: they include limited information, pervasive cultural stigma, and inadequate healthcare infrastructure. Addressing these barriers is critical to reducing unintended pregnancies, preventing sexually transmitted infections, and achieving national and international health objectives.

Exploring preferences to accessing sexual and reproductive health services: A qualitative study of adolescents' and service provider perspectives.

Background: Understanding what adolescents want and how preferences are likely to vary among different groups is important to make the healthcare system responsive to the needs of adolescents and to maximize service utilization. Despite this, evidence is scarce in this aspect. Therefore, this study aimed to explore preferences for accessing Sexual and Reproductive Health (SRH) services from the perspective of adolescents and health care providers in the South Ethiopia Regional State.

Factors associated with perceived social support among adolescents in Gamo Zone, Southern Ethiopia: a community-based cross-sectional study.

Introduction: Perceived social support plays a crucial role in adolescent development, health, well-being, and resilience. Understanding the factors associated with perceived social support among adolescents is essential for designing effective interventions. However, research in this area, particularly within specific contexts, remains limited.

Mentorship in health research institutions in Africa: A systematic review of approaches, benefits, successes, gaps and challenges.

Background: In Africa, where the burden of diseases is disproportionately high, significant challenges arise from a shortage of skilled researchers, lack of research funding, and limited mentorship opportunities. The continent faces a substantial gap in research output largely attributed to the dearth of mentorship opportunities for early career researchers.

Objective: To explore existing mentorship approaches, identify challenges, gaps, successes, and benefits, and provide insights for strengthening mentorship programs in African health research institutions.

Adolescent utilization of sexual and reproductive health services in Gamo Zone, Southern Ethiopia. Insights from multilevel and latent class analysis.

Introduction: Adolescents face unique challenges related to their sexual and reproductive health (SRH), with access to timely services being critical for positive outcomes. However, SRH service utilization among adolescents remains low. This study aimed to identify factors influencing SRH service use among adolescents in Gamo Zone, Ethiopia.

Support for sexual and reproductive health and rights in Sub-Saharan Africa: a new index based on World Values Survey data.

Background: Addressing attitudes is central to achieving sexual and reproductive health and rights (SRHR) and Agenda 2030. We aimed to develop a comprehensive index to measure attitudinal support for SRHR, expanding opportunities for global trend analyses and tailored interventions.

Methods: We designed a new module capturing attitudes towards different dimensions of SRHR, collected via the nationally representative World Values Survey in Ethiopia, Kenya, and Zimbabwe during 2020-2021 (n = 3,711).

Individual, partner, and community variables associated with method-specific contraceptive beliefs in urban and rural Kenya.

Objectives: Global unmet need for contraception remains high. Contraceptive health-related beliefs are a barrier to contraceptive use but are poorly understood. This study examined quantitative differences in two health-related beliefs between pills, injectables, and implants.

Prevalence of adolescent mental disorders in Kenya, Indonesia, and Viet Nam measured by the National Adolescent Mental Health Surveys (NAMHS): a multi-national cross-sectional study.

Background: Mental disorders are the leading global cause of health burden among adolescents. However, prevalence data for mental disorders among adolescents in low-income and middle-income countries are scarce with often limited generalisability. This study aimed to generate nationally representative prevalence estimates for mental disorders in adolescents in Kenya, Indonesia, and Viet Nam.

Exploring Barriers to Accessing Adolescents Sexual and Reproductive Health Services in South Ethiopia Regional State: A Phenomenological Study Using Levesque's Framework.

Introduction: Evidence suggests that adolescents face multiple barriers to accessing Sexual and Reproductive Health (SRH) services. However, there remains a notable gap in the literature regarding the nuanced interplay between supply-side and demand-side barriers. Therefore, this study aimed to examine barriers to accessing SRH services in the Gamo Zone of South Ethiopia Regional State.

Socio-Ecological Analysis of Barriers to Access and Utilization of Adolescent Sexual and Reproductive Health Services in Sub-Saharan Africa: A Qualitative Systematic Review.

Background: In sub-Saharan African countries (SSA), despite the efforts to enable adolescents to access sexual and reproductive health (SRH) services, there are limited systematic review studies that comprehensively synthesize barriers to accessing services using a social-ecological model. Therefore, this review was conducted to fill this gap.

Methods: This study protocol was registered in the PROSPERO database (CRD42022259095).

Women's beliefs about methods and contraceptive discontinuation: Results from a prospective study from Nairobi and Homa Bay counties in Kenya.

Background: Rates of contraceptive discontinuation are high in many low and middle countries contributing to unmet need for contraception and other adverse reproductive health outcomes. Few studies have investigated how women's beliefs about methods and strength of fertility preferences affect discontinuation rates. This study examines this question using primary data collected in Nairobi and Homa Bay counties in Kenya.

Sexual and reproductive health service utilization among adolescent girls in Kenya: A cross-sectional analysis.

We examined the association between adolescents' sexual and reproductive health (SRH) service utilization in the past 12 months and structural, health facility, community, interpersonal, and individual level factors in Kenya. This cross-sectional analysis used baseline data collected in Homa Bay and Narok counties as part of the In Their Hands intervention evaluation from September to October 2018. In total, 1840 adolescent girls aged 15 to 19 years were recruited to complete a baseline survey.

School attendance and sexual and reproductive health outcomes among adolescent girls in Kenya: a cross-sectional analysis.

Background: Given the high burden of adverse sexual and reproductive health outcomes (SRH) and low levels of school attendance among adolescent girls in Kenya, this study sought to elucidate the association between school attendance and SRH outcomes among adolescent girls in Homa Bay and Narok counties.

Methods: This study uses baseline quantitative data from the mixed-methods evaluation of the In Their Hands (ITH) program which occurred between September to October 2018 in Homa Bay and Narok counties. In total, 1840 adolescent girls aged 15-19 years participated in the baseline survey, of which 1810 were included in the present analysis.

Exposure to violence, adverse life events and the mental health of adolescent girls in Nairobi slums.

Introduction: Mental health problems rank among the leading causes of disability among young people globally. Young people growing up in urban slums are exposed to adverse childhood experiences, violence, and other adversities. There is limited research on how exposure to violence and adverse life events influence adolescents' mental health in urban poor settings.

Impacts of multisectoral cash plus programs after four years in an urban informal settlement: Adolescent Girls Initiative-Kenya (AGI-K) randomized trial.

Background: The vast majority of adolescent births occur in low- and middle-income countries and are associated with negative outcomes for both the mother and her child. A multitude of risk factors may explain why few programs have been successful in delaying childbearing and suggest that multisectoral interventions may be necessary. This study examines the longer-term impact of a two-year (2015-17) multisectoral program on early sexual debut and fertility in an urban informal settlement in Kenya.

Exploring Providers' Perception Towards Provision of Sexual and Reproductive Health Services for Unmarried Adolescents in Gamo Zone, Southern Ethiopia: A Phenomenological Study.

Background: Healthcare providers play a critical role in the provision of sexual and reproductive health services for adolescents. In Ethiopia, due to different reasons, including healthcare providers associated reasons, most unmarried adolescents are not accessing the services. However, little is known about healthcare providers' perception towards the provision of SRH services for unmarried adolescents.

Impacts of two-year multisectoral cash plus programs on young adolescent girls' education, health and economic outcomes: Adolescent Girls Initiative-Kenya (AGI-K) randomized trial.

Background: Early adolescence is a critical window for intervention when it is possible to lay a foundation for a safe transition to adulthood, before negative outcomes occur. The Adolescent Girls Initiative-Kenya randomized trial tested the effects of combinations of interventions for young adolescent girls in two sites - the Kibera informal settlement in Nairobi and rural Wajir County in the Northeastern region.

Methods: The interventions included community dialogues on the role and value of girls (violence prevention), a conditional cash transfer (education), weekly group meetings for girls with health and life skills training (health), and training and incentives for financial literacy and savings activities (wealth creation).

The Potential of Self-Managed Abortion to Expand Abortion Access in Humanitarian Contexts.

Refugees and displaced people face uniquely challenging barriers to abortion access, including the collapse of health systems, statelessness, and a lack of prioritization of sexual and reproductive health services by humanitarian agencies. This article summarizes the evidence around abortion access in humanitarian contexts, and highlights the opportunities for interventions that could increase knowledge and support around self-managed abortion. We explore how lessons learned from other contexts can be applied to the development of effective interventions to reduce abortion-related morbidity and mortality, and may improve access to information about safe methods of abortion, including self-management, in humanitarian settings.

Measuring the Prevalence of Mental Disorders in Adolescents in Kenya, Indonesia, and Vietnam: Study Protocol for the National Adolescent Mental Health Surveys.

Purpose: In low- and middle-income countries, there are limited data on mental disorders among adolescents. To address this gap, the National Adolescent Mental Health Surveys (NAMHS) will provide nationally representative prevalence data of mental disorders among adolescents in Kenya, Indonesia, and Vietnam. This paper details the NAMHS study protocol.

Method-specific beliefs and subsequent contraceptive method choice: Results from a longitudinal study in urban and rural Kenya.

Introduction: Evidence from sub-Saharan Africa, including Kenya, shows that negative beliefs about contraceptive methods are associated with non-use. However, little is known about the relationship between contraceptive beliefs and subsequent method choice.

Methodology: We used data from a two-year longitudinal survey of married women aged 15-39 years at enrollment from one urban site (Nairobi) and one rural site (Homa Bay) in Kenya.

HIV trends and disparities by gender and urban-rural residence among adolescents in sub-Saharan Africa.

Background: In sub-Saharan Africa HIV transmission is a major challenge in adolescents, especially among girls and those living in urban settings. Major international efforts have aimed at reducing sexual transmission of HIV. This analysis aims to assess the trends in HIV prevalence by gender in adolescents, as well as urban-rural disparities.

Intimate partner violence against adolescents and young women in sub-Saharan Africa: who is most vulnerable?

Background: Intimate partner violence (IPV) is a global public health and human rights issue that affects millions of women and girls. While disaggregated national statistics are crucial to assess inequalities, little evidence exists on inequalities in exposure to violence against adolescents and young women (AYW). The aim of this study was to determine inequalities in physical or sexual IPV against AYW and beliefs about gender based violence (GBV) in sub-Saharan Africa (SSA).

"I was tricked": understanding reasons for unintended pregnancy among sexually active adolescent girls.

Background: While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15-19 in two Kenya counties with the highest rate of teenage pregnancy.

Methods: We used the "In Their Hands" (ITH) program's baseline evaluation data.