How do social norms influence the sexual and reproductive health of very young adolescents in sub-Saharan Africa? A scoping review protocol.

Introduction: Introduction Very young adolescents (VYAs, aged 10-14 years) in sub-Saharan Africa (SSA) have the worst sexual and reproductive health (SRH) outcomes of this age group worldwide due to structural, behavioural, socioeconomic and other factors. Social and gender norms have important consequences for the SRH and wellbeing of VYAs both now and over their life course. SRH programming often focuses on older adolescents (aged 15-19 years), overlooking younger ones. This scoping review sets out to explore how social and gender norms influence VYAs' SRH in SSA, in addition to exploring interventions that have been effective, to inform a context-specific intervention.

Methods: We will employ the methodology developed by Arksey and O'Malley to review the available literature. We will search online databases (PubMed/MEDLINE, CINHAL, EMBASE, PsycINFO, Cochrane Library, and African Index Medicus) for original studies published between 1 January 2000 and 31 December 2024. Further, we will perform a manual search to include relevant grey literature. The steps in the review are: 1) defining the research question, 2) identifying relevant studies, 3) selecting studies, 4) charting the data, and 5) collating, summarising, and reporting the results.

Results: Results We will report findings in accordance with the guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. We will analyse and summarise data about study characteristics using descriptive statistics. We will use thematic analysis to analyse and summarise key themes and issues. We will triangulate quantitative and qualitative findings.

Discussion: The review will map the breadth of studies focusing on social and gender norms, and SRH among VYAs, in addition to exploring interventions that have been effective. Findings will help us and others develop context-specific, bespoke interventions.