Multisectoral Programming for Adolescent Health and Well-being in Sub-Saharan Africa-Insights From a Symposium Hosted by UNICEF and the Bill & Melinda Gates Foundation

Whole-of-community and intersectoral interventions that address alcohol-related harms: A scoping review

Alcohol harms threaten global population health, with youth particularly vulnerable. Low - and middle-income countries (LMIC) are increasingly targeted by the alcohol industry. Intersectoral and whole-of-community actions are recommended to combat alcohol harms, but there is insufficient global evidence synthesis and research examining interventions in LMIC. This paper maps existing literature on whole-of - community and intersectoral alcohol harms reduction interventions in high-income countries (HIC) and LMIC. Systematic searching and screening produced 61 articles from an initial set of 1325: HIC (n = 53), LMIC (n = 8). Data were extracted on geographic location, intersectoral action, reported outcomes, barriers, and enablers. HIC interventions most often targeted adolescents and combined community action with other components. LMIC interventions did not target adolescents or use policy, schools, alcohol outlets, or enforcement components. Programme enablers were a clear intervention focus with high political support and local level leadership, locally appropriate plans, high community motivation, community action and specific strategies for parents. Challenges were sustainability, complexity of interventions, managing participant expectations and difficulty engaging multiple sectors. A learning agenda to pilot, scale and sustain whole-of-community approaches to address alcohol harms in settings is crucial, with consideration of local contexts and capacities, more standardised methods, and a focus on community-driven action.

Implementation of a Multisectoral Approach to Address Adolescent Pregnancy: A Case Study of Subnational Advocacy Informing National Scale-Up in Kenya

Adolescent pregnancy continues to be a major concern globally, especially in sub-Saharan Africa, where it contributes to high maternal mortality and morbidity and other non-health consequences, such as school dropouts. Addressing adolescent sexual and reproductive health requires an enabling environment that extends beyond an individual to community and society levels through concerted efforts by various sectors and agencies. From 2016 to 2022, we implemented an advocacy intervention in Kenya that catalyzed multisectoral collaboration to address adolescent sexual and reproductive health issues, specifically adolescent pregnancy, at subnational and national levels. In this article, we document our experiences implementing the intervention by presenting a case study of this initiative, including the processes and lessons learned. Our experience to date demonstrates that multisectoral initiatives can be rolled out to address adolescent pregnancies in countries that continue to have a high burden of adolescent pregnancy. Successful implementation requires inclusivity, commitment, and leadership to fully realize the potential that multisectoral actions have in preventing adolescent pregnancy.

Preventing malnutrition within the first 1000 days of life in under-resourced communities: An integrative literature review

This integrative review aimed to summarise existing best evidence practice for preventing malnutrition within the First 1000 Days of Life in under-resourced communities. BioMed Central, EBSCOHOST (Academic Search Complete, CINAHL and MEDLINE), Cochrane Library, JSTOR, Science Direct and Scopus were searched as well as Google Scholar and relevant websites for grey literature. Most recent versions of strategies, guidelines, interventions and policies; published in English, focussing on preventing malnutrition in pregnant women and in children less than 2 years old in under-resourced communities, from January 2015 to November 2021 were searched for. Initial searches yielded 119 citations of which 19 studies met inclusion criteria. Johns Hopkins Nursing Evidenced-Based Practice Evidence Rating Scales for appraising research evidence and non-research evidence were used. Extracted data were synthesised using thematic data analysis. Five themes were derived from extracted data: 1. Improving social determinants of health using a multisector approach; 2. Enhancing infant and toddler feeding; 3. Managing healthy nutrition and lifestyle choices in pregnancy; 4. Improving personal and environmental health practices; and 5. Reducing low-birthweight incidence. Further exploration regarding preventing malnutrition in the First 1000 Days in under-resourced communities is required using high-quality studies. Systematic review registration number: H18-HEA-NUR-001 (Nelson Mandela University).

"Pick your team wisely": A case study of a long-standing research-practice partnership

Research-practice partnerships (RPP) provide opportunities to connect researchers, practitioners, and/or community development professionals in meaningful ways, thereby improving the quality of research, evaluation, and practice in communities. Yet, there is still much to learn about how successful partnerships between researchers and practitioners develop. Historically, research on this topic has emphasized challenges that prevent RPP from developing to their highest potential, with limited information available on ways to promote RPP and how to ensure RPP are mutually beneficial for participants. However, research on partnerships more generally, such as multisector partnerships, can contribute meaningfully to the RPP field. We present an in-depth case study on a successful, long-term partnership. In this study, we pull from the broader partnership literature to explore contexts that are likely to promote partnerships, as well as the activities that can strengthen RPP. Findings focus on addressing ways to promote RPP and highlight the importance of preexisting factors, such as a culture that values both researcher and practitioner expertise, history, and chemistry between partners. Additionally, non-professional space and time, productive disagreements, clear but evolving roles, and shared power were found to strengthen collaboration within the partnership. Specific advice for anyone considering joining an RPP is also discussed.