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Agyepong IA, Agblevor E, Odopey S, Addom S, Enyimayew Afun NE, Agyekum MP, Asante PY, Aye GE, Darko N, Diarra A, Fenny AP, Gladzah A, Ibrahim N, Kagambega A, Wallace LJ, Novignon J, Yaogo M, Borgès Da Sliva R, Ensor T, Mirzoev T. Interventions for adolescent mental, sexual and reproductive health in West Africa: A scoping review. PUBLIC HEALTH IN PRACTICE 2024; 8:100530. [PMID: 39105105 PMCID: PMC11298589 DOI: 10.1016/j.puhip.2024.100530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 06/27/2024] [Indexed: 08/07/2024] Open
Abstract
Objectives A quarter of West Africa's population are adolescents 10-19 years. Their mental, sexual, and reproductive health is inter-related. We therefore aimed to examine published evidence on effectiveness of interventions for adolescent mental, sexual and reproductive health in the Economic Community of West African States (ECOWAS) to inform development, implementation and de-implementation of policies and programs. Study design The study design was a scoping review. Methods We considered all qualitative and quantitative research designs that included adolescents 10-19 years in any type of intervention evaluation that included adolescent mental, sexual and reproductive health. Outcomes were as defined by the researchers. PubMed/Medline, APA PsycINFO, CAIRN, and Google Scholar databases were searched for papers published between January 2000 and November 9, 2023.1526 English and French language papers were identified. After eliminating duplicates, screening abstracts and then full texts, 27 papers from studies in ECOWAS were included. Results Interventions represented three categories: service access, quality, and utilization; knowledge and information access and intersectionality and social determinants of adolescent health. Most studies were small-scale intervention research projects and interventions focused on sexual and reproductive or mental health individually rather than synergistically. The most common evaluation designs were quasi-experimental (13/27) followed by observational studies (8/27); randomized, and cluster randomized controlled trials (5/27), and one realist evaluation. The studies that evaluated policies and programs being implemented at scale used observational designs. Conclusion Research with robust evaluation designs on synergistic approaches to adolescent mental, sexual and reproductive health policies, interventions, implementation and de-implementation is urgently needed to inform adolescent health policies and programs.
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Affiliation(s)
- Irene A. Agyepong
- Ghana College of Physicians and Surgeons. (GCPS), Accra, Ghana
- Dodowa Health Research Center, Ghana
| | - Emelia Agblevor
- Ghana College of Physicians and Surgeons. (GCPS), Accra, Ghana
| | - Selase Odopey
- Dodowa Health Research Center, Ghana
- School of Public Health, University of Ghana, Ghana
| | - Selasie Addom
- Ghana College of Physicians and Surgeons. (GCPS), Accra, Ghana
- Ghana Mental Health Authority, Accra, Ghana
| | | | | | | | - Grace Emmanuelle Aye
- Ghana College of Physicians and Surgeons. (GCPS), Accra, Ghana
- Dodowa Health Research Center, Ghana
| | | | - Aïssa Diarra
- Laboratoire d’études et Recherches sur les dynamiques Sociales et le développement local. (LASDEL), Niger
| | - Ama Pokuaa Fenny
- University of Ghana, Institute of Statistical, Social and Economic Research (ISSER UG), Ghana
| | | | - Nassirou Ibrahim
- Laboratoire d’études et Recherches sur les dynamiques Sociales et le développement local. (LASDEL), Niger
- Université de Montréal Quebec, Canada
| | - Aline Kagambega
- Institut National de Santé Publique, Observatoire National de Santé de la Population (IASP), Burkina Faso
| | | | - Jacob Novignon
- Kwame Nkrumah University of Science and Technology (KNUST) Department of Economics, College of Humanities and Social Sciences, Ghana
| | - Maurice Yaogo
- Institut National de Santé Publique, Observatoire National de Santé de la Population (IASP), Burkina Faso
| | | | | | - Tolib Mirzoev
- London School of Hygiene and Tropical Medicine, London UK Department of Global Health and Development London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Yang Z, Chen W, Chen W, Ma Q, Wang H, Jiang T, Jin M, Zhou X. Factors associated with voluntary HIV counseling and testing among young students engaging in casual sexual activity: a cross-sectional study from Eastern China. BMC Public Health 2024; 24:1109. [PMID: 38649927 PMCID: PMC11036676 DOI: 10.1186/s12889-024-18562-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVES To investigate the factors associated with voluntary HIV counseling and testing (VCT) among young students engaging in casual sexual activity and to establish a scientific rationale for developing targeted intervention strategies for preventing HIV/AIDS in this population. METHODS Stratified cluster sampling was used to conduct a survey using questionnaires to collect demographic and behavioral information for statistical analysis. RESULTS Data from 611 young students, who reported engaging in casual sexual activity, were included in the statistical analysis. Among these, 68 (11.13%) students underwent the VCT. Among young students who engaged in casual sexual activity, those who were non-Zhejiang residents (adjusted odds ratio [aOR]: 2.11; 95% Confidence Interval [CI]: 1.17-3.80), those who had received AIDS-themed lectures or health education courses from the school in the past year (aOR = 3.96, 95% CI = 1.49-10.50), those who had received HIV risk self-assessment conducted by the school in the past year (aOR = 2.31, 95% CI = 1.17-4.59), and those who had engaged in commercial sex activity in the past year (aOR = 1.98, 95% CI = 1.07-3.66) were more inclined to have undergone VCT. Male students (aOR = 0.37, 95% CI = 0.18-0.77) and those who used condoms consistently during casual sexual activity (aOR = 0.45, 95% CI = 0.21-0.97) were less likely to undergo VCT. CONCLUSION Casual sexual activity was relatively prevalent among young students, posing a potential risk for HIV transmission. These findings will be instrumental in the development more effective HIV prevention and control strategies for young students. Additionally, it highlights the necessity of promoting and popularizing VCT among young students without Zhejiang province residency, who are involved in commercial sexual activity, and/or those who lacking HIV education. Moreover, additional research and implementation of refined HIV behavioral interventions specifically tailored to young students are necessary to enhance their awareness and knowledge of HIV prevention.
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Affiliation(s)
- Zhongrong Yang
- Huzhou Center for Disease Control and Prevention, Zhejiang province, 313000, Huzhou, China
| | - Wanjun Chen
- Department of HIV/STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, No.3399, Binsheng Road, 310051, Hangzhou, Zhejiang province, China
| | - Weiyong Chen
- Department of HIV/STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, No.3399, Binsheng Road, 310051, Hangzhou, Zhejiang province, China.
| | - Qiaoqin Ma
- Department of HIV/STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, No.3399, Binsheng Road, 310051, Hangzhou, Zhejiang province, China
| | - Hui Wang
- Department of HIV/STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, No.3399, Binsheng Road, 310051, Hangzhou, Zhejiang province, China
| | - Tingting Jiang
- Department of HIV/STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, No.3399, Binsheng Road, 310051, Hangzhou, Zhejiang province, China
| | - Meihua Jin
- Huzhou Center for Disease Control and Prevention, Zhejiang province, 313000, Huzhou, China
| | - Xin Zhou
- Department of HIV/STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, No.3399, Binsheng Road, 310051, Hangzhou, Zhejiang province, China
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Agblevor EA, Darko NA, Acquah PA, Addom S, Mirzoev T, Agyepong IA. "We have nice policies but…": implementation gaps in the Ghana adolescent health service policy and strategy (2016-2020). Front Public Health 2023; 11:1198150. [PMID: 38148876 PMCID: PMC10749951 DOI: 10.3389/fpubh.2023.1198150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/20/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Although policies for adolescent health exist in Ghana, their implementation is challenging. Availability of services for adolescent sexual and reproductive health and adolescent mental health remains less than desired, with adolescent mental health being particularly neglected despite being an important contributor to poor health outcomes. This study presents an analysis of gaps in the implementation of the Ghana Adolescent Health Service Policy and Strategy (2016-2020), including how and why the context influenced the observed implementation gaps. Methods Data for this study is drawn from 17 in-depth interviews with purposefully identified key stakeholders in adolescent mental, sexual, and reproductive health across the national and subnational levels; four focus group discussions (FGDs) with district health management teams; and 11 FGDs with adolescents in and out of schools in four selected districts in the Greater Accra region. Data were analyzed using both inductive and deductive approaches. The deductive analysis drew on Leichter's conceptualization of context as structural, cultural, situational, and environmental factors. Results Of the 23 planned strategies and programs for implementing the policy, 13 (57%) were partially implemented, 6 (26%) were not implemented at all, and only 4 (17%) were fully implemented. Multiple contextual factors constrained the policy implementation and contributed to the majority of strategies not being implemented or partially implemented. These factors included a lack of financial resources for implementation at all levels of the health system and the related high dependence on external funding for policy implementation. Service delivery for adolescent mental health, and adolescent sexual and reproductive health, appeared to be disconnected from the delivery of other health services, which resulted in weak or low cohesion with other interventions within the health system. Discussion Bottom-up approaches that engage closely with adolescent perspectives and consider structural and cultural contexts are essential for effective policy implementation. It is also important to apply systemic and multi-sectoral approaches that avoid fragmentation and synergistically integrate policy interventions.
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Affiliation(s)
- Emelia Afi Agblevor
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | | | - Priscilla Ama Acquah
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Selasie Addom
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Tolib Mirzoev
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Irene Akua Agyepong
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
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