Peer-reviewed article
Mapping drivers of sexual and reproductive health injustices among adolescent girls in Kenya, Ghana, and Zambia: a scoping review
Dona Anyona, Rieke van der Graaf, Fleur Kootstra, Josephat M. Nyagero, Julie Fraser et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined research on sexual and reproductive health injustices affecting adolescent girls in Kenya, Ghana, and Zambia. The authors identified 18 papers and found that poverty, cultural gender norms, low education, disability discrimination, peer pressure, and limited access to sexual and reproductive health services are the main drivers of these injustices. Adolescent pregnancy emerged as a key issue connected to all identified drivers. The findings aim to inform policies and programmes to protect girls' sexual and reproductive health rights.
Key points
- In 2022, approximately 12 million girls globally were married before age 18, with adolescent girls' SRHR most problematic in Africa (40% in West and Central Africa, 32% in East and Southern Africa)
- Main drivers of SRHR injustices identified were poverty, culture and gender norms, disability-based discrimination, low education level, peer pressure, and limited access to SRH services due to financial and geographic barriers
- Adolescent pregnancy was identified as the main issue cutting across all drivers of SRHR injustice
- Poverty was identified as a primary driver that interconnects with lack of education, limited access to SRH services, and cultural factors
- Adolescent pregnancy may relate to human rights violations including lack of access to services, lack of education, and early child marriage
Limitations
This is a scoping review that maps drivers across existing literature rather than measuring outcomes or testing interventions. The review is limited to three countries and 18 papers, so findings may not represent the full range of evidence or be generalizable across Africa.
Abstract
Abstract Background Violation of adolescent girls’ sexual reproductive health rights (SRHR) leads to injustices that impact their well-being with potentially fatal and life-long consequences. These injustices often arise due to early marriage, and in 2022, approximately 12 million girls were married before the age of 18, globally. Adolescent girls’ SRHR is especially problematic in Africa, with the highest levels being from West and Central Africa (40%), followed by East and Southern Africa (32%). To address the problem of adolescent girls’ SRHR violations, interventions have included formulating laws and policies to protect the rights and welfare of girls in national legislation, as well as in regional and international human rights instruments. Despite these efforts, the literature that explicitly focuses on SRHR lacks mapping related to drivers of adolescent girls’ SRH injustices to inform programming and policies. Therefore, a scoping review was necessary to map and understand what drives these injustices of adolescent girls’ SRHR in Africa. Methods We conducted a scoping review of papers using a SRHR lens to identify the drivers of adolescent girls’ SRHR injustices in Kenya, Ghana, and Zambia, drawing on multidisciplinary papers. We utilised the Web of Science, PubMed, HeinOnline, JSTOR, Scopus, ScienceDirect, and HINARI databases. Drivers of adolescent girls’ SRHR injustices were extracted from the papers and thematically categorised. Results We identified 18 papers on adolescent girls’ SRHR from Kenya, Ghana, and Zambia. The main drivers therein included poverty, culture and gender norms, discrimination based on disability, low education level, peer pressure, and limited access to SRH services, such as financial and geographic barriers. The main issue that cut across all these drivers was adolescent pregnancy. Conclusion From the papers, using an SRHR frame, poverty is one of the main drivers that stands out and interconnects with others, including lack of education, lack of access to SRH services, and culture. All of the identified drivers were related to adolescent pregnancy. While adolescent pregnancy in itself may not be a human rights violation, it may relate to violations such as lack of access to services, lack of education, and early child marriage. The outcomes of the review will inform policy interventions to protect adolescent girls’ SRHR.