Quality early childhood education (ECE) can improve children's learning and development in low- and middle-income countries, but little evidence exists of programs targeting marginalized girls in vulnerable rural communities. This study used a matched-pair mixed-methods community-randomized trial to evaluate a preschool program for marginalized girls (N = 466, Mage = 5-years; W1 = 2022; W2 = 2023) from 16 rural Hausa-ethnic communities in Nigeria. The program yielded considerably large impacts on every domain of school readiness assessed (dt = 0.89-1.52). In qualitative interviews (N = 30, data collected in 2023), parents discussed witnessing their daughters' learning and development as well as their future educational and life goals for their daughters. Results demonstrate that access to high-quality ECE in highly disadvantaged communities can dramatically improve girls' learning and potentially change parental perceptions about girl-child education.
Youth in northern Ghana experience high rates of unintended pregnancy due to limited access to and use of sexual and reproductive healthcare (SRH) services. Peer-led interventions are effective in increasing the youth uptake of SRH services, but limited peer-led interventions have been developed for Ghana. This study explores youth (ages 15-24 years) and clinical provider perspectives on youth SRH to inform the co-design of a peer-led SRH counseling program in northern Ghana. We conducted a qualitative study using semi-structured interviews with 22 SRH providers and 27 youth. We then conducted an inductive thematic analysis and mapped themes onto the COM-B (Capability-Opportunity-Motivation-Behavior) model. Results revealed that youth capability to make informed and confident SRH decisions is constrained by a fragmented information environment. Although access to SRH services is increasing in the region, logistical and privacy barriers limit adolescents' opportunities to engage in care. Religious and cultural norms stigmatize youth SRH care, though support for contraceptive use is growing among more educated sectors. Youth motivation to use SRH services is driven by a desire for autonomy but undermined by concerns about contraceptive side effects and anticipated stigma. This study supports the co-development of a contextually grounded peer counseling SRH intervention in northern Ghana.
Background Adolescent-to-Parent Violence (APV) is acknowledged as a form of family violence, wherein the conventional parent-adolescent relationship is disrupted. The Adolescent-parent relationship dynamic can be shaped by the conservative and collective nature of Jordanian culture. Aim This qualitative study aimed to explore adolescents' views on violence towards their parents in the context of Jordanian culture. Methodology Constructivist grounded theory methodology guided this study. Four focus group discussions with adolescents (aged 10-19 years) from early, middle, and late stages were conducted; adolescents were recruited from one private and one public school in Amman. Data were collected and analyzed simultaneously. Findings The main findings were categorized into five main themes: Types of violence, Causes of violence, Consequences of violence, Managing violence, and Violence-specific characteristics. Conclusions This is the first study in Jordan that highlights the phenomenon of APV in Jordan, including different types of violence, the causes from adolescents' views, the consequences of violence, how adolescents manage it, and specific characteristics of APV. APV breeds further violence towards others. Additional research is needed to explore APV parents' perceptions. Moreover, exploring the best possible ways to minimize violent incidences within the community is necessary.
Background The concept of empowerment is challenging to operationalize and measure; it is multidimensional, the outcomes are not always directly observable, and meanings of empowerment are highly contextual and socially and culturally situated. This study aimed to explore perspectives of empowerment among adolescent girls in Nepal to identify statements for inclusion in a context-specific empowerment measure. Methods We used a participatory and mixed method research method called concept mapping in 3 districts in Nepal. Three sequential concept mapping sessions were used to solicit, organize, and process how participants responded to the prompt: "The life of an adolescent girl improves when she has/can…" The Concept Systems Global software was used to manage and analyze the concept mapping brainstorming, sorting, and rating data using established tools, such as multidimensional scaling and cluster analysis. Results Concept mapping was conducted with 113 participants, including national experts, program staff, adolescents, and their mothers. They identified 105 items that fall into a 4-cluster solution: education and knowledge, decision-making, supports and skills, and physical infrastructure. Rating data uncovered there was some overlap between the top 10 most important items between the national-level experts and other stakeholder groups; however, several components associated with empowerment differed by stakeholder group in terms of importance. Conclusion This research represents a critical step in exploring definitions of empowerment among adolescent girls in the Nepal context and with expert input. These results led to the development of a contextually specific definition of empowerment. Researchers and practitioners interested in developing context-specific understandings of complex topics that incorporate community voices and perspectives could use a similar concept mapping approach in other countries to explore various topics with diverse populations.
The climate crisis will have an impact on everyone, everywhere, affecting both present and future generations, but there are unique ways in which the crisis is impacting the lives of women and girls. This commentary reviews growing evidence on the effects of climate change on sexual and reproductive health and rights (SRHR) and gender-based violence (GBV), illustrating how the crisis is augmenting preexisting gender inequalities. Far greater attention to SRHR and GBV is needed within climate actions to ensure the fulfillment of the International Conference on Population and Development Programme of Action and a sustainable future for women and girls.
Background Despite widespread availability of sexual and reproductive health (SRH) services and educational initiatives in South Africa, risky sexual behaviours, including unprotected sex, remain prevalent among young adults. These behaviours drive high rates of unplanned pregnancies, unsafe abortions and sexually transmitted infections. The misalignment between interventions and behavioural outcomes reflects deeper, underexplored systemic barriers - including misinformation, stigma, provider bias and weak policy implementation - embedded within institutional structures and practices. Aim Guided by the socio-ecological model, this study explored the factors influencing young adults' access to SRH services, drawing on the perspectives of both young adults and SRH providers. Setting Three public clinics in Soshanguve township, South Africa. Methods A qualitative exploratory study design was used. Semi-structured interviews were conducted with a convenience sample of 15 young adults and a purposive sample of five SRH service providers. Data were analysed thematically. Results Findings revealed multilevel barriers influencing the use of SRH services by young adults: limited SRH knowledge and misconceptions (individual level); poor parent-child communication and peer pressure (interpersonal level); stigma and religious norms (community level); long waiting times, privacy concerns and provider bias (institutional level) and inadequate youth-friendly policies and restricted access to services like abortion (policy level). Conclusion Improving SRH service access and outcomes requires context specific, multilevel interventions aligned to the perspectives of young adults and providers.Contribution: This study offers a nuanced exploration of SRH service utilisation in an under-resourced setting, generating context-specific insights to inform youth-centred, socio-culturally responsive policy development and service planning.
Background Sexual and Gender Based Violence is a pervasive human rights violation that disproportionately affects vulnerable populations in conflict-affected settings. In Africa, regions such as the Demographic Republic of Congo, South Sudan, and Ethiopia's Tigray have seen the systematic use of SGBV as a weapon of war, with devastating physical, psychological, and socio-economic consequences. Despite increased attention to this issue, significant barriers persist in addressing SGBV effectively. Objective This scoping review aims to map the nature, barriers, and facilitators in preventing and responding to sexual and gender based violence in African conflict zones. The review focuses particularly on contexts with ongoing or recent conflict, including Tigray, to inform interventions and identify knowledge gaps. Methods Following the PRISMA-ScR guidelines, guided by the methodological framework of Arksey and O'malley (2005), a comprehensive literature search was conducted across multiple datasets including PubMed, CINAHL, Africa Journal Online, and Google Scholar. Both peer-reviewed and gray literatures from 2000 to 2024 were included focusing on African conflict-affected regions. Eligible studies were selected through a three - stage screening process and data were extracted and synthesized thematically. Results A total of 39 studies were included. The review identified diverse forms of Sexual and Gender Based Violence ranging from sexual slavery, rape, and torture to intimate partner violence and child marriage. Key barriers to effective response included deep-rooted socio-cultural stigma, weak legal systems, health system collapse, insecurity, limited awareness, and understanding. Facilitators included community engagement, survivor-centered and trauma informed care models, multi-sectorial coordination, legal reforms, and technological innovations such as mobile health services and digital reporting platforms. Conclusion Addressing Sexual and Gender Based Violence in conflict-affected African setting requires a holistic, survivor-centered, and multi-sectorial approach. Political commitment, investment in justice and health systems, and the integration of gender-sensitive strategies into peace building efforts are essential. The review underscores the urgency for coordinated, evidence-based interventions to support survivors, prevent future violence, and contribute to sustainable peace and gender equality. Future research should rigorously evaluate these interventions' impact and scalability to inform policy and programs in African conflict settings.
This systematic review explores the relevance, implementation, and assessment of 21st century life skills education in sub-Saharan Africa, with a focus on socio-emotional learning, soft skills, and resilience. It identifies life skills as essential for youth development, particularly among vulnerable populations facing social and economic adversity. Despite policy recognition across sub-Saharan Africa, life skills integration into education systems remains inconsistent due to infrastructural gaps, teacher preparedness, and lack of culturally relevant frameworks. The review analyses 27 intervention assessments, revealing that experiential, structured, and contextually adapted pedagogies-particularly those targeting internal domains like self-esteem and self-efficacy-yield significant psychosocial and educational outcomes. It also highlights a critical gap in validated, context-sensitive assessment tools, with most relying on Western self-report measures. Community and school-based programs showed positive outcomes, especially when grounded in participatory learning and local relevance. The study underscores the need for scalable models, systemic evaluation, and policy alignment, and advocates for strengthening teacher training and community involvement. It concludes with recommendations to enhance life skills programming through sustained, context-specific approaches and improved measurement frameworks. The findings aim to inform policymakers, educators, and practitioners in developing effective strategies for fostering youth competencies across the region.
This study aims to enhance understanding of child and adolescent suicide by raising awareness of the issue and analyzing the socio-demographic characteristics, suicide methods, and triggering factors associated with these cases. A total of 47 pediatric suicide cases were analyzed based on forensic autopsy reports conducted at the Erzurum Forensic Medicine Group Presidency between 1 January 2018 and 31 December 2024. The mean age of the subjects was 15.32 years, with the majority belonging to the 15–17 age group. Suicides predominantly occurred in rural areas and at home. The most common method was firearm injury (51%), followed by hanging (42.6%). Violent methods were used in all cases. A proportion of the cases (10.6%) had diagnosed psychiatric disorders, and a similar proportion (10.6%) originated from broken families. Triggering factors included family conflicts, relationship problems, and pregnancy. Suicides were generally more common in the summer months. Easy access to firearms in rural areas and family conflicts were identified as significant risk factors for suicide. To prevent suicide among children and adolescents, it is important to raise social awareness, strengthen communication within families, improve pediatricians’ knowledge of the issue, and increase the effectiveness of counseling services in schools. Additionally, we suggest that supporting adolescents living in rural areas and expanding access to psychological help mechanisms could play an important role in reducing suicide rates.
Background Short stature and thinness among adolescent girls continue to be a severe public health problem in Ethiopia, due mainly to inadequate dietary intake, which turn affected by several factors. Evidence shows that in low and middle-income countries, the factors related to culture and belief play a pivotal role in making a difference in eating, negatively affecting girls. In Ethiopia, the roles of these factors in influencing the eating behavior of adolescent girls have not been well investigated. Objective This qualitative study was conducted to explore the barriers of eating among adolescent girls in Ethiopia. Methods A qualitative study was employed in northwest Ethiopia from January to April 2021. A focus group discussion of adolescent girls and an in-depth interview of mothers and adolescent boys were separately conducted. A total of six focus group discussions involving a total of forty-three adolescent girls and an in-depth interview of twelve adolescent males and ten mothers were performed. The adolescent girls and boys were aged 15 to 19, attending grades 9-12. The participants were selected using a purposive sampling method. Content analysis was employed to identify the predominant themes. The analysis was conducted using Open Code. Results Four themes emerged from the current study. These included religion, the culture of male dominancy, roles and responsibilities, and perception related to girls' body food requirements and the consequences of proper feeding of adolescent girls on their behavior. Specifically, girls start fasting at an early age due to religious reasons; girls do not eat before the males eat and outside the home out of respect for males; girls spend most of their time at home doing less energy-demanding work; girls' body food requirement is lower and girls better tolerate hunger than their counterpart boys; and if girls eat well, they would not be disciplined, were among the reasons mentioned by the study participants for girls' intake of lower quality and quantity food. Conclusion Religion, the culture of male dominancy, roles given to females and males and the perception that girls' bodies require a lower quantity of food and well-nourished girls will not be disciplined were common factors responsible for the poor dietary behavior of adolescent girls. Educating the community about the food requirements of girls, the consequences of their inadequate feeding, and the misconception existing in the community about girls' food requirements is crucial. Strengthening policies and strategies helpful for empowering women and balancing gender inequalities may be required.
