Insights into the role of changing historical-political-cultural contexts and social norms in shaping adolescent girls’ and boys’ futures contributes to an understanding of human development at the intersection of gender and youth in low- and middle-income countries. This study investigates the capabilities and aspirations of adolescent girls and boys and their evolution in Amhara against the background of three successive political regimes that governed Ethiopia over the last 90 years, the Haile-Selassie imperial regime (1930–1974), the socialist military Derg regime (1974–1991), and the Ethiopian People's Revolutionary Democratic Front (1991–2019), each with their own institutions, structures and infrastructure, and gender- and age-related relations and norms. The study adopts a capability approach with a gender and generationing development lens as a framework and relies on qualitative data collected through community- and mixed-generation group discussions. The study illustrates that, even if institutional and structural barriers became less stringent over time, cumulative gender- and age-related obstacles – some rooted in beliefs, norms, traditions and relations – hindered the expansion of adolescents’ capability success, consistently more so for girls than boys. (The threat of) gender-based violence pervasively constrains girls’ capabilities success and aspirations in spite of more formal protective institutions.
Bethelihem Gebre Alwab, Els Lecoutere, Nicola Jones
This paper draws on the concept of ‘evolving capacities’ to elucidate how young people’s networks of relationships within their wider socioecological environments, including online, constrain or enable their emergent citizenship in the global South. This analytical framework is applied to case studies from a decade of longitudinal mixed methods research in Ethiopia, Bangladesh, and Jordan by the Gender and Adolescence: Global Evidence (GAGE) programme to explore youth civic engagement dynamics. The paper shows how a multi-level intersectional analysis of young people’s evolving political capacities - conceiving of political participation and civic engagement as shaped by a nexus of diverse socioecological influences that evolve over adolescence into early adulthood - can offer novel insights into supporting youth civic participation amid political fragmentation.
Research suggests that adolescents in humanitarian settings are particularly vulnerable to mental health challenges, but there is less attention to how mental health and psychosocial support (MHPSS) in these settings considers climate-related factors. This article aims to bridge this gap by reviewing studies on the impact of MHPSS interventions in humanitarian settings for adolescents in low- and middle-income countries. Our findings indicate there is a lack of attention to climate change; none of the 25 studies identified mentioned climate change or considered it in the intervention design. Given the urgency of the climate crisis, it is vital that MHPSS interventions for adolescents in humanitarian settings are adapted to respond to climate change-related factors. We also found that the data from such studies are rarely disaggregated by sex or disability. This is vital in order to deepen our understanding of the intersectional impacts of MHPSS on adolescents.
Sustainable development is an effort to balance social progress with environmental equilibrium and economic growth. Young people affected by forced displacement are particularly vulnerable to the economic, environmental and social challenges of their surroundings. Using a framework that centres sustainable development on these three interconnected pillars, this article explores how the economic and environmental contexts in Lebanon impact adolescents’ and youth social development, drawing on qualitative data from adolescents in refugee and host community settings. The article highlights that adolescents face economic challenges because of the national economic crisis, exacerbated by COVID-19 lockdowns and service closures, poor labour market opportunities for youth—and for refugees in particular—and rising living costs. The environmental challenges facing adolescents include inadequate shelter (especially in collective shelters and informal tented shelters) and inadequate water, sanitation and hygiene (WASH) facilities. These economic and environmental conditions in turn influence adolescents’ social capabilities such as their physical and mental health, and voice and agency. The article concludes by highlighting the need for a more integrated approach to sustainable development that will allow both present and future generations in Lebanon to meet their own needs and live empowered lives. It outlines measures that could help achieve this approach, including: creating policies and programmes that promote investment in technical and soft skills-building to equip young people with the skills they need to take up jobs within the green economy; investing in adolescent-friendly social protection with linkages to environmental projects; and improved shelter, health and WASH facilities, particularly in response to the ongoing and future impacts of climate change.
As the mid-way point for the United Nations Sustainable Development Goals (SDG) timeframe nears, countries affected by conflict and fragility represent one of the key challenges to achieving SDG 4—-ensuring inclusive and equitable quality education for all. Drawing on qualitative research undertaken in late 2021 in South Gondar zone, in Ethiopia’s war-torn northern Amhara region, with adolescent girls and boys (n = 80), their caregivers (n = 11) community leaders and local service providers, including teachers (n = 31), this article explores the experiences of young people during and after their communities were occupied by the Tigray People’s Liberation Front, and the multi-pronged effects the conflict has had on their educational pathways. It finds that for many, schooling has been disrupted by: recruitment into the armed forces or organized youth movements (Fano); destruction of school infrastructure and records by the occupying forces; an inability to concentrate on education on account of trauma and stress; and a loss of educational aspirations given fears of prolonged insecurity. At the school level, it also identifies negative impacts in terms of teacher presence, teaching quality and the provisioning of educational activities; compounded by reduced education budgets as local, regional and federal government resources are diverted to the war effort. The article concludes with some reflections on the implications of our findings for government, development partners, communities, non-governmental organizations, and schools, in their efforts to strengthen education services and build resilience, including through linkages with social protection, justice, and psychosocial support services, in contexts of ongoing fragility.
Risks associated with unintended pregnancy include unsafe abortions, poor maternal health-seeking behaviour, poor mental health, and potentially, maternal and infant deaths. Adolescent girls with unintended pregnancies are particularly vulnerable as they are at higher risk of eclampsia, premature onset of labour, and increased neonatal morbidity and mortality. Unintended pregnancy, with the right combination of interventions, can be avoided. Evidence-based decision-making and the need for a robust appraisal of the evidence have resulted in many systematic reviews. This review of systematic reviews focuses on adolescent pregnancy prevention and will seek to facilitate evidence-based decision-making. Two review authors independently extracted data and assessed the methodological quality of each review according to the AMSTAR 2 criteria. We identified three systematic reviews from low- and middle-income countries and high-income counties and included all socioeconomic groups. We used vote counting and individual narrative review summaries to present the results. Overall, skill-building, peer-led and abstinence programmes were generally effective. Interventions focused on information only, counselling and interactive sessions provided mixed results.In contrast, exposure to parenting and delaying sexual debut interventions were generally ineffective. Adolescent pregnancy prevention interventions that deploy school-based primary prevention strategies, i.e. strategies that prevent unintended pregnancies in the first place, may effectively reduce teenage pregnancy rates, improve contraceptive use, attitudes and knowledge, and delay sexual debut. However, the included studies have methodological issues, and our ability to generalise the result is limited.
Sahra Mohamed, Michael Give Chipeta, Tony Mwenda Kamninga et al.
Integration of environmental, economic, and social approaches to development is crucial to achieve the United Nations Sustainable Development Goals. Global evidence reflects that this integration is often imbalanced, with development policies and programs in many low- and middle-income countries placing greater emphasis on economic needs than environmental vulnerabilities. Drawing on qualitative research undertaken in mid-2021, this article explores how limited integration of environmental, economic, and social aspects has affected the development of Rohingya refugee adolescents who were forcibly displaced from Myanmar to the Cox’s Bazar district of Bangladesh. Cox’s Bazar is one of the most climate-vulnerable areas in Bangladesh and is subject to extreme rainfall, landslides, and flash floods. The article highlights the ways in which Rohingya adolescents are highly vulnerable to both the direct and indirect consequences of these environmental conditions due to poverty, and inadequate housing infrastructure and water, sanitation, and hygiene facilities. It discusses the ways in which these environmental challenges intersect with socioeconomic disadvantage, especially limited education, skills development, and livelihood opportunities for young people, which are in turn compounded by limited voice and agency, and a dearth of security and protection measures. For some Rohingya adolescent girls and boys, the findings suggests that these multi-dimensional vulnerabilities place them at risk of exploitation by traffickers, smugglers, extremist groups, and criminals. The article concludes by highlighting the importance of explicitly integrating environmental aspects into policy and programs that support Rohingya adolescents to develop their full capabilities, and encouraging their meaningful participation in policy dialogues and accountability processes.
Human rights education in humanitarian settings provides an opportunity for adolescent refugees to understand and exercise their human rights, respect the rights of others, and gain active citizenship skills. This paper examines non-formal education programmes and the extent to which they embed education about, through and for human rights; it draws on mixed method data from two diverse contexts–Rohingya refugees in Bangladesh and Syrian refugees in Jordan. We find stark differences in how human rights are reflected in non-formal education programming for refugees. In Jordan, the Makani programme integrates human rights across subjects and teacher pedagogy, and fosters skills for active citizenship. By contrast, in Cox’s Bazar, Bangladesh, a lack of basic rights hinders the delivery of meaningful human rights education for Rohingya adolescents. We conclude that human rights education should be a core pillar of humanitarian responses, but that it requires significant adaptations to contextual realities.
Megan Devonald, Nicola Jones, Silvia Guglielmi et al.
OBJECTIVE: To understand the relationship between the COVID-19 pandemic and menstrual hygiene management (MHM) among adolescent girls in Ethiopia and to explore which girls were most affected by pandemic disruptions. DESIGN: Two rounds of data from surveys and interviews were collected with adolescent girls immediately prior to and during the COVID-19 pandemic. The primary analysis is cross-sectional, controlling for pre-COVID-19 covariates. SETTING: The setting was three zones in two regions of Ethiopia: East Hararghe and East Shewa Zones in Oromia and South Gondar Zone in Amhara. Data were collected in December 2019-March 2020 and September 2020-February 2021. PARTICIPANTS: 742 adolescent girls, ages 11-25 years. OUTCOME MEASURES: Four primary outcomes were explored (1) the number of challenges girls experienced; (2) adolescent-identified challenges managing menstrual hygiene; (3) adolescent-identified difficulties accessing MHM products and (4) adolescent-identified difficulties accessing soap or water. RESULTS: Girls who were more vulnerable to COVID-19 were more likely to have worse MHM outcomes. An SD increase in household vulnerability to COVID-19 was associated with an 8.7 percentage point increase in the likelihood that the respondent had difficulty getting MHM products (p<0.001), a 6 percentage point increase in the likelihood that she reported facing a challenge managing her menstruation (p=0.003) and a 5.2 percentage point increase in the likelihood she lacked soap or water (p=0.001). Qualitative themes, used to triangulate the quantitative findings, suggest that mobility restrictions, shutdowns of the local market, disruptions in supply chains, poverty, stigma and fear about contracting COVID-19 affected girls' access to MHM supplies. CONCLUSIONS: The results of this study suggest that MHM was left behind in the COVID-19 response. New programming and policy interventions need to address financial hardship and disruptions to supplies to manage menstruation as well as tackle the inequitable gender norms that stigmatise menstruation during emergencies.
Maureen Murphy, Rebecca Dutton, Kiya Gezahegne et al.
BACKGROUND: Until recently, global public health initiatives have tended to overlook the ways that social factors shape adolescent health, and particularly how these dynamics affect the specific needs of adolescents in relation to information about puberty, menstruation and sexual health. This article draws on mixed methods data from rural and urban areas of Ethiopia to explore how access to health information and resources - and subsequently health outcomes - for adolescents are mediated by gender and age norms, living in different geographical locations, poverty, disability and migration. METHODS: Data was collected in 2017-2018 for the Gender and Adolescence: Global Evidence (GAGE) mixed-methods longitudinal research baseline in three regions of Ethiopia (Afar, Amhara and Oromia). Quantitative data was collected from over 6800 adolescents and their caregivers, with qualitative data obtained from a sub-sample of 220 adolescents, their families and communities. Adolescent participants shared their experiences of health, illness and nutrition over the previous year; their knowledge and sources of information about sexual and reproductive health and puberty; and their attitudes toward sexual and reproductive health. Regression analysis was used to explore differences by gender, age, rural/urban residence, and disability status, across a set of adolescents' health knowledge and other outcomes in the quantitative data. Intersectional analysis was used in analysing the qualitative data. RESULTS: Analysis suggested that gender inequality intersects with age, disability and rural/urban differences to shape young people's access to information about puberty, with knowledge about this topic particularly lacking amongst younger adolescents in rural areas. Drought and lack of access to clean water exacerbates health challenges for adolescents in rural areas, where a lack of information and absence of access to preventive healthcare services can lead to permanent disability. The research also found that gaps in both school-based and alternative sources of education about puberty and menstruation reinforce stigma and misinformation, especially in rural areas where adolescents have higher school attrition rates. Gendered cultural norms that place high value on marriage and motherhood generate barriers to contraceptive use, particularly in certain rural communities. CONCLUSIONS: As they progress through adolescence, young people's overall health and access to information about their changing bodies is heavily shaped by intersecting social identities. Structural disadvantages such as poverty, distress migration and differential access to healthcare intersect with gender norms to generate further inequalities in adolescent girls' and boys' health outcomes.
