Interventions and Strategies to Improve Sexual and Reproductive Health Outcomes among Adolescents Living in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Abstract

Adolescent’s access to quality Sexual and Reproductive Health and Rights interventions has been a major issue in most of the low- to middle-income countries (LMICs) across the globe. This systematic review aims to identify the relevant community and school-based interventions that can be implemented in -LMICs to promote adolescent’s sexual and reproductive health and rights outcomes. We identified 54 studies and our review findings suggest that Adolescent’s Sexual and Reproductive Health and Rights (ASRHR) educational interventions, provision of financial incentives, and provision of comprehensive -post-abortion family planning services are effective in increasing adolescent’s knowledge on ASRHR, attitude towards ASRHR, uptake of ASRHR services, contraception and decreased unwanted pregnancy rates among young women. However, we found inconclusive and limited evidence on the effectiveness of the interventions to improve violence prevention and adolescent behaviors towards safe sexual practices. More rigorous studies with long-term follow-ups are needed to assess the effectiveness of such interventions.

Prevalence of Premarital Sexual Practice and Its Associated Factors Among Dire Dawa University Students, 2022

“…Students who did not use the YSRH service were more likely to engage in premarital sexual activity. This finding in line with the studies done in Haramaya High School (35), Eastern Ethiopia (36), Low-and Middle-Income Countries (37), Washington (38), and Sub-Saharan Africa (39). This may be due to the fact that YSRH services like counseling may provide adequate information about the consequences of premarital sex for the users.…”

Effectiveness of peer-led education interventions on contraceptive use, unmet need, and demand among adolescent girls in Gedeo Zone, South Ethiopia. A cluster randomized controlled trial

“…Different systematic review study findings showed that school-based peer-led intervention increased contraceptive use after five and 17 months of intervention [ 23 ] and led to a decrease in unwanted pregnancies [ 3 ]. Contraceptive use increased significantly after six months of school-based peer education intervention in the current study.…”

“…However, other studies indicated that educational intervention alone may not increase contraceptive use among adolescents. An intervention focusing on reproductive health services, including comprehensive post-abortion family planning services and financial incentives, produced positive changes in contraceptive utilisation and demand [ 3 , 4 ].…”

“…However, these adolescents are exposed to several reproductive health challenges and consequences due to limited access to and poor utilization of contraceptive services. For example, early pregnancy and childbirth in adolescents are the leading health problems in many low-income countries (LICs) [ 3 ]. Girls under 19 years of age have a 50% higher risk of stillbirth and neonatal death in addition to obstetric fistula, eclampsia, postpartum haemorrhage, and postpartum endometritis [ 2 ].…”

“…The Sustainable Development Goals (SDGs) agenda acknowledges the importance of reproductive health education at school [ 13 ]. Peers may influence adolescents contraceptive use [ 3 ], which suggests the importance of addressing friends or peers to create a supportive social environment for contraceptive use [ 14 ]. The present study evaluated the effectiveness of peer-led education interventions in improving contraceptive use, unmet needs, and demand in sexually active adolescent girls in the Gedeo Zone, south Ethiopia.…”