Multiple Impacts of Ethiopia’s Health Extension Program on Adolescent Health and Well-Being: A Quasi-Experimental Study 2002–2013

Rudgard, William E.; Dzumbunu, Silinganisiwe P.; Yates, Rachel; Toska, Elona; Stöckl, Heidi; Hertzog, Lucas; Emaway, Dessalew; Cluver, Lucie

doi:10.1016/j.jadohealth.2022.04.010

Cited by 6 publications

(1 citation statement)

References 26 publications

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“…Second, most studies focusing on accelerators used cross-sectional data and longitudinal data up to two time points (Chipanta et al, 2022;Cluver et al, 2019;Haag et al, 2022;Mebrahtu et al, 2021;Meinck et al, 2021). The current study is one of the first accelerator research using data from three time points, which could pose essential understanding of the long-term effects of consistent exposure to accelerators, enhancing their potential to be considered protective factors (Rudgard et al, 2022). The study objectives were to 1) evaluate the association between eight hypothesised accelerators in reductions of two or more ontological insecurity outcomes aligned with SDG targets and 2) assess whether experiencing multiple accelerators might be linked to more significant reductions in risk factors for ontological insecurity.…”

Section: Introductionmentioning

confidence: 99%

Accelerating ontological security for South African adolescents living in high HIV-prevalence areas: a longitudinal study

Hertzog

Banougnin

Stöckl

et al. 2022

Psychology, Health & Medicine

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Ontological security is the personal need to build fundamental certainty about the continuity of life events. It is central to long-term human development, particularly among adolescents in highly vulnerable communities in South Africa. We examined the cumulative effects of eight hypothesised provisions (development accelerators) in reducing the risks of ontological insecurity outcomes aligned with Sustainable Development Goals (SDGs) targets. Three waves of survey data from adolescents living in high HIV prevalence areas in South Africa were analysed. We used standardised tools to measure twelve outcomes linked to two dimensions of ontological security: mental health and violence. Sustained receipt (at baseline and followups) of eight hypothesised accelerators were examined: emotional and social support, parental/caregiver monitoring, food sufficiency, accessible health care, government cash transfers to households, basic economic security, positive parenting/caregiving, and participation in extramural activities. Associations of all accelerators with outcomes were evaluated using multivariable regressions controlling for age, sex, orphanhood and HIV status, rural/urban location, and informal housing. Cumulative effects were tested using marginal effects modelling. Of 1,519 adolescents interviewed at baseline, 1,353 (89%) completed the interviews at two follow-ups. Mean age was 13.8 at baseline; 56.6% were female. Four provisions were associated with reductions in twelve outcomes. Combinations of accelerators resulted in a percentage reduction risk in individual indicators up to 18.3%. Emotional and social support, parental/caregiver monitoring, food sufficiency and accessible health care by themselves and in combination showed cumulative reductions across twelve outcomes. These results deepen an essential understanding of the longterm effects of consistent exposure to accelerators on multidimensional human development. They could be directly implemented by existing evidence-based interventions such as peer-based psychosocial support, parenting programmes, adolescentresponsive healthcare and food support, providing safer and healthier environments for South African adolescents to thrive.

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