Power to participants: methodological and ethical reflections from a decade of adolescent advisory groups in South Africa

Cluver, Lucie; Doubt, Jenny; Wessels, Inge; Asnong, Carine; Malunga, Samantha; Mauchline, K.; Vale, Beth; Medley, Sally; Toska, Elona; Orkin, Kate; Dunkley, Yasmin; Meinck, Franziska; Myeketsi, Noxolo; Lasa, Samkelo; Rupert, Caroline; Boyes, Mark; Pantelic, Marija; Sherr, Lorraine; Gittings, Lesley; Hodes, Rebecca; Kuo, Caroline; Chetty, Angelique Nicole; Thabeng, Mildred

doi:10.1080/09540121.2020.1845289

Cited by 17 publications

(35 citation statements)

References 25 publications

(26 reference statements)

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“…We consulted prior to baseline with local traditional leaders, local provincial government, pre-piloted with adolescents from these population groups, and introduced the study at multiple community meetings. The design of the study and questionnaire was carried out in consultation with our South African Teen Advisory Group [12].…”

Section: Methodsmentioning

confidence: 99%

Accelerating Sustainable Development Goals for South African adolescents from high HIV prevalence areas: a longitudinal path analysis

Meinck

Orkin

Cluver

2021

BMC Med

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Background Adolescents experience a multitude of vulnerabilities which need to be addressed in order to achieve the Sustainable Development Goals (SDGs). In sub-Saharan Africa, adolescents experience high burden of HIV, violence exposure, poverty, and poor mental and physical health. This study aimed to identify interventions and circumstances associated with three or more targets (“accelerators”) within multiple SDGs relating to HIV-affected adolescents and examine cumulative effects on outcomes. Methods Prospective longitudinal data from 3401 adolescents from randomly selected census enumeration areas in two provinces with > 30% HIV prevalence carried out in 2010/11 and 2011/12 were used to examine six hypothesized accelerators (positive parenting, parental monitoring, free schooling, teacher support, food sufficiency and HIV-negative/asymptomatic caregiver) targeting twelve outcomes across four SDGs, using a multivariate (multiple outcome) path model with correlated outcomes controlling for outcome at baseline and socio-demographics. The study corrected for multiple-hypothesis testing and tested measurement invariance across sex. Percentage predicted probabilities of occurrence of the outcome in the presence of the significant accelerators were also calculated. Results Sample mean age was 13.7 years at baseline, 56.6% were female. Positive parenting, parental monitoring, food sufficiency and AIDS-free caregiver were variously associated with reductions on ten outcomes. The model was gender invariant. AIDS-free caregiver was associated with the largest reductions. Combinations of accelerators resulted in a percentage reduction of risk of up to 40%. Conclusion Positive parenting, parental monitoring, food sufficiency and AIDS-free caregivers by themselves and in combination improve adolescent outcomes across ten SDG targets. These could translate to the corresponding real-world interventions parenting programmes, cash transfers and universal access to antiretroviral treatment, which when provided together, may help governments in sub-Saharan Africa more economically to reach their SDG targets.

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Section: Methodsmentioning

confidence: 99%

Accelerating Sustainable Development Goals for South African adolescents from high HIV prevalence areas: a longitudinal path analysis

Meinck

Orkin

Cluver

2021

BMC Med

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“…A recent review of experience of youth involvement, particularly in research activities in South Africa, provides useful lessons for a future short courses and programming. 8 …”

Section: Discussionmentioning

confidence: 99%

Building capacity to facilitate policy implementation: A short course in adolescent and youth health in South Africa

Ferguson

Ahmed

Motshwane

et al. 2022

J. Public Health Afr.

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In order to respond more effectively to the health of young people in South Africa, in 2017 the National Department of Health of South Africa released the National Adolescent & Youth Health Policy. The Policy focused on a range of health problems and recommended interventions for delivery through multiple settings and government departments. It also included specific recommendations to empower and involve young people in policy and programme implementation. Adaptation of a short course on adolescent health in lowand middle-income countries, organized annually by the London School of Hygiene and Tropical Medicine and the World Health Organization, was piloted in 2017 as one means of contributing to the implementation of the Policy. The Adolescent & Youth Health Policy short course was subsequently offered in 2018 and 2019, attracting 96 participants working on adolescent health in various organizations at national and provincial levels throughout the country. Most participants (75%) successfully completed the course, as assessed by the completion criteria that had been defined. The range of topics for the assignments selected by the participants over the 3 years reflected both the content and intent of the Policy. The evaluations of the short course indicate that it helped to create legitimacy and strengthen the capacity of various constituencies, both of which are important prerequisites for policy implementation.

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“…The AYHP has demonstrated that youth participation is possible through long standing research partnerships and is a foundation on which to build and contextualise youth as expert actors, as a more proactive approach to youth engagement in policy processes and programmes. As documented by Cluver et al 73 participatory research approaches, such as youth participatory action research, photo-voice, and digital modes, can acknowledge and attempt to address the power imbalances that privilege researchers and adult perspectives and agendas, as well as challenge top-down policy development. [74][75][76][77][78][79] However, it is also important to be aware of the relevant methodological, pedagogical approaches as well as tensions, power relations and potential resistance by policy-makers and other actors.…”

Section: Positioning and Research Processesmentioning

confidence: 99%

Between Rhetoric and Reality: Learnings From Youth Participation in the Adolescent and Youth Health Policy in South Africa

Jacobs

George

2022

Int J Health Policy Manag

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Background: Youth participation makes an essential contribution to the design of policies and with the appropriate structures, and processes, meaningful engagement leads to healthier, more just, and equal societies. There is a substantial gap between rhetoric and reality in terms of youth participation and there is scant research about this gap, both globally and in South Africa. In this paper we examine youth participation in the Adolescent and Youth Health Policy (AYHP) formulation process to further understand how youth can be included in health policy-making. Methods: A conceptual framework adapted from the literature encompassing Place, Purpose, People, Process and Partnerships guided the case study analysis of the AYHP. Qualitative data was collected via 30 in-depth, semi-structured interviews of policy actors from 2019-2021. Results: Youth participation in the AYHP was a ‘first’ and unique component for health policy in South Africa. It took place in a fragmented policy landscape with multiple actors, where past and present social and structural determinants, as well as contemporary bureaucratic and donor politics, still shape both the health and participation of young people. Youth participation was enabled by leadership from certain government actors and involvement of key academics with a foundation in long standing youth research participatory programs. However, challenges related to when, how and which youth were involved remained. Youth participation was not consistent throughout the health policy formulation process. This is related to broader contextual challenges including the lack of a representative and active youth citizenry, siloed health programs and policy processes, segmented donor priorities, and the lack of institutional capability for multi-sectoral engagement required for youth health. Conclusion: Youth participation in the AYHP was a step toward including youth in the development of health policy but more needs to be done to bridge the gap between rhetoric and reality.

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Power to participants: methodological and ethical reflections from a decade of adolescent advisory groups in South Africa

Cited by 17 publications

References 25 publications

Accelerating Sustainable Development Goals for South African adolescents from high HIV prevalence areas: a longitudinal path analysis

Accelerating Sustainable Development Goals for South African adolescents from high HIV prevalence areas: a longitudinal path analysis

Building capacity to facilitate policy implementation: A short course in adolescent and youth health in South Africa

Between Rhetoric and Reality: Learnings From Youth Participation in the Adolescent and Youth Health Policy in South Africa

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