Wamoyi, J., Mshana, G., Mongi, A., et al. Reproductive Health (December 2014), doi: 10.1186/1742-4755-11-88.
This literature review summarized interventions addressing structural drivers for the sexual and reproductive health risks facing young people (aged 14–24 years) in sub-Saharan Africa. The authors reviewed 15 articles published between 2000 and 2013 on interventions that tackled gender norms and livelihoods or poverty reduction, and that were aimed at vulnerable young people in sub-Saharan Africa. They found that most interventions addressed multiple structural factors. Seven interventions focused on HIV prevention through addressing gender norms, improving school attendance, improving participants' economic situations, and creating safe spaces; eight focused on either economic empowerment alone or economic empowerment and school attendance. Three studies focused on livelihoods and safe spaces; three on comprehensive sexuality and behavior change and communication; and two on parent-child communication and relationship. Because these interventions varied substantially in design and methods of evaluation, this review was not able to identify the effectiveness of any specific intervention. However, the review provided lessons learned from each intervention design that can be used when developing programs for adolescents. The authors concluded that while numerous interventions are addressing structural drivers among adolescents in sub-Saharan Africa, additional evaluations are needed to assess how these interventions work to reduce vulnerability to HIV.