Realising agency: insights from participatory research with learners in a South African sexual and reproductive health programme

Chelsea Coakley; Devyn Lee; Carey Pike; Laura Myers; Miriam Hartmann; Asantewa Oduro; Noluthando Ntlapo; Linda-Gail Bekker; Youth Investigators of the Goals for Girls study

doi:10.3389/fpubh.2024.1329425

Realising agency: insights from participatory research with learners in a South African sexual and reproductive health programme

Front Public Health. 2024 Oct 9:12:1329425. doi: 10.3389/fpubh.2024.1329425. eCollection 2024.

Authors

Affiliations

¹ Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
² Centre for Social Science Research, Faculty of Humanities, University of Cape Town, Cape Town, South Africa.
³ Grassroot Soccer, Cape Town, South Africa.
⁴ Women's Global Health Imperative, RTI, Berkeley, CA, United States.
⁵ Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
⁶ Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witswatersrand, Johannesburg, South Africa.
⁷ South African Medical Research Council, Cape Town, South Africa.

Abstract

Background: Investing in the capabilities of adolescents is essential to achieving the United Nations Sustainable Development Goals, which focus on realising adolescent girls and young women's (AGYW) rights to education, health, bodily autonomy and integrity, sexual and reproductive health (SRH) and well-being. Despite significant scientific and programmatic progress in understanding and responding to their unique and intersecting vulnerabilities, AGYW continue to face disproportionate risk of STIs, HIV and early pregnancy. Health promotion and preventative interventions stand to be improved by early and meaningful engagement of AGYW in intervention design and delivery.

Methods: This study employed Youth Participatory Action Research (YPAR) to co-generate lessons for future school-based SRH programming. The 5-step YPAR process included: (1) youth investigator recruitment; (2) youth investigator training and co-design of YPAR methods; (3) youth investigator-led data collection; (4) collaborative analysis and interpretation; and (5) dissemination.

Results: Collaborative analysis revealed improvements in self-concept and bodily autonomy, understanding and formation of healthy relationships and demand for girl-centred health services and information at school. Additionally, the study highlights YPAR's positive influence on both the collaborative process and outputs of research. Further, it provides further insight into the quantitative biomedical and socio-behavioural findings of a larger experimental impact evaluation, in which it was nested.

Conclusion: Results from YPAR methods point to high programme acceptability and practical lessons to inform future school-based SRH programming. The inclusion of adolescent girls in the design, delivery and evaluation of intervention research that affects their lives is an important strategy for improving acceptability, and also has demonstrated value in building their health and social assets. Future recommendations include parental involvement, and employing quantitative measures for better evaluation of youth engagement, leadership and partnerships in the research process.

Keywords: health promotion; intervention research; participatory research; sexual and reproductive health; youth & adolescence.

MeSH terms

Adolescent
Community-Based Participatory Research
Female
Health Promotion / methods
Health Services Research
Humans
Reproductive Health* / education
Sexual Health* / education
South Africa

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was funded by ViiV Healthcare Positive Action for Adolescents Programme, as was stated in the other papers for G4G.