Which Structural Interventions for Adolescent Contraceptive Use Have Been Evaluated in Low- and Middle-Income Countries?

Helen Elizabeth Denise Burchett (), Dylan Kneale, Sally Griffin, Málica de Melo, Joelma Joaquim Picardo and Rebecca S. French
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Helen Elizabeth Denise Burchett: Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Dylan Kneale: EPPI-Centre, UCL Social Research Institute, University College London, London WC1H 0NR, UK
Sally Griffin: International Center for Reproductive Health: Mozambique, Maputo, Mozambique
Málica de Melo: International Center for Reproductive Health: Mozambique, Maputo, Mozambique
Joelma Joaquim Picardo: International Center for Reproductive Health: Mozambique, Maputo, Mozambique
Rebecca S. French: Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK

IJERPH, 2022, vol. 19, issue 18, 1-31

Abstract: Reducing adolescent childbearing is a global priority, and enabling contraceptive use is one means of achieving this. Upstream factors, e.g., gender inequalities, fertility norms, poverty, empowerment and schooling, can be major factors affecting contraceptive use. We conducted a systematic map to understand which structural adolescent contraception interventions targeting these upstream factors have been evaluated in LMICs. We searched eight academic databases plus relevant websites and a 2016 evidence gap map and screened references based on set inclusion criteria. We screened 6993 references and included 40 unique intervention evaluations, reported in 138 papers. Seventeen evaluations were reported only in grey literature. Poverty reduction/economic empowerment interventions were the most common structural intervention, followed by interventions to increase schooling (e.g., through legislation or cash transfers) and those aiming to change social norms. Half of the evaluations were RCTs. There was variation in the timing of endline outcome data collection and the outcome measures used. A range of structural interventions have been evaluated for their effect on adolescent contraceptive use/pregnancy. These interventions, and their evaluations, are heterogenous in numerous ways. Improved understandings of how structural interventions work, as well as addressing evaluation challenges, are needed to facilitate progress in enabling adolescent contraceptive use in LMICs.

Keywords: contraception; family planning; adolescent; structural; upstream; intervention evaluation; cash transfer; schooling; norms; empowerment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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