The gender transformative and responsive health systems to address unmet adolescent mental, sexual, and reproductive health needs project is being conducted in Ghana, Niger and Burkina Faso over a 36-month period.

This research project will examine pressing issues in adolescent health. The general objective is to co-design and formatively evaluate participatory interventions with adolescents, communities and frontline providers to enable gender transformative, improved and responsive primary health care systems for adolescent sexual, reproductive and mental health and wellbeing in Ghana, Niger and Burkina Faso.

The overarching study design is Participatory Action Research (PAR).  Ghana, Burkina Faso and Niger in West Africa are purposively selected for the research to be able to explore the issues in the varying contexts of anglophone and francophone West Africa as well as the relative extremes and middle range of country socio-economic and socio-demographic contexts.  Mixed methods of data collection and analysis will be used including non-participant observation, key informant interviews, focus group discussions, development of rich pictures and causal loop diagrams with participants to explore experiences, situations and contextually relevant solutions.  Stakeholder mapping and analysis and exploration of power, interests and positions in relation to adolescent sexual, reproductive and mental health will also be conducted.  At least one contextually relevant intervention for adolescent sexual, reproductive and mental health and wellbeing will be co-produced and piloted in each country.

Expected results of this project will be the generation of evidence to improve the quality of health services for adolescents, enhance relationships, norms, and power dynamics within the community, and influence policy and structural changes for enhanced adolescent sexual, reproductive, and mental health in ways that are culturally acceptable and contextually relevant in West Africa.


Why Now?

Globally, there are encouraging trends of declining adolescent pregnancy and childbirth, accompanied by increases in school participation, demand for contraception and age at first marriage.  However, declines are lower in West Africa than other parts of the world and adequate quality, culturally and contextually appropriate sexual and reproductive health services for adolescents are needed. This can impact health outcomes and reduce adolescents vulnerability to unintended pregnancy, gender-based violence, child and early forced marriage, and a range of other negative health and wellbeing outcomes.  Also important in adolescence is the neglected – but critical – issue of adolescent mental health. Gender and social norms affect power (ability to achieve what you want to do), resources and status.  Some of these norms can be very empowering, others can be inequitable and cripple the potential of adolescents of both sexes.

Our Objectives

  1. To explore the values, social norms, power, practices and perspectives of adolescents, communities, and frontline providers of primary health care on adolescent mental, sexual and reproductive health and rights in Ghana, Burkina Faso and Niger
  2.  To explore values, social norms, power, practices and perspectives on masculinity and femininity and how they affect the status of adolescent girls and their agency in decisions regarding mental, sexual and reproductive health
  3. To explore discuss and document barriers and facilitators to adolescent and community engagement in the design and implementation of interventions to improve adolescent mental, sexual and reproductive health and wellbeing to inform current and future interventions
  4.  To draw on the understanding of values, social norms, power, practices, perspectives, facilitators and barriers to co-design and pilot test on a small scale contextually appropriate and potentially gender transformative interventions for improved access to and responsiveness of adolescent primary sexual, reproductive and mental health services that are implementable within available resources
  5.  To select and implement research uptake and advocacy efforts for gender transformative and responsive primary health care interventions, policy analysis and reform aimed at catalysing structural change for adolescent sexual, reproductive and mental health and document effectiveness and lessons for current and future work

Planned Project Impact

We anticipate gaining and share increased in-depth understanding of the issues in  gender transformative and responsive primary health care systems for adolescents. We also anticipate to develop and pilot at least one co-designed intervention that  enables gender transformative and responsive adolescent sexual reproductive and mental health and wellbeing services at health systems primary care level in each  country. We also anticipate to engage policy makers and practictioners and advocate  for use of the evidence from research to inform adolescent health policy and  program development and implementation.

We will engage with stakeholders not just as a way to share findings but as a key  strategy to strengthen the capacities of stakeholders to be able to interpret and carry  out intersectional gender analysis; this can allow for ongoing intersectional gender  analysis beyond the lifespan of the project.

Engagement and participation in an area such as adolescent sexual, reproductive  and mental health needs to be prolonged if transformation is desired. The three  years of this project represents a relatively short term engagement. However, our  involvement of adolescents themselves, frontline providers of primary care to  adolescents and communities provides the potential for long term engagement of the  stakeholders involved in the issues, well beyond the life span of this program.


Dodowa Health Research Centre
ghana health service
alliance for reproductive health rights

The AdoWA project is funded by the IDRC