ArticleTropical medicine & international health : TM & IH2020
Are out-of-school adolescents at higher risk of adverse health outcomes? Evidence from 9 diverse settings in sub-Saharan Africa.
Article in Tropical medicine & international health : TM & IH, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Interventions aiming to improve menstrual, sexual, reproductive, and mental health among out-of-school girls: a systematic review.Frontiers in public health · 2024Pooled it
- Protocol for a cluster randomized controlled trial among young people and their peers to reduce substance use and inequitable gender beliefs in Southern Africa.Addiction science & clinical practice · 2026Article
- Article
- Reaching out-of-school girls with HPV vaccination: A qualitative evaluation in six low- and middle-income countries using the RE-AIM framework.medRxiv : the preprint server for health sciences · 2026Article
- Implementation and evaluation of the Y-Check comprehensive adolescent health check-up intervention in Zimbabwe: a pre-post mixed-methods study.Nature medicine · 2026Article
- Prevalence and correlates of prevalent sexually transmitted infections among young women employed as domestic workers in Central Uganda: a community-based cross-sectional study.BMJ public health · 2026Article
- Burden and determinants of anaemia among in-school young adolescents in Ethiopia, Sudan and Tanzania.Maternal & child nutrition · 2025Article
- Consumption of commercial and traditional sugar-sweetened beverages among adolescents in Pakistan: evidence from a national survey.Frontiers in nutrition · 2025Article
- School Dropout, Absenteeism and Coverage of Sexual and Reproductive Health Services in South Africa: Are Those Most at Risk Reached?AIDS and behavior · 2024Article
- Self-esteem and self-concept as correlates of life satisfaction and attitudes toward school among Ghanaian girls.Journal of research on adolescence : the official journal of the Society for Research on Adolescence · 2024Article
- Co-occurrence of non-communicable disease risk factors among adolescents in Jos, Nigeria.African journal of primary health care & family medicine · 2024Article
- Integrating Mental Health Management into Empowerment Group Sessions for Out-of-School Adolescents in Kenyan Informal Settlements: A Process Paper.International journal of environmental research and public health · 2024Article
- An innovation bootcamp model for developing youth-led HIV self-testing delivery strategies in Nigeria: post-designathon capacity building.Frontiers in public health · 2024Article
- A Systematic Review Protocol for the Effectiveness of Psycho-Educational Intervention Programmes in Addressing the Psychological Risk Factors Associated with Non-Communicable Diseases among Adolescents.International journal of environmental research and public health · 2023Article
- School attendance and sexual and reproductive health outcomes among adolescent girls in Kenya: a cross-sectional analysis.Reproductive health · 2023Article
- "It's the poverty"-Stakeholder perspectives on barriers to secondary education in rural Burkina Faso.PloS one · 2022Article
- Health and economic benefits of secondary education in the context of poverty: Evidence from Burkina Faso.PloS one · 2022Article
- The Food and Health Environment in Junior Secondary Schools in Urban Burkina Faso: A Cross-Sectional Study of Administrators, Food Vendors and Early Adolescents.International journal of environmental research and public health · 2021Article
- Article
- "Because at school, you can become somebody" - The perceived health and economic returns on secondary schooling in rural Burkina Faso.PloS one · 2019Article
Corrections and comments
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Authors and funding
13 authors at 11 institutions in 11 countries.
Funding
Abstract
objectivesWe analysed mutually comparable surveys on adolescent attitudes and behaviours from nine sites in seven sub-Saharan African countries, to determine the relationship between school enrolment and adolescent health outcomes.
methodsData from the Africa Research, Implementation Science, and Education Network cross-sectional adolescent health surveys were used to examine the associations of current school enrolment, self-reported general health and four major adolescent health domains: (i) sexual and reproductive health; (ii) nutrition and non-communicable diseases; (iii) mental health, violence and injury; and (iv) healthcare utilisation. We used multivariable Poisson regression models to calculate relative risk ratios with 95% confidence intervals (CI), controlling for demographic and socio-economic characteristics. We assessed heterogeneity by gender and study site.
resultsAcross 7829 adolescents aged 10-19, 70.5% were in school at the time of interview. In-school adolescents were 14.3% more likely (95% CI: 6-22) to report that their life is going well; 51.2% less likely (95% CI: 45-67) to report ever having had sexual intercourse; 32.6% more likely (95% CI: 9-61) to report unmet need for health care; and 30.1% less likely (95% CI: 15-43) to report having visited a traditional healer. School enrolment was not significantly associated with malnutrition, low mood, violence or injury. Substantial heterogeneity was identified between genders for sexual and reproductive health, and in-school adolescents were particularly less likely to report adverse health outcomes in settings with high average school enrolment.
conclusionsSchool enrolment is strongly associated with sexual and reproductive health and healthcare utilisation outcomes across nine sites in sub-Saharan Africa. Keeping adolescents in school may improve key health outcomes, something that can be explored through future longitudinal, mixed-methods, and (quasi-)experimental studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.