Promoting Participation in African High Schools: A Scoping Review.

Learning is the primary occupation of adolescents in high schools, although they engage in a much wider range of occupations at school. Recent systematic and scoping reviews from high-income countries (HICs), classified by the World Bank, with the United States as the most prominent, provide evidence to support the role of occupational therapy in school participation for adolescents with developmental, health, and environmental barriers. However, participation for high school learners in the African context differs from that of learners from an HIC context, due to the unique challenges faced by learners in Africa. These challenges include poverty, educational challenges (e.g., early school dropout and teacher shortfall), infrastructure and resource shortages, cultural expectations and inequalities (e.g., family and gender norms), conflict, and instability. A scoping review was conducted to map interventions that promote participation in schools internationally and to evaluate their suitability for the African context. The Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA) extension guidelines were used to guide this review. Sources about the nature of school-based interventions for adolescents (12-18 years) that indicated a clear link between the intervention and participation in schools, published in English (with no restriction on years) and peer-reviewed, were included. A total of 2689 studies (excluding duplicates) were identified, and 15 were included. Framework analysis was used to evaluate the suitability of interventions, including the characteristics of the evidence, community-based practice, practice approaches, sustainability, cultural norms, and spirituality. Four interventions were identified as suitable for the African context: a recovery program for adolescents with substance use disorders, a social cognitive intervention to promote social skills in adolescents with autism, a transition readiness service to promote work participation, and coping strategies to promote adolescents' mental health in schools. Recommendations were made to include spirituality when delivering interventions for adolescents in African schools.