Submission ID 118470
| Issue/Objective | Adolescents face complex mental and sexual reproductive health (MSRH) challenges, yet their voices remain marginalised in shaping responsive health systems. Traditional interventions often overlook their lived realities, especially gender-specific vulnerabilities. This study uses rich pictures-a participatory visual method-to explore how adolescents express their experiences, challenges, and ideas for inclusive MSRH solutions. These visual narratives offer insights to inform youth-led, gender-responsive approaches in adolescent health programming. |
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| Methodology/Approach | Rich pictures were used as a participatory method to explore adolescents' lived experiences in Ghana under the IDRC/UK-MRC-funded Adolescent Health West Africa consortium. During the initial data collection phase (2021-2023), 44 drawings were collected from adolescents aged 12-19 in in-school and out-of-school settings, including 16 males and 11 females. Each was accompanied by a verbal narrative. Thematic analysis captured adolescents' everyday realities, gendered concerns, and visions for safer, more supportive environments, informing the broader situational analysis. |
| Results | Emerging themes revealed that unintended pregnancy, substance use, depression, and peer pressure were common challenges, with notable gender differences in how these issues were represented. Female adolescents frequently associated early and unintended pregnancy with feelings of shame, anxiety, and in some cases, suicidal ideation - underscoring the profound mental health burden that accompanies sexual health outcomes for girls. In contrast, male adolescents more often depicted substance use - such as alcohol and marijuana - as mechanisms for emotional regulation, especially in response to rejection, peer influence, and societal expectations tied to masculinity. Despite these challenges, adolescents demonstrated clear leadership in identifying context-specific solutions. They advocated for early and comprehensive sexuality education, confidential and youth-friendly counselling spaces, peer-led outreach initiatives, and greater involvement of parents and community actors in adolescent health. Their visual and narrative accounts underscored not only the complexity of their experiences but also their capacity to co-create meaningful, gender-responsive approaches to adolescent health system reform. |
| Discussion/Conclusion | This study highlights the value of participatory visual tools like rich pictures in amplifying adolescent voices on gender, mental health, and sexual health. Adolescents emerged as active agents envisioning inclusive, equitable systems. Centering their lived experiences and co-created solutions is key to advancing youth leadership and gender inclusion in global health policy. |
| Presenters and affiliations | Priscilla Acquah Ghana College of Physicians and Surgeons Emelia Agblevor Ghana College of Physicians and Surgeons Lauren Wallace York University Natasha Darko Dodowa health research Bernice Gyawu Dodowa Health Research Tolib Mirzoev London school of Hygiene and Tropical Medicine Irene Agyepong Ghana College of Physicians and surgeons |
