Submission ID 131666
| Issue/Objective | Adolescents in low-resource settings face persistent barriers to accessing sexual and reproductive health (SRH) services, including stigma, restrictive gender norms, limited provider capacity, and fragmented service delivery. In Lira, Northern Uganda, these challenges contribute to high rates of unintended pregnancy (~22% in the Lango sub-region, with some communities reporting up to 45%) and unsafe abortion. Despite growing evidence on these barriers, translating knowledge into practical, scalable solutions remains limited. This study aimed to develop and operationalize a co-designed, implementation-ready training and systems integration toolkit to strengthen adolescent-responsive SRH service delivery. This work was conducted under an IDRC-funded project led by Lira University. |
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| Methodology/Approach | A citizen science-driven, mixed-methods design was implemented (2024-2026) in Lira District. Baseline assessments examined adolescents' knowledge, attitudes, and practices, and barriers and facilitators to SRH service uptake. Findings were disseminated through participatory community dialogues involving adolescents, healthcare workers, and citizen scientists (including religious, cultural, political, and community leaders). Priority issues informed the co-design of a modular toolkit integrating training, service delivery workflows, and accountability mechanisms. The toolkit was validated through community review, expert consultation, and endorsement by the Adolescent Technical Working Group at the Ministry of Health, Uganda. |
| Results | The toolkit includes competency-based training for healthcare workers and citizen scientists, integrated service delivery workflows linking family planning and post-abortion care, and monitoring and quality improvement tools. Early implementation demonstrates: (1) a ≥30% increase in health workers' competency scores in adolescent-responsive SRH care following training; and (2) a ≥25% increase in adolescents reporting access to non-judgmental SRH services at participating facilities. Additionally, facilities adopting the toolkit reported improved integration of SRH services within routine care and strengthened community-facility linkages through trained citizen scientists. |
| Discussion/Conclusion | This study demonstrates how citizen science approaches can translate evidence into practical, scalable implementation tools that strengthen health workforce capacity and system integration. By training both providers and community actors, the toolkit bridges service delivery gaps and enhances accountability through monitoring and quality improvement mechanisms. This model offers a transferable approach for embedding adolescent-responsive SRH services in primary healthcare systems and advancing equitable, context-driven global health solutions. |
| Presenters and Affiliations | Samson Udho Lira University Maxson Kenneth Anyolitho Lira University Judith Akello Abal Lira University Edmonton Acheka Lira University Morris Chris Ongom GLOFORD Odette Murara University of Calgary Bernard Omech Lira University |
