Farquharson Karinn, Quinn-Savory Alexandra, Zulaika Garazi, Mason Linda, Nungo Susan, Nyothach Elizabeth, Unger Holger, Sivakami Muthusamy, Spinhoven Philip, Phillips-Howard Penelope A, van Eijk Anna Maria
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
Front Public Health. 2024 Dec 4;12:1440930. doi: 10.3389/fpubh.2024.1440930. eCollection 2024.
Out-of-school adolescent girls (OoSGs) can lack education on menstrual, sexual, reproductive, and mental health (SRMH) and be more vulnerable to SRMH harms. Targeted interventions could reduce these risks. We assessed interventions and their effectiveness among OoSGs globally.
Six online databases were searched for interventional studies targeting SRMH problems in OoSGs. Two coders independently abstracted data from each eligible study, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We summarized results using forest plots.
A total of 1,244 studies were screened; eight studies with sufficient information on SRMH outcomes were included (9,084 OoSGs, range 100-3,026 per study, overall study quality low-to-moderate). Six were educational programmes, and two were cash interventions; no study was directed at mental health. Participants were recruited through village census, outreach workers, and work locations. Some improvements were seen in indicators of SRMH knowledge (four studies), attitudes (one study), and risky sexual behaviors (four studies); however, no reduction was seen in human immunodeficiency virus or herpes simplex virus-2 incidence (two studies).
This review suggests that programmes can improve OosG's SRMH knowledge, attitudes, and practices and can be delivered in low resource contexts. Effective interventions are needed to support OoSGs, including interventions focusing on SRMH support incorporating elements of cash-transfer, and comprehensive sexual education, and to aid local policy and programming.
失学少女可能缺乏有关月经、性、生殖和心理健康（SRMH）的教育，更容易受到SRMH伤害。有针对性的干预措施可以降低这些风险。我们评估了全球范围内针对失学少女的干预措施及其效果。
检索了六个在线数据库，以查找针对失学少女SRMH问题的干预性研究。两名编码员按照系统评价和Meta分析的首选报告项目指南，独立从每项符合条件的研究中提取数据。我们使用森林图总结结果。
共筛选了1244项研究；纳入了八项关于SRMH结果有足够信息的研究（9084名失学少女，每项研究范围为100 - 3026名，总体研究质量为低到中等）。六项是教育项目，两项是现金干预措施；没有研究针对心理健康。参与者通过村庄普查、外展工作人员和工作地点招募。在SRMH知识指标（四项研究）、态度（一项研究）和危险性行为指标（四项研究）方面有一些改善；然而，在人类免疫缺陷病毒或单纯疱疹病毒2感染率方面没有下降（两项研究）。
本综述表明，这些项目可以提高失学少女的SRMH知识、态度和行为，并且可以在资源匮乏的环境中实施。需要有效的干预措施来支持失学少女，包括侧重于结合现金转移和全面性教育等要素的SRMH支持的干预措施，并协助地方政策和规划。
