Strengthening intersectoral collaboration for adolescent sexual and reproductive health: a community-embedded intervention in Ebonyi state, Nigeria.

BACKGROUND

Adolescent sexual and reproductive health (ASRH) is a critical global health concern, demanding multifaceted approaches for effective intervention. This paper presents a qualitative exploration of an innovative community-embedded intervention aimed at enhancing intersectoral collaboration to improve ASRH outcomes.

METHODS

A qualitative study design was employed to explore the types, processes, and factors that enabled or constrained intersectoral collaborations in implementing a community-embedded intervention for ASRH in Ebonyi State, Nigeria. Thirty in-depth interviews and 18 focus group discussions were conducted with policymakers, health service providers, teachers, community gatekeepers, parents, and adolescents. The interview transcripts were coded in NVivo 12. The outputs of the coded transcripts were analyzed using thematic analysis and presented as narratives.

RESULTS

Key findings highlight the emergence of three predominant collaboration models: horizontal integration between healthcare and education sectors, horizontal integration across various governmental agencies (formal providers) and non-governmental organizations (informal providers), and diagonal integration bridging gaps between community stakeholders and service providers. The processes underpinning these collaborations emphasize the significance of trust-building, shared goals, and clear communication. The study identifies the pivotal role of champions and intermediaries in facilitating collaboration, along with the necessity for a supportive institutional framework. The enabling factors include robust leadership commitment, dedicated funding mechanisms, and a favorable policy environment. Conversely, challenges stemming from resource constraints, conflicting interests, and organizational silos hindered collaboration efforts.

CONCLUSION

This research underscores the potential of community-embedded interventions to strengthen intersectoral collaboration for the acceptability and adoption of ASRH strategies. It offers a valuable resource for policymakers, healthcare professionals, and stakeholders seeking to enhance ASRH outcomes through collaborative efforts.