Lay health worker-delivered and technology-based interventions for sexual and reproductive health among adolescents and young adults in low- and middle-income countries: protocol for a scoping review.
This paper presents a protocol for a scoping review of lay health worker-delivered and technology-based sexual and reproductive health interventions targeting adolescents and young adults aged 10-24 in low- and middle-income countries, to synthesize existing evidence and identify gaps for future research.
Key Findings
Background
Adolescents and young adults in low- and middle-income countries face elevated risk of harmful sexual and reproductive health practices due to multiple structural and social factors.
Identified risk factors include limited knowledge, low availability or acceptability of modern contraceptives, gender inequality, and cultural practices like child marriage.
The paper characterizes these as systemic barriers specific to the LMIC context.
No quantitative data are provided in this protocol paper; these are contextual framing statements.
Background
Lay health worker-delivered and technology-based interventions are characterized as cost-effective and scalable solutions for SRH among AYAs in LMICs.
The protocol notes that 'too little is currently known about the scope, content and conditions of the effectiveness and sustainability of these approaches.'
Synthetic evidence on this topic is described as 'scarce.'
The review is framed as necessary to fill this knowledge gap and identify where further research is needed.
Methods
The scoping review protocol targets studies on SRH preventive and educational interventions for AYAs aged 10-24 years in LMICs delivered by lay health workers or via technological means.
Outcomes to be assessed include SRH literacy, sexual risk behaviours, pregnancies, sexually transmitted infections, and gender-based violence, among others.
Key databases to be searched include PubMed via MEDLINE and Embase.
The search will cover publications from 1 January 2000 up to 23 January 2024.
Screening will be conducted using Covidence software.
Methods
A narrative synthesis following synthesis without meta-analysis (SWiM) guidelines will be used to analyze and present findings from included studies.
Data extraction will cover study details, methods, intervention strategies, outcomes, and findings.
The protocol explicitly states a narrative synthesis approach, indicating heterogeneity in expected study designs that precludes meta-analysis.
The review is limited to publicly accessible databases that do not require prior ethical approval for access.
Methods
The protocol was prospectively registered and the findings are intended for dissemination to both policymakers and researchers in LMICs.
The protocol was registered with the Open Science Framework on 7 May 2024 (osf.io/vna2z).
Dissemination is planned through peer-reviewed journal publications and presentations at national and international conferences and stakeholder meetings in LMICs.
The review aims to 'provide a synthesis of existing interventions, highlight best practices for their implementation and identify potential avenues for future research.'
What This Means
This paper describes the plan (protocol) for a scoping review—a type of study that maps out what research already exists on a topic. The researchers intend to systematically search scientific databases to find and summarize studies about programs designed to improve sexual and reproductive health (SRH) among young people aged 10 to 24 in lower-income countries. Specifically, they are interested in programs delivered by community health workers (people without formal medical training) or through technology such as mobile phones or the internet. The review will look at a wide range of outcomes including knowledge about sexual health, risky sexual behaviors, pregnancy rates, sexually transmitted infections, and gender-based violence.
This research suggests that young people in low- and middle-income countries face particular challenges around sexual and reproductive health, including lack of information, limited access to contraception, and harmful cultural practices. Community-based and technology-driven programs are seen as promising because they can potentially reach many people at relatively low cost, but the researchers note that not enough is currently known about how well these programs work, what makes them effective, or how to sustain them over time.
By mapping out what studies have been done and what they found, this scoping review aims to give policymakers and researchers a clearer picture of what approaches exist, which ones show promise, and where more research is needed. The protocol itself does not yet contain results—it describes the methodology that will be used to conduct the review—but it lays the groundwork for evidence that could inform health programs targeting vulnerable young populations worldwide.
Kern M, Neumann C, Bosompim B, Ann D, Kurniawan A, Dlamini N, et al.. (2025). Lay health worker-delivered and technology-based interventions for sexual and reproductive health among adolescents and young adults in low- and middle-income countries: protocol for a scoping review.. BMJ open. https://doi.org/10.1136/bmjopen-2024-094209