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. 2025 May 31;22(Suppl 1):74.
doi: 10.1186/s12978-025-01994-3.

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

Chinyere Ojiugo Mbachu  1 , Irene Ifeyinwa Eze  2   3 , Obinna Onwujekwe  1
Affiliations

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

Chinyere Ojiugo Mbachu et al. Reprod Health. .

Abstract
in English, French

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.

RéSUMé: CONTEXTE: La santé sexuelle et reproductive des adolescent(e)s et jeunes (SSRAJ) est un problème de santé mondial crucial, exigeant des approches multidimensionnelles pour une intervention efficace. Cet article présente une exploration qualitative d’une intervention innovante communautaire, visant à renforcer la collaboration intersectorielle pour améliorer les résultats de la SSRAJ. MéTHODES: Une étude qualitative a été réalisée pour étudier les types, les processus et les facteurs qui ont permis ou limité les collaborations intersectorielles dans la mise en œuvre d’une intervention communautaire pour la SSRAJ dans l’État d’Ebonyi, au Nigéria. Trente entretiens approfondis et 18 discussions de groupe ont été menés avec des décideurs politiques, des prestataires de services de santé, des enseignants, des responsables communautaires, des parents et des adolescents. Les transcriptions des entretiens ont été codées dans NVivo 12. Les résultats des transcriptions codées ont été analysés à l’aide d’une analyse thématique et présentés sous forme de récits. RéSULTATS: Les principales constatations mettent en évidence l’émergence de trois modèles de collaboration prédominants, à savoir l’intégration horizontale entre les secteurs des soins de santé et de l’éducation, l’intégration horizontale entre divers organismes gouvernementaux (prestataires officiels) et organismes non gouvernementaux (prestataires informels) et l’intégration diagonale comblant les écarts entre les parties prenantes de la communauté et les prestataires de services. Les processus qui sous-tendent ces collaborations soulignent l’importance de l’instauration de la confiance, d’objectifs communs et d’une communication claire. L’étude identifie le rôle central des champions et des intermédiaires dans la facilitation de la collaboration, ainsi que la nécessité d’un cadre institutionnel de soutien. Les facteurs habilitants comprennent un engagement solide des dirigeants, des mécanismes de financement dédiés et un environnement politique favorable. À l’inverse, les défis découlant des contraintes de ressources, des intérêts conflictuels et des cloisonnements organisationnels ont entravé les efforts de collaboration. CONCLUSION: Cette recherche souligne le potentiel des interventions communautaires de renforcer la collaboration intersectorielle pour l’acceptabilité et l’adoption des stratégies en matière de SSRAJ. Elle offre une ressource précieuse aux décideurs politiques, aux professionnels de la santé et aux parties prenantes qui cherchent à améliorer les résultats de la SSRAJ par le biais d’efforts de collaboration.

Keywords: Adolescent; Community-embedded intervention; Intersectoral collaboration; Qualitative study; Sexual and reproductive health.

Plain language summary

This research focuses on improving adolescent sexual and reproductive health (ASRH) in Ebonyi State, Nigeria, through a community-embedded intervention. The study explores how different groups like policymakers, healthcare providers, teachers, community leaders, parents, and adolescents work together to improve ASRH.The study found three main ways these groups collaborate: 1. Horizontal collaboration between healthcare and education sectors. 2. Horizontal collaboration between government agencies and non-governmental organizations 3. Diagonal collaboration bridging gaps between community members and service providers. Successful collaboration relies on building trust, having shared goals, and clear communication. The study highlights the importance of champions and intermediaries who help facilitate collaboration. It also emphasizes the need for strong leadership, dedicated funding, and supportive policies to make these collaborations work.However, challenges like limited resources, conflicting interests, and organizational barriers can make collaboration difficult. Overall, the research shows that community-embedded interventions can improve ASRH by bringing different groups together to work toward a common goal.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The authors confirm that the research was performed in accordance with the Declaration of Helsinki. Ethical approval for the study was obtained from the Research and Ethics Committee of the Ministry of Health Ebonyi State, Nigeria (Ref: ERC/SMOH/AI/005/18-21) and University of Nigeria Teaching Hospital Enugu (Ref: UNTH/CSA/329/OL.5). Written informed consent to participate in the study was obtained from respondents 18 years and above. For those below 18, consent was first obtained from parents or legal guardians, and this was followed by written assent from the adolescent. Participation was voluntary, and all participants were informed of the purpose of the study and their roles and rights, including that they could withdraw their participation at any time during data collection and before data analysis commences. Consent for publication: Written informed consent was obtained from the participant to publish their anonymized individual details in this manuscript. The consent form is held by the authors and is available for review by the Editor-in-Chief. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Framework of types, processes, and factors influencing intersectoral collaboration
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