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This paper presents empirical and methodological findings from an art-based, participatory process with a group (n  = 16) of adolescent and young advisors in the Western Cape Province of South Africa. In a weekend workshop, participants reflected on their participation in 12 years of health and development-related research through theatre, song, visual methodologies and semi-structured interviews. Empirical findings suggest that participants interpreted the group research encounter as a site of empowerment, social support and as a socio-political endeavour. Through song, theatre and a mural illustration, they demonstrated that they value 'unity' in research, with the aim of ameliorating the conditions of adolescents and young people in other parts of South Africa and the continent. Methodological findings document how participants deployed art-based approaches from South Africa's powerful history of activism, including the struggle against apartheid, the fight for anti-retroviral therapy and more recent social movements towards decolonization. [ABSTRACT FROM AUTHOR]

Growing evidence documents the effects of the COVID-19 pandemic on adolescents in East and Southern Africa. We present and explore the longitudinal health and development-related priorities and challenges of adolescent advisors in South Africa and Kenya, including prior to, and during the COVID-19 pandemic. Findings were co-generated with adolescent advisors in the Eastern Cape Province of South Africa (n=15, ages 18–22 in 2019) and Kisumu, Kenya (n=16, ages 10–14 in 2020). Prior to COVID-19, adolescent advisors engaged in a participatory exercise to share and explore their health and development-related priorities and challenges in 2019 and 2020. During the COVID-19 pandemic in 2020 and 2021, members of the same groups shared their experiences, challenges and coping strategies in semi-structured telephone interviews (Eastern Cape: n=14, aged 19–23; Kisumu n=12, aged 11–16) and group-based remote participatory social media activities (n=27 activities with n=12 advisors, Eastern Cape). We thematically analysed COVID-19 activities, considering them alongside pre-pandemic priorities and challenges. Many of the health and development-related priorities and challenges identified prior to COVID-19 remained issues of concern during COVID-19. These included education; victimization and violence; teenage pregnancy; substance use; household tension, conflict and inadequate family and caregiver support; health and medication concerns (South Africa) and water and food shortages (Kenya). Other issues such as financial insecurity, mental health, and crime were strong themes that emerged during COVID-19, which were not directly reported as priorities prior. Although almost all of adolescent advisors' most pressing pandemic-related challenges were also priorities for them prior to COVID-19, these issues were often discussed as new, and caused by the onset of COVID-19. While demonstrating how COVID-19 has exacerbated pre-existing vulnerabilities, we also suggest that the pandemic may have brought about a new way for adolescents to make sense of, and articulate pre-existing challenges. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify possible entry points for interventions that can act as development accelerators for children and adolescents in South Africa and Malawi. Methods: This study was a secondary data analysis. Data were sourced from the Child Community Care longitudinal study which tracked child well‐being outcomes among 989 children (4–13 years) and their caregivers affected by HIV and enrolled in community‐based organizations in South Africa and Malawi. We examined associations between five hypothesized accelerating services/household provisions—measured as access at baseline and follow‐up and 12 child outcomes that relate to indicators within the Sustainable Development Goals (SDGs) framework. We calculated the adjusted probabilities of experiencing each SDG aligned outcome conditional on receipt of single, combined or all identified accelerators. Results: The results show household food security is associated with positive child education and cognitive development outcomes. Cash grants were positively associated with nutrition and cognitive development outcomes. Living in a safe community was positively associated with all mental health outcomes. Experiencing a combination of two factors was associated with higher probability of positive child outcomes. However, experiencing all three accelerators was associated with better child outcomes, compared with any of the individual factors by themselves with substantial improvements noted in child education outcomes. Conclusions: Combined delivery of specific interventions or services may yield greater improvements in child outcomes across different developmental domains. It is recommended that multiple support avenues in combination like improving food security and safe communities, as well as social protection grants, should be provided for vulnerable children to maximize the impact. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore and describe how peer pressure and coercion to sexual activity manifested among adolescents in a district in South African and how primary healthcare nurses could support them to resist it. Background: When adolescents engage in early sexual activity, unplanned pregnancies and sexual transmitted infections become health threats. Notwithstanding the governmental health promotion programmes to improve the sexual health of the youth in South Africa, adolescents are still having unprotected sex and even multiple sex partners. Methods: A constructivist grounded theory study was done. The initial sample consisted of 10 adolescents and nine professional nurses who were selected from six primary healthcare clinics in the identified district. Constant comparative data collection and analysis were done to identify the initial codes that were theoretically saturated through another round of data collection and analysis involving five participants (four professional nurses and one health educator). Findings: The findings of the study refer to the definition of peer pressure and coercion and the relationship between professional nurses and adolescents. Ways to optimize the relationship in order for nurses to substitute for parental shortcomings in guiding adolescents towards responsible sexual behaviour and to address the adolescents' vulnerability regarding peer pressure were identified. Conclusion: Challenging adolescent–nurse interaction incidents were identified that warranted different approaches to build on existing initiatives to improve adolescent‐friendly health services. Implications for nursing practice and policy: Primary healthcare nurses should perform complementary roles to substitute for parents who do not have the skills to guide their adolescent children towards responsible sexual behaviour. Programmes need to be developed to enable nurses to optimize their relationships with adolescents and to deliver services through mobile healthcare units to adolescents where they regular socialize. Management should provide budgets for nurses to use multimedia to interact with adolescents. [ABSTRACT FROM AUTHOR]