Zifune (Find Yourself)
Zifune (“Find Yourself”) was a randomised control trial of a second-wave life skills intervention, delivered to adolescents who had been part of the Thula Sana (“Hush Baby”) study as infants nearly two decades prior. The aim of Zifune was to prevent interpersonal violence among adolescents through a solution based
life skills programme for adolescent boys and girls, delivered over 8 group sessions.
Adolescents and their caregivers were assessed with a range of measures post intervention to determine the effectiveness of the intervention. In addition, during 2020, a telephonic assessment took place to determine the impact of the COIVD-19 pandemic on adolescent participants and their caregivers.
The Zifune project also forms part of the ‘Accelerating Achievement for Africa’s Adolescents Hub’, where potential “accelerators” are being identified to help achieve positive outcomes at scale for adolescents and young people in sub-Saharan Africa.
HASHTAG (Health Action in ScHools for a Thriving Adolescent Generation)
HASHTAG is a school-based mental health promotion and prevention intervention for at-risk adolescents in South Africa and Nepal. It is comprised of two activities. Strategy 1, Thriving Environment in Schools (TES), is a school climate improvement strategy and Strategy 2, Thrive Together (TT) comprises an adolescent psychosocial intervention delivered in a school-based setting.
Formative research started in 2020 to inform the development of the intervention, and HASHTAG will be developed and tested in a feasibility trial in 2021.
South Africa and
Measurement of Mental Health among Adolescents at the Population Level (MMAP)
UNICEF, with the support of experts, is leading efforts to develop a data collection tool to capture information on adolescents’ mental health at a population level in low- and middle-income countries. ILCHR is leading the validation and adaptation of the tool for use in South Africa, involving a mix of qualitative and quantitative approaches, including clinical validation of depression, anxiety and suicidality. The final outcome will be a tool for use in household surveys to assess the prevalence of mental health conditions among adolescents aged 10-14 and 15-19.
Local translators conducted an initial translation of the MMAP tool into isiXhosa, which was then reviewed by a panel of mental health experts for accuracy. The translated tool was presented to adolescents and their caregivers through a series of focus group discussions to determine the comprehensibility, acceptability, relevance and completeness of the items in the tool.
If I Were Thabo - If I Were Jack
If I Were Jack (JACK) is an evidence-based, user-informed educational intervention targeted toward young people aged 14 years designed to prevent adolescent pregnancy and promote positive sexual health and relationships. In 2019-2020, our team worked with stakeholders in Lesotho and South Africa to co-design contextually relevant versions of this evidence-based, gender-transformative intervention. If I Were Thabo, the resulting adapted and co-developed intervention, will begin to be implemented in 2021.
If I Were Thabo will proceed in two phases. Phase 1 involves the development of intervention and assessment materials that are relevant to the local context, and Phase 2 assesses the extent of the intervention’s feasibility through small-scale implementation and evaluation of the intervention, with the final goal of running an effectiveness trial.
Teaching Recovery Techniques (TRT)
A trauma screening study took place among 340 high school students in Khayelitsha to gain a more comprehensive understanding of the impact of trauma and adversity on adolescent mental health, followed by the pilot testing of the Teaching Recovery Techniques (TRT) intervention for affected adolescents. TRT has been implemented in conflict and post-conflict settings, and this was the first time it was implemented in a South African setting.
A feasibility randomised control trial was conducted to test the adapted group-based TRT programme with adolescent participants and their caregivers, in order to address the trauma-related distress children can experience following traumatic events.
and their caregivers
Adolescent Mental Health Matters: landscape analysis
ILCHR contributed to a landscape analysis of UNICEF’s efforts to support adolescent mental health and psychosocial support services at the global, regional, and country level, to highlight strengths and critical factors influencing UNICEF’s work and identifying opportunities for strengthening UNICEF’s strategies, policies, and programmes that support adolescent mental health.
A landscape analysis was conducted in 2019 through key informant interviews with UNICEF regional and country teams, programme data collection, and a desk review of programme materials, strategy documents, tools and reports to identify opportunities for strengthening UNICEF’s adolescent mental health and psychosocial support services.
Evidence reviews for WHO Helping Adolescents Thrive guidelines
Helping Adolescents Thrive (HAT) is a global initiative to promote adolescents’ emotional wellbeing, mental health and functioning, and to prevent mental health conditions, risk behaviours and self-harm in order to improve health across the lifespan.
Since 2018, our team has been involved in a range of supporting activities including systematically reviewing and meta-analysis evidence from psychosocial interventions to inform WHO guidelines on promotive and preventive mental health interventions for adolescents. Findings from the evidence review are now being used to develop a HAT intervention package, which will continue in 2021.
Emotional regulation as a core component for prevention and promotion of adolescent mental health
We conducted a realist review on interventions that include emotional regulation skills as a means to prevent depression and anxiety in adolescents. To further contextualise findings, we engaged in consultations with adolescents in South Africa and Nepal in order to explore their views on these interventions and our findings, with relevance for low-resource settings.
We completed the review in late 2020 and produced a number of materials to share results, including a video, infographic and lay summary.
Evidence review for WHO adolescent service delivery guidelines
This review examined psychosocial interventions targeted at adolescents and young people ages 10-24 living with HIV that aimed to improve engagement in health care and clinical HIV outcomes.
This review was conducted as part of the 2020 WHO Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection, which included a section on service delivery under which this review falls.
We completed the review and presented results to the WHO Guidelines Development Group in late 2020. The final guideline including recommendation based on our review is under development.