Agenda co-creation process

The research agenda’s cocreation involved three phases: (1) preparation, (2) cocreation and (3) validation. In the preparatory phase, we conducted a scoping review of existing adolescent SRH studies to identify critical evidence gaps.4 14 We also mapped key actors involved in abortion and SRH research, programming and policymaking in the region. The cocreation phase involved a 2-day research agenda-setting workshop held in October 2019 in Nairobi with the key actors identified in the preparatory phase. During the workshop, 50 representatives from 11 SSA countries identified key policy advocacy goals and priority evidence needed to advance these goals. After the workshop, participants reviewed and validated the emerging research priorities.

Key advocacy goals of the new research agenda

At the regional level, two main advocacy goals—promoting access to education and CSE, and ending child marriage—were identified as critical in reversing the trend of poor adolescent SRH outcomes. Stakeholders identified the implementation of the Continental Education Strategy 2016–2025 as essential. They noted a need for the subcluster on Education for Health and Well-being of the African Union (AU) to develop the Continental Strategy on Education for Health and Well-being for Adolescents and Young People in Africa. Participants emphasised the need to further advance the AU Campaign to End Child Marriage, currently in its second phase and started in 2014.15 The campaign, which started in 2014, aims to accelerate the end of child marriage in Africa by enhancing awareness of the implications of the practice, supporting legal and policy actions, social mobilisation at the grassroots and national levels and increasing the capacity of non-state actors to undertake evidence-based policy advocacy.

In the Eastern Africa Community subregion, passing the Sexual and Reproductive Health Rights Bill was noted as a priority. The Bill includes provisions to promote adolescent and youth access to SRH services, information and commodities, regulate harmful practices such as child marriage and female genital mutilation, and ensure reintegration and access to education for pregnant and parenting girls. In the West African subregion, promoting the formulation of subregional Economic Community of West African States (ECOWAS) frameworks addressing CSE implementation for in and out-of-school adolescents was highlighted as the main policy goal.

The Southern Africa subregion, in its commitment to adolescent SRH, has already developed several policies and strategies pursuant to its commitment to adolescents SRHR.16 These focus on SRH, HIV and key populations. Implementing these policies fully, with regular monitoring and evaluation and an accountability framework, was considered the utmost priority.

Priority evidence needs to advance key policy advocacy goals

Stakeholders outlined a range of critical evidence needs to advance the above policy advocacy goals outlined above. The identified evidence requires either empirical research or synthesising and repackaging existing evidence to make it more accessible to the end-users.

Cross-cutting approaches for better uptake of evidence

The stakeholders identified a set of approaches and principles to inform and guide research geared towards adolescent SRH policies and advocacy. First, they underscored the need for researchers to explore and use context-sensitive terminologies (eg, CSE vs life skills education, abortion vs pregnancy termination). Second, they pointed out that research ought to produce 'data' and evidence that brings to the fore—including through visual products—the lived experiences, human stories, and faces of individuals or groups. Accordingly, stakeholders identified participatory research—coproduction with communities or groups of interest—as essential in knowledge production. Third, they underscored the need for researchers to adopt an intersectionality approach (considering, eg, key populations, disability, socioeconomic status, gender, geographical location, etc) to identify marginalised groups of adolescents. Finally, active and effective strategies to engage intended users of generated findings were considered integral to all research. Participants highlighted the need for deliberate approaches to appraise and build media capacity to frame and report evidence tailored to targeted audiences meaningfully. They advocated for problem-driven political economy analyses to understand decision-makers' motivation, interests and values, identify who holds power, who to engage and how to move the agenda forward. These analyses were noted to ensure the framing of information in ways that would change the ‘hearts and minds' of those central to the decision-making.

Beyond these approaches, participants emphasised the need for research to move beyond 'data-rich countries and regions. They noted a clear need to pursue the generation of evidence in Francophone and Lusophone countries in Central, Eastern and Western Africa. Participants noted that the evidence generated should enable comparative analysis and opportunities for cross-country peer exchange and learning within the context of subregional or regional bodies. Finally, the politics of research funding need to be understood and addressed to ensure adequate financial resources to undertake the research agenda.