Table 3

Mapping multisectoral implications of adolescent health

#	Intervention approaches/settings	Health issues	Health sector role and actors	Alignment
1	Adolescent-friendly health services at health facilities11 19 31	Sexual and Reproductive Health and Rights (SRHR) Mental health	Health sector as lead actor as service provision in health facilities is its core mandate.	Referral linkages between health, education, social services, justice system and peer led networks reinforce the impact of health or constraining if there are not clear systems for referral between the sectors. Good adolescent health services are an enabling factor supporting non-health goals such as school retention.
2	Individual-based/family-based interventions8 11 19 32 Therapeutic counselling Voluntary medical male circumcision (VMMC) Parenting programmes Peer mentoring Digital individual and group behavioural interventions Vocational training.	SRHR Mental Health Violence prevention	Health sector as a lead, bilateral/trilateral or minimal actor depending on the intervention or context Clinical services are a core mandate for health. Mental health individual/family based interventions are coproduced by health, social development, education, sports. VMMC interventions are coproduced by health, education, local government and community/traditional leadership. Violence prevention interventions that are the core business of social development, education, police, has positive spillover effects for health, which is a minimal actor.	Collaboration is reinforcing or enabling, but could also be constraining if there are not clear referral systems, understanding of roles and responsibilities, counteracting if lack of shared vision between various sectors or if other sectors are not effective in preventing violence or when harmful social norms and practices continue or increase.
3	School based interventions8 9 11 19 32 33 Provision of health services Health promotion including comprehensive sexuality education Mental health group based interventions Prevention of violence, bullying	SRHR Mental health Violence prevention	Health and education sector as bilateral/trilateral actors for school based interventions School-based interventions are coproduced by health and education	Collaboration between health and education and other sectors could be categorised as reinforcing or enabling but could also be constraining when education and health is not aligned, or counteracting if broader societal contexts are harmful, particularly with regards to gender.
4	Youth centres11 Delivering HIV testing, condoms as well as other health services Recreation Vocational training	SRHR	Health sector as a bilateral/trilateral partner or minimal actor depending on the intervention and context Youth centres are coproduced by health and other sectors when delivering health services. Health is a minimal actor when other sectors core business has positive spillover effects for health.	Collaboration between actors could be described as enabling or reinforcing as provision of services through youth centres could contribute to goals of various actors, however it could also be constraining if policies and programmes not aligned.
5	Community mobilisation8 12 13 19 32 Prevention of and response to harmful practices, such as female genital mutilation (FGM) and child marriage Promotion of mental health through arts, parent training, child social skills) Prevention of violence against adolescent girls Changing social norms around early marriage and pregnancy	SRHR Mental health Violence prevention	Health sector as a bilateral/trilateral sector, supporting or minimal actor depending on the intervention and context FGM and Cutting (FGM/C) interventions are coproduced by health sector, community and traditional/cultural leadership to change social norms Community based mental health interventions are coproduced by social development, education, and health sectors Changing gender norms to prevent violence against adolescent girls requires support from the health sector for other sectors: social development, criminal justice, gender and/or youth development Gang and street violence prevention, after school dance, leisure or education activities are the core business of other sectors with spillover effects for health which is a minimal actor.	Collaboration could be categorised as multisectoral as preventing harmful practices are inextricably linked to adolescent health constraining if there are not clear systems for referral between the sectors or counteracting if a lack of a shared vision or if conflicts with local norms and practices or when legal and policy environment not supportive.
6	Conditional cash transfers11 (CCTs) to adolescents To stay in school To remain Sexually Transmitted Infections (STI) free Unconditional cash transfers (UCTs) to adolescents	SRHR	Health sector as bilateral/trilateral or minimal actor depending on the intervention and context CCTs are coproduced with health if involving delivery of health services UCTs are the core business of other sectors with spillover effects for health, which is a minimal actor	Collaboration could be categorised as reinforcing as interventions which include CCTs have a positive contribution to achieving adolescent health goals and outcomes, and enabling for UCTs as better well-being is supported by health services indirectly.
7	Improve/retain secondary school enrolment and quality of education20 32	SRHR Mental health	Health sector as a minimal actor Interventions to improve/retain secondary school enrolment are the core mandate of other sectors with spillover effects for health, which is a minimal actor.	Collaboration could be categorised as enabling as improving retention in secondary school is inextricably linked to adolescent health goals and outcomes. Counteracting when not supported by legal and policy framework and cross cutting gender inequality systems.