Mapping drivers of sexual and reproductive health injustices among adolescent girls in Kenya, Ghana, and Zambia: a scoping review

Background Violation of adolescent girls’ sexual reproductive health rights (SRHR) leads to injustices that impact their well-being with potentially fatal and life-long consequences. These injustices often arise due to early marriage, and in 2022, approximately 12 million girls were married before the age of 18, globally. Adolescent girls’ SRHR is especially problematic in Africa, with the highest levels being from West and Central Africa (40%), followed by East and Southern Africa (32%). To address the problem of adolescent girls’ SRHR violations, interventions have included formulating laws and policies to protect the rights and welfare of girls in national legislation, as well as in regional and international human rights instruments. Despite these efforts, the literature that explicitly focuses on SRHR lacks mapping related to drivers of adolescent girls’ SRH injustices to inform programming and policies. Therefore, a scoping review was necessary to map and understand what drives these injustices of adolescent girls’ SRHR in Africa. Methods We conducted a scoping review of papers using a SRHR lens to identify the drivers of adolescent girls’ SRHR injustices in Kenya, Ghana, and Zambia, drawing on multidisciplinary papers. We utilised the Web of Science, PubMed, HeinOnline, JSTOR, Scopus, ScienceDirect, and HINARI databases. Drivers of adolescent girls’ SRHR injustices were extracted from the papers and thematically categorised. Results We identified 18 papers on adolescent girls’ SRHR from Kenya, Ghana, and Zambia. The main drivers therein included poverty, culture and gender norms, discrimination based on disability, low education level, peer pressure, and limited access to SRH services, such as financial and geographic barriers. The main issue that cut across all these drivers was adolescent pregnancy. Conclusion From the papers, using an SRHR frame, poverty is one of the main drivers that stands out and interconnects with others, including lack of education, lack of access to SRH services, and culture. All of the identified drivers were related to adolescent pregnancy. While adolescent pregnancy in itself may not be a human rights violation, it may relate to violations such as lack of access to services, lack of education, and early child marriage. The outcomes of the review will inform policy interventions to protect adolescent girls’ SRHR.