Adolescent and young people mental health challenges and community-based solutions in rural settings: findings from a human-centered design workshop in Dodoma, Tanzania

Adolescent and young people (AYP) mental health remain a major public health concern in low-resource settings, where social and structural factors intersect. However, there is limited evidence on context-specific challenges and youth-driven solutions. Therefore, this study explored mental health challenges and co-create feasible, AYP-driven solutions in rural setting, Tanzania. This study employed a qualitative human-centered design (HCD) approach. A two-day participatory co-design workshop was conducted with 30 AYP and 16 adult stakeholders in Chamwino, Tanzania. Data were collected using World Café discussions, Five Whys analysis, Brainwriting and prioritization matrices. Data analysis was guided by social ecological model (SEM) thematic approach. Mental health challenges identified included emotional distress, feelings of invisibility, and peer comparison at the individual level; parental conflicts, sibling comparison, and challenges related to polygamous family settings at the family level; peer influence, bullying, and poverty at the community level; and limited youth-friendly health services and unemployment at the structural level. Proposed solutions included promotion of sports activities, strengthening peer support systems, utilizing digital communication platforms, and enhancing the roles of teachers in addressing AYP mental health challenges. Mental health challenges among AYP are driven by interconnected individual, family, community, and structural factors. Addressing these challenges requires integrated interventions, including youth-friendly services, peer support, recreational activities, digital health communication, and strengthened involvement of teachers and community health workers.