@All, Iโd like to hear from colleagues working on adolescent SRH, mental health, GBV and economic strengthening.
A 2026 cluster randomised trial in western Kenya (Weiser et al., BMJ Global Health) tested Shamba Maisha, an agricultural livelihood intervention for HIV-affected households, and looked at what it did for adolescent girls living in them.
Girls in intervention households had:
1. less food insecurity (OR 0.45)
2. fewer depressive symptoms in the secondary analysis (OR 0.42), though the primary analysis was not statistically significant
3. less sexual intimate partner violence in the secondary analysis (OR 0.28, wide CI of 0.08โ0.91)
Unprotected sex did not differ between arms. This is one trial, in HIV-affected households and with unmarried girls, so the findings are encouraging rather than conclusive.
Even so, they challenge how we usually fund and design adolescent health programmes. If a better household livelihood can lower a girlโs exposure to violence and distress, why do we treat economic strengthening and adolescent SRH as separate sectors?
Questions for the group:
1. Is this evidence strong enough to justify routinely adding livelihood components to adolescent health programming in Kenya, or should we wait for the larger follow-up trials?
2. Would the effects hold outside HIV-affected households and for girls not enrolled in a health programme?
3. What would integration need in practice, such as joint funding, shared indicators, or county level coordination between agriculture, health and education?
4. Are there other Kenyan or African examples of livelihood or cash-plus approaches improving adolescent outcomes?
