Implementation of community health interventions for adolescents in LMICs: a scoping review

Abstract Background Adolescents in low- and middle-income countries (LMICs) face multiple health challenges, including rising burden of non-communicable diseases (NCDs) and limited access to health services. Community-based interventions could promote adolescent health, but their sustainability is a challenge. This scoping review aimed to identify implementation strategies, barriers, and facilitators for sustainability. Methods Joanna Briggs Institute methodology and PRISMA-ScR guidelines, systematic search (Ovid MEDLINE; Scopus) for peer-reviewed studies published since 2010. Eligibility screening by independent reviewers using Rayyan.ai for community-based health interventions to adolescents (10-19 yrs) in LMICs with focus on implementation strategies, outcomes, or sustainability. Narrative synthesis of data. Results Inclusion criteria were met by 53 studies from 22 LMICs. Interventions were implemented in varied non-clinical community settings: youth clubs, informal settlements, schools, sports fields, faith-based centers, and digital platforms. Most studies used mixed or qualitative designs, focusing on sexual and reproductive health, mental health, NCD prevention, and life skills. Key implementation strategies included community mobilization, peer education, cultural adaptation, and multi-stakeholder engagement. Facilitators of sustainability were strong community ownership, implementors’ ongoing capacity building, and supportive policy frameworks. Barriers included workforce shortages, funding constraints, and limited cross-sector collaboration. Most interventions demonstrated positive health outcomes, but few addressed long-term sustainability. Conclusions For sustainability in LMICs, adolescent health interventions need cross-sectoral integration with national and local policies and systems, dedicated funding streams, and stakeholder engagement. Key messages • Findings of this scoping review support development of context-specific sustainability frameworks for program implementation to promote adolescent health in low- and middle-income countries. • Policymakers should prioritize investments in community-led, multisectoral interventions to ensure long-term health benefits for youth in low- and middle-income countries.