# Strengthening intersectoral collaboration for adolescent sexual and reproductive health: a community-embedded intervention in Ebonyi state, Nigeria

## TL;DR

This study explores how different groups in Nigeria can work together to improve adolescent sexual and reproductive health through community-based collaboration.

## Contribution

The paper introduces a community-embedded intervention that identifies three collaboration models to enhance intersectoral efforts for adolescent sexual and reproductive health.

## Key findings

- Three collaboration models emerged: horizontal integration between healthcare and education, horizontal integration between government and NGOs, and diagonal integration between stakeholders and service providers.
- Successful collaboration depends on trust, shared goals, clear communication, and the presence of champions and intermediaries.
- Enabling factors include strong leadership, funding, and supportive policies, while challenges include resource constraints and organizational silos.

## Abstract

Adolescent sexual and reproductive health (ASRH) is a critical global health concern, demanding multifaceted approaches for effective intervention. This paper presents a qualitative exploration of an innovative community-embedded intervention aimed at enhancing intersectoral collaboration to improve ASRH outcomes.

A qualitative study design was employed to explore the types, processes, and factors that enabled or constrained intersectoral collaborations in implementing a community-embedded intervention for ASRH in Ebonyi State, Nigeria. Thirty in-depth interviews and 18 focus group discussions were conducted with policymakers, health service providers, teachers, community gatekeepers, parents, and adolescents. The interview transcripts were coded in NVivo 12. The outputs of the coded transcripts were analyzed using thematic analysis and presented as narratives.

Key findings highlight the emergence of three predominant collaboration models: horizontal integration between healthcare and education sectors, horizontal integration across various governmental agencies (formal providers) and non-governmental organizations (informal providers), and diagonal integration bridging gaps between community stakeholders and service providers. The processes underpinning these collaborations emphasize the significance of trust-building, shared goals, and clear communication. The study identifies the pivotal role of champions and intermediaries in facilitating collaboration, along with the necessity for a supportive institutional framework. The enabling factors include robust leadership commitment, dedicated funding mechanisms, and a favorable policy environment. Conversely, challenges stemming from resource constraints, conflicting interests, and organizational silos hindered collaboration efforts.

This research underscores the potential of community-embedded interventions to strengthen intersectoral collaboration for the acceptability and adoption of ASRH strategies. It offers a valuable resource for policymakers, healthcare professionals, and stakeholders seeking to enhance ASRH outcomes through collaborative efforts.

This research focuses on improving adolescent sexual and reproductive health (ASRH) in Ebonyi State, Nigeria, through a community-embedded intervention. The study explores how different groups like policymakers, healthcare providers, teachers, community leaders, parents, and adolescents work together to improve ASRH.

The study found three main ways these groups collaborate:

Horizontal collaboration between healthcare and education sectors.Horizontal collaboration between government agencies and non-governmental organizationsDiagonal collaboration bridging gaps between community members and service providers.

Horizontal collaboration between healthcare and education sectors.

Horizontal collaboration between government agencies and non-governmental organizations

Diagonal collaboration bridging gaps between community members and service providers.

Successful collaboration relies on building trust, having shared goals, and clear communication. The study highlights the importance of champions and intermediaries who help facilitate collaboration. It also emphasizes the need for strong leadership, dedicated funding, and supportive policies to make these collaborations work.

However, challenges like limited resources, conflicting interests, and organizational barriers can make collaboration difficult. Overall, the research shows that community-embedded interventions can improve ASRH by bringing different groups together to work toward a common goal.