Barriers and facilitators to community-based, peer-led sexual and reproductive health intervention for adolescent girls and young women in northeastern Uganda

A qualitative study

Bibliographic Data

ID19594366
AuthorsAlimah Komuhangi (0000-0003-4871-8698, Texila American University, corresponding author), Rogers Kajabwangu (0000-0003-4101-011X, Mbarara University of Science and Technology), Jonathan Izudi (0000-0001-9065-0389, Mbarara University of Science and Technology)
EditorsJanet Seeley (0000-0002-0583-5272)
Year2026
Volume6
Issue6
Pagese0005828
Publication date2026-06-11
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0005828
PMID42275282
OpenAlexW7164368257
LanguageEN
Citations received1
References cited20

Peer-led interventions can effectively improve sexual and reproductive health (SRH) knowledge, promote safer sexual behaviors among adolescents and young people, especially where health system capacity is limited. To inform a planned pre-post study, we explored the barriers and facilitators to the implementation of a community-based, peer-led SRH intervention for adolescent girls and young women (AGYW) aged 15–24 years in northeastern Uganda. We designed a qualitative case study and collected data through focus group discussions across AGYW in six categories: in-school, out-of-school, ever given birth, and never given birth, aged 15–17 years, and aged ≥18 years. We also conducted key informant interviews with SRH officials in the district and at two health facilities. Data collection was guided by the socioecological model. We performed thematic analysis and reported findings using themes along with the participants’ quotes mapped onto the socioecological model. A total of 51 adolescent girls and young women, and five key informant interviews with the district and health facility level officials were conducted. Findings show that the anticipated barriers and facilitators to implementation occur across socioecological levels. At the individual level, stigma and fear of judgment hindered participation, whereas trust in peers supported engagement. Limited autonomy hindered access at the interpersonal level, but support from family and friends helped. Institutional barriers included judgmental provider attitudes and confidentiality concerns; existing youth-friendly services and school clubs were facilitators. At the community level, myths, misconceptions, and restrictive cultural norms posed challenges, while community dialogues and champions encouraged acceptance. No major policy barriers were noted; however, supportive SRH policies and existing partnerships were facilitators. The implementation of the intervention may be influenced by several factors across individual, interpersonal, institutional, community, and policy levels. Future implementation should consider addressing the barriers while leveraging the facilitators to enhance implementation outcomes among AGYW

Confidentiality · Focus group · Interpersonal communication · Intervention (counseling) · Psychological intervention · Qualitative property · Qualitative research · Reproductive health · Thematic analysis · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions

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Open DOIOpen Access