ADOLESCENT GIRLS’ NUTRITION AND SEXUAL AND REPRODUCTIVE HEALTH IN UGANDA: UNDERSTANDING THE FACTORS THAT INFLUENCE HEALTH SEEKING CHOICES

Adolescents comprise a large portion of the world’s population, and their nutrition and sexual choices have global impacts. In Uganda, the population is growing rapidly, which is linked to the high fertility rates of the young population, an issue compounded by sexual preferences, early child marriages, high school drop-out rates, especially for girls, and large number of unintended pregnancies due to lack of access to and information on use of modern contraceptive methods. Adolescence represents a change in social roles - a transition from childhood to adulthood that is often swift, with lack of time to prepare and educate adolescents on their health needs, health rights, and nutritional requirements. During adolescence, high nutrient-dense foods are needed to accommodate increased nutrient requirements, especially for girls and pregnant adolescents. However, adolescents from poor urban and rural areas in Uganda have less access to nutritious food and health care than their wealthier urban counterparts, placing them at increased risk for undernourishment and malnutrition. In addition to having limited access to foods and undergoing changes in social roles, adolescent girls in Uganda are at increased risk for negative health outcomes since they marry young or are encouraged to participate in transactional sexual relationships, as their sexual exchange worth increases during puberty. This thesis has assembled literature on culturally appropriate data paired with a multi-method, peer-to-peer approach to create a foundation for knowledge of adolescent girls and their needs and wants. Providing the space to include adolescent voices, the thesis takes a strengths-based, decolonized, de-siloed research approach that considers both traditional beliefs and adolescents’ overall well-being. Adolescent involvement in research processes is critical to understanding the full impacts of nutrition and sexual and reproductive health and rights (SRHR) and to creating an adolescent-led foundation, which is currently missing in the literature. This context-building exercise can provide a base from which to evaluate current and future adolescent interventions. Assessment of available nutrition- and SRHR-based adolescent research and interventions has identified gaps in knowledge that have the potential to be filled through future mixed methods research proposed in this paper