How Do Teenagers in Africa Manage Their Health? A Systematic Review of Practices, Challenges, and Pathways to Intervention

Abstract

Adolescence represents a critical juncture for establishing health behaviors that shape long-term well-being, yet teenagers in Africa navigate this developmental phase within contexts marked by significant structural and systemic vulnerabilities. With the adolescent population on the continent projected to reach 1.3 billion by 2050, understanding how this demographic manages its health is imperative for achieving Sustainable Development Goal 3. This systematic literature review synthesizes evidence from 2012 to 2023 to examine the health management practices of African teenagers and the challenges they encounter. Following PRISMA guidelines, a systematic search of Google Scholar, WHO, UNICEF, the Journal of Adolescent Health, and the International Journal of Health yielded 513 articles, of which 30 met stringent inclusion criteria for qualitative synthesis. The findings reveal a paradoxical landscape wherein health-enhancing practices; such as protective gear use, healthy eating, and physical activity; coexist with pervasive health-risk behaviors, including substance use, unsafe sex, unsafe abortion, and sedentary lifestyles. Critically, these risk behaviors are not merely individual choices but are systematically reinforced by profound structural barriers: inadequate sexual and reproductive health (SRH) knowledge, prolonged queues and inconvenient hours at health facilities, lack of privacy, negative provider attitudes, and severe financial constraints limiting access to nutritious food and contraceptive commodities. Socio-cultural determinants, including early marriage, religious prohibitions, and peer influence, further compound these challenges. This review makes an empirical contribution by demonstrating that fragmented interventions targeting individual behavior change are insufficient in isolation; instead, the evidence points to a confluence of systemic failures that collectively undermine adolescent health. From a policy standpoint, the findings necessitate a paradigm shift toward integrated, adolescent-responsive health systems that embed comprehensive SRH and nutrition education within school curricula, enforce adolescent-friendly service standards across all health facilities, and address economic barriers through targeted social protection programs. Concerted action across health, education, and social welfare sectors is essential to dismantle the multifaceted obstacles African teenagers face. Failure to do so will perpetuate cycles of preventable morbidity, compromise the continent's demographic dividend, and delay progress toward universal health coverage. This review recommends that governments and development partners prioritize co-designed interventions with adolescents themselves, ensuring that health services are not only available but also accessible, acceptable, and equitable for all teenagers regardless of socioeconomic status, gender, or geographic location.