Adolescent Health

World Vision recognizes that adolescents face a variety of challenges that impact their ability to thrive:

• Around 1.1 million adolescents die of preventable causes every year. Millions more suffer from injury, sexual and mental abuse, and ill health.
• Adolescent girls ages 15 to 19 face the added risk of morbidity and mortality due to complications during pregnancy and childbirth. Twelve million girls in that range — and at least 777,000 girls under 15 — give birth each year in developing regions. The leading cause of death for girls ages 15 to 19 globally is complications from pregnancy and childbirth.
• Child marriage (marriage before the age of 18) limits children’s abilities to reach their full potential, as they drop out of school prematurely; are at a much higher risk of complications related to early pregnancy, childbearing, and motherhood; and are at risk of intimate partner violence.

However, targeted comprehensive investments and opportunities in adolescent health — including education, socioeconomic development, and the prevention of violence — offer a chance for adolescents to flourish and become productive adults.

To address the physical, social, and mental health of adolescents, World Vision programming co-invests in education and keeping girls in schools, which may translate into reductions in early sexual debut and unintended pregnancies among adolescent girls. We also promote supportive parenting and communities, including activities that engage men and boys in livelihoods, HIV and AIDS prevention, and the prevention of forced child marriages. Additionally, improving WASH in schools leads to girls’ retention by allowing for dignified and safe menstrual hygiene management.

World Vision’s adolescent programming consists of intersectional and crosscutting interventions and approaches described below that seek outcomes in child protection, education, health, gender equality and social inclusion, and economic well-being. Adolescent health requires the intersection of these holistic approaches, which together work to address communities’ needs, and support and promote young people’s health and cognitive, social, emotional, and spiritual development.

Following are some examples of our holistic adolescent programming:

• Interpersonal Psychotherapy for Groups is an evidence-based mental health and psychosocial support group therapy intervention for 12- to 19-year-olds. It reduces symptoms of depression (and has shown some indications of being beneficial to reducing anxiety and harmful substance use, including alcohol) by improving the quality of the participants’ social and interpersonal functioning.
• Common Elements Treatment Approach is an evidence-based mental health intervention that is delivered in the community by laypeople and is used to address common mental health problems for adolescents and adults. World Vision, in partnership with Johns Hopkins University, piloted this model in secondary schools in India.
• Citizen Voice and Action (CVA) strengthens adolescents’ participation in decision-making, improves social accountability and local advocacy, and facilitates dialogue between communities and government to improve services (like education and child protection services) that impact the daily lives of adolescents and their families. As adolescents are often direct users of basic services, they play a powerful role in the CVA community meetings, often raising topics adults will not raise.
• Menstrual hygiene management includes providing separate latrines for girls in schools, safe disposal and/or water and soap stations for washing menstrual hygiene products, training adolescents to make reusable sanitary pads, and cultivating positive knowledge and behaviors toward menstrual health.
• Village Savings and Loans facilitate savings and access to small loans and instills hope by enabling adolescents to plan, cope with household emergencies, develop their livelihoods, and invest in their health, education, and economic well-being.
• Early Warning System tracks performance, attendance, and behavior at school and refers adolescent girls at risk for dropping out to a school-community accountability group that intervenes to keep girls in school.
• Channels of Hope mobilizes faith leaders and faith communities to meaningfully address (in contextually appropriate ways) gender and gender-based violence in its various forms in local communities.
• Psychological first aid (PFA) provides immediate support to an individual who is showing signs of psychosocial distress. When trained in PFA, helpers can offer PFA to children and adults following emergency situations, disclosure of abuse (e.g., child abuse, sexual- and gender-based violence), or at any point in time if a person is distressed. A facilitator’s manual and PFA manual are available in multiple languages. All staff working with children or families affected by violence should be trained in PFA skills.
• Girls Clubs are established at the community level to engage 30 to 50 girls ages 14 to 24 to build resilience and reduce risk of HIV infection and other vulnerabilities. These clubs are located in communities to reach out to schools and schoolgirls in need of adolescent services. Health information, promotion, and skills building are provided at the Girls Club activities.

The HIV epidemic disproportionately affects adolescent girls and young women (AGYW). Across the globe in 2023, an estimated 1.5 million adolescents (10-19 years old) were living with HIV and 140,000 were newly infected. U.N. AIDS statistics indicate that in sub-Saharan Africa, AGYW are more than twice as likely to acquire HIV as their male counterparts due to gender-related factors, including harmful gender norms and taboos related to sexuality. However, keeping girls in school is one key way to help prevent child marriage, pregnancy, and gender-based violence — and reduce their risk of HIV infection.

Uganda: Strengthening School-Community Accountability for Girls’ Education (SAGE)
The SAGE program was a two-year U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)-funded project implemented by World Vision and managed by John Snow Research and Training, Inc. Through SAGE, a component of the Determined, Resilient, Empowered, AIDS-free and Safe (DREAMS) project, World Vision implemented activities that aimed to reduce school dropouts and HIV infections among 38,750 AGYW in 151 secondary schools across 10 districts with some of the highest levels of dropouts and HIV infections.

The project implemented two adolescent-led, adult-supported innovations: 1) early warning system (EWS) and 2) stay in school committees (SISCs). The project trained school and community stakeholders, established AGYW-led SISCs in schools, and changed student attendance norms by promoting adolescent leadership and community action to reduce dropouts. The SISC uses the EWS to track school attendance, behavior, and performance. SAGE’s innovative combination approach also helped shift social norms and practices around girls’ education, violence against children, reproductive health, and positive discipline.

According to the endline survey findings, the percentage of AGYW who were absent from school for at least a month in a term during the last 12-month period dropped by 2.5 percentage points between baseline (12.7%) and endline (10.2%). Further, SAGE monitoring data reported an increase of girls retained in school at the end of the project (44,351), at 99.7% in 2019 (compared to 88.5% in 2016). For HIV status, the percentage of AGYW ages 15 to 19 who tested for HIV in the last 12 months and know their status increased by 3.8 points in the intervention/treatment areas, from 92.5% at baseline in 2017 to 96.3% at endline in 2018. The findings suggest that the combined EWS and SISC approaches are a potentially effective intervention to identifying girls at risk of dropping out of school, mitigating the causes of dropout, and potentially decreasing risky behaviors and reducing risk of HIV infection.

Kenya and Bangladesh: Big Dream to End Child Marriage 
Every year, 12 million girls become child brides, according to UNICEF. In Bangladesh, 51% of girls marry before age 18, the highest prevalence in South Asia. In Kenya, child marriage remains common in several regions, where prevalence is well above the national average. World Vision is committed to a future where no child is subjected to child marriage or female genital mutilation, and where every girl can decide if, when, and whom to marry.  

Through Big Dream to End Child Marriage, we work with communities across seven counties in Kenya and four sub-districts in Bangladesh to address the root causes of child marriage and help girls stay safe, in school, and free to shape their own futures.  

Our five-pillar approach focuses on:

1. Behavior change: Helping families and communities adopt beliefs and practices that value girls, through community dialogues and positive parenting training.  
2. Education access: Covering school fees and life-skills training so girls can stay enrolled and shape their own futures. 
3. Economic empowerment: Helping families build financial resilience through savings groups and skills training, so economic pressure doesn’t push girls into marriage. 
4. Water and sanitation access: Bringing clean water closer to communities and equipping schools with menstrual hygiene facilities so girls can attend without disruption.
5. Child protection: Strengthening local protection systems and legal frameworks to prevent and respond to child marriage.  
6.  

Kenya results: The program has enrolled 51,344 households, representing more than 469,000 people, and has directly benefited more than 173,000 individuals to date. More than 6,500 vulnerable children received school fee subsidies, and participating schools maintained a 98% retention rate between October 2025 and March 2026. More than 4,200 people took part in training on positive social norms, and 1,826 parents completed positive parenting training. Families are also building financial resilience through 423 active savings groups with more than 9,000 members. As child protection systems strengthened, including new child-friendly desks in police stations, case reporting and referrals rose from 612 in fiscal year 2025 to 1,829 by mid fiscal year 2026 — a sign that families are increasingly willing and able to report cases and seek help.  

Bangladesh results: The program directly reached more than 52,000 people, with an additional 218,000 people reached indirectly through community systems strengthening. More than 2,500 vulnerable girls received stipends to stay in school, and more than 2,300 adolescent girls completed life-skills training. More than 4,300 parents and caregivers were trained in positive parenting, and 900 household couples took part in sessions supporting more equitable, nonviolent family relationships. Twenty-eight child marriage prevention committees are now active at the local government level, and more than 700 children and adolescents have been mobilized through youth forums to strengthen their voice in protection and advocacy efforts.