WHO. Mental health of adolescents. 2021. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health#:~:text=Emotional%20disorders&text=Depression%20is%20estimated%20to%20occur,affect%20school%20attendance%20and%20schoolwork.

IHME. Global Burden of Disease (GBD) Study. Institute for Health Metrics and Evaluation. Accessed 11 Aug 2024, 2024. https://vizhub.healthdata.org/gbd-results/?params=gbd-api-2019-permalink/380dfa3f26639cb711d908d9a119ded2.

IHME. Global Health Data Exchange (GHDx). Institute of Health Metrics and Evaluation. https://vizhub.healthdata.org/gbd-results/.

Sharma M, Lakhan R. Chapter 10 - Mental health. In: Effective approaches to global health issues. Amsterdam: Academic Press; 2025. p. 211–235. https://www.sciencedirect.com/book/9780443290985/effective-approaches-to-global-health-issues.

Jörns-Presentati A, Napp A-K, Dessauvagie AS, et al. The prevalence of mental health problems in sub-Saharan adolescents: A systematic review. PLoS One. 2021;16(5):e0251689.

Article  PubMed  PubMed Central  Google Scholar 

Cortina MA, Sodha A, Fazel M, Ramchandani PG. Prevalence of child mental health problems in sub-Saharan Africa: a systematic review. Arch Pediatr Adolesc Med. 2012;166(3):276–81.

Article  PubMed  Google Scholar 

WHO. Adolescent health. 2023. Accessed 27 Sept 2023. https://www.who.int/health-topics/adolescent-health#tab=tab_1.

Busch V, Loyen A, Lodder M, Schrijvers AJ, van Yperen TA, de Leeuw JR. The effects of adolescent health-related behavior on academic performance: A systematic review of the longitudinal evidence. Rev Educ Res. 2014;84(2):245–74.

Article  Google Scholar 

MoH. Ministry of Health Strategic Plan 2020/21 - 2024/25. Kampala: Ministry of Health; 2015. https://www.health.go.ug/document/strategic-plan-2020-2025.

Third National Development Plan (NDPIII) 2020/21 - 2024/25. 2020.

Group WB. Data Bank: Gender Statistics. The World Bank. Accessed 8 Aug 2024. https://databank.worldbank.org/source/gender-statistics/Series/SE.PRM.CMPT.FE.ZS.

Invensus. Service Coverage: School completion. 2024. Accessed 10 Aug 2024. https://afdb-scorecard.invenus.dev/en/indicators/school-completion.

UNESCO. Upper secondary completion rate in Uganda. United Nations Educational, Scientific and Cultural Organization. https://www.education-inequalities.org/indicators/comp_upsec_v2#maxYear=2021&minYear=2016&ageGroup=%22comp_upsec_v2%22.

Pilgrim NA. The effects of family environment on sexual vulnerability among adolescent girls, ages 15–19, in Rakai. Uganda: The Johns Hopkins University; 2011.

Google Scholar 

Mayanja Y, Kamacooko O, Bagiire D, Namale G, Seeley J. Epidemiological findings of alcohol misuse and dependence symptoms among adolescent girls and young women involved in high-risk sexual behavior in Kampala, Uganda. Int J Environ Res Public Health. 2020;17(17):6129.

Article  PubMed  PubMed Central  Google Scholar 

Nyakato VN, Achen C, Chambers D, et al. Very young adolescent perceptions of growing up in rural southwest Uganda: Influences on sexual development and behavior. Afr J Reprod Health. 2021;25(2):50–64.

PubMed  Google Scholar 

Råssjö E-B, Mirembe FM, Darj E. Vulnerability and risk factors for sexually transmitted infections and HIV among adolescents in Kampala. Uganda AIDS care. 2006;18(7):710–6.

Article  PubMed  Google Scholar 

Matovu JK, Bukenya JN, Kasozi D, et al. Sexual-risk behaviours and HIV and syphilis prevalence among in-and out-of-school adolescent girls and young women in Uganda: A cross-sectional study. PLoS One. 2021;16(9):e0257321.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kaggwa MM, Najjuka SM, Bongomin F, Mamun MA, Griffiths MD. Prevalence of depression in Uganda: A systematic review and meta-analysis. PLoS One. 2022;17(10):e0276552.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kinyanda E, Kizza R, Abbo C, Ndyanabangi S, Levin J. Prevalence and risk factors of depression in childhood and adolescence as seen in 4 districts of north-eastern Uganda. BMC Int Health Hum Rights. 2013;13:1–10.

Article  Google Scholar 

Bukenya B, Kasirye R, Lunkuse J, et al. Depression, anxiety, and suicide risk among Ugandan youth in vocational training. Psychiatr Q. 2022;93(2):513–26.

Nalugya-Sserunjogi J, Rukundo GZ, Ovuga E, Kiwuwa SM, Musisi S, Nakimuli-Mpungu E. Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda. Child Adolesc Psychiatry Ment Health. 2016;10:1–8.

Article  Google Scholar 

Nabunya P, Damulira C, Byansi W, et al. Prevalence and correlates of depressive symptoms among high school adolescent girls in southern Uganda. BMC Public Health. 2020;20:1–11.

Article  Google Scholar 

Logie CH, Okumu M, Mwima S, Hakiza R, Chemutai D, Kyambadde P. Contextual factors associated with depression among urban refugee and displaced youth in Kampala, Uganda: findings from a cross-sectional study. Confl Heal. 2020;14:1–13.

Google Scholar 

Bonin L. Patient education: Depression in children and adolescents (Beyond the Basics). UpToDate; 2020.

Zuilkowski SS, Jukes MC. The impact of education on sexual behavior in sub-Saharan Africa: a review of the evidence. AIDS Care. 2012;24(5):562–76.

Article  PubMed  Google Scholar 

Gummerson E. Have the educated changed HIV risk behaviours more in Africa? Afr J AIDS Res. 2013;12(3):161–72.

Article  PubMed  Google Scholar 

McClinton Appollis T, Mathews C, Lombard C, Jonas K. School Dropout, Absenteeism and Coverage of Sexual and Reproductive Health Services in South Africa: Are Those Most at Risk Reached? AIDS Behav. 2024;28(10):3525–42.

Pettifor AE, Levandowski BA, MacPhail C, Padian NS, Cohen MS, Rees HV. Keep them in school: the importance of education as a protective factor against HIV infection among young South African women. Int J Epidemiol. 2008;37(6):1266–73.

Article  PubMed  PubMed Central  Google Scholar 

Vavrus F. Girls’ schooling in Tanzania: the key to HIV/AIDS prevention? AIDS Care. 2006;18(8):863–71.

Article  CAS  PubMed  Google Scholar 

Jukes M, Simmons S, Bundy D. Education and vulnerability: the role of schools in protecting young women and girls from HIV in southern Africa. AIDS. 2008;22:S41–56.

Article  PubMed  Google Scholar 

Stoner MC, Pettifor A, Edwards JK, et al. The effect of school attendance and school dropout on incident HIV and HSV-2 among young women in rural South Africa enrolled in HPTN 068. AIDS. 2017;31(15):2127–34.

Article  PubMed  Google Scholar 

Santelli JS, Mathur S, Song X, et al. Rising School Enrollment and Declining HIV Risk, Adolescents, Rakai District, Uganda, 1994.

Nyirenda M, Newell ML, Mugisha J, et al. Health, wellbeing, and disability among older people infected or affected by HIV in Uganda and South Africa. Glob Health Action. 2013;6:19201. https://doi.org/10.3402/gha.v6i0.19201.

Article  PubMed  Google Scholar 

Ssewamala FM, Karimli L, Torsten N, et al. Applying a family-level economic strengthening intervention to improve education and health-related outcomes of school-going AIDS-orphaned children: lessons from a randomized experiment in Southern Uganda. Prev Sci. 2016;17:134–43.

Article  PubMed  PubMed Central  Google Scholar 

Ssewamala FM, Karimli L, Han C-K, Ismayilova L. Social capital, savings, and educational performance of orphaned adolescents in Sub-Saharan Africa. Child Youth Serv Rev. 2010;32(12):1704–10.

Article  PubMed  PubMed Central  Google Scholar 

Ssewamala FM, Han C-K, Neilands TB. Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: Findings from a randomized clinical trial in rural Uganda. Soc Sci Med. 2009;69(2):191–8.

Article  PubMed  PubMed Central  Google Scholar 

Bird K. The intergenerational transmission of poverty: An overview. In: Shepherd A, Brunt J, editors. Chronic Poverty: Concepts, Causes and Policy. London: Palgrave Macmillan; 2013. p. 60–84. https://link.springer.com/book/10.1057/9781137316707.

McBain RK, Salhi C, Hann K, Salomon JA, Kim JJ, Betancourt TS. Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial. Health Policy Plan. 2016;31(4):415–24.

Article  PubMed  Google Scholar 

Rukundo A, Kibanja G, Steffens K. Psychoactive Substance Use and School Performance among Adolescents in Public Secondary Schools in Uganda. 2014.

Woldehanna T, Endale K, Hamory J, Baird S. Absenteeism, Dropout, and On-Time School Completion of Vulnerable Primary School Students in Ethiopia: Exploring theRole of Adolescent Decision-Making Power in the Household, Exposure toViolence, and Paid and Unpaid Work. Eur J Dev Res. 2021;33(5):1349–89.

Article  Google Scholar 

UDHS. Uganda demographic and health survey 2016. Key indicators report. Uganda Bureau of Statistics, ICF: UBOS, and Rockville Maryland; 2016.

Kish L. Sampling organizations and groups of unequal sizes. Am Sociol Rev. 1965;30:564–72.

Article  CAS  PubMed  Google Scholar 

Gadow KD, Sprafkin JN. Child symptom inventory 4: Screening and norms manual. Checkmate Plus; 2002.

Sprafkin J, Gadow KD, Salisbury H, Schneider J, Loney J. Further evidence of reliability and validity of the Child Symptom Inventory-4: Parent checklist in clinically referred boys. J Clin Child Adolesc Psychol. 2002;31(4):513–24.

Article  PubMed  Google Scholar 

Mpango RS, Kinyanda E, Rukundo GZ, Gadow KD, Patel V. Cross-cultural adaptation of the Child and Adolescent Symptom Inventory-5 (CASI-5) for use in central and south-western Uganda: the CHAKA project. Trop Doct. 2017;47(4):347–54.

Article  PubMed  Google Scholar 

APA. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). American Psychiatric Association. Accessed 11 Aug 2024. https://www.psychiatry.org/dsm5.

Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6.

Article  PubMed  Google Scholar 

Cavazos-Rehg P, Xu C, Kasson E, Byansi W, Bahar OS, Ssewamala FM. Social and economic equity and family cohesion as potential protective factors from depression among adolescents living with HIV in Uganda. AIDS Behav. 2020;24:2546–54.