Positive Youth Development Programs in Low- and Middle-Income Countries: Conceptual Framework and Review of Efficacy

Introduction: Positive youth development (PYD) has served as a framework for youth prevention programs in high-income countries since the 1990s and has demonstrated broad behavioral health and developmental benefits. PYD programs build skills, assets and competencies; foster youth agency; build healthy relationships; strengthen the environment; and transform systems to prepare youth for successful adulthood. Programs are designed to have proximal impact on these PYD constructs (e.g. skills, agency, and supportive environments) which in turn influence behaviors which lead to achieving positive outcomes such as good physical and mental health and safer communities. The goal of this paper is to systematically review the impact of PYD programs in low- and middle-income countries (LMICs).

METHODS: Targeted searches of knowledge repository websites and key word searches of Scopus and Pub Med identified over 21,500 articles and over 3,700 evaluation reports published between 1990 and mid-2016. Ninety-seven PYD programs with evaluations in LMICs were included in the final review, of which 38 had at least one experimental or rigorous quasi-experimental evaluation.

RESULTS: About half of the 97 programs were delivered in schools and most of the remaining were delivered through community organizations. Sixty percent of the 38 programs with rigorous evaluations demonstrated positive effects on behaviors, including substance use and risky sexual activity, and/or more distal developmental outcomes, such as employment and health indicators.

CONCLUSIONS: There is promising evidence that PYD programs can be effective in LMICs. Of the programs with rigorous evaluations, the programs which intentionally targeted several related positive youth outcomes are the most promising for larger-scale implementations; however, more rigorous examination with long-term follow-up is required to establish if these programs offer benefits similar to those seen in higher-income countries.