Peer providers delivering health and wellbeing services for adolescents and youth – a scoping review of implementation experience and impact from Eastern and Southern Africa

BACKGROUND: Adolescents and youth in Eastern and Southern Africa face significant health challenges, including high HIV prevalence, requiring comprehensive, youth-responsive healthcare. Peer provider interventions, where young people deliver health services are increasingly implemented, but evidence on effectiveness is fragmented. OBJECTIVES: This scoping review aimed to map evidence on design, implementation, and effectiveness of peer provider-delivered health interventions for adolescents and youth in Eastern and Southern Africa. METHODS: We searched medical and social science databases (PubMed, Cochrane, Web of Science, EBSCOHost) for peer-reviewed literature between January 2014-May 2024. Eligible studies evaluated interventions where adolescents or youth acted as peer providers of health or wellbeing services. Data were extracted on study design, intervention characteristics, outcomes, and implementation features. 40 studies met inclusion criteria. RESULTS: Interventions primarily targeted HIV prevention and treatment, with fewer addressing connectedness and safety. Multiple wellbeing domains were associated with positive outcomes. Effective implementation included structured referral systems, integration with professional health services, participatory education, supportive supervision, and alignment with WHO quality standards. Many studies lacked theoretical frameworks, limiting understanding of impact mechanisms. CONCLUSIONS: Peer provider interventions show promise for improving adolescent health in Eastern and Southern Africa, particularly multi-component, youth-responsive interventions. Strengthening theoretical foundations and implementation research are critical for effectiveness, scalability, and sustainability.