The health needs of adolescents and young adults (AYAs) have been neglected in tuberculosis (TB) care, control, and research. AYAs, who are distinct from younger children and older adults, undergo dynamic physical, psychological, emotional, cognitive, and social development. Five domains of adolescent well-being are crucial to a successful transition between childhood and adulthood: (1) Good health; (2) connectedness and contribution to society; (3) safety and a supportive environment; (4) learning, competence, education, skills, and employability; and (5) agency and resilience. This review summarizes the evidence of the impact of TB disease and treatment on these five domains of AYA well-being.

Background Social innovation in health is a community-engaged process that links social change and health improvement, drawing on the diverse strengths of local individuals and institutions. However, there are few studies that examine community engagement, financing and outcomes. The purpose of this study is to use a qualitative descriptive analysis to assess 40 social innovations in health identified through a global open call. Methods This qualitative analysis examined social innovation case studies from low- and middle-income countries identified by a global social innovation network. A crowdsourcing open call identified projects and key components of each social innovation were evaluated by an independent panel. We used a US Centers for Disease Control and Prevention framework to measure community engagement as shared leadership, collaboration, involvement, consultation or informing. We used descriptive statistics to examine key aspects of community engagement, financing, health outcomes and non-health outcomes. Results Data from 40 social innovations were examined. Social innovations were from Africa (21/40), Asia (11/40), and Latin America and the Caribbean (8/40). Community engagement was diverse and robust across the cases and 60% (24/40) had either shared leadership or collaboration. Financing for social innovation came from research grants (23), national or provincial government support (15), revenues from sales (13), donations (13) and local government support (10). Social innovations reported health and non-health outcomes. Conclusion Our data demonstrate social innovations had robust community engagement. Innovative financing mechanisms provide mechanisms for sustaining social innovations. Further research on health and non-health outcomes of social innovation is needed.

While the distribution of mosquito bed nets is a widely adopted approach for malaria prevention, studies exploring how the usage of a net may be influenced by its source and other factors remain sparse. A standardized questionnaire and home-visit observations were used to collect data from 9 villages in Budondo sub-county, Uganda in 2016. Household- and individual-level data were collected, such as bed net ownership (at least one net versus none), acquirement source (free versus purchased), demographics, as well as knowledge of malaria and preventative measures. Net-level data, including alternative uses, and bed net quantity and integrity, were also collected. Mixed effects logistic regression models were performed to identify the key determinants of bed net use. Overall, the proportion of households with at least one bed net was 40%, while bed net availability was only reported among 27% of all household members. Awareness of the benefits of bed net use was statistically significantly associated with ownership of at least one net (OR = 1.72, 95% CI 1.11–2.68, p = 0.02). Among those who own net(s), the odds of a bed net being correctly used (i.e., to sleep under) after adjusting for potential confounders were significantly lower for nets that were obtained free compared to nets that were purchased by the owners themselves (OR = 0.33, 95% CI 0.21–0.51, p < 0.01), resulting in an alternative use of the net. Other factors such as female gender, children ≤ 5 years old, and pregnancy status were also significantly associated with having a net to sleep under (all p < 0.01). Understanding inter- and intra-household net-use factors will help malaria control programmes more effectively direct their efforts to increase public health impact. Future studies may additionally consider socioeconomic status and track the lifetime of the net.

The COVID-19 pandemic has profoundly disrupted the provision of health services across the globe. Travel to hospitals is restricted and many health facilities have limited services, deepening financial problems for some clinics and hospitals.1 Vulnerable groups who are already marginalised by their gender, race or nationality have been disproportionately affected by COVID-19.2 In response, social innovations have been developed to protect vulnerable groups and rapidly pivot health systems towards COVID-19. Social innovations in health are inclusive solutions that meet the needs of end users through a multistakeholder, community-engaged process to address the healthcare delivery gap.3 Social innovation is particularly well suited for the COVID-19 response because it focuses on local needs, develops low-cost solutions and builds on community strengths (figure 1). In partnership with partner academic institutions, the Special Programme for Research and Training in Tropical Diseases launched the Social Innovation in Health Initiative (SIHI) in 2014. SIHI focuses on research, training and advocacy related to social innovation in health. In collaboration with partners, the network organised an online open event to discuss social innovation responses to emergencies.4 This piece highlights how social innovation has contributed to the COVID-19 response and presents three examples of social innovation projects that have adapted to the pandemic. These examples demonstrate how social innovation during COVID-19 has mobilised local communities, swiftly adapted existing health services and built strong partnerships.

Social innovation in health provides solutions to address healthcare delivery gaps using community engagement as a strategy. This study aimed to assess and understand the extent to which social innovation in health projects in LMICs use community engagement approaches in their processes, and how these shape and influence the outcomes of these health projects. We used a sequential mixed methods approach. Semi-structured interviews with social innovators were followed by an online survey among social innovation researchers and implementers. Interviews were recorded, transcribed and analyzed using NVivo 11, and themes informed development of the survey tool. The survey data were analyzed using STATA version-14 and descriptive statistics were presented. A total of 27 social innovators participated in semi-structured interviews, with 66.7% from Africa. The survey respondents had a mean age of 38.6 years (SD ± 11.5) and most of them were males 141 (51.5%). Community engagement in social innovation health projects was mostly utilized during problem identification 167 (62.1%), intervention identification and design 179 (66.5%), and delivery of interventions 213 (79.2%). Half of the social innovations 135 (52.1%) had very high level of community engagement, described as collaborative or shared leadership. There was differential participation of community stakeholders at different stages of the social innovation projects. Community engagement resulted into intervention acceptance, community ownership, and improved sustainability of interventions. Key sustainability strategies employed in social innovation health projects included capacity building, integration with existing health systems, partnerships, and financial interventions. More than half of the social innovation health projects used community engagement strategies across the various stages of their work. However, there is still need to create strong governance structures, co-create interventions with communities, and have shared responsibilities with the communities in order to attain the desirable high level of community engagement and substantiality in social innovation health projects in LMICs.