Family Support, Social Support, and Psychosocial Wellbeing of High School Adolescent Girls in Uganda

Background and purpose

Adolescence is a developmental period associated with psychosocial challenges or stressors that stem from the loss of a parent(s), unsupportive parents, poverty, and lack of surrounding social support. These challenges greatly affect adolescents’ self-esteem, self-efficacy, and increase hopelessness. Previous studies have indicated associations between interpersonal factors such as relationships with peers, siblings, and adults and familial level factors such as family guidance, care and support with self-esteem and self-efficacy among adolescents. However, few studies have focused on adolescent girls, particularly in Sub-Saharan Africa. Yet, compared to adolescent boys, girls are at a high risk of poor psychosocial outcomes, which increase their risk of engaging in risk taking behaviors, exposing them to HIV. Therefore, this study examined family support and social support factors associated with the psychosocial wellbeing of adolescent girls in Uganda.

Methods

Data from a five-year longitudinal randomized control trial (2017-2022) was used. Study participants were identified and recruited from 47 secondary schools in five geographical districts in Southern Uganda. A total of 1260 adolescent girls aged 14-17 years, enrolled in the first year of secondary school, and living within a family were recruited in the study. We used hierarchical linear regression models to examine the family support (family cohesion, care, and relationships) and social support (social relationships related to parents, teachers, classmates, and friends) factors associated with adolescents’ psychosocial wellbeing, as measured by Rosenberg self-esteem, Beck hopelessness, and Tennessee self-concept scales. Block 1 included sociodemographic and household characteristics and block 2 included family factors and social factors.

Results

The mean age was 15.4 years, with the majority of participants (57%) between 14 and 15 years. Family asset ownership (β= 0.20; 95% CI: 0.11, 0.29), perceived child-caregiver support (β= 0.07; 95% CI: 0.03, 0.11), classmate support (β= 0.10; 95% CI: 0.01, 0.18) and peer support (β= 0.07; 95% CI: 0.02, 0.12) were positively associated with self-esteem. In addition, being a non-orphan (β= 1.36; 95% CI: 0.13, 2.60), family asset ownership (β= 0.39; 95% CI: 0.17, 0.62), family care and relationships (β= 0.31; 95% CI: 0.16, 0.47), perceived child-caregiver support (β= 0.12; 95% CI: 0.01, 0.47), guardian support (β= 0.46; 95% CI: 0.32, 0.59), classmate support (β=0.19; 95% CI: 0.01, 0.37), teachers support (β= 0.45; 95% CI: 0.28, 0.61), and peer support (β= 0.29; 95% CI: 0.20, 0.38) were positively associated with self-efficacy. Finally, family asset ownership (β= -0.12; 95% CI: -0.16, -0.08), family care and relationship (β= -0.06; 95% CI: -0.11, -0.02), perceived child-caregiver support (β= -0.03; 95% CI: -0.06, -0.01), guardian support (β= -0.06; 95% CI: -0.11, -0.01), teacher’s support (β= -0.09; 95% CI: -0.14, -0.05), and peer support (β= -0.06; 95% CI: -0.09, -0.04) were all associated with lower levels of hopelessness.

Conclusions and implications

Study findings indicate that family support and social support are associated with the psychosocial wellbeing of adolescents. Findings suggest the need for family strengthening interventions and social support networks to enhance adolescents’ self-esteem and self-efficacy as well as reduce their hopelessness.