Exploring Mental Health Outcomes for Adolescent Girls and Young Women in Burundi through a Positive Youth Development Lens: Resilience in Context

Introduction: This study employs the Positive Youth Development (PYD) framework to examine mental health service delivery and outcomes among adolescent girls and young women in Burundi—a population disproportionately affected by socio-political instability, poverty, and limited access to care. PYD emphasizes building on young people's strengths and potential, rather than focusing solely on risks or deficits. In this context, the initiative aims to foster resilience, agency, and social connectedness by engaging youth as active participants in shaping their own mental health trajectories.

Methods: The team conducted 34 Key Informant Interviews with stakeholders across government, education, health, and community sectors to identify barriers, facilitators, and opportunities for integrating mental health into education systems.

Additionally, 8 Focus Group Discussions with 55 adolescent girls and young women explored experiences, perceptions, and cultural factors influencing mental health. Discussions highlighted the link between education and well-being and informed context-sensitive, trauma-informed strategies to improve mental health access and support.

Findings: The mental health of adolescent girls and young women (AGYW) in Burundi is impacted by a range of household, systemic, and individual factors. These include domestic violence, poverty, family conflict, and limited access to education. Natural disasters, stigma around mental health, and trauma from conflict and displacement further worsen their emotional well-being. The lack of supportive environments and services leaves many AGYW vulnerable to anxiety, depression, and long-term psychological distress. AGYW in Burundi face significant mental health barriers driven by gender inequality, poverty, trauma, stigma, and limited access to education and support. Harmful cultural norms, early pregnancy, school dropout, violence, and weak family and community support systems deepen emotional distress and prevent access to care. Addressing these challenges requires culturally sensitive, trauma-informed interventions that promote equity, safety, and open dialogue around mental health. Facilitators of AGYW’s mental health in Burundi include peer-to-peer learning, which builds support networks and resilience; safe spaces and school-based mentors (like the "Aunts and Uncles" model), which foster trust and emotional expression; and community structures that offer protection and support through child protection committees and awareness efforts. Public education and advocacy help reduce stigma, while supportive government policies—including mental health programs in schools and menstrual hygiene support—strengthen systems for care. Together, these factors create safer, more supportive environments for AGYW to thrive emotionally and socially.

Discussion: The findings of this illustrate not only the challenges faced by girls and young women, but also the intrinsic strengths they possess and the external supports that can be leveraged to improve mental health outcomes. The study underscores the importance of youth engagement, inclusive programming, and community-rooted interventions that empower young people as leaders and changemakers, the hallmark of the PYD approach. These insights inform the development of holistic, gender-responsive mental health practice that prioritizes youth potential and well-being.