From Fragmentation to Transformation: A Grounded Theory Study on the Process of Integrating Sexual and Reproductive Health, Mental Health and Psychosocial Support for Children and Adolescents in Johannesburg, South Africa
(2025) MPHN40 20251Social Medicine and Global Health
- Abstract
- Gender-based violence (GBV) remains a pressing public health challenge in South Africa, deeply rooted in intersecting social, economic, and structural factors. Comprehensive approaches are increasingly recognized as essential for addressing the complex nature of the issue. While efforts to prevent GBV among children and adolescents can yield long-term, sustainable outcomes, they often remain fragmented. To overcome this fragmentation, integrative models of care are being advocated as a means to more effective prevention. There is limited understanding of how sexual and reproductive health and rights (SRHR) and mental health and psychosocial support (MHPSS), two critical frameworks for youth well-being, can be integrated in GBV prevention... (More)
- Gender-based violence (GBV) remains a pressing public health challenge in South Africa, deeply rooted in intersecting social, economic, and structural factors. Comprehensive approaches are increasingly recognized as essential for addressing the complex nature of the issue. While efforts to prevent GBV among children and adolescents can yield long-term, sustainable outcomes, they often remain fragmented. To overcome this fragmentation, integrative models of care are being advocated as a means to more effective prevention. There is limited understanding of how sexual and reproductive health and rights (SRHR) and mental health and psychosocial support (MHPSS), two critical frameworks for youth well-being, can be integrated in GBV prevention programming. This study explores the process of integration between SRHR and MHPSS within community-based GBV prevention programs for children and adolescents in Johannesburg. Using a constructivist grounded theory methodology, the research draws on in-depth interviews with practitioners to explore how the integration is intervowen. The resulting conceptual model “The Pathway of Integration: From Fragmentation to Transformation” which unfolds the process through five interrelated stages: Fragmented, Emerging, Coordinated, Embedded, and Transformational integration. Each of these stages characterized by specific properties and shaped by contextual conditions across micro, meso, and macro levels. These stages do not follow a strict linear trajectory but instead represent overlapping and dynamic degrees of integration that coexist and shift over time. The results highlight participation as a foundational element in the integration process, as well as the increased mattering and empowerment of youth, stakeholder involvement, cross-sector collaboration, and strengthened community resilience. All of these aspects progressively deepening as integration becomes more embedded, supported by harmonised political will, funding resources and evolving gender norms. (Less)
- Popular Abstract
- In South Africa, gender-based violence (GBV) is a deeply rooted issue, affecting individuals, homes, communities and broader society. This is a huge public health issue since it has serious consequences for young people’s mental well-being and sexual health. Although the services that try to respond to these challenges tend to operate in isolation, delivering support separately and without coordination. This fragmentation can lead to gaps in care for the young people who need help the most. This study looks at how two significant types of support, mental health and psychosocial support, and sexual and reproductive health and rights, can be better connected in programs that aim to prevent GBV. By interviewing community workers in... (More)
- In South Africa, gender-based violence (GBV) is a deeply rooted issue, affecting individuals, homes, communities and broader society. This is a huge public health issue since it has serious consequences for young people’s mental well-being and sexual health. Although the services that try to respond to these challenges tend to operate in isolation, delivering support separately and without coordination. This fragmentation can lead to gaps in care for the young people who need help the most. This study looks at how two significant types of support, mental health and psychosocial support, and sexual and reproductive health and rights, can be better connected in programs that aim to prevent GBV. By interviewing community workers in Johannesburg who deliver these services the study aimed to understand how integration happens on the ground. From this, a model was created that shows five different stages of integration, from completely separate services to fully transformational approaches. The study found that when services work more closely together, young people are more likely to feel heard, supported, and empowered. These programs also become more effective when they are backed by political support, funding, and a shared belief in gender equality. This study helps us understand how to design better community-based responses to GBV, ones that treat mental health and sexual health as interconnected, because they are deeply linked in young people’s lives. It offers practical ideas for how organisations, governments, and communities can work together to build safer, more supportive environments for young people, where GBV does not just get addressed, but is prevented from happening in the first place. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/student-papers/record/9221575
- author
- Schreber, Heléne LU
- supervisor
- organization
- course
- MPHN40 20251
- year
- 2025
- type
- H2 - Master's Degree (Two Years)
- subject
- keywords
- Intergrated care, GBV, SRHR, MHPSS, Johannesburg, South Africa
- language
- English
- id
- 9221575
- date added to LUP
- 2026-06-12 12:33:35
- date last changed
- 2026-06-12 12:33:35
@misc{9221575,
abstract = {{Gender-based violence (GBV) remains a pressing public health challenge in South Africa, deeply rooted in intersecting social, economic, and structural factors. Comprehensive approaches are increasingly recognized as essential for addressing the complex nature of the issue. While efforts to prevent GBV among children and adolescents can yield long-term, sustainable outcomes, they often remain fragmented. To overcome this fragmentation, integrative models of care are being advocated as a means to more effective prevention. There is limited understanding of how sexual and reproductive health and rights (SRHR) and mental health and psychosocial support (MHPSS), two critical frameworks for youth well-being, can be integrated in GBV prevention programming. This study explores the process of integration between SRHR and MHPSS within community-based GBV prevention programs for children and adolescents in Johannesburg. Using a constructivist grounded theory methodology, the research draws on in-depth interviews with practitioners to explore how the integration is intervowen. The resulting conceptual model “The Pathway of Integration: From Fragmentation to Transformation” which unfolds the process through five interrelated stages: Fragmented, Emerging, Coordinated, Embedded, and Transformational integration. Each of these stages characterized by specific properties and shaped by contextual conditions across micro, meso, and macro levels. These stages do not follow a strict linear trajectory but instead represent overlapping and dynamic degrees of integration that coexist and shift over time. The results highlight participation as a foundational element in the integration process, as well as the increased mattering and empowerment of youth, stakeholder involvement, cross-sector collaboration, and strengthened community resilience. All of these aspects progressively deepening as integration becomes more embedded, supported by harmonised political will, funding resources and evolving gender norms.}},
author = {{Schreber, Heléne}},
language = {{eng}},
note = {{Student Paper}},
title = {{From Fragmentation to Transformation: A Grounded Theory Study on the Process of Integrating Sexual and Reproductive Health, Mental Health and Psychosocial Support for Children and Adolescents in Johannesburg, South Africa}},
year = {{2025}},
}