Mother–Daughter Interventions In Sub-Saharan Africa: A Systematic Review

Background and Purpose: Mother–daughter dyads represent a pivotal intergenerational unit with unique potential to influence adolescent girls’ health, psychosocial well-being, and long-term life trajectories. In sub-Saharan Africa (SSA), where gender norms, poverty, and HIV risk intersect, dyadic interventions may offer a culturally resonant pathway for improving outcomes among adolescent girls and young women (AGYW). However, the extent, nature, and effectiveness of such interventions remain unclear. This systematic review critically examines mother–daughter interventions in SSA, focusing on study design, implementation strategies, outcomes, and effectiveness, while assessing the strength of the evidence base to inform policy and practice. Findings are synthesized using the PEN-3 cultural model to foreground culturally grounded insights.

Methods: Guided by PRISMA protocols, we conducted a comprehensive search across thirteen electronic databases for peer-reviewed intervention studies implemented in SSA that explicitly engaged mother–daughter dyads. Studies were screened using predefined inclusion criteria related to population, intervention design, and outcomes. Of 130 unique records identified, 11 full-text articles were assessed for eligibility, and 3 studies met inclusion criteria. Data were extracted and synthesized using a directed content analysis approach, organized according to the PEN-3 domains: Cultural Identity, Relationships and Expectations, and Cultural Empowerment.

Results: Only three studies met inclusion criteria, underscoring a critical gap in the evidence base. Across studies, interventions primarily leveraged person-level entry points and demonstrated promising effects on adolescent mental health outcomes (including reductions in anxiety and depressive symptoms), improvements in caregiver–daughter communication, and enhanced coping and interpersonal skills. One intervention demonstrated the feasibility of integrating adolescent HPV vaccination with maternal cervical cancer screening, highlighting opportunities for intergenerational health service delivery. Another emphasized the role of mother–daughter dyads as active co-creators of culturally relevant intervention strategies, strengthening acceptability and engagement. Despite these strengths, interventions largely overlooked broader ecological influences, including extended family systems, community norms, and structural barriers such as food insecurity and transportation constraints. Engagement with cultural practices was present but often insufficiently theorized or operationalized.

Conclusions and Discussion: Despite strong theoretical justification and cultural relevance, the evidence base for mother–daughter interventions in SSA remains extremely limited. Existing studies provide important proof of concept but lack the scale, diversity, and methodological rigor needed to inform policy or widespread implementation. Findings highlight the need for multilevel, culturally grounded interventions that move beyond individual and dyadic processes to incorporate extended family networks and address structural constraints shaping AGYW outcomes. Future research should prioritize rigorous designs, scalability, and contextually embedded approaches that center cultural strengths. Strategic investment in such interventions is urgently needed to harness the transformative potential of mother–daughter relationships in improving social, economic, health and well-being outcomes across generations in SSA.