Skip to main content
SpringerLink
Log in

Social Enterprises for Child and Adolescent Health in Sub-Saharan Africa: A Realist Evaluation

  • Chapter
  • First Online:
Child Behavioral Health in Sub-Saharan Africa

Abstract

The Goal 3 of the United Nations Sustainable Development Goals is “to ensure healthy lives and promote well-being for all at all ages.” In sub-Saharan Africa, millions of children and adolescents are still facing unmet health needs. Social enterprises have emerged as a way to identify and bring about potentially transformative societal change that ultimately improves health and well-being; however, few have targeted their social mission toward improving health outcomes in sub-Saharan Africa. We conducted a realist evaluation of social enterprises appraised by the Schwab Foundation for Social Entrepreneurship, one of the world’s most influential social entrepreneurship organizations for social enterprises that address child and adolescent health needs in sub-Saharan Africa. Nine social enterprise interventions, mothers2mothers, Last Mile Health, Living Goods, Embrace Innovations, Zipline, GiftedMom, VisionSpring, Table for Two International, and BasicNeeds identified from Schwab Foundation for Social Entrepreneurship, and an ongoing social entrepreneurship project led by the authors—4 Youth By Youth—were presented in this chapter. Findings illustrate the possibilities of using social enterprises to address the unmet health needs of children and adolescents in sub-Saharan Africa. It also suggests avenues for future research to advance sustainable social enterprises aimed at improving the health and well-being of children and adolescents in the region.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Addicott, R. (2011). Social enterprise in health care: Promoting organisational autonomy and staff engagement. King’s Fund.

    Google Scholar 

  • Agyepong, I. A., Sewankambo, N., Binagwaho, A., Coll-Seck, A. M., Corrah, T., Ezeh, A., … Masiye, F. (2017). The path to longer and healthier lives for all Africans by 2030: The Lancet Commission on the future of health in sub-Saharan Africa. The Lancet, 390(10114), 2803–2859.

    Article  Google Scholar 

  • Akombi, B. J., Agho, K. E., Merom, D., Renzaho, A. M., & Hall, J. J. (2017). Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016). PLoS One, 12(5), e0177338.

    Article  Google Scholar 

  • Astbury, B., & Leeuw, F. L. (2010). Unpacking black boxes: Mechanisms and theory building in evaluation. American Journal of Evaluation, 31(3), 363–381. https://doi.org/10.1177/1098214010371972

    Article  Google Scholar 

  • BasicNeeds. (2017). Retrieved from http://www.basicneeds.org/

  • Berhane, Y., Canavan, C. R., Darling, A. M., Sudfeld, C. R., Vuai, S., Adanu, R., … Guwatudde, D. (2020). The age of opportunity: Prevalence of key risk factors among adolescents 10–19 years of age in nine communities in sub-Saharan Africa. Tropical Medicine & International Health, 25(1), 15–32.

    Article  Google Scholar 

  • Boah, M., Azupogo, F., Amporfro, D. A., & Abada, L. A. (2019). The epidemiology of undernutrition and its determinants in children under five years in Ghana. PLoS One, 14(7), e0219665.

    Article  Google Scholar 

  • Bundy, D. A., de Silva, N., Horton, S., Patton, G. C., Schultz, L., Jamison, D. T., … Allen, N. (2018). Investment in child and adolescent health and development: Key messages from disease control priorities. The Lancet, 391(10121), 687–699.

    Article  Google Scholar 

  • Chae, S., Haberland, N., McCarthy, K. J., Weber, A. M., Darmstadt, G. L., & Ngo, T. D. (2020). The influence of schooling on the stability and mutability of gender attitudes: Findings from a longitudinal study of adolescent girls in Zambia. Journal of Adolescent Health, 66(1), S25–S33.

    Google Scholar 

  • Chambers, D. A., Glasgow, R. E., & Stange, K. C. (2013). The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science, 8(1), 117. https://doi.org/10.1186/1748-5908-8-117

    Article  Google Scholar 

  • Children’s Investment Fund Foundation. (2020). Reducing under-5 mortality in Uganda. Retrieved from https://ciff.org/impact/uganda-reducing-under-5-mortality/

  • Clancy, E., & Mayo, A. (2009). Launching a social enterprise see-and-treat service. Emergency Nurse, 17(3), 22–24. https://doi.org/10.7748/en2009.06.17.3.22.c7088

    Article  Google Scholar 

  • Embrace Innovations. (2020). Retreived from https://www.embraceinnovations.com/

  • Farmer, J., Kamstra, P., Brennan-Horley, C., De Cotta, T., Roy, M., Barraket, J., … Kilpatrick, S. (2020). Using micro-geography to understand the realisation of wellbeing: A qualitative GIS study of three social enterprises. Health & Place, 62. https://doi.org/10.1016/j.healthplace.2020.102293

  • Gordon, K., Wilson, J., Tonner, A., & Shaw, E. (2018). How can social enterprises impact health and well-being? International Journal of Entrepreneurial Behavior & Research, 3, 697–713.

    Article  Google Scholar 

  • Iwelunmor, J., Blackstone, S., Veira, D., Nwaozuru, U., Airhihenbuwa, C., Munodawafa, D., … Ogedegbe, G. (2016). Toward the sustainability of health interventions implemented in sub-Saharan Africa: A systematic review and conceptual framework. Implementation Science, 11(1), 43. https://doi.org/10.1186/s13012-016-0392-8

    Article  Google Scholar 

  • Iwelunmor, J., Ezechi, O., Obiezu-Umeh, C., Gbajabiamila, T., Nwaozuru, U., Oladele, D., & Tucker, J. (2019). Crowdsourcing youth-friendly strategies to promote HIV self-testing (HIVST) services in Nigeria. Paper presented at the APHA’s 2019 annual meeting and expo (Nov. 2-Nov. 6).

    Google Scholar 

  • Jagosh, J. (2019). Realist synthesis for public health: Building an ontologically deep understanding of how programs work, for whom, and in which contexts. Annual Review of Public Health, 40(1), 361–372. https://doi.org/10.1146/annurev-publhealth-031816-044451

    Article  Google Scholar 

  • Kassebaum, N., Kyu, H. H., Zoeckler, L., Olsen, H. E., Thomas, K., Pinho, C., … Ghiwot, T. T. (2017). Child and adolescent health from 1990 to 2015: Findings from the global burden of diseases, injuries, and risk factors 2015 study. JAMA Pediatrics, 171(6), 573–592.

    Article  Google Scholar 

  • Kerlin, J. A. (2010). A comparative analysis of the global emergence of social enterprise. Voluntas: International Journal of Voluntary and Nonprofit Organizations, 21(2), 162–179. https://doi.org/10.1007/s11266-010-9126-8

    Article  Google Scholar 

  • Liu, L., Oza, S., Hogan, D., Chu, Y., Perin, J., Zhu, J., … Black, R. E. (2016). Global, regional, and national causes of under-5 mortality in 2000–15: An updated systematic analysis with implications for the sustainable development goals. The Lancet, 388(10063), 3027–3035.

    Article  Google Scholar 

  • Living Goods. (2020). Retrieved from https://livinggoods.org/

  • Macaulay, B., Roy, M. J., Donaldson, C., Teasdale, S., & Kay, A. (2018). Conceptualizing the health and well-being impacts of social enterprise: A UK-based study. Health Promotion International, 33(5), 748–759.

    Google Scholar 

  • Marmot, M., Friel, S., Bell, R., Houweling, T. A. J., Taylor, S., & Commission on Social Determination of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. The Lancet, 372(9650), 1661–1669.

    Article  Google Scholar 

  • McAllister, D. A., Liu, L., Shi, T., Chu, Y., Reed, C., Burrows, J., … Campbell, H. (2019). Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: A systematic analysis. The Lancet Global Health, 7(1), e47–e57.

    Article  Google Scholar 

  • McKague, K., & Harrison, S. (2019). Gender and health social enterprises in Africa: A research agenda. International Journal for Equity in Health, 18(1), 95.

    Article  Google Scholar 

  • Mothers2Mothers. (2020). Retrieved from https://www.m2m.org/

  • Nilsson, M., Griggs, D., & Visbeck, M. (2016). Policy: Map the interactions between sustainable development goals. Nature, 534(7607), 320–322.

    Article  Google Scholar 

  • Nwaozuru, U., Gbajabiamila, T., Obiezu-Umeh, C., Mason, S., Tahlil, K., Oladele, D., … Ezechi, O. (2020). An innovation bootcamp model to develop HIV self-testing social enterprise among young people in Nigeria: A youth participatory design approach. The Lancet Global Health, 8, S12.

    Article  Google Scholar 

  • Osgood-Zimmerman, A., Millear, A. I., Stubbs, R. W., Shields, C., Pickering, B. V., Earl, L., … Bhatt, S. (2018). Mapping child growth failure in Africa between 2000 and 2015. Nature, 555(7694), 41–47.

    Article  Google Scholar 

  • Pawson, R., & Tilley, N. (1997). Realistic evaluation. SAGE Publications.

    Google Scholar 

  • Roy, M. J., Donaldson, C., Baker, R., & Kay, A. (2013). Social enterprise: New pathways to health and well-being? Journal of Public Health Policy, 34(1), 55–68.

    Article  Google Scholar 

  • Roy, M. J., Donaldson, C., Baker, R., & Kerr, S. (2014). The potential of social enterprise to enhance health and well-being: A model and systematic review. Social Science & Medicine, 123, 182–193. https://doi.org/10.1016/j.socscimed.2014.07.031

    Article  Google Scholar 

  • Schwab Foundation. (2020). Social entrepreneurships. Retrieved from http://www.schwabfound.org/entrepreneurs

  • Smith, T. W., Calancie, L., & Ammerman, A. (2015). Social entrepreneurship for obesity prevention: What are the opportunities? Current Obesity Reports, 4(3), 311–318. https://doi.org/10.1007/s13679-015-0162-y

    Article  Google Scholar 

  • UN. (2015). United Nations: Transforming our world: The 2030 agenda for sustainable development. UN.

    Google Scholar 

  • Van Malderen, C., Amouzou, A., Barros, A. J., Masquelier, B., Van Oyen, H., & Speybroeck, N. (2019). Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa: A decomposition analysis. BMC Public Health, 19(1), 760.

    Article  Google Scholar 

  • Werner, L. K., Jabbarian, J., Kagoné, M., McMahon, S., Lemp, J., Souares, A., ... & De Neve, J. W. (2019). “Because at school, you can become somebody”–The perceived health and economic returns on secondary schooling in rural Burkina Faso. PloS one, 14(12), e0226911.

    Google Scholar 

  • Wilkinson, R. G., & Marmot, M. (2003). Social determinants of health: The solid facts. World Health Organization.

    Google Scholar 

  • Willis, C. D., Riley, B. L., Stockton, L., Abramowicz, A., Zummach, D., Wong, G., … Best, A. (2016). Scaling up complex interventions: Insights from a realist synthesis. Health Res Policy Syst, 14(1), 88.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Saint Louis University, College for Public Health and Social Justice, Department of Behavioral Science and Health Education, Saint Louis, MO, USA

    Juliet Iwelunmor, Ucheoma Nwaozuru, Chisom Obiezu-Umeh, Florida Uzoaru & Stacey Mason

  2. University of Virginia School of Medicine, 200 Jeanette Lancaster Way, Charlottesville, VA, USA

    Sarah Blackstone

  3. Nigerian Institute of Medical Research, Clinical Sciences Division, Medical Compound, 6 Edmund Crescent, Lagos, Nigeria

    Titilola Gbaja-Biamila, David Oladele & Oliver Ezechi

  4. Georgia State University, School of Public Health, Atlanta, GA, USA

    Collins Airhihenbuwa

Authors
  1. Juliet Iwelunmor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah Blackstone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ucheoma Nwaozuru
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chisom Obiezu-Umeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Florida Uzoaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stacey Mason
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Titilola Gbaja-Biamila
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David Oladele
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Oliver Ezechi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Collins Airhihenbuwa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juliet Iwelunmor .

Editor information

Editors and Affiliations

  1. Brown School, Washington University in St. Louis, St. Louis, MO, USA

    Fred M. Ssewamala

  2. Brown School, Washington University in St. Louis, St. Louis, MO, USA

    Ozge Sensoy Bahar

  3. Brown School, Washington University in St. Louis, St. Louis, MO, USA

    Mary M. McKay

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Iwelunmor, J. et al. (2022). Social Enterprises for Child and Adolescent Health in Sub-Saharan Africa: A Realist Evaluation. In: Ssewamala, F.M., Sensoy Bahar, O., McKay, M.M. (eds) Child Behavioral Health in Sub-Saharan Africa. Springer, Cham. https://doi.org/10.1007/978-3-030-83707-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-83707-5_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-83706-8

  • Online ISBN: 978-3-030-83707-5

  • eBook Packages: Social SciencesSocial Sciences (R0)

Publish with us

Policies and ethics

Search

Navigation