title: Can Social Protection Improve Sustainable Development Goals for Adolescent Health?
abstract: BACKGROUND
  The first policy action outlined in the Sustainable Development Goals (SDGs) is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa.
  
  
  METHODS
  We conducted a longitudinal survey of adolescents (10-18 years) between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of 'cash' (economic provision) and 'care' (psychosocial support) social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models.
  
  
  RESULTS
  Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger); SDG 3 (AIDS, tuberculosis, mental health and substance abuse); SDG 4 (educational access); SDG 5 (sexual exploitation, sexual and reproductive health); and SDG 16 (violence perpetration). For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys' hunger and girls' school dropout. For tuberculosis, and for boys' sexual exploitation and girls' mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens.
  
  
  CONCLUSIONS
  National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development.
authors.affiliation: Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, Oxford, United Kingdom.|Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Lucie D
authors.identifier: http://orcid.org/0000-0002-0418-835X
authors.initials: LD
authors.lastname: Cluver
authors.affiliation: DPHRU, School of Clinical Medicine, and DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: F Mark
authors.initials: FM
authors.lastname: Orkin
authors.affiliation: Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, Oxford, United Kingdom.
authors.forename: Franziska
authors.initials: F
authors.lastname: Meinck
authors.affiliation: Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, Oxford, United Kingdom.|Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Boyes
authors.affiliation: Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, Oxford, United Kingdom.
authors.forename: Alexa R
authors.initials: AR
authors.lastname: Yakubovich
authors.affiliation: Department of Infection & Population Health, University College London, London, United Kingdom.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Sherr
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D002648:Child; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D016017:Odds Ratio; D011203:Poverty; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data