Background The COVID-19 pandemic has exacerbated struggles for youth living in poor households. Youth in rural Tanzania are particularly vulnerable given widespread poverty, lack of formal sector employment opportunities, and health risks. We examine influences of the pandemic on economic insecurity and mental health and explore the coping strategies employed by youth and their households. Methods We conducted mixed-method data collection with youth ( N = 760 quantitative and N = 44 qualitative interviews) and households ( n = 542) via mobile phone among a sub-set of a cohort from an on-going longitudinal sample in two rural regions in Tanzania. In addition to phone interviews, we collected data bi-weekly via SMS messaging. We present mixed-methods, descriptive analysis of the outcomes and longitudinally compare quantitative outcomes pre- and post-COVID-19, within the same individuals. Results Adverse economic impacts were most salient, and to cope, youth engaged in more labor and domestic chores. Compared to prior the COVID-19 pandemic, youth reported spending more time caring for elderly or sick household members and gathering firewood or nuts. Conclusions These findings underscore the potential opportunity to promote policies and programs which address risks youth face. Recommended measures include expansion and adaptation of social protection policies, strengthened food and nutrition surveillance and referral systems, and scaling up community-based mental health programming.

Adolescent alcohol use remains an under-addressed population health issue across Africa. Although the literature explores the intersection of alcohol use and vulnerability to HIV and AIDS, there is limited evidence on the gendered uptake and use of alcohol among adolescents. Capturing adolescents’ voiced experiences about the societal influences shaping their alcohol usage is essential for identifying contextually relevant interventions to reduce their vulnerability to alcohol and related risky behaviours, such as unsafe sex. We conducted qualitative research in urban Tanzania, including key informant interviews, systematic mapping of alcohol availability, in-depth interviews with adolescents in and out of school and adults, and participatory methodologies with adolescents ages 15-19. The findings described here were drawn from the participatory methodologies (n = 177); and in-depth interviews with adolescents (n = 24) and adults (n = 24). Three key themes emerged: (1) boys’ increased social vulnerability to alcohol consumption; (2) the ways in which stigma shapes girls’ alcohol usage; and (3) how gendered perceptions of alcohol use reinforce societal inequalities. There exists an urgent need to address the social and gendered vulnerabilities of youth in Africa to the uptake and use of alcohol, and identify interventions that reshape notions of masculinity increasing boy’s vulnerability to use.

Abstract Societal factors influencing adolescent alcohol initiation and use are not well documented in Tanzania. The goal of this qualitative study was to explore the structural and environmental factors influencing adolescent alcohol uptake and use in urban Tanzania. 177 adolescents aged 15–19 from varying socioeconomic backgrounds participated in 16 participatory groups (separated by sex and in-school/out-of-school status) at sites in four different locations in Dar es Salaam, Tanzania. Participatory methods were used, including listing and ranking activities, and photovoice, exploring adolescent’s perceptions around youth alcohol use, and recommendations for structural interventions to prevent or reduce adolescent alcohol uptake and use. Themes included: (1) “idle time” shapes adolescent alcohol use in urban Tanzania; (2) societal influences shape the locations where adolescents consume or purchase alcohol; and, (3) adolescents’ recommendations about structural approaches for reducing their idle time and vulnerability to alcohol use. Our findings highlight the need for programs and policies aimed at reducing youth idle time as an approach to reducing alcohol use, such as increasing opportunities for employment, extracurricular activities, and entertainment, particularly for adolescent boys in urban Tanzania, given their increased vulnerability to the uptake and use of alcohol.