Objective:

To evaluate the implementation and effectiveness of the S-NICE intervention in improving adolescent sexual and reproductive health outcomes in rural Mozambique.

Approach:

Key Findings:

• Coverage of new modern contraceptive users increased from 5.45% to 10.12% in intervention facilities.
• Adolescent pregnancy rates declined from 13.76% to 11.64% in intervention facilities.
• Differences in contraceptive uptake and adolescent pregnancy rates between intervention and comparison facilities did not reach statistical significance.
• S-NICE demonstrated moderate-to-high fidelity and strong acceptability across stakeholder groups.
• Barriers included infrastructure constraints, staff turnover, and sociocultural norms.

Interpretation:

S-NICE was associated with favorable trends in adolescent sexual and reproductive health outcomes and demonstrated strong implementation performance.

Limitations:

• Causal effects could not be conclusively established due to the quasi-experimental study design.
• The study was limited to a specific rural context in Mozambique.

Conclusion:

Structured, data-driven, multisectoral implementation strategies may strengthen adolescent- and youth-friendly health services delivery in low-resource contexts. Longer-term evaluations are needed to assess impact and sustainability.

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