Effective school-based preventive interventions for alcohol use in Africa: a systematic review

  • Sachi Tomokawa
  • Kimihiro Miyake
  • Takeshi Akiyama
  • Yuka Makino
  • Akihiro Nishio
  • Jun Kobayashi
  • Masamine Jimba
  • Irene Ayi
  • Sammy M Njenga
  • Takashi Asakura
Keywords: School-based preventive interventions; alcohol use; Africa; systematic review.


Background: Despite recognition of the risks of alcohol use and importance of prevention from an early age, the effectiveness of school-based interventions in Africa has not been clarified.

Objective: We aimed to identify effective school-based alcohol use prevention interventions in Africa.

Methods: We searched eight databases for peer-reviewed articles published until February 3, 2019 that reported on randomized controlled trials, cluster randomized controlled trials, controlled clinical trials, pre-post quasi-experimental stud- ies, cohort studies, and case-control studies. The full-texts of relevant studies were searched.

Results: Four of 2797 papers met our eligibility criteria. All reported interventions targeted secondary school students in South Africa and were incorporated in the school curriculum. The interventions comprised multi-component activities with participatory and peer educational methods, and applied modified programs originally developed in the US. However, inter- vention effects were inconsistent among studies, although the interventions tended to have a positive effect on non-drinkers at baseline, with stronger effects in girls.

Conclusion: Interventions had positive effects on students that were non-drinkers at baseline, especially girls. Although we could not find robust evidence that school-based interventions changed attitudes, frequency/quantity of drinking, and intentions to use alcohol, one intervention showed an increase in students’ alcohol refusal self-efficacy.

Keywords: School-based preventive interventions; alcohol use; Africa; systematic review.


Journal Identifiers

eISSN: 1680-6905