Hairdressers as Mental Health Gatekeepers in Adolescent Sextual Reproductive Health Contexts in Northern Uganda

Abstract

Background: Adolescents aged 10–19 in sub-Saharan Africa face overlapping sexual, reproductive, and mental health challenges, exacerbated by stigma, poverty, and limited youth-friendly services. Despite the documented intersection between adolescent sexual and reproductive health (SRH) and mental health, integrated interventions remain scarce, especially in resource-limited settings like Northern Uganda. Hair salons serve as culturally accepted social spaces where hairdressers often engage adolescents in personal discussions, suggesting their potential as informal mental health gatekeepers within SRH contexts. Methods: A qualitative exploratory study was conducted in Lira City and peri-urban Norther n Uganda using in-depth interviews (IDIs) and focus group discussions (FGDs) with adolescent girls and hairdressers. Purposive sampling was employed until thematic saturation. Data were analyzed thematically, focusing on adolescents’ experiences, hairdressers’ perspectives, and emerging opportunities for integration. Results: Hair salons were identified as trusted, non-judgmental environments where adolescents disclosed mental health and SRH concerns. Hairdressers provided informal emotional support and advice, and adolescents valued their confidentiality and empathy. Challenges such as stigma, restrictive gender norms, and limited referral pathways constrained this role. Both groups expressed readiness for training to strengthen psychosocial support and linkage to formal health services. Conclusion: Hairdressers in Northern Uganda act as critical informal gatekeepers for adolescent mental health and SRH, providing culturally relevant support in trusted community spaces. These findings highlight the need for structured training and referral mechanisms to harness this potential and improve adolescent health outcomes. Keywords: adolescents, mental health, sexual and reproductive health, hairdressers, gatekeepers