A Discrete Preference Report on Population and Development Issues in Sub-Saharan Africa: A Mixed-methods Analysis of Environmental Illiteracy, Sexual Health Risks and Substance Abuse among Youth

Abstract

Background and Aim: Sub-Saharan Africa (SSA) possesses a, uniquely, youthful population approximately 65%, compared to other continents, yet the potential for a demographic dividend is jeopardized by a complex set of interconnected public health challenges. While a high level of environmental illiteracy, sexual health risks, and substance abuse have often been studied in isolation, this study the following specific objectives are pursued: To assess the level of environmental literacy among SSA youth and evaluate its contribution to environmental pollution and biodiversity loss. To analyze emerging trends in sexual and reproductive health, including the prevalence of transactional sex and shifts in contraceptive use, and to explore associated clinical trends. To investigate the health literacy, perceptions, and key drivers of substance abuse and drug addiction among the youth population. To synthesize the findings from these three domains to propose a holistic framework for integrated public health intervention and policy formulation. Study Design: We employed a convergent mixed-methods design, this research collected integrated quantitative and qualitative sample size of seventy -two respondents (n=72) data from youth across 24 Sub Saharan African countries to analyze the synergistic interactions between these domains. Methods: This study employed a convergent mixed-methods design to investigate the interlinked nature of environmental illiteracy, sexual health risks, and substance abuse among youth in Sub-Saharan Africa (SSA). The design is consistent with a syndemic framework, which requires understanding how these challenges cluster and interact under shared socioeconomic pressures Results: The findings reveal a critical disconnect between environmental awareness (90%) and harmful practices, largely attributed to economic despair and externalized responsibility. Economic pressure was the primary driver (88%) of transactional sex, which was strongly linked to substance use, with 22% of engaged youth participating to support a substance habit. Substance abuse was normalized (89%) and driven by peer pressure (95%), mental health challenges (90%), and economic despair (82%). Thematic analysis identified key syndemic pathways, including a cycle of economic desperation and mental health strain. Conclusion: The study concludes that these challenges are not discrete but form an interconnected syndemic fueled by poverty and systemic failures. Consequently, standalone interventions are inherently ineffective. We propose the Integrated Youth Resilience and Empowerment (I-YRE) Framework, advocating for multi-sectoral strategies that combine environmental education, green entrepreneurship, co-located health services, and participatory governance to holistically build youth resilience and achieve sustainable development.