COMMUNITY-BASED PREVENTION OF SUBSTANCE USE AMONG YOUNG PEOPLE IN DEVELOPING COUNTRIES: A SYSTEMATIC LITERATURE REVIEW

Abstract

Substance use disorders among young people in developing countries have increased substantially, yet prevention science remains concentrated in high-income settings. This systematic review examined community-based prevention approaches targeting adolescents and young adults aged 10-24 years in low- and middle-income countries (LMICs). Six databases were searched systematically for studies published between 2000 and 2024, with inclusion criteria specifying community-based interventions, young people in LMICs, and substance use outcomes. Study quality was assessed using the Cochrane Risk of Bias tool and Newcastle-Ottawa Scale. Sixty-six studies met inclusion criteria, with 38 providing sufficient data for meta-synthesis. Family-strengthening programmes showed the largest effect sizes, followed by school-based life skills training and peer education approaches. Cultural adaptation emerged as a critical moderator of programme effectiveness, whilst implementation challenges included resource constraints, stigma, and limited trained personnel. Community-based prevention appears effective in LMIC settings when programmes are culturally adapted and adequately resourced, though the evidence base remains uneven across regions. Future research should prioritise rigorous trials in sub-Saharan Africa and South Asia, where burden is highest but evidence is thinnest.