The paper by Shukla et al. examines how gender transformative interventions (GTIs) reduce adolescent pregnancy in low- and middle-income countries through a realist synthesis approach. Adolescent pregnancy, driven by harmful gender norms and socio-economic factors, poses significant health and social challenges, particularly in disadvantaged groups. The study analyzes 28 documents covering 14 interventions across three settings: schools, health facilities, and communities. Key strategies include fostering supportive environments, comprehensive sexual health education, empowering boys to adopt positive gender norms, and using digital health apps for sexual reproductive health. Community-based interventions emphasize life skills, economic support for girls, and engaging community members to foster gender-positive environments. These approaches lead to outcomes such as increased contraceptive use, delayed marriage, and reduced adolescent pregnancy. The paper proposes eight nuanced program theories to inform future GTIs, offering valuable insights into creating effective strategies tailored to diverse socio-cultural contexts.

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