BackgroundAlthough Sudan has one of the highest prevalence of female genital mutilation or cutting (FGM/C), there have been shifts in e practice. These shifts include a reduction in the prevalence among younger age cohorts, changes in the types of FGM/C, an increase in medicalization, and changes in age of the practice. The drivers of these shifts are not well understood.MethodQualitative data drawn from a larger study in Khartoum and Gedaref States, Family and Midwife individual interviews and focus group discussions. Analysis and categorization within a Social Norms theoretical framework.ResultsMajor findings confirmed shifts in the type FGM/C (presumably from infibulation to non-infibulating types) and increasing medicalization in the studied communities. These shifts were reported to be driven by social, professional and religious norms.ConclusionChanges in FGM practice in Sudan include drivers which will not facilitate abandonment of the practice instead lead to normalization of FGM/C. Yet professionalisation of Midwives including their oath to stop FGM/C has potential to facilitate abandonment rapidly if developed with other Sudan health professionals.

The Population Council confronts critical health and development issues-from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programmes, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organisation governed by an international board of trustees. www.popcouncil.org GRACe is a leading regional center of excellence on gender and reproductive health and rights; Providing quality resources for all stakeholders, building capacities, promoting evidence-based planning and policy for empowering women and men and promoting reproductive health as a fundamental human right for all. GRACe values are gender equality, women empowerment, integrity, respect for human rights and excellence. It aims to promote gender equality and reproductive health and rights of the community in general and of women in Sudan and the region. www.grace.

In Sub‐Saharan Africa (SSA), adolescents make up around one‐quarter of the population who are growing up in a rapidly urbanizing environment, with its associated risks and benefits, including impacts on health, psychosocial development, nutrition, and education. However, research on adolescents' health and well‐being in SSA is limited. The ARISE (African Research, Implementation Science and Education) Network's Adolescent Health and Nutrition Study is an exploratory, school‐based study of 4988 urban adolescents from five countries: Burkina Faso, Ethiopia, South Africa, Sudan, and Tanzania. A multistage random sampling strategy was used to select the schools and adolescents. Adolescent boys and girls aged 10–15 years were interviewed using a standardized questionnaire by trained enumerators. The questionnaire covered multiple domains including demographic and socioeconomic characteristics, water, sanitation and hygiene practices, antimicrobial resistance, physical activity, dietary behaviours, socioemotional development, educational outcomes, media use, mental health, and menstrual hygiene (only for girls). Additionally, a desk review of health and school meal policies and programs and a qualitative investigation into health and food environments in schools were conducted with students, administrators, and food vendors. In this paper, we describe the study design and questionnaire, present profiles of young adolescents who participated in the study, and share field experiences and lessons learned for future studies. We expect that this study along with other ARISE Network projects will be a first step toward understanding young people's health risks and disease burdens, identifying opportunities for interventions and improving policies, as well as developing potential research capacities on adolescent health and well‐being in the SSA region.

Anaemia among adolescents is a global health problem. However, evidence regarding its burden and risk factors, particularly for younger adolescents and in sub-Saharan Africa (SSA), remains scarce. We aimed to assess the prevalence and potential determinants of anaemia among urban and semi-urban in-school young adolescents in Ethiopia, Sudan and Tanzania. We conducted a school-based survey among 3558 adolescents aged 10−14 years. A capillary blood sample was used to assess haemoglobin concentration. We assessed anaemia prevalence and examined associations between measures at the individual, household and school levels and anaemia using Poisson regression models adjusted for school and country-level clustering. The prevalence of anaemia was 32.0% overall, and 10.8% in Ethiopia, 25.0% in Sudan and 58.3% in Tanzania. Being a boy [adjusted risk ratio (RR): 1.11,

Adolescents face the risk of the triple burden of malnutrition—the co‐existence of micronutrient deficiencies, underweight and overweight and obesity and related noncommunicable diseases. Poor‐quality diets are a modifiable risk factor for all forms of malnutrition in adolescents. However, there is limited knowledge about diet quality for African adolescents. We analyzed data from 4609 school‐going adolescents aged 10–15 years in Burkina Faso, Ethiopia, Sudan and Tanzania. Dietary intake was assessed using food frequency questionnaires, and diet quality computed using the Global Diet Quality Score (GDQS). Generalized estimating equations linear regression models were used to evaluate factors associated with adolescent diet quality. Mean adolescent age was 12.4 (±1.4) years and 54% of adolescents were female. Adolescents reported physical activity on 1.5 (±1.7) days/week. The mean GDQS (±SD) was 20.6 (±4.0) (maximum 40). Adolescent consumption of vegetables, fruit, nuts and seeds, eggs, fish and poultry was low, and refined grain consumption was relatively high. Boys consumed unhealthy foods less frequently but consumed fewer cruciferous vegetables and deep orange tubers. Older adolescents had higher fish and lower red meat consumption. Having an unemployed mother versus farmer (estimate −2.60, 95% confidence interval [CI]: −4.81, −0.39), and having 3–4 days of physical activity per week versus none (estimate 0.64, 95% CI: 0.11, 1.17) were associated with GDQS. We found evidence of poor‐quality adolescent diets and gender and age differences in the consumption of healthy diets. Programs to address poor‐quality diets should consider tailoring interventions for adolescent girls and boys of different ages and also consider the role of physical activity in these contexts.