Associations between sustainable development goals accelerators and well-being, by household heads’ disability status among adolescents in Zambia – a cross-sectional study

Abstract Objectives We examined associations between accelerators (interventions impacting two or more SDG targets) and well-being indicators among adolescents in Zambia. Methods We randomly sampled 1,800 households receiving social cash transfers (SCT) in four districts, surveyed adults 16 years and older. Using multivariable logistic regressions, stratified by household heads disability status, we examined associations between accelerators (SCT, life-long learning (LLL), mobile phone access (MPA)) and seven well-being indicators among adolescents 16 to 24 years old. We predicted adolescents’ probabilities of reporting indicators using marginal effects models. Results We included 1,725 adolescents, 881(51.1%) girls. MPA was associated with no poverty (adjusted Odds Ratio [aOR] 2.08, p<0.001), informal cash transfers (aOR 1.82 p=0.004), seeking mental support (aOR 1.61, p=0.020); SCT with no health access restrictions related to disability (aOR 2.56, p=0.004), lesser odds seeking mental support (aOR 0.53, p=0.029); LLL with informal cash transfers (aOR 3.49, p<0.001), lower school enrolment (aOR 0.70, p=0.004). Adolescents living with disabled household heads reported worse poverty, good health, less suicidal ideation. Conclusions Accelerators - SCT, LLL, MPA - were associated with well-being indicators. Adolescents living with disabled household heads benefited less. Relevance to SDGs This paper shows that adopting accelerators can help achieve SDGs-aligned well-being indicators for adolescents living in poverty. However, accelerators may not offset disability-related inequalities. Adolescents living with disabled household heads may require more attention to achieve the SDGs. SDGs targets 1.2. no poverty; 1.3.1 social cash transfers, Informal cash transfers; 3. good Health; 3.4. no suicidal ideation; 3.4. seeking mental support; 4.1. school enrolment; 10. no health access restrictions related to disability.