More adolescents are surviving cancer and being treated outside the hospital-setting, allowing them to return to typical activities of development like attending school. Effective preparation for school re-entry is an important aspect of easing the transition back-to-school following a cancer diagnosis. Previous research has used the terms school re-entry, school re-entry preparation, and school reintegration interchangeably. For the purposes of the current study, school re-entry refers to going back-to-school. School re-entry preparation or interventions refers to the preparatory process implemented for the initial return to school following a cancer diagnosis. Conversely, school reintegration refers to the ongoing or long-term adjustment of the child or adolescent with cancer to the school environment. Research in school re-entry preparation began in the late 1970s, but much is still not well understood about appropriate school re-entry preparation in terms of application, outcome, or the adolescent's needs. The adolescent with cancer's perspective has been grossly neglected in research. Furthermore, current research lacks an operational definition of "successful school re-entry" and knowledge of specific factors associated with positive school re-entry outcomes. Identifying variables that positively impact the school re-entry process is critical to improving and individualizing school re-entry interventions. The current study used an adaption of the Disability-Stress Coping Model (DSC; Wallander & Varni, 1998) to both define school re-entry success and identify potential predictors that may impact school re-entry success. In addition, to obtain a more comprehensive picture of re-entry success, adolescents with cancer rated the success of their back-to-school experiences. The current study asked 85 adolescents with cancer (ages 11 - 19 years) to complete a web-based survey asking about their re-entry experiences and daily functioning. Results provided tentative support for a discrepancy between professional and adolescent re-entry needs/goals. Findings suggest that a subset of adolescents with cancer may be at risk for poor school re-entry/reintegration outcomes, including females, being of lower SES, having certain types of cancer (brain tumors, leukemia), undergoing specific treatments (radiation, chemotherapy), being out of school for longer periods of time, having pre-morbid academic difficulties, and/or having poor social support. Adolescents who demonstrate these risk factors may warrant increased, specialized attention when preparing to return to school. In addition to systemic and within-person factors from the adapted DSC model, findings suggest that developmental characteristics of adolescence must be considered in planning re-entry intervention. Appropriate modifications to school re-entry preparation for adolescents may include utilizing electronic and social media, implementing peer mentors, focusing on reinforcing appropriate social circles, and emphasizing autonomy. More research is needed to understand how to best assist the adolescent with cancer in returning to school.

The high levels of early and unintended pregnancy among adolescents in African countries including Lesotho are attributed to various factors. These include inaccessibility, negative and unfavourable community attitude towards adolescent contraceptive uptake and use, poor knowledge of sexual and reproductive health issues including sexuality education, high levels of poverty and vulnerability, negative socio-cultural practices such as child marriage, and increasing sexual and gender-based violence. Adolescent pregnancy and parenting are usually associated with poor health, social exclusion, and stigma, leading to girls’ suspension and sometimes expulsion from school. Most African governments have adopted laws and developed policies protecting the rights of all children, including adolescents’ rights to enrol and be retained in school. These rights are to be always protected, including during pregnancy and motherhood. Aiming to explore the challenges in implementing policies and guidelines on school re-entry, this dissertation argues that despite the constitutional, legal and policy provisions to protect pregnant and parenting adolescent girls, punitive and discriminatory strategies against them undermine countries’ human rights commitments. Using the socio-legal approach, the study attributes the legal, policy and strategy implementation challenges, especially those on sexual and reproductive health and education to influences of family, societal, religious and cultural beliefs and practices. It proposes more comprehensive, innovative, gender transformative, targeted and rights-based interventions; and supportive policies and strategies to facilitate continuous awareness creation, social and attitudinal change, and social justice to address adolescents’ specific needs and justify the state’s obligations and legal duties to respect, protect and fulfil citizen’s rights in Lesotho. / Mini Dissertation (MPhil (Sexual and Reproductive Rights in Africa))--University of Pretoria, 2021. / Centre for Human Rights / MPhil (Sexual and Reproductive Rights in Africa) / Unrestricted

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