Social media and adolescent well-being in the Global South

Despite the rapid proliferation of digital technologies in the Global South, most academic research on social media and adolescent well-being has primarily focused on the Global North. This review investigates how social media impacts adolescent well-being in the Global South. We first review five regions (Sub-Saharan Africa, Middle East & North Africa, Latin America, China and South & South-East Asia) to highlight the complex ways social media interacts with well-being around the world. We then outline research gaps in the current understanding of the impacts of social media use on adolescent populations in diverse cultural contexts. We finally highlight potential lines of inquiry that future researchers could explore to build a nuanced, contextual perspective of the risks and opportunities of social media use. This review provides comprehensive evidence on how digital technol- ogy impacts children and their life outcomes globally. By examining both digital opportunities and the impact of digital divide for adoles- cents, this report sheds light on how we can harness the good and limit the harm.


Introduction
Gaps in children and adolescents' digital access in the Global South 1 have been closing over the last decade [1]. While "one in three internet users globally is a child", this proportion is estimated to be higher in the Global South [2]. For example, in Sub-Saharan Africa (specifically Ghana, Malawi, and South Africa), young people make up the majority of mobile users, even among the poor [3]. However, up to two-thirds of children (ages 3 to 17) in the Global South are still underconnected [4], accentuating existing inequalities [5*]. In these settings, mobile-only or smartphone connectivity predominates.
Social media is now used extensively by youth around the world. Yet much of the existing work investigating the impact of social media use on adolescent well-being has focused entirely on the Global North (e.g., the USA, or Europe) [6,7]. For example, in a scoping review of social media use and well-being among adolescents, Schønning et al. (2020) reviewed a total of 79 articles of which only eight were from the Global South [8**]. Little is known about how social media influences adolescents beyond Western populations [2]. This is a substantial oversight as 88% of the world's population, and the majority of adolescents [9], live in the Global South. With nine out of the ten countries with the most Facebook users worldwide located in the Global South [10], and social media sites like WeChat reaching 1.2 billion users in Asia, it is critical to diversify the science of social media use (SMU). The aim of our review is therefore to a) examine the cross-cultural variation in SMU and well-being, b) integrate findings across the different regions in the Global South to better understand how engagement with social media influences adolescents' well-being, and c) describe emerging themes and directions for researchers to diversify the study of social media and well-being. divergent findings showing positive, negative, and null associations [6,7,11,12]. Yet this largely inconclusive evidence base cannot be generalised to the Global South given the stark socio-economic or contextual differences [8]. Indeed, persistent digital access gaps exist both within and between countries in the Global South with factors such as age, income, gender, education and social norms exacerbating these divides [ Secondly, Global South regions might have culturally and linguistically specific factors that impact psychological well-being [24]. Particularly, higher collectivism might play an important role in well-being in these regions [25], for example, the pan-African concept of Ubuntu, translated as, I am because we are, is central to the idea of well-being [26]. So, does engagement with social media uphold the value of Ubuntu and foster social inclusion for African adolescents? Further, in South Asia, the culture of preserving family honour (izzat) might prevent girls from accessing social media and subsequently deprive them of positive digital connections. This raises the question of how the impact of SMU on well-being might differ between South Asian, African and American adolescents. Such a comparison would require researchers to appreciate the cultural traditions rooted in non-Western contexts and rigorously test potential contextual similarities or differences.

Integrating findings from the Global South
To avoid overgeneralisation across the Global South, we will review insights from five regions separately: Sub-Saharan Africa, Middle East & North Africa (MENA), Latin America, China and South & South-East Asia.

Sub-Saharan Africa
African adolescents, particularly those living in the sub-Saharan region and girls living in rural areas, are the least digitally connected globally [27]. While some work on sub-Saharan populations has examined the impact of social media on social capital [28], cyber-bullying [29] or gender-based violence [30], there are insufficient highquality studies linking SMU and well-being. Further, most research focuses only on a few African countries, e.g., South Africa [31].
The reasons for this lack of research could relate to the stigma that surrounds mental health in sub-Saharan Africa [32], as well as there being other challenges that attract a large share of research efforts (e.g., infectious diseases and promoting physical health). Even in relation to social media, scientific investigations have prioritised work examining, for example, how SMU can enhance primary healthcare in rural areas [33], generate COVID-19 awareness [34], or help with HIV surveillance [35].

The Middle East and North Africa (MENA)
The MENA region is one of the most diverse in terms of digital access [36], yet the evidence on how SMU impacts adolescent well-being is limited. Most available evidence examines children's internet use in general or focuses on risks such as cyberbullying, online sexual content, risky online behaviour or excessive internet use [37e39].
The link between socialising online and well-being is often implicit in the research on MENA populations rather than explicitly measured. However, as children use social media to stay in touch with family and friends, socialise and meet new people [40], we argue that social media can offer intimacy, social support, and distraction and thus positively influences well-being [41]. Yet, MENA girls and young women are less likely to have a social media profile than their male peers, one reason being heightened parental disapproval [42,43]. Failures to abide by conservative gender norms are treated more harshly in MENA girls, e.g., when sharing social media photos [44] or when communicating online with others [40].

South & Southeast Asia
With more than half of the world's adolescents living in Asia [9] and the highest rates of child internet use occurring in this region [45], Asia represents an important case study on SMU.
In the South Asia region, qualitative studies and grey literature provide accumulating evidence of persistent gender inequalities and restrictive gender norms that affect both access to devices and time spent online [46,47]. However, a 2018 policy report stated that social media provides a 'digital safe haven' for adolescents in countries like Afghanistan where girls can use such online spaces to engage with topics such as women's rights, sexuality, domestic violence and abortion [48].
Research has also highlighted various risks: suicides relating to social media posts in Bangladesh [49], cyberbulling in Pakistan [50], SMU leading to poor mental health in India [51] and recruitment of adolescent girls into prostitution in Nepal [52]. Yet there is also evidence that social media and digital technologies provide benefits, such as giving a new form of voice and agency to girls [46] and positively benefitting their education [53]. A qualitative study in East Asia (Cambodia, Indonesia, Malaysia, and Thailand) found that SMU has both positive (e.g., enabling communication) and negative (e.g., promoting self-harm) impacts on mental health. It can particularly enable marginalised young children, e.g., refugee children or children with visual or hearing disability [45*], to reap the benefits of social connections.

China
While popular Western social media platforms such as Facebook, Twitter and Instagram are banned in China, the country represents one of the biggest social media markets in the world with a high proportion of young WeChat, QZone and Sina Weibo users [54]. It is crucial to consider the urban-rural differences within China, with differences in gender and moral norms that impact access and usage [55]. The prevalence of problematic SMU and its impact on adolescent well-being have been widely researched in empirical studies, review articles, qualitative and longitudinal investigations [56e59]. For example, studies explore the negative impact of WeChat excessive use [58*] or Qzone use leading to depression via negative social comparisons [60], suggesting an overall trend towards examining the negative impact of SMU, as in the Global North. Yet other research paints a more nuanced picture showing that "WeChat usage itself is neither good nor bad per se, but that the kind of usage matters [58*,61*]. Despite the limited work on the positive effects of SMU, studies have found that it can boost well-being, particularly among LGBT populations [62*].

Latin America
Most young people in Latin America are internet users [63], using social media like WhatsApp to receive social support and meet friends. Research in Latin America has largely focused on general device access and digital skills in adolescents rather than SMU [64]. Furthermore, most data are collected in countries such as Brazil, Chile, Costa Rica and Uruguay, as part of the Global Kids Online Study [65]. In these countries, between 13% and 44% of participants report contact with strangers online, 30% have been exposed to content that upset them and between 5% and 10% have experienced cyberbullying [66]. One-fourth of adolescents have received sexual content [67].
Overall, research focusing on social media's impact on adolescent well-being in Latin America remains scant [68]. In line with worldwide trends, previous research has focused mostly on associations of SMU with psychopathology (Colombia [69]), sleep (México [70]) or compulsive use (Colombia and México [71]). However, evidence suggests that SMU both positively and negatively affects psychological well-being. In Mexico, indigenous Maya adolescents believe that digital technologies alter social networks in ways that can both contribute to (e.g., increasing family closeness and security) and detract from (e.g., turning attention away from the family) family relations [72]. In Chile, scholars found that while problematic use is associated with lower subjective well-being, recreational, social and educational internet use is associated with higher wellbeing [73*]. In Perú, positive experiences with SMU (e.g., getting help online) were associated with less loneliness during the pandemic, with reverse patterns for the negative experiences with SMU [74]. Adolescents in Chile and El Salvador report mixed perceptions of social media as a source of emotional support, connection with like-minded peers, and relaxation but also consider it a risky place [75].

Recommendations for future research
There are a variety of emerging themes that pose open research questions about the link between SMU and adolescent well-being. We focus on three avenues that would allow future researchers to build a more holistic understanding of social media effects in this area. First, research needs to account for the multifaceted nature of digital inequalities and examine whether these amplify the harms and benefits of SMU in the Global South. In many low-resource settings, social media can enable access to essential services such as health and education, boosting well-being. This makes the study of social media even more pertinent given the pre-existing sociopolitical and patriarchal barriers that impede access in the first place. Second, researchers must be careful about appropriating theories or research insights from Global North contexts without considering the geopolitical, socio-economic and cultural dimensions of Global South contexts in their research designs. Third, researchers need to move beyond overly generalised Global North vs Global South differences and instead investigate the various micro-level individual variables (e.g., parenting and family dynamics), and macro-level ecological variables (e.g., cultural values) that might change how social media influences adolescent well-being.

Conclusion
This review highlights a lack of research on social media use and adolescent well-being in the Global South, making it difficult to draw meaningful comparisons within the Global South and between the Global South and Global North. To address this chasm of evidence, we recommend researchers a) co-develop a research agenda with Global South-based partners [76*] to build a localised understanding of SMU; b) incorporate greater diversity in types of the social media studied [77*] and strengthen methods to ensure comparability of findings across contexts using mixed-method approaches (e.g., combining qualitative methods, longitudinal studies and representative surveys); and c) engage diverse stakeholders when designing and collecting data with a special focus on hard to reach and marginalised populations. Only by conducting more inclusive research, will we begin to understand how social media impacts wellbeing in the majority of the world's adolescent population.