EDITOR’S CHOICE

https://doi.org/10.5005/jp-journals-10006-2268
Journal of South Asian Federation of Obstetrics and Gynaecology
Volume 15 | Issue 3 | Year 2023

Time to Address the Needs of Adolescents

Jonathan D Klein

International Association for Adolescent Health; Department of Pediatrics, University of Illinois, Chicago, United States of America

Corresponding Author: Jonathan D Klein, Savithri and Samuel Raj Professor of Pediatrics and Associate Vice-Chancellor for Research, University of Illinois, Chicago, United States of America; President, International Association for Adolescent Health. e-mail: jonklein@uic.edu

How to cite this article: Klein JD. Time to Address the Needs of Adolescents. J South Asian Feder Obst Gynae 2023;15(3):259–260.

Source of support: Nil

Conflict of interest: None

Received on: 21 May 2023; Accepted on: 20 June 2023; Published on: 31 July 2023

In October 2022, the Partnership for Women’s, Children’s and Adolescent Health (PMNCH) launched a campaign for adolescent health and well-being. Along with the World Health Organization, other UN agencies, healthcare professional associations, other public and private sector civil society partners, and many youth-led and youth-serving organizations, the call to action included a blog (1point8b.org). Definition of health and well-being and launched planning towards a Global Forum for Adolescents (GFA). The conceptual framework for adolescent well-being has five domains: (1) Good health and optimum nutrition; (2) Connectedness, positive values, and contribution to society; (3) Safety and a supportive environment; (4) Learning, competence, education, skills and employability; and (5) Agency and resilience (Fig. 1).1 These domains recognize the interconnectedness between individual health, community, and society in allowing every young person to thrive and achieve their potential as productive, engaged young adults. The Global Forum on October 11–12th, 2023, hopes to be the world’s largest gathering of adolescents and youth. More than a million young people are expected to contribute their opinions and their voices to the 1point8 Billion campaign (www.1point8.org), to highlight what young people want.2 The forum, and events held around the world, will be a platform for youth to call for action and investments by governments and others to promote well-being through policies, funding commitments, and political will. The Forum will be held virtually, to allow widespread participation across countries and time zones, and to recognize young people’s commitment to reducing carbon footprints and the climate impact of international travel.

Fig. 1: Adolescent well-being definition and conceptual framework
Source: Partnership for maternal, newborn and child health (PMNCH) based on Ross and colleagues.3 https://pmnch.who.int/images/librariesprovider9/illustration/adolescents-health-ecological-framework-color.png?sfvrsn=fcf49ae_5 (Accessed 12 July 2023)

To truly have a sustainable and meaningful impact on adolescent health and well-being, countries must invest in health services that meet the needs of young people. These cost-effective investments in preventive care include screening and counseling for injury prevention, obesity and malnutrition, tobacco and alcohol use, and of course chemoprophylaxis for vaccine-preventable diseases.4 Evidence-based screening, counseling, and treatments can and must address mental health, nutrition, and sexual and reproductive health in primary care settings. Families, communities, and educational settings are critical partners in health and well-being. Healthcare workers need skills and training, and access to referral resources, to include common and preventable health problems of youth in routine primary care and maternal, child, and adolescent services. This requires investments in health systems, building on and expanding efforts that delivered disease-specific services toward more comprehensive care. It also requires education of front-line and referral workforces, so that clinicians are able to address prevention and access to care. These interventions should include screening and primary and secondary prevention of non-communicable diseases (NCDs) and the many risk factors for NCDs that start during childhood and adolescence. These must be aligned with vaccine and chemoprophylaxis recommendations for the second decade of life, with new efforts underway by WHO to establish guidelines for mental health and preventive care for children and youth, and with the guidelines and recommendations of specialty and primary care societies that are highly salient to national clinical stakeholders. For those readers who would like to explore the evidence in detail, a series of background and technical papers on adolescent well-being have been published in the BMJ and are available on the PMNCH website.5 Additional papers on successful models and their implementation, accountability, and measurement, and the investment case for adolescent health are forthcoming.

Healthcare professional associations are essential to strengthening sustainable health systems and adequate healthcare delivery for young people’s needs. Global organizations for primary care, pediatrics, adolescent health, obstetrics and gynecology, midwifery, nursing, and trainee groups representing millions of healthcare professionals around the world have made new commitments to adolescent health and well-being which include both collaborating and promoting collaboration at the country level by national member societies to advocate for and help implement new national and subnational commitments to adolescent health and well-being. Healthcare professionals, including young professionals, are both critical to the experience adolescents have with health systems and to changing community, national, and subnational policies and services for adolescents.

The 1.8 billion young people for change campaign developed with and for young people, gives priority to adolescent and youth voices alongside other advocates to stimulate commitments from governments for greater investments and for policies that support youth.1,6,7 To hear some of what young people want in their own words (see Blog 1point8b.org). Partnership for women’s children and adolescent health has appropriately focused advocacy for governments to make enduring and substantial commitments. At a national or subnational level, improving the delivery of services centered on adolescents requires action by national governments, coordinated with a variety of non-governmental partners. Investing in adolescents benefits not only their own health, but also their future health, and that of their children. Adolescent and young adult parents are at risk for adverse maternal and child health outcomes, as well as for lifelong chronic illness, and primary care and clinical preventive services are effective at changing the trajectory of these outcomes throughout the life course. Our professional societies are critical stakeholder voices, both as advocates for what adolescents need and as the healthcare workforce and educators who need to translate evidence and policies into practice to reach every young person.

The PMNCH healthcare professionals’ association constituency global partners organizations have made new, collective commitments to collaborate and promote collaboration at the country level by national member societies. The International Association for Adolescent Health (IAAH), a global organization of multidisciplinary adolescent health professionals, is leading an active collaboration with participation from the International Pediatric Association (IPA), the International Federation of Gynecology and Obstetrics (FIGO), the International Confederation of Midwives (ICM), the International Council of Nurses (ICN), the Council of International Neonatal Nurses (COINN), the World Organization of Family Doctors (WONCA), and young professional and student groups including the Junior Doctors Network of the World Medical Association (JDN-WMA), the International Federation of Medical Student Associations (IFMSA), the Young Professionals Network of the International Association of Adolescent Health (YPN-IAAH), and the Young Midwives Leadership Program of the International Confederation of Midwives (YMLP-ICM).

We hope this call to collaborate will encourage each of our national professional societies to work together to mobilize resources and commitments from their governments and lead to the implementation of new efforts to improve adolescent health services. Countries can and should commit to meaningful engagement of young people, evidence-based policies, care improvement strategies, and implementation of new, funded programs for adolescent well-being. Each of our national, state, and district organizations, and each of us as clinicians and public health advocates also have opportunities to help make comprehensive, coordinated adolescent services a reality. We urge everyone to engage with the 1.8 billion young people for change and the upcoming Global Forum for Adolescents this fall, recognizing this October’s events as the start of improving health and well-being for all the world’s adolescents.

REFERENCES

1. Partnership for Maternal, Newborn & Child Health. 1.8 billion young people for change campaign and the global forum for adolescents. Geneva; PMNCH. Available from: https://pmnch.who.int/news-and-events/campaigns/1-8-billion.

2. Ross DA, Hinton R, Melles-Brewer M, et al. Commentary: Adolescent well-being: A definition and conceptual framework. J Adolesc Health 2020;67(4):472–476. DOI: 10.1016/j.jadohealth.2020.06.042.

3. Sheehan P, Rasmussen B, Sweeny K, et al. The economic case for investment in adolescent wellbeing. Background paper for multi-stakeholder consultations on effective programming to promote adolescent well-being. Geneva; PMNCH, 2021. Available from: https://pmnch.who.int/resources/tools-and-toolkits/adolescent-papers).

4. Partnership for Maternal, Newborn & Child Health. Adolescent health and well-being. Available from: https://pmnch.who.int/our-work/focus-areas/adolescent-health-and-well-being.

5. Partnership for Maternal, Newborn & Child Health. What Young People Want. Geneva; PMNCH. Available from: https://www.1point8b.org/chatbot.

6. UN Major Group for Children and Youth. Adolescent well-being framework: Virtual youth consultation report. Geneva; PMNCH. Available from: https://pmnch.who.int/resources/publications/m/item/virtual-youth-consultation-report.

7. World Health Organization, Partnership for maternal, Newborn and Child Health (PMNCH), UN Women, UNAIDS, UNESCO, UNICEF, UN Major Group for Children and Youth, World Food Programme. Multistakeholder consultations on programming to promote adolescent well-being: Summary report. Geneva; World Health Organization, 2022. Avalilable from: https://pmnch.who.int/resources/publications/m/item/multistakeholder-consultations-on-programming-to-promote-adolescent-well-being.

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