Health sector priorities
Towards universal health coverage. As the health sector moves toward a drive for universal health coverage, adolescents must not be left behind. A combination of biomedical, behavioural and structural interventions during adolescence is necessary to maximize health across the life-course. This will require a much more strategic, integrated and systematic focus on adolescents in all aspects of health systems strengthening: Adolescents have specific needs but are often among those least well served by health services as currently organized.62 63 Adolescents must often overcome many barriers to obtain even those services that are available.
Specific data needed. Adequate sex- and age-specific data to plan and monitor interventions are crucial. Much progress has been made over the past 20 years. There is now better information available both about the health status of adolescents and about the coverage and quality of some of the interventions implemented in response to their health needs.
However, much more needs to be done,64 including developing consensus about core indicators, improving the disaggregation and quality of the data, strengthening data collection and analysis, and using the available data more effectively to link specific inputs and outputs with health outcomes and impact.
Human rights and health. The majority of adolescents are included in the up-to-18 years definition of “child” adopted by the Convention on the Rights of the Child (CRC). In addition to General Comment No. 4 on adolescent health and development in the context of the CRC,65 a new General Comment on Article 24 of the CRC (the right to the highest attainable standard of health) has recently been prepared.66
Video of Maria HerzcogThese General Comments outline the legal responsibilities of governments and other stakeholders to respect, protect and fulfil adolescents’ rights to health. The CRC and other human rights instruments provide the foundations for national policies and legislation that facilitate and mandate interventions for adolescent health.
A human rights-based approach to adolescent health is important for many reasons: to advocate adolescent health from the perspective of government obligations rather than the health sector’s public health aspirations; to help focus on issues of equity, ensuring that no adolescents are neglected because of marginalization and discrimination; to agree on universal standards for responding to issues that are often culturally sensitive and controversial, such as sexuality education and informed consent by minors to treatment; and to ensure that adolescents are listened to and engaged.
the Committee on the RightsWorking with other sectors. While adolescent health is important in its own right, it also affects many other aspects of adolescents’ lives, for example, education and employment. Thus, many sectors have an interest in adolescents being healthy.
At the same time, actions implemented by many sectors are important to adolescent health, including employment, housing and the built environment, public recreational areas, public transport, water and sanitation, criminal justice, the media and especially education. Just as adolescent health and nutrition make important contributions to enrolment, retention in school and the ability to learn, education and the physical and social environment in schools have a major impact on adolescents’ physical and mental health and the development of health-related behaviours.67-70
Return on investment. The economic rationale for investing in adolescent health has been strengthened from a number of different perspectives in the past decade.71 72 The collection and analysis of data on programme and intervention costs have increased,73-75 and some initial efforts have explored cost-effectiveness.76 77 There have also been developments in assessing the economic impact of investing in adolescent health,78 and there is now a strong economic case to be made for a number of interventions that are implemented during the adolescent years.79
Investing in the wellbeingMore research is still needed to better understand the return on investments made at different stages of the life-course on adolescent health outcomes and on the effect of interventions during adolescence on health outcomes later in life. However, this should not excuse inaction: The example of tobacco use, a behaviour that typically starts during adolescence and has major impact on adult health, highlights the price that countries will pay if they do not direct more resources and action to adolescents now.
Health is extremely important because it has an enormous effect on our capacity to concentrate and work well. Being careless about it could be detrimental to our future.
female, 18-19, France
Health is the basis for everything; if you want to study or work, you need to be in good physical and mental health.
female, 15-17, South Africa
Without it (health), we cannot reach the potential of our lives that we could reach if we are healthy. Both in a state of mind and physical. Every person should be equal in that respect.
male, 15-17, United Kingdom
Adolescents on what can be done to improve services: Improve and make it easier for young people to access services and information so that we may be more aware and up-to-date on what is good for our health.
female, 15-17, Paraguay
Health is important to me because being in a state of complete health means being able to function at my full potential, and hence being able to perform at my best and contribute as much as I can to the activities I am involved in.
female, 15-17 Switzerland
