How to strengthen strategic information
The health sector is responsible for collecting, analysing, using and disseminating demographic and epidemiological data and health service statistics on the health system’s response to adolescent health. These data are important for action both in the health sector and in other sectors.
However, as the discussions above indicate, the availability of data on adolescents worldwide are far from complete and, further, vary by the type of indicator and data sources. Of the 32 proposed core health indicators for adolescents, available data for 16 cover at least 50% of the world’s adolescents, but the data validity for some of the inputs and outputs have not been confirmed. Overall, indicators of inputs and outputs are less prevalent than for outcome and impact. WHO headquarters is focusing efforts on addressing these gaps, particularly in low and middle income countries.
Further actions to address specific data gaps in health domains and opportunities for strengthening strategic information are summarized here:the need for better
- Give more attention to strategic information for the adolescent years. Otherwise, adolescents will continue to remain hidden, and what we fail to measure, we fail to act on. Without data the health sector cannot plan, monitor, document and evaluate programmes and interventions to assure that they are well targeted and make the best use of resources.
- Disaggregate all data on the first 20 years of life by sex and 5-year age groups. Some countries have made significant progress in this direction. In many others there are still significant gaps. Every effort needs to be taken to support countries to disaggregate available data by age and sex and to ensure that these data remain disaggregated when they are synthesized at the national level.
- Integrate an adolescent component into all data collection systems. All national systems for health data collection should be reviewed to find ways to incorporate a focus on adolescents—for example, ensuring that the adolescent age group receives adequate attention in national health sector reviews and that new health planning and financing tools pay attention to adolescents—for example, the One Health tool.21
- Identify and respond to specific weaknesses in data collection. Some adolescents are not well represented in the statistics currently collected, for example, household survey data on boys, 10–14 year olds and adolescents who are not in school. Few data cover mental health problems. Very little information is collected about protective factors. Biological data are needed to complement self-reported information about risk behaviours. Longitudinal data are needed to complement cross-sectional data in order to better understand what is happening along the life-course.
- Make it possible to link data collected on adolescents. The health of adolescents is supported by a safe and supportive environment that they live in, provided by schools, employment opportunities, safe spaces for recreation and legal provisions for their access to services, to cite some examples. Data are often available from these settings that are not considered when intervening to improve the health of adolescents. More attention needs to be given to making it possible to link the various data that countries collect. For example, within the health sector household surveys, facility-based surveys and school health surveys should be linked. Similarly, across sectors data collected by the health sector should be linked with data from sectors such as education and employment.
- Synthesize and disseminate the evidence base for action. An important role of the health sector is synthesizing, sharing and adapting effective evidence-based interventions that respond to adolescents’ priority health problems. Examples of this effort are the recommendations made by the WHO guidelines review process, Cochrane reviews and national-level processes for examining the effectiveness of interventions for public health and clinical interventions (e.g. the work of the Centers for Diseases Control in the United States of America and the National Institute for Health and Care Excellence (NICE) in the United Kingdom).
- Strengthen research on adolescent health: problems and responses. An important function of the health sector is to develop and support research priorities that respond to gaps in the available data and in the evidence base for action: epidemiological research, programme reviews and impact evaluations, and implementation research. In particular, better data are needed on the cost of interventions in order to assess their cost-effectiveness.
Adolescents on what stops them from using health services: Delays in public services, like at the hospital; often they attend to your needs but it’s already too late, and they can be very rude, which is psychologically damaging.
female, 18-19 Mexico
Adolescents on what stops them from using health services: Fear, distance, not being aware that they (health services) are available in your region
female, 15-17 Switzerland
Barriers to using services- Negative / judgmental attitude of health care providers, long waiting periods, lack of trust in diagnosis.
female, 18-19 Romania
I do not find enough time to perform sports and I find unhealthy food in front of me.
female, 18-19 Saudi Arabia
I just found out that my school has a nurse (two years after getting there).
female, 18-19 Peru
I don’t sleep well often; sometimes I don’t eat enough because I’m scared of gaining weight and sometimes I just don’t feel the need. I am also enormously stressed.
female, 18-19 France
Adolescents on what stops them from using health services: Long distance from the health center, lack of information on available health services and lack of money to pay for health services like STI's treatment
female, 18-19 Uganda