Global investment in Adolescents

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Building the foundations for sustainable development: a case for global investment in the capabilities of adolescents

As the World Bank meetings begin, a new study, Building the foundations for sustainable development: a case for global investment in the capabilities of adolescents, published yesterday in The Lancet, builds upon our Lancet Commission on Adolescent Health and Wellbeing which highlighted the importance of investing in adolescents, and shows that investments in adolescent health and wellbeing are some of the best that can be made towards achieving the SDGs.

Improving the physical, mental and sexual health of adolescents aged 10-19 years, at the cost of US$4.6 per person per year, could bring a 10-fold economic benefit by averting 12 million adolescent deaths and preventing more than 30 million unplanned pregnancies in adolescents.

Investment1Similarly, investing to increase the extent and quality of secondary education, at a cost of US$22.6 per person per year, would generate economic benefits about 12 times higher and result in an additional 12 million formal jobs for people aged 20–24 years.

The findings are published in The Lancet on the eve of the World Bank Spring Meetings in Washington D.C. [1] where finance and development leaders from 188 countries will discuss the critical need for investment in adolescents.


The Lancet: Investing in adolescent health and education could bring 10-fold economic benefit


In addition to health and education, the study shows that investing in improving road safety, at US$ 0.60 per person per year, would give economic benefits about 6 times higher and prevent nearly 500,000 adolescent deaths by 2030. Programmes to reduce child marriage, at US$3.8 per person, had a 5.7-fold return on investment and could cut child marriage by around a third.

“Some of the best investments in adolescent health and wellbeing lie outside the health sector – tackling child marriage, reducing road injuries and improving education. There is little doubt that the actions outlined in our study could be delivered on a large scale in countries, transforming the lives of boys and girls around the world. The economic and social impacts of investments in adolescent health and wellbeing are high by any standards, and are among the best investments that the global community can make to achieve the UN’s Sustainable Development Goals.” says lead author Professor Peter Sheehan, Victoria University. [2]

The study published yesterday was led by authors from Victoria University, the University of Melbourne (Australia) and UNFPA, the United Nations Populations Fund. Four of the Lancet Commissioners (G Patton, S Sawyer, N Reavley, J Mahon) were involved.

Globally, HIV/AIDS, road traffic accidents, drowning, diarrhoeal and intestinal infectious diseases, lower respiratory infections and malaria are responsible for about half of all deaths for 10–14 year olds. Road traffic accidents, self-harm and violence are the leading causes of death for 15–24 year olds, and depression is the leading cause of ill health affecting more than 1 in 10 10-24 year olds [4].

In the analysis, the authors calculate the economic and social impact of health interventions aimed at improving maternal, newborn and reproductive health services, improved access to treatments for HIV/AIDS, malaria, depression, alcohol dependence and epilepsy, and expansion of HPV vaccinations. They also calculate the impact of programmes to reduce child marriage and interpersonal violence. Education programmes analysed in the study include those aimed at reducing drop-out, providing free school uniforms, better teaching methods and computer, radio and TV assisted learning. Finally, they also calculate the impact of interventions to improve road safety such as helmet and seat belt use, speed compliance, alcohol testing as well as safer roads and improved motor vehicle safety.

“Investing in young people is in everyone’s interest,” says UNFPA Executive Director, Professor Babatunde Osotimehin. “A small investment in empowering and protecting the world’s over a billion adolescents can bring a ten-fold return, or sometimes even more. Our pioneering research must now be seen by policy makers, and used to chart the way forward.” [2]

The total cost to 2030 of all the interventions studied, except those for education, is estimated at $524 billion, equivalent to $6.7 per person per year. For education, the overall total is estimated at $1774 billion, or $22.6 per person per year. Overall, the total annual investment across all programmes amounts to 0.20% of the global Gross Domestic Product.

triple-d_mg“There are 1.2 billion 10- to 19-year-olds in the world today. Investments to transform health, education, family and legal systems will help improve their physical, cognitive, social, and emotional capabilities. This will generate a triple dividend reducing death and disability in adolescents today, promote health and productivity across the life-course, and because this is the next generation to parent, provide the best possible start to life for the generation to come. This generation of young people can transform all our futures. There is no more pressing task in global health than ensuring they have the resources to do so,” says Professor George Patton, co-author from the University of Melbourne, and Commission Chair. [2]

The authors note several limitations, mostly related to the quality of evidence available. While the evidence base for the cost and impact of interventions in sexual, reproductive, maternal and child health is strong, there is still a great need for research on many interventions to improve adolescent health. The authors have therefore taken a conservative approach to their analysis.


The paper can be accessed here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30872-3/abstract   

[1] World Bank spring meeting https://www.imf.org/external/Spring/2017/index.htm
[2] Quote direct from author and cannot be found in the text of the Article
[3] Adolescent Health Commission http://www.thelancet.com/commissions/adolescent-health-and-wellbeing
[4] Global Burden of Disease 2013, Adolescents http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00648-6/fulltext

Seven briefs for seven adolescent research challenges

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Welcome to the Septuplets!

On behalf of The Lancet Commission on Adolescent Health and Wellbeing and the UNICEF Office of Research – Innocenti, I am very pleased to announce the birth of a new series of seven briefs on how to conduct research with adolescents in low- and middle- income countries.

The current cohort of adolescents and young adults is the largest the world has ever seen – 1.8 billion. Investments in adolescent health and wellbeing offer a triple dividend:  to adolescents today, towards health and wellbeing across the lifespan, and to the next generation of the world’s children. While much is understood about adolescence, The Lancet Commission on Adolescent Health and Wellbeing highlights the great need for continuing research with young people, so that we address the tremendous unrealised opportunities, not only for the health and wellbeing of young people themselves, but also for the future of society and future generations.

These seven new briefs focus on research methodologies, and are intended to identify best-practice approaches for conducting research with adolescents. The briefs cover diverse topics including: indicators and data sources; research ethics; research with disadvantaged, vulnerable and/or marginalised populations; participatory research; measuring the social determinants of health, and economic strengthening interventions for improving adolescent wellbeing. Written by leading experts in adolescent health and wellbeing, the briefs are designed to improve how research on adolescent health and wellbeing in low- and middle- income countries is conducted and interpreted.

“The briefs cover: indicators and data sources; research ethics, research with disadvantaged, vulnerable and/or marginalized populations, participatory research, measuring the social determinants of health, and economic strengthening interventions for improving adolescent wellbeing.”

Adolescents are unique human beings—no longer children but not quite fully-formed adults. They have distinctive needs, exceptional capabilities, and matchless potential. As the father of two adolescent men, I understand first-hand the exhilaration, the frustration, and the pride that adolescence draws out of us. As an adolescent medicine physician, I have had the supreme pleasure of working closely with, and learning from, this special group of human spirits. And as a public health policy wonk, I have been amazed to see the recent global explosion of interest in adolescence. A key global force driving this recent interest has been the Lancet Commission and its fearless leader: George Patton from the University of Melbourne. The Lancet Commission provides a blueprint for a new understanding of the importance of adolescence in a lifetime of health and wellbeing.

I was pleased to be able to lead the writing of Brief 3, Inclusion with protection: obtaining informed consent when conducting research with adolescents. This brief addresses ways to work ethically with adolescents in conducting research. Research ethics has been a long standing cause for me. Too often adolescents have been excluded from essential research, based on the false premise of protection from research risk. Brief 3 provides an avenue to inclusion with protection building on the concepts of the Convention on the Rights of the Child, particularly the concept of emerging capacities. Adolescents are often best able to make informed and sensible decisions about their own lives. Inclusion of adolescents in research is essential if adolescents are to reap the full benefits of research. Research can guide the creation of improved policies and programmes for adolescents and appropriately tailored services and infrastructure. Research can also strengthen adolescent resiliency, promote wholesome development, reduce adolescent morbidity and mortality, improve nutritional status, promote educational success and mental health, prevent risk behaviours, and prevent or treat infectious disease.

In my own service on ethics committees, I have too often seen adolescents excluded from specific research projects – even low risk studies. Either the investigators or the ethics committee could not figure out an ethical way to include adolescents in studies which could promote adolescent health and wellbeing. We can and should do better. Brief 3 suggests ethical and practical ways to resolve these dilemmas.

These briefs are part of a broader effort to increase understanding of the social and structural determinants of adolescent wellbeing. Adolescence is marked by multiple physical, psychological, and social role transitions. Social and structural determinants and social role transitions are key drivers of health and wellbeing during the adolescent period. By influencing vital social transitions from adolescence into adulthood, these social and structural determinants have enormous implications for an adolescent’s health and wellbeing during adolescence and across the lifespan. Briefs 1, 6 and 7 address the scope of these social determinants and ways to address them in research.

The UNICEF research briefs are the result of a year’s work by a small army of contributors: authors, reviewers, and advisors, all acknowledged in the briefs, who worked tirelessly to refine the briefs and made special efforts to insure the writing was accessible and its utility, maximised. Special thanks to my collaborator and co-editor Nikola Balvin from the UNICEF Office of Research – Innocenti. I join her in thanking the UNICEF Innocenti, which insightfully recognised the importance of this effort and generously supported the writing and publication of these briefs. The briefs should be useful to a wide range of stakeholders interested in adolescence research, but are primarily designed to assist professionals, including UNICEF staff, who conduct, commission, or interpret research and/or evaluate research findings in international development contexts, in order to make decisions about programming, policy, and advocacy. The seven briefs are available online at: unicef-irc.org/adolescent-research-methods/

Serving as an editor is a bit like having a baby. There is always a bit of uncertainty about arrival dates and how the offspring will arrive. The gestation period often seems a bit longer than expected; the labour pains can be sharp. Despite all the travails, the delivery is accompanied with pride and wonder. What a beautiful product we have helped bring into the world!

We hope this effort will make the world a better place for the adults who care about adolescents and – especially – for the adolescents themselves.


Dr. John Santelli is one of Commission leads, as well as a Professor of Population and Family Health and Pediatrics and was the chair of the Department of Population and Family Health at the Mailman School of Public Health, Columbia University.

This initiative was funded by the UK Department for International Development.

This post was originally posted on UNICEF’s website about the series.

World Health Day

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World Health Day 2017 poster: Eastern Mediterranean  World Health Day 2017 poster - Depression: Let’s talk

World Health Day 2017

“Depression: let’s talk”

April 7 is #WorldHealthDay, a day that is celebrated every year (on April 7) to mark the anniversary of the founding of the World Health Organisation. The theme of this years World Health Day campaign is Depression.

Depression affects people of all ages, from all walks of life, in all countries. It causes mental anguish and impacts on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living. At worst, depression can lead to suicide, now the biggest killer of teenage girls (15-19 years) worldwide and the second leading cause of death among 15-29-year-olds.

In a blog piece published earlier in the year, Suicide & Adolescent Girls, Commissioner Suzanne Petroni wrote on this surprisingly changing landscape of depression, suicide and adolescents.

Adolescents, no matter where they live, face a host of challenges as they navigate the rocky waters between childhood and adulthood. During adolescence, both boys and girls experience rapid physical growth and changes, accompanied by shifts in cognitive and emotional development. At the same time, environmental factors, including influences from family, peer groups, schools, communities and societal expectations more broadly, can work to either support or hinder young people’s wellbeing.

Yet, depression can be prevented and treated. A better understanding of what depression is, and how it can be prevented and treated, will help reduce the stigma associated with the condition, and lead to more people seeking help.

According to the latest estimates from WHO, more than 300 million people are now living with depression, an increase of more than 18% between 2005 and 2015. Lack of support for people with mental disorders, coupled with a fear of stigma, prevent many from accessing the treatment they need to live healthy, productive lives.

The overall goal of the “Depression – let’s talk” campaign is that more people with depression, everywhere in the world, both seek and get help.

This short video, ‘Let’s talk about depression – focus on adolescents and young adults’ has been produced as part of WHO’s “Depression: let’s talk” campaign and highlights some of the symptoms of depression  and the importance of talking as the first step towards getting help.

 


WHO have developed a set campaign materials for use in “Depression: let’s talk”  campaign activities and beyond, and include:

Call for evidence

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CALL FOR EVIDENCE & CONTRIBUTIONS on “ACCOUNTABILITY TO ADOLESCENTS”

Independent Accountability Panel Report 2017 

Deadline: 31 March 2017

The Independent Accountability Panel (IAP) for Every Woman, Every Child, Every Adolescent welcomes contributions for its 2017 report on the theme of Accountability to Adolescents’ Health and Human Rights by 31 March to info@iapewec.org.

The IAP would like to hear from you:

  • What are the main accountability mechanisms in place and major accountability gaps for adolescents?
  • What promising solutions, approaches and practices are underway? For example, to improve services for adolescents? What results are being obtained and what resources are becoming available for adolescent health, development and rights?
  • What recommendations do you have for strengthening accountability to adolescent health and rights?

The IAP is seeking evidence of the following:

  • Effective Accountability Mechanisms at all levels, with a Focus on Adolescents — from local to global.
  • Large-scale Programmes & Investments for Adolescent Health and Beyondat national, provincial and district levels, including cross-sectoral strategies and investment frameworks.
  • Resource Available for Adolescent Health & Rights.
  • Promising monitoring and accountability initiatives for the Global Strategy’s scope of issues across its Survive, Thrive, Transform pillars more broadly.

How to Submit Your Contributions: 
This document will provide further details and guidance on submitting your contributions by the deadline of 31 March 2017.

They invite inputs from all stakeholders – representatives of governments, parliaments, civil society, youth and women’s groups, academia, health providers, human rights defenders, donors, the private sector, UN and other partners.

IAAH Congress on Adolescent Health

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IAAH logo2

The International Association for Adolescent Health
11th World Congress on Adolescent Health

Investing in Adolescent Health – the Future is Now

27-29 October, 2017 | New Delhi, India

Dear Subscribers,

Just reminding you that on 27-29 October 2017 the International Association for Adolescent Health (IAAH) together with the Public Health Foundation of India (PHFI) and MAMTA Health Institute for Mother and Child is hosting the 11th World Congress on Adolescent Health, “Investing in Adolescent Health – the Future is Now” in New Delhi, India.

This is sure to be a terrific event, with international and national participants (researchers, clinicians, policy makers, program managers and young people), all of whom are seeking to learn more about cutting-edge research as well as to share ideas and experiences about policies and programmes for adolescent health, wellbeing and development.

Further information about the Congress can be found here.

Key dates:

  • Abstracts due 12 April 2017 [submit your abstracts here]
  • Early bird registration ends 31 May 2017 [register here]

Key programme highlights:

  • Lancet standing commission on adolescent health & wellbeing (that’s us! 🙂 )
  • Mental health and adolescents
  • Young adolescents (10-14 years)
  • Interactive/social media and adolescent health

On another note, the LancetYouth would like to take this opportunity to congratulate Professor Susan Sawyer (one of our Commission leads) as the new President of the International Association for Adolescent Health (IAAH). Susan, this is a really significant time for adolescent health organisations and we have no doubt that your passion and dedication to adolescent health will mean you will be fabulous in this role. From all of as at the LancetYouth we wish you the very best in this important role.

“This generation of adolescent and young people can transform all of our futures; there is no more pressing task in global health than ensuring they have the resources to do so.”

In case you missed it

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Launch of General Comment 20 on the Implementation of the Rights of the Child during Adolescence

On the margins of the 74th session of the Committee on the Rights of the Child, on 7 February 2017, a ground breaking General Comment on the realization of the rights of adolescents was launched.  But there was nothing marginal about the event itself.  The conference room in the Palais des Nations was packed far beyond capacity with Member States, NGOs and UN left standing in the back and peering through the door for this monumental event. “All children and adolescents want to be heard and have their opinions count so that they can contribute towards better, healthier and peaceful societies,” stressed 16 year old Henry Marzano Sacón who is the President of the Consultative Committee of Boys, Girls, and Adolescents of Ecuador and who participated in the launch. The line-up of States, requesting to speak reflected States’ commitment to the realization of the General Comment.

image3With the adoption of the General Comment 20, States will now have access to detailed guidance on the measures necessary to ensure the realization of the rights of children during adolescence, and in line with the 2030 Agenda for Sustainable Development. “This is not a document whose time has come; it is long overdue!” stated Benyam Dawit Mezmure, Chairperson of the Committee on the Rights of the Child. The General Comment highlights the importance of a human rights-based approach that includes recognition and respect for the dignity and agency of adolescents; their empowerment, citizenship and active participation in their own lives; the promotion of optimum health, well-being and development; and a commitment to the promotion, protection and fulfilment of their human rights, without discrimination.

While the Convention recognizes the rights of all persons under 18 years, its implementation to date has largely been blind to children in the second decade.  The General Comment lifts up the importance of taking into account children’s development and their evolving capacities. Approaches adopted to ensure the realization of the rights of adolescents differ significantly from those adopted for younger children. The General Comment raises the profile and awareness on adolescents and allows States to strengthen their approach to the realization of adolescents’ rights.

“UNICEF welcomes this General Comment as a normative guidance for realizing the rights of children in their second decade of life,” mentioned Judith Diers, Chief, Adolescent Development and Participation Section at UNICEF HQ. She confirmed that  “UNICEF commits to working with adolescents and States parties to strengthen reporting on adolescents rights’ as part of their CRC report preparation. We will also work closely with State parties due to report in 2019 to model collaborative processes for reporting to the CRC.”

The General Comment recognizes adolescence as a life stage characterized by growing opportunities, capacities, aspirations, energy and creativity, but also significant vulnerability.  It emphasizes that adolescents are agents of change and a key asset and resource with the potential to contribute positively to their families, communities and the countries.

The full ‘General Comment 20 on Realizing the Rights of Children during Adolescence’ can be read here.


On Tuesday 14th February, UNICEF hosted a Geneva launch of the CRC General Comment 20 on Realizing the Rights of Children during Adolescence. One of our Commissioners Judith Diers (who serves as the chief of adolescent development and participation at UNICEF) was there at the launch event and was involved in the creation of the document. “It was an incredible event – with standing room only – full of member states, NGOs and others.  It was the culmination of 5 years of work – a great moment for adolescent rights” – Judith Diers.

Enrol now

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Global Adolescent Health course,  enrol now!

2017 course start dates: 6 Mar, 22 May, 7 Aug, 23 Oct

Interested in learning more about ‘global adolescent health’ or are you in need of a refresher? This free University of Melbourne course, led by our very own Lancet Commissioners – Professors Susan Sawyer (@susansawyer01) and George Patton (@gcpatton1) will explore the dynamic factors affecting the health and wellbeing of young people around the world, and how important it is for individuals, communities and nations that we improve their health and life chances.

Over 25% of the world’s population is aged between 10 and 24 years. As the future leaders and drivers of growth, productivity and innovation, young people are our greatest assets. Investment in their health and wellbeing has social, economic and other benefits that continue across the lifespan and into the next generation.

This course adopts a life-course framework to take a holistic view of youth health and wellbeing. It explores changing patterns of adolescent health and development; how puberty and adolescent brain development may shape future health; and how what happens in adolescence can affect the next generation. It also looks at the major health and social issues affecting young people and ways of addressing these through policy, practice and programming.

Do I have to pay for this course? NO – you may access 100% of material in this course for free.

Time commitment: 6-8 weeks of study, 3-4 hours/week

Who is this class for? Anyone with an interest in the health and wellbeing of young people. For more information or to enrol head to the course homepage.

What is the most interesting thing you’ll learn if you take this course? You’ll learn how what happens during adolescence can impact not only the future health of individuals, but the health of the next generation as well. You’ll develop an understanding of the key factors impacting upon youth health and learn how to be a better advocate for the health and wellbeing of young people.

YouthPower Learning Grants

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YPRequest for Applications:
YouthPower Learning Grants

Making Cents International (Making Cents) under the United States Agency for International Development (USAID)-funded contract YouthPower Learning is seeking grant applications from qualified entities as part of its efforts to further assess, evaluate, document, and disseminate innovative work in positive youth development and cross-sectoral youth programming.

YouthPower Learning is launching requests for applications (RFA) for grants in the following thematic areas:

Click here to download the YouthPower Learning Grants RFA#002-2017 documents.

Click here to download the YouthPower Learning Grants RFA#003-2017 documents.


Issuance Date: February 27, 2017
RFA Current Closing Date: April 13, 2017, 21:00 GMT


These funding opportunities are posted on www.YouthPower.org and may be amended. Potential applicants should regularly check the website to ensure they have the latest information pertaining to this RFA. If you have difficulty accessing this document, please contact the Grants Manager via email at grants@youthpower.org.

Any information that substantially changes the requirements of this RFA shall be released through the issuance of an amendment to the RFA. Making Cents may, at its own discretion, extend the deadline for the submission of applications.

Scoping meeting

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On Monday 27th February and Tuesday 28th February, representatives, academics and youth advocates from a variety of organisations and universities are coming together for an initial scoping meeting to plan the next 5 + years of a ‘Lancet Standing Commission on adolescent health and wellbeing’. This meeting will take place in Seattle, and is hosted by the Bill & Melinda Gates Foundation.

Why a scoping meeting?

The six recommendations from our Commission Report (below) cover diverse topics, and their implementation well require engagement with different constituents, disciplines and sectors. They in fact represent work that is likely to continue for decades into the future. The work of the Standing Commission is intended to be pursued over the next five years. We simply can’t do everything that needs to be done in this field in five years! We therefore need to focus on what is most important and achievable. The scoping meeting will provide an opportunity to consider areas of priority focus.

Recommendation 1: Reframing and rethinking adolescent health and wellbeing
Recommendation 2: Assessing health needs and responses
Recommendation 3: Achieving universal health coverage
Recommendation 4: Create protective and empowering social scaffolds through intersectoral partnerships
Recommendation 5: Youth engagement and empowerment
Recommendation 6: Growing knowledge and capacity

Watch this space to see, how we ‘The Standing Commission on adolescent health and wellbeing’ with our collaborators, plan to change the global face of adolescent health and wellbeing.


We are very grateful for the support of  the Bill & Melinda Gates Foundation, which provided much of the funding for the 2016 report. The Foundation has committed to developing a comprehensive and integrated approach to adolescent health.

this-generation

Webinar

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health for all adols - webinar

“Health for All Adolescents: What is shaping adolescent health today” Webinar


Watch it here!


On Feb 1, the American Public Health Association; The Partnership for Maternal, Newborn & Child Health; the HHS Office of Adolescent Health, and The Lancet Commission on Adolescent Health and Wellbeing hosted a webinar to provide the latest information on changing policy, economic, and environmental issues that shape adolescent health.

Globally, we have seen dramatic gains in women’s and younger children’s health, but adolescents continue to lag behind other age groups. Ensuring the healthy development of today’s adolescents reaps triple benefits for their health now, for their future adult life, and for future generations. However, the factors that shape adolescent health span multiple domains and are complex. How do we, the professionals who work with youth, handle these factors? Find out by watching the “Health for All Adolescents” webinar.

The Commission would like to thank everyone involved, especially the speakers (Commission chair – George Patton, and Commissioners Terry McGovern and John Santelli), and a special thank you to Evelyn Kappeler who moderated the event.

“Adolescents and young adults face unprecedented social, economic, and cultural change. We must transform our health, education, family support, and legal systems to keep pace with these changes.”

View the webinar slides (all are downloadable PDFs): George PattonJohn Santelli, Terry McGovern

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