Many of us look back fondly on our adolescent years as a period of good health and growth. But the truth is, if you’re reading this as an adult who experienced a healthy adolescence, you’re one of the lucky ones.
Adolescence is a crucial time in our lives, our development and our futures. A time for physical and cognitive growth, increased independence and expanding social identity.
But for millions of young people around the world today, adolescence (from age 10 to 19) is marred by poor health and nutrition. The impact can be both immediate and long term. 1.2 million adolescents die each year, mostly from preventable causes. For many adolescents who survive, deprivation prevents them from growing into healthy adults and meeting their full potential.
Additionally, gender and social norms, including gender-based discrimination and bias, limit adolescents’ ability to exercise their rights and freedoms. 12 million girls are married during childhood each year. And complications from pregnancy and childbirth are still a leading cause of death amongst adolescent girls.
While there have been some gains in reducing deaths of young people since the Millennium Development Goals, when compared with progress in tackling under-5 deaths, the world has been slow to reduce youth mortality (between the ages of 15 and 24). Between 1990 and 2019, under-5 mortality fell by over 50% but by comparison, mortality in adolescents and youth reduced by just 34%.
Throughout the COVID-19 pandemic, critical services to adolescent health – sexual reproductive health and rights (SRHR), nutrition and mental health – have been the most severely disrupted. With shifting financial priorities due to the pandemic, these crucial services – like mental health services, which are already massively underfunded at just 2% of countries’ average health budget spend – risk greater cuts.
The impact on real lives
In stopping young people meeting their friends and taking part in school and sports activities, lockdown restrictions during the pandemic have left millions of teenagers increasingly isolated. The impact on adolescent mental health has been stark, with reports of increased anxiety and depression amongst young people.
Adolescent girls are at particular risk. In communities where boys and girls access different opportunities based on their gender, teenage girls who were forced to leave school due to the lockdowns are more likely to never return. Girls who are aspiring teachers, doctors or athletes may be forced to marry early and have children early. This year, UNICEF projected an additional 10 million child brides over the next decade as a result of the pandemic, with Kenya and Zimbabwe, for example, reporting alarming rises in teenage pregnancies.
In times of crises, disruptions in access to essential SRHR services – like counselling, family planning and contraception – correlate with a spike in unintended pregnancies. Such disruptions occur when community-based SRHR services and outreach are shut down or essential health workers are redistributed away from SRHR services to the frontlines of a crisis response.
Moment of opportunity
This week FP2030 launched, offering a new opportunity for governments and donors to commit new investments to meet the SRHR needs of women and girls globally. The UK government hosted the first Family Planning Summit in 2012, which saw the launch of FP2020 and governments first committing to ensure access to comprehensive SRHR services. As a champion of the rights of women and girls to access essential health services under the mandate to end preventable deaths, now is the time for the UK to step up its support and include the needs of adolescents.
Additionally, tomorrow – Friday 19 November – policy-makers, researchers and youth advocates will attend the 12th World Congress on Adolescent Health and in December, the Nutrition for Growth Summit will take place. These key global moments provide new opportunities for governments to make transformative commitments and increase investments in adolescent health and nutrition.
Yet, to meet the needs of the world’s adolescents – a diverse group of 1.2 billion individuals with unique and varying needs – governments and donors must make the right investments in the right places, and at the right time. That time is now.
Our recommendations
Our recent policy briefing Investing in the Now and the Future: Why governments must commit to adolescent health and nutrition highlights key model commitments governments can make to build health and nutrition services that truly meet the needs of adolescents.
We call for policy-makers to recognise the gender-related nuances that impact adolescents’ access to health and nutrition services, an important reflection to reduce gender-based inequalities that impact health and nutrition outcomes. Importantly, the report endorses an adolescent-responsive approach, which “integrates adolescent services into each component of the health and nutrition system and adapts policies, procedures and programmes to respond to the unique and diverse needs and preferences of adolescents”.
Figure 1: Key model commitments governments can make to invest in adolescent-responsive health and nutrition systems
Investing in adolescents delivers a “triple dividend” on returns:
- improving the health and wellbeing of adolescents today
- securing healthier trajectories across their life course
- setting them up to have healthier families in the future.
Global overseas development assistance for adolescent health is paltry at just 1.6%, with the majority of childhood investment focused on 0–5 years. The early years are crucial for development – and so are the adolescent years.
Act now
Donors must step up to meet the needs of adolescents, especially those who live in multi-burden countries. If adolescents continue to fall through the gaps of service provision between paediatric and adult care, then countries will struggle to realise SDG commitments and will fail to achieve universal health coverage.
The UK government has historically been a champion of and investor in global overseas development assistance for family planning, SRHR and nutrition. It should now grasp the opportunity to show leadership by stepping up funding and support as befits their commitment to women and girls.
Donors must not falter now. Moments like FP2030, Nutrition for Growth, and the replenishment of the Global Financing Facility, are crucial opportunities for the UK government to re-commit to greater investment in adolescents and the services that meet their needs.
With less than a decade to Agenda 2030, we must not let these opportunities slip by.
