“Action for adolescent health: Towards a common agenda” (WHO) 1997


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The Members of the WHO/UNFPA/UNICEF Study Group on Programming for Adolescent Health emphasized the crucial need for the three agencies to provide complementary support to countries, by working within a common technical framework, in order to strengthen and expand the activities in countries aimed at promoting adolescent health in a more systematic fashion. The Common Agenda for Action encourages the three UN agencies with principal interest and experience in the area of adolescent health, to support activities in countries in complementary ways. The Common Agenda is intended to reflect the policies of the three agencies and serve as a basis for discussion at country level in the determination of their support of country-level programming. It also provides specific suggestions for collaborative activities to advance programming for adolescents at different levels.

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“Action for adolescent health: Towards a common agenda” (WHO) 1997

  1. 1. ACTION forAdolescent HealthTowards a Common AgendaRecommendations from a joint Study Group WHO UNFPA UNICEF
  2. 2. Foreword In November 1995, the World Health Organization,the United Nations Population Fund and the UnitedNations Childrens Fund jointly convened a StudyGroup* on Programming for Adolescent Health. On thebasis of current experiences, especially in developingcountries, the Study Group:q reviewed the scientific evidence regarding theeffectiveness of key interventions for adolescent health;q highlighted the essential factors and strategiesneeded to establish, implement and sustain programmesfor adolescent health;q developed a common framework for countryprogramming;q recommended priority actions to accelerate andstrengthen programming for adolescent health, includingthe global and regional support needed for country-levelprogramming. This brochure reflects the recommendations of theStudy Group.* Study Group is a meeting of experts which reviews the latest knowledge and makesrecommendations on major subjects of public health importance.
  3. 3. UNICEF/Troels NorlenIntroduction No longer children, not yet adults. Adolescence isa period of rapid development when young peopleacquire new capacities and are faced with many newsituations. This presents not only opportunities forprogress but also risks to health and well-being. Asadolescents face the challenges of the second decade oflife, a little help can go a long way in channeling theirenergy towards positive and productive paths. Neglect ofadolescents can lead to problems, both immediately andin the years ahead. One of the most importantcommitments a country can make for future economic,social and political progress and stability is to addressthe health and development needs of its adolescents.
  4. 4. Todays world offers adolescents bothremarkable opportunities and risks to their health.Adolescents (85% of whom live in developing countries)make up about 20% of the worlds population. More thanever before, adolescents are able to attend school andbenefit from technological progress. Yet at the same time,the lives of millions of adolescents are marred by poverty,inadequate education and work opportunities,exploitation, war, civil unrest and ethnic and genderdiscrimination. Rapid urbanization, telecommunication,travel and migration bring both new possibilities and newrisks to young people. These conditions may directlyjeopardize health and may also undermine the traditionalsocial support that helps young people prepare for,negotiate and explore the opportunities and demands oftheir passage to adulthood. Moreover, societysexpectations of behaviours, roles, access to resources andprospects for development vary for adolescent boys andgirls. Decreasing influence of family and culture, earlierpuberty and later marriage - all these extend the risks ofunprotected sexual activity in unmarried adolescents inmany parts of the world. In some countries, early marriageand childbearing lead to high maternal and infant mortalityrates. In others, sexually transmitted diseases, includingHIV/AIDs, pose enormous health risks to adolescents.Potentially harmful substances - tobacco, alcohol andother drugs - are now more readily available toadolescents and threaten their health in both the shortand long term. Violence inflicted by and on young peopleis a growing phenomenon. Young men frequently takepart in acts of violence, including wars. Suicide attemptsappear to be on the increase among the young and manyare the victims of violence, including sexual abuse, oftenperpetrated by adults.
  5. 5. Adolescence: a gateway to the promotion ofhealth. Many of the behavioural patterns acquired duringadolescence (such as gender relations, sexual conduct, theuse of tobacco, alcohol and other drugs, eating habits, anddealing with conflicts and risks) will last a lifetime. They willaffect the health and well-being of future children.Adolescence provides opportunities to prevent the onsetof health-damaging behaviours and their futurerepercussions. Fortunately, adolescents are receptive tonew ideas; they are keen to make the most of theirgrowing capacity for making decisions. Their curiosity andinterest are a tremendous opening to foster personalresponsibility for health. Furthermore, engaging in positiveand constructive activities provides occasions to forgerelationships with adults and peers as well as acquirebehaviours that are crucial to health. UNICEF/Marcus Halevi
  6. 6. Health problems of adolescents are interrelated.Many of the factors that underlie unhealthy developmentin adolescents stem from the social environment. Theyinclude poverty and unemployment, gender and ethnicdiscrimination and the impact of social change on familyand communities. While programme efforts foradolescent health cannot directly focus on inequities andinjustices in society, it must be recognized that theseconditions are real constraints to improving the healthand well-being of adolescents. The attitudes andbehaviours programmes seek to influence (eg. sexualbehaviour and gender relations, use of substances, dealingwith conflicts and risks), often arise from and feed offone another. For example, the use of psychoactivesubstances alters judgement and thus makes aggressiveacts, unprotected sex and accidents more likely.Moreover, the preventive interventions for thesebehaviours are the same and all contribute to positivepersonal growth and development. WHO/Andrew Bull
  7. 7. Successful programmes require support to expandtheir reach. While interventions still need refinement,enough is known to act now. Programmes must providethe support and opportunities for adolescents to:q acquire accurate information;q build skills;q obtain counselling (especially during crises);q have access to health services, including those for reproductive health and;q live in a safe and supportive environment.The social environment must foster personaldevelopment and encourage young people to adopthealthy behaviours. Policies and the media can strengthenand communicate positive norms for both adult andadolescent behaviours, such as those related to equalityand gender equity. Adolescents can be entrusted togradually take on adult responsibilities throughparticipating in decisions that effect their lives and bymaking contributions to their families and communities.Meeting basic needs for safety, belonging and self-esteemas well as mastering key skills for living improves theoverall development of adolescents. This will enableadolescents to avoid health risks, and provide motivationto practice healthy behaviours. Programme efforts needto take into account that adolescents are not alike andthat interventions and the way they are delivered willvary according to differing needs and circumstances.
  8. 8. Impetus and direction for increased action foradolescent health come from many sources. The basicrights and obligations related to the promotion andprotection of the health of adolescents are articulated inthe United Nations Convention on the Rights of theChild, as well as the earlier Convention on theElimination of All Forms of Discrimination againstWomen. Further elaboration and support come fromrecent international conferences and statements such asthe 1994 International Conference on Population andDevelopment, the 1995 Fourth World Conference onWomen and the United Nations World Programme ofAction for Youth to the Year 2000 and Beyond.Moreover, explicit measures to support, stimulate andstrengthen national laws, policies and programming foradolescent health have been adopted by WHO, UNFPAand UNICEF. The time has come for countries, with supportfrom the international community, to make a concertedeffort to plan, monitor and strengthen their activities foradolescent health.
  9. 9. Laying the groundwork:the Study Group called for action byWHO, UNFPA & UNICEF toq Promote the use of the Framework for CountryProgramming for Adolescent Health. The framework is agraphic summary of the elements which need to beconsidered in programming for adolescent health incountries. It also highlights the key challenges in theprogramming process.q Develop clearly defined goals for the activities theagencies will undertake in support of the acceleration ofnational programming for adolescent health, and asystem for monitoring the ways the agencies worktogether.q Strengthen and expand collaboration in countrieswith other United Nations organizations and agencies(eg. UNDP, UNDCP, UNESCO, UNHCR and the WorldBank) and relevant partners including multi/bilateraldonors, nongovernmental organizations and the privatesector to support action for adolescent health.q Support country programming based on individualcountry priorities and situations and work throughexisting processes to coordinate operational activities ofthe UN system.q Bring this Common Agenda and relatedissues to the attention of the governing bodies of thethree organizations, and act on the recommendations,taking into consideration each organizations respectivemandate, structure and comparative advantage.
  10. 10. Country level actionsq Make the case for adolescent health. Advocate theneed for adolescent health policies and programmes,including sexual and reproductive health, on the basis ofthe public health and economic benefits which accruefrom investing in the health and development of youngpeople.q Describe needs and generate commitment.Cosponsor situation analyses and planning activities, withthe meaningful involvement of young people, such ascreating multisectoral national task forces or conveningnational workshops, in order to forge coalitions withinterested organizations and develop common plans ofaction.q Build capacity. Initiate collaborative trainingand sensitization for country nationals (includingyoung people) and agency staff to improve and sustainprogramming for adolescent health. D Baudraz - Geneva
  11. 11. q Sustain action. Support the implementation ofcountry action plans and/or other clearly focusedactivities, mobilizing local resources and building onexisting infrastructures within the public, NGO andprivate sectors.q Demonstrate feasibility. Support thoseapproaches which have the potential to be taken to scalein cost-effective and sustainable ways. In order to studythe lessons learned, carry out joint programme reviews,complementary to programming processes.q Share the knowledge. Intensify means used toshare information within the country that focuses onhealth status of adolescents and successful programmingexperiences.q Understand and evaluate. Support the monitoring,evaluation and operations research of programmes,including the use of appropriate indicators, putting thisinformation to use to inform the community andimprove the quality and coverage of programmes.
  12. 12. Regional level actions toreinforce country effortsq Support programmes. Cosponsor and supportregional networks for training and exchanging ideas andinformation.q Understand and evaluate. Collect and analyseinformation on the health status of adolescents andcountry efforts in programming for adolescents health.Support operations research of programming to distilbest practices.q Share the knowledge. Organize and facilitatestudy visits of policy makers, religious leaders andprogramme managers to successful programmes,especially those that demonstrate the meaningfulinvolvement of young people. Produce programmingguidelines, increase the dissemination and availability ofsuccessfulprogramme resource materials and provide support fortheir adaptation.q Build capacity and commitment. Organizeinteragency staff meetings to inform and mobilizepersonnel, extend consensus, identify priorities foraction within and between agencies and facilitate accessto regional resource persons.
  13. 13. Global level actions to extendquality and reach of programmingq Strengthen the rationale for adolescent health.Reinforce the public health and economic evidence andarguments for adolescent health programming whichwill help increase the investment of resources inprogramming activities.q Measure. Develop appropriate indicators andapproaches for their measurement, for use in planning,monitoring and evaluating programmes in countries.q Demonstrate feasibility. Information is urgentlyneeded on how programming can be taken to scale incost-effective and sustainable ways. To bring focused,timely attention to this key point, agencies should makea concerted effort to support and study the experiencesof 4-6 countries that indicate readiness to expandcritical aspects of their adolescent health programmingto significant scale over the next 2-3 years.q Extend knowledge. Synthesize information andgive examples of the best practices for adolescent healthprogramming. Identify cost-effective and sustainableapproaches for taking programming to scale throughsupport of research. Develop practical tools to assistprogramme development and implementation.q Share the knowledge. Manage informationneeded for programme acceleration, including use ofnew technologies such as CD-ROM and the Internet. Setup a system to monitor the status of adolescent healthfor inclusion in the Progress of Nations and otherpublications.
  14. 14. Adolescent Health & Development Programme Family & Reproductive Health World Health Organization© World Health Organization, 1997This document is not a formal publication of the World Health Organization (WHO), andall rights are reserved by the Organization. The document may, however, be freely reviewed,abstracted, reproduced and translated, in part or in whole, but not for sale nor for use inconjunction with commercial purposes.WHO/FRH/ADH/97.9 May 1997