Existing health services often fail the world’s adolescents (10 to 19-year-olds). Many adolescents who suffer from mental health disorders, substance use, poor nutrition, intentional injuries and chronic illness do not have access to critical prevention and care services. Meanwhile, many behaviours that have a lifelong impact on health begin in adolescence.
“These standards provide simple yet powerful steps that countries – both rich and poor – can immediately take to improve the health and wellbeing of their adolescents, reflecting the stronger focus on adolescents in the new Global Strategy for Women’s, Children’s and Adolescents’ Health that was launched in New York in September,” says Dr Anthony Costello, Director of Maternal, Children’s and Adolescents’ Health at WHO.
Global Strategy for Women’s, Children’s and Adolescents’ Health
Adolescents are a unique group
Adolescents form a unique group, rapidly developing both physically and emotionally but are often dependent on their parents or guardians. WHO and UNAIDS Global standards for quality health-care services for adolescents recommend making services more “adolescent friendly”, providing free or low-cost consultations, and making medically accurate age-appropriate health information available. They also highlight the need for adolescents to be able to access services without necessarily having to make an appointment or requiring parental consent, safe in the knowledge that any consultation remains confidential, and certain that they will not experience discrimination.
“If we want to keep adolescents healthy, we have to treat them with respect,” says Dr Costello. “Adolescents are particularly vulnerable to certain health issues. The top three causes of death among adolescents are road traffic injuries, AIDS-related illnesses and suicide.
“AIDS is the leading cause of death among adolescents in Africa and the second primary cause of death among adolescents globally,” says Dr Mariângela Simão, Director of Rights, Gender, Prevention and Community Mobilization at UNAIDS. “All adolescents, including key populations, have a right to the information and services that will empower them to protect themselves from HIV.”
Not only is adolescence a period of life when people are particularly vulnerable to certain health issues, it is also a time when critical behaviours are shaped that will affect health in the future.
“So many behaviours – healthy or unhealthy – that impact the rest of our lives begin in adolescence,” adds Dr Costello. “The health sector cannot stand there and tell people they are sick because of the ways they use tobacco and alcohol, and their attitudes to diet and exercise, if it does not do a better job of helping people develop healthy habits as adolescents.”
Training health workers is critical
Dr Valentina Baltag, adolescent health expert at WHO, says: “There are countries where every fifth citizen is an adolescent. Yet most students in medical and nursing schools graduate with no understanding of the specific needs of adolescents in accessing healthcare. This is unacceptable.”
The Global standards for quality health-care services for adolescents call for an inclusive package of information, counselling, diagnostic, treatment and care services that go beyond the traditional focus on sexual and reproductive health.
Adolescents should be meaningfully involved in planning, monitoring and providing feedback on health services and in decisions regarding their own care.
More than 25 low- and middle-income countries have already adopted national standards for improving adolescent health services.
The global standards from WHO and UNAIDS are built on research from these countries, as well as feedback from health providers and more than 1000 adolescents worldwide. They are accompanied by an implementation and evaluation guide that outlines concrete steps that countries can take to improve health care for adolescents.