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Adolescents in a changing world The case for urgent investment Hosted by the World Health Organization Adolescents in a changing world The case for urgent investment Hosted by the World Health Organization Adolescents in a changing world: the case for urgent investment ISBN 978-92-4-009499-4 (electronic version) ISBN 9... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
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iii Contents Foreword......................................................................................................................................... viii Preface.............................................................................................................................................. ix Ack... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Introduction and review – the urgency of action on adolescent well-being...........................1 1.1 Emerging conditions shaping adolescent well-being..................................................................... 1 1.2 Domains, linkages and platforms.............................................................. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Health investments...................................................................................................................15 2.1 A broad package of health interventions provided to adolescents.............................................15 2.2 HPV ................................................................ | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Building connectedness, agency and resilience......................................................................27 3.1 Connectedness................................................................................................................................... 27 3.2 Agency and resilience............................ | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Investing in adolescent mental health....................................................................................40 4.1 Introduction........................................................................................................................................ 40 4.2 Importance of mental health............ | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
School feeding – one key response to malnutrition................................................................51 5.1 Introduction.........................................................................................................................................51 5.2 Recent studies and action, both locally and ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Education, skills and employment...........................................................................................55 6.1 School attendance and the quality of learning.............................................................................. 55 6.2 Methodology – education model................................. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Violence and injuries.................................................................................................................67 7.1 Introduction........................................................................................................................................ 67 7.2 IPV....................... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Additional methodological details and tables related to Chapter 1.......................100 1.
The cost of inaction........................................................................................................................... 100 2.
Validation of models....................................................... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Detailed methodology for health services modelling.................................................................. 103 Tables related to Chapter 1....................................................................................................................112 Annex 1: References.................................... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Chapter 2 tables............................................................................................................ 118 Annex 2: References.............................................................................................................................. 126 List of figures Fig.
1.1 Five domains of... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
1.2 Platforms, linkages and interventions in the investment case modelling................................ 4 Fig.
3.1 Structural equation model............................................................................................................. 36 Fig.
3.2 Relationship between SEL interventions, school climat... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
4.1 Adolescent* global burden by cause of disease, proportion of global disease burden, tier 2 classification level, 2019..................................................................................................................... 42 Fig.
4.2 DALY rates for the global adolescent (10–19 years) burden of disease... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
4.3 Scatter diagram of adolescent mental health DALY rate (2019) versus GNI per capita (Atlas method), 202 countries, 2018........................................................................................................... 43 Fig.
4.4 Adolescent* mental disorders by type, DALY rate, 202 countries, 2019............ | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The case for urgent investment v List of tables Table 1.1 The five domains and sub-domains of adolescent well-being................................................. 3 Table 1.2 Origins and development paths for eight benefit-cost models used in this report............. 6 Table 1.3 ROI from scale-up of adolescent health... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
4.5 Scatter diagram of adolescent mental health DALY rate versus youth unemployment rate, 26 LICs, 2019......................................................................................................................................... 45 Fig.
4.6 Scatter diagram of adolescent mental health, DALY rate, versus pol... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
6.1 Educational attainment by country group as defined by Filmer et al.
(2018, p59) using data from Lee and Lee (2016)...................................................................................................................... 56 Fig.
6.2 Primary school learning test scores by region, not including South As... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
7.1 The ecological framework, examples of risk factors at each level............................................ 69 Fig.
B7.1 Modelling framework for child marriage estimations............................................................. 70 Fig.
B7.2 Number of school completions before and after the interventions, 20... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
B7.3 Total additional cost and economic benefits of child marriage prevention, US$ billion, 2024–2050, 70 selected countries.............................................................................................................. 71 Fig.
7.2 Road traffic injuries and fatalities, 10–19-year-olds, by income group, ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
7.3 Rates of serious road traffic injuries and fatalities, 10–19-year-olds, by income group, 2019 per 100 000.......................................................................................................................................... 77 Fig.
7.4 Modelling framework........................................... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
7.5 Estimated BCRs of investment in road safety interventions for adolescents by gender, 77 countries, 2023–2050.............................................................................................................................. 80 Fig.
7.6 Costs, benefits and intervention type, road traffic fatalities and s... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
8.1 Developing countries’ increasing external public debt, median values for developing countries, 2010–2021................................................................................................................................... 83 Contents vi Table 2.2 ROI from scale-up of HPV vaccination, screening and tre... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
in the emerging literature on malnutrition in adolescents....................... 52 Table 5.2 School health and nutrition programmes, summary of the key messages of the multi-agency report Ready to Learn and Thrive (UNESCO, UNICEF, WFP, 2023).................................. 53 Table 6.1 List of modelled education int... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
7.2 Projected deaths and serious injuries due to road traffic accidents in adolescents, 77 countries, 2023–2050.............................................................................................................................. 79 Table 7.3 Estimated costs and benefits of investment in road safety interventio... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Table A1.7 Country/territory coverage of analyses ................................................................................112 Table A2.1 Countries included in OHT modelling, income status.........................................................118 Adolescents in a changing world. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The case for urgent investment vii List of boxes Box 7.1 Estimating the economic and social benefits of reducing child marriage.............................. 70 Box A1.1 VISES reports and other papers ............................................................................................... 103 Table A2.2 Interven... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
122 Table A2.9 Reduction in prevalence of mental disorders and other NCDs through OHT interventions, female adolescents, 2023–2035...................................................................................... 123 Table A2.10 Reduction in prevalence of mental disorders and other NCDs through OHT interventions, m... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
TB in adolescents cost per death averted 2023 to 2023................................................... 125 Table A2.19 TB in adolescents deaths averted 2023 to 2035................................................................ 126 Table A2.20 TB in adolescents economic and social benefits and costs ($ million) and ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Growing up in a world that is churning with historic transformations – political, social, economic and environmental – they have both deep concerns and high expectations for themselves and their societies.
As global leaders and advocates for human rights, we rally behind and stand with adolescents, in all their divers... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This landmark report makes a critical, social and economic case for countries and communities to invest in the well-being of adolescents and girls in particular.
For countries, investing in adolescent well-being is not just a moral imperative, it’s a strategic investment in resilient communities and sustainable develo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
UNFPA, UNICEF and WHO are committed to listening to, and meaningfully engaging with, adolescents, and to advocating for the acceleration of sustainable investments in them and in their well-being. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
From ensuring their education and skills training to supporting access to quality health information and comprehensive services, including for sexual and reproductive health, to promoting mental health support and fostering safe and secure environments, we are dedicated to equipping adolescents with the knowledge, tool... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Working together with adolescents, youth and allies, we are determined to forge a brighter future where every young person has the opportunity to realize their potential, contribute meaningfully to their communities and advance a more equitable and sustainable future for all. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Catherine Russell Executive Director, UNICEF Dr Natalia Kanem Executive Director, United Nations Population Fund (UNFPA) Dr Tedros Adhanom Ghebreyesus WHO Director-General ix Preface As we reach the halfway mark of the SDGs, the global landscape has been marred by unprecedented challenges.
Among the most affected demo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Despite these adversities, adolescents have demonstrated remarkable resilience, emerging as catalysts for positive change, embodying hope, and serving as sources of inspiration for communities worldwide.
Today, adolescents make up more than 16% of the world’s population.
They are a demographic which is often overlook... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
In recent years, there has been more recognition of the unique challenges to well-being confronting adolescents, and of the need to address these in development agendas, but action has been slow.
This report focuses on the imperative of investing holistically in adolescents and their well-being.
Such investments can ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
As is evident throughout the report, the economic and social returns from a wide range of investments to address adolescent well-being are significant.
The report makes a compelling case for investing in adolescents, they are living in a world facing multifaceted crises, and they will be tomorrow’s changemakers and le... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
That amounts to 7.7% of the total GDP of those countries included in the models, which themselves include around 80% of the world’s population.
The report provides valuable insights into interventions where investments will yield high returns, including those focused on health services and multisectoral interventions,... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This evidence base is crucial for policymakers, practitioners, researchers, educators, donors, and civil society organizations as we map the road ahead for a better and more sustainable future.
As well, the report is a significant step forward in advocating for adolescent well-being, where adolescents have the support... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
It calls for more prioritisation, increased investment, and immediate action for adolescent well-being.
Finally, investing in adolescents and their well-being strengthens the human capital of a country, and hence a country’s potential for future development and for ending extreme poverty and creating more inclusive so... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
As we embark on this journey, we eagerly anticipate the discussions and collaboration this report will catalyse, around creating futures where adolescents are empowered to thrive in a secure and healthy environment and realise their full potential and rights. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Rt Hon Helen Clark PMNCH Board Chair and Former Prime Minister of New Zealand Dr David Imbago Director, YIELD Hub and Chair, PMNCH Adolescents and Youth Constituency (2021–2024) Professor Bruce Rasmussen Director, Victoria Institute of Strategic Economic Studies, Victoria University, Australia x Acknowledgements The Wo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This report was developed under the overall direction of Anshu Mohan of PMNCH (Partnership for Maternal, Newborn and Child Healh), with coordination from Sophie Marie Kostelecky (PMNCH) and Bhavya Nandini (PMNCH). | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The lead writers of the report are: Peter Sheehan, Bruce Rasmussen, Kim Sweeny, Neelam Maharaj, John Symons and Margarita Kumnick (Victoria University, Australia), David Ross (FIA Foundation, Germany), Anshu Mohan (PMNCH, Switzerland), Bhavya Nandini (PMNCH, India), Sophie Marie Kostelecky (PMNCH, Spain). | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
WHO contributors and reviewers WHO is grateful for the technical contributions of WHO headquarter staff nominated by WHO headquarter departments: Anshu Banerjee, Valentina Baltag, Prerna Banati (Maternal, Newborn, Child and Adolescent Health and Ageing), Melanie Bertram (Delivery for Impact), Daniel Chisholm (Mental He... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Reviewers from United Nations agencies.
Contributors and reviewers from United Nations agencies WHO is grateful for the technical contributions of members of the Expert Consultative Group from United Nations Agencies: Anurita Bains (UNICEF, United States of America), Danielle Engel and Howard S. Friedman (UNFPA, Unite... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Technical Expert Consultative Group Patricia Akweongo (School of Public Health, University of Ghana, Ghana), Chris Armstrong (Plan International, Canada), Peter Azzopardi and Susan Sawyer (University of Melbourne and Royal Children’s Hospital, Australia), Donald Bundy (London School of Hygiene and Tropical Medicine, Un... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Other technical contributors and reviewers: WHO is grateful for the contributions of Karen Canfell, Michael Caruana, Diep Nguyen, Daniela Rivas and Katie Simms (University of Sydney, Australia), and Alison Welsh (Victoria University, Australia).
Financial support WHO acknowledges the financial support provided by Fond... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Declarations of conflicts of interest None of the external writers, reviewers or experts on the Technical Expert Consultative Group declared any conflict of interest. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
xi Acronyms 4Rs Program on Reading, Writing, Respect and Resolution AEP Adolescence Education Programme BCR Benefit-cost ratio CBT Cognitive behavioural therapy CCT Conditional cash transfer CI Confidence interval CL Cooperative learning CMBC Child marriage benefits cost CTC Communities that care CVPP Cardiff Violence ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
QALY Quality-adjusted life year RCT Randomized controlled trial RMNCH Reproductive, maternal, newborn and child health ROI Return on investment SDGs Sustainable Development Goals SEHER Strengthening Evidence base on scHool-based intErventions for pRomoting adolescent health SEL Social and emotional learning SEYLE Savin... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
These range from the effect of population changes and age distribution, the impact of climate change on mental health and well-being, the learning crisis and the persistent inequality, violence and neglect of human rights experienced, especially by women.
The world urgently needs a new investment programme to improve ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The cost of inaction is too high.
This investment must cover all five domains of adolescent well-being: health, connectedness, safety, learning and employability, and agency and resilience, and the linkages between them.
Investment must underpin a global programme carried out at the local level with initiatives tailo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Transformative investment in three key platforms or systems is necessary: universal health coverage (UHC), including primary health care (PHC); enhanced schools that focus on learning, health, nutrition and student well-being; and support systems based in local communities.
These platforms are not only key points for ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The purpose of this report is to present the case for this much-needed investment in supporting adolescent well-being across the globe.
By investment we mean a planned programme of spending on interventions known to be effective in increasing adolescent well-being in all its facets.
To this end, an extensive review o... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
As is evident throughout this report, the economic and social returns from a wide range of investments to address adolescent well-being are high.
Such investments will reduce inequalities and help to protect the human rights of adolescents.
They have never been more timely, given the current state of the global demog... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Finally, investing in adolescents and their well-being strengthens the human capital of a country, and hence the country’s potential for future development and for ending extreme poverty and creating more inclusive societies.
With many affected countries already highly indebted, large-scale support from the internatio... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
At the same time, locally tailored interventions taking account of specific needs and local knowledge and expertise about effective programmes will be crucial.
The modelling presented in this report was for interventions introduced and progressively scaled up over the period 2024 to 2035.
Where the interventions were... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This is the ratio of the value of benefits to the cost of the investments necessary to achieve those benefits.
For a wide range of investments analysed here, the BCRs are 10 or above, with much higher values in many cases.
An investment in which the benefits are 10 times the cost is a very strong one indeed.
It is n... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This does not deny their importance to adolescent well-being but rather challenges researchers to strengthen their knowledge.
The coverage of the BCR results within this report reflects the availability of studies in the literature. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
xiii Within the need for an extensive programme of investment to build the universal platforms, based on BCR studies and other evidence assembled here, we identified six priority areas: malnutrition: hunger and undernutrition, micronutrient deficiencies and overweight/obesity; mental health: both prevention and tre... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Although a return of at least US$ 10 dollars for every US$ 1 spent is excellent, the cost of the full suite of investments described here are high.
Total costs to span until 2035 are estimated to approach US$ 2.8 trillion, or an average of about US$ 230 billion per annum over the 12-year period of 2024 to 2035 in pres... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Large-scale and immediate investment to increase the capabilities and well-being of adolescents is now of critical importance.
This investment will empower young people to meet the challenges before them and to thrive in the decades ahead.
The cost of inaction will be very high.
We estimate that the average annual c... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This amounts to an average of 7.7% per annum of the projected total GDP of the emerging market and developing economies, over this 27 year period.
As this report demonstrates, the returns on these investments – the returns to action – are also high, both in terms of BCRs and in terms of fulfilling human rights and red... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The time for action is now.
Executive summary Cambodia: Disability inclusion in health, 2023 © WHO/Miguel Jeronimo Cholera outbreak in Sierra Leone, 2012 © WHO/Fid Thompson 1 1.
Introduction and review – the urgency of action on adolescent well-being 1.
Introduction and review – the urgency of action on adolescent w... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Below, we summarize eight challenges arising from ongoing processes of global change.
Population trends and unplanned pregnancies.
Reflecting very different trends in birth rates, adolescent populations are projected to rise sharply in many countries (for example, by 60% by 2050 in sub-Saharan Africa) but to fall p... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
At both extremes, the rate of population change will have major effects on the development process for young people.
In many countries, continuing population growth reflects an ongoing high rate of unplanned pregnancies and the continued, if declining, incidence of child marriage.
Impact of climate change. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Impact of climate change.
It is now clear that continuing climate change, manifesting both in the growing frequency of dangerous weather events and in projections of future warming, is adversely affecting adolescent mental health in many countries, and the physical conditions for young people in some regions.
As th... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Learning crisis.
While rates of attendance at school have risen in almost all countries, there is now evidence that the learning achieved by adolescent populations has plateaued and is far from acceptable levels in many countries.
Low levels of literacy and numeracy provide a poor base from which to address other e... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Manual and routine jobs are being replaced by new technologies across the board; the service and care sectors are displacing the goods sectors, especially as sources of employment, while emerging artificial intelligence (AI) technologies imply a new era of change.
Employment will remain a major challenge for young peo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The double burden of disease.
For some time now, the double burden of disease—a continuing burden of communicable disease combined with a rising incidence of noncommunicable diseases (NCDs)—has been a reality in many countries.
As the precursors of future NCDs, such as malnutrition, obesity and poor mental health, ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Continuing malnutrition.
Malnutrition, which covers undernutrition, micronutrient deficiencies and obesity, remains a critical challenge for current and emerging adolescent cohorts.
Indeed, the double burden of malnutrition (DBM)—the simultaneous manifestation of undernutrition and overweight/obesity—affects most l... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
While this report focuses mainly on one response to malnutrition, the various dimensions of malnutrition remain a key challenge for adolescents around the world.
Persistent inequality and violence.
Pronounced inequality, both within and across countries, remains a persistent, and in some respects an increasing, rea... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Adolescent well-being is, on average, lower in LICs than in high-income countries (HICs) and, within a country, lower in the lower socioeconomic groups than in higher socioeconomic groups.
Increasing migration pressures.
The combination of rapid population growth in many countries and the growing impact of climate ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This applies to both cross-border and internal migration, and to both distressed or refugee flows and to voluntary migration.
Where the skills of the migrants match those of the recipient country or region, both parties are likely to benefit, but this may not be the case for refugees and distressed migrants leaving an... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
2 Adolescents in a changing world.
The case for urgent investment Adolescent well-being: Adolescents thrive and are able to achieve their full potential 1.
UN H6+ is a partnership of the United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), United Nations Women, World Health Organization (W... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
PMNCH (Partnership for Maternal, Newborn and Child Health), United Nations Education, Scientific and Cultural Organization (UNESCO), United Nations Major Group on Children and Youth (UNMGCY), and the World Food Programme (WFP) joined the UN H6 on the UN H6+ Technical Working Group on Adolescent Health and Well-being. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
1.2 Domains, linkages and platforms 1.2.1 The five domains of adolescent well-being In planning and developing a case for investment in programmes that aim to improve adolescent well- being, the targets for such programmes must be clear.
This relates to the various domains of adolescent well-being and the linkages tha... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Recent work by the UN H6+1 Technical Working Group on Adolescent Health and Well-being (Ross et al., 2020) has clarified the definition and five domains of adolescent well-being (see Fig.
1.1).
These are: good health and optimum nutrition; connectedness, positive values and contribution to society; safety and a suppo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Fig.
1.1 Five domains of adolescent well-being Each of these domains and their subdomains (see Table 1.1) are important to well-being.
Adolescence brings a maturation of all bodily systems and is a phase of sensitivity to the physical, nutritional and social environment.
During this phase, the social dimensions of w... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Adolescence is also a phase when risks, including tobacco and alcohol use, physical inactivity, poor diet, and overweight and obesity, increase the probability of contracting NCDs in later life.
The interventions must address each of the domains of well-being (Patton et al., 2016).
3 1. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Introduction and review – the urgency of action on adolescent well-being Table 1.1 The five domains and sub-domains of adolescent well-being Good health and Good health and optimum nutrition optimum nutrition Connectedness, Connectedness, positive values positive values and contribution and contribution to society to s... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
(2020).
These domains of well-being are not separate, independent aspects of adolescent well-being.
Many factors influencing adolescent development have interactive effects with one another with a complex interplay between physical and mental health, learning, sexual maturation and the connectedness, safety and suppo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Some of these aspects of health and growth during adolescence affect maternal health during pregnancy, which is a critical factor in providing a healthy start to life.
These linkages, both within and across generations, are of critical importance.
Given this complex mosaic of influences and interactions, we need an a... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
Many factors combine to undermine the well-being of adolescent girls in all too many countries.
These include limited education, child marriage, high and early fertility, poor access to health care and fertility control, low status within the family and the community and endemic violence toward women. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The literature increasingly recognizes that if interventions are to be effective in shaping the various domains of well-being in ways that take account of the diverse linkages between them, they need to be situated within strong platforms or systems designed for this purpose.
As noted earlier, these platforms or syste... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
1.2.2 The UHC system It is vital that the health system provides UHC to adolescents and that this care is extended to emerging issues for adolescents, such as poor cardiovascular health.
This is far from the case in most countries.
With inequality heavily shaping the access that many adolescents have to good quality ... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
This has long been a priority of the World Health Organization (WHO) and extensive literature has outlined the need for UHC, the progress being made towards it and the pivotal role of developing PHC within UHC.
This same literature also makes clear that, in spite of progress, adolescents in many parts of the world, an... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The investment programme of 95 interventions analysed in this report would be a major step forward in providing UHC for adolescents.
1.2.3 The enhanced school platform The school is a pivotal institution for shaping adolescent development and one that receives extensive funding.
Over the past two decades, the surge i... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
4 Adolescents in a changing world. | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
The case for urgent investment Key platforms Universal health coverage system Enhanced schools Community development Interventions Sexual and reproductive health Infectious diseases Nutrition Non-communicable diseases Mental health Substance abuse Retention at school Learning quality Social and emotional learning/schoo... | https://transfered-docs-lawep.s3.amazonaws.com/thematic1e/rr/1726050126293.pdf | https://www.unfpa.org/sites/default/files/pub-pdf/adolescents-in-a-changing-world---the-case-for-urgent-invesment.pdf |
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