ADOLESCENT HEALTH

A focus on the adolescent phase of the life course is crucial for building a solid foundation for the SDGs.
Today’s adolescents will be 2030 policy and decision-makers. Adolescents8 are exposed to a range of risks
and suffer from a variety of illnesses, the most significant being unipolar depressive disorder, road injury,
iron deficiency anaemia, HIV/AIDS and self-harm.9 While mortality rates are low compared to other age
groups, most causes of death among adolescents are preventable. Importantly, many health behaviours
that are adopted during adolescence can have lasting impacts on health through the life course.

TRENDS POSITIVE DEVELOPMENTS

Adolescent mortality rates declined between 2000 and 2012, with the Increased policy focus in countries: Among the national health policy
number of global deaths falling from 1.5 million to 1.3 million.9 The documents from 109 countries retrieved in 2013 from the WHO
adolescent birth rate (births to those age 15–19) declined by about Country Planning Cycle Database, 84% of the policies included some
30% between 1990–1995 and 2010–2015 (Figure 4.24). The declines attention to adolescents.
were greatest in lower-middle-income countries (44%).102
Global advocacy: The new UN Every Woman Every Child Global
In 2014 over 1.6 million adolescents in the African Region were living Strategy 2015–2020 includes adolescent health and, in 2012, the UN
with HIV/AIDS, which has become a leading cause of death among Secretary-General called for the development of a UN system-wide
adolescents globally.9,103 Action Plan on Youth (Youth-SWAP) to enhance the coherence and
synergy of UN system-wide activities in key areas related to youth
development, including health.
CHALLENGES CHALLENGES cont.
Spurring action in countries: Major causes of deaths and ill-health
Figure 4.24 in adolescents, such as mental health, substance use and nutrition 2000, where one out of every three deaths among boys age 15–19
Improved coverage of interventions: Across countries with available
Adolescent birth rates by country income group, 1990–2015102 related disorders, do not get sufficient attention in national health is due to interpersonal violence. The rate among those age 15–19 in
data, there has been a steady increase in young women’s use of modern
policies. Among the national health policy documents from 109 the Eastern Mediterranean Region has increased since 2000 due to
1990–1995 1995–2000 2000–2005 2005–2010 2010–2015 contraceptive methods over the past two decades.104 In eastern and
countries, only approximately one third address tobacco and alcohol war-related deaths.9
160 southern Africa, where the HIV burden is high, the percentage of girls
and boys who was sexually active before age 15 declined, and rates use among adolescents, and only one quarter address mental health.
140 Increasing monitoring: Although one in six people in the world is an
of condom use among girls increased from 22% to 33%.103
Births per 1000 girls aged 15–19

120 Reducing road traffic injuries: The leading cause of death among adolescent, adolescent health is monitored poorly compared to many
adolescents is road traffic injuries (Figure 4.25), which will become other age groups.
100 Benefits from childhood interventions: The increase in the immunization
coverage with measles vaccine in childhood translated into health an even greater problem as rates of vehicle ownership increase in
80 the future, particularly in developing countries. Improving equity: Adolescents have decreased rates of access to family
gains for adolescents, which reiterates the importance of the life
planning services compared to older age groups. For example, based
60 course approach to policies and interventions.
Treating mental illness: Suicide is estimated to be the number one on survey data from 49 low- and middle-income countries, median
40 coverage of demand for family planning satisfied with modern and
Education: Rates of enrolment in secondary school have increased cause of death among women age 15–19, and depression is the
20 leading cause of illness and disability in adolescence. In any given traditional contraceptives is 1.5 times higher in women age 20–49
globally since 1990. For example, in 2000, the out-of-school population
year, 10–20% of adolescents will experience a mental health problem, (66%) than in adolescents age 15–19 (42%).16
0 of children of lower secondary school age was 97 million, compared
Low-income Lower-middle- Upper-middle- High-income to 63 million by 2012,20 despite an absolute increase in the population most commonly depression or anxiety.105
countries income income countries Removing barriers to care: Adolescents often find health services
countries countries in this age range.
Improving nutrition and physical activity: Many boys and girls in unacceptable because of perceived lack of respect, confidentiality
developing countries enter adolescence undernourished. The number and fear of stigma or discrimination. For adolescents responding to
of adolescents who are overweight or obese is increasing in both low- a WHO global consultation, cost and poor access were the top two
and high-income countries. Available survey data indicate that fewer reasons preventing them from using health services.9
Figure 4.25 than one in every four adolescents meets the recommended guidelines
Global top 10 causes of death among adolescents by sex, 20121 for physical activity. Anaemia resulting from a lack of iron affects girls
Male Female and boys, and is the third cause of years lost to death and disability.9
140
Ensuring sexual and reproductive health services and rights: There are STRATEGIC PRIORITIES
120 considerable barriers to access to health services due to mandatory third The 2030 SDG declaration mentions adolescents or youth in several
party authorization, and barriers to implementation of comprehensive
Deaths (thousands)

100 instances as a vulnerable population. The targets include a few specific

80
sexuality education.106 Early marriage of an estimated 39 000 adolescent targets for youth, mostly on employment, but several targets that, if
girls every day often deprives them of their education, health and met, will substantially improve adolescent health. In addition to disease-
60
long-term prospects.107 An estimated 33 million women age 15–24 specific interventions, such as increasing access to male circumcision
40 have an unmet need for family planning in 61 countries.104 Globally, and HPV vaccination, structural, environmental and social changes
20 some 30% of girls age 15–19 who are cohabiting have experienced are required. These include infrastructure changes to improve road
0
violence by a partner.9 Although the overall number of HIV-related safety, greater alcohol and tobacco taxation, and increased access to
deaths is down 30% since the peak eight years ago, estimates education. In addition, actions to create adolescent-responsive health
Endocrine, blood,
Road injury

HIV/AIDS

Self-harm

Lower respiratory
infections
Interpersonal
violence
Diarrhoeal
diseases

Drowning

Meningitis

Epilepsy

immune disorders

suggest that adolescents are the only population group in which HIV
deaths are rising.105
Confronting adolescent male mortality: In the Region of the Americas,
the adolescent mortality rate for males has been stagnant since
systems are necessary, such as facilitation of the adoption of health
promoting and protecting policies that prevent exposure to harms and
enable adolescents to adopt healthy lifestyles and strengthening of the
capacity of primary and referral-level facilities to deliver adolescent
responsive services.

92 HEALTH IN 2015: FROM MDGs TO SDGs REPRODUCTIVE, MATERNAL, NEWBORN, CHILD, ADOLESCENT HEALTH AND UNDERNUTRITION 93