Engaging Young People for a New Era of Sustainable Health and Development

Engaging Young People for a New Era of Sustainable Health and Development

{Photo credit: MSH staff}Photo credit: MSH staff

The teenage years. Changes seem to happen overnight. Puberty. Your first crush. Fighting with a parent. Discovering your identity, your purpose, and your role in the community. A confusing and challenging, yet rewarding, coming of age... an emerging adult.

Half the world’s population is under 30 years old. About 1.8 billion people, the largest generation of youth in history, are between the ages of 10 and 24. In most countries in sub-Saharan Africa, people ages 15 to 29 will continue to comprise about half of the population for the next four decades. How does this unprecedented proportion of young people impact public health, and a community and country’s sustainable development?

Sustainable health outcomes will depend on how we engage and empower our youth.

Last May, UN Secretary General Ban Ki Moon and more than 1,000 Youth Ambassadors agreed that unless young people are given a platform to bring about change, it is highly unlikely that post-2015 improvement will affect those who need it most.  To achieve the new Sustainable Development Goals (SDGs), communities and countries, and development partners like us, will need to partner together to engage and empower youth. Youth participation and engagement are key to achieving the post-2015 SDGs, especially those of health, gender equality, education, and livelihood development.  

Unique health needs

Too often, youth are underrepresented in discussions and decision-making about their health and development. The enthusiasm, imagination, and insights of youth are devalued or not sought. Programs lump youth together without acknowledging the heterogeneity and drastically different needs across the spectrum of ages or socioeconomic and cultural contexts. There is a lack of clarity on the entry points for youth to get involved. There is little mention of youth as a subpopulation, even though they require special interventions.

Among young people, there are particularly poor reproductive, and maternal health outcomes. Unmet need for family planning is generally higher among younger women; an analysis of 61 countries found that in most regions of the world (all but the Middle East and North Africa), women aged 15-24 have greater unmet need than those 25 and above.

Nearly 35 percent of the global burden of disease has roots in adolescence.

More than 10 percent of all births worldwide (about 16 million) are to girls aged 10 to 19 years old. The highest rates of early pregnancy occur in the poorest countries, where nearly 10 percent of girls become mothers by age 16. Sub-Saharan Africa has made the least progress on adolescent pregnancy as a region since 1990, with 116 births per 1,000 adolescent girls in 2015.

Youth often face discrimination, stigma, and discouragement from adults, not only in health service environments but also from potential employers, political structures, and for girls, the education system. Adolescent mothers are more likely to have health problems, such as anaemia, malaria, postpartum haemorrhage, obstetric fistula, HIV and other sexually transmitted infections (STIs), and mental health disorders like depression. Many girls who become pregnant have to leave school. Young people often cite lack of resources, distance, and provider attitudes as barriers to accessing health services, especially related to sexual and reproductive health (SRH).

Build community support for youth health

Improving the health of young people requires community support; access to quality, relevant education; participation in decision-making; access to health services; and access to employment opportunities and livelihoods.

Take Rifkatu. At age 16, she is one of thirty female students who participated in a health club at her school, organized by MSH and partners in Gombe State, Nigeria. Rifkatu and her peers are health ambassadors, using creative writing, drama, and storytelling to share health knowledge with their friends and families. 

Watch a video of Rifkatu's and peers' creative work here

Or take Geomack, age 21. He has been studying to be a medical assistant at the Malawi College of Health Sciences in Lilongwe for a year as part of a training and bonding program in six Malawian districts. The new program, funded by the US Centers for Disease Control and Prevention (CDC), is a win-win for young people and rural communities: Students are eager to serve communities, gain clinical skills, and develop a livelihood; and local leaders are enthusiastic about the program’s potential to improve staffing, service delivery, and care.

Meet Geomack and read more about the Malawi program here

Youth are our now.

Youth are creative, impulsive, passionate. Youth may lack resources, but they are resourceful.  Youth know nothing and everything at the same time. Youth are mobile--adept at using the latest technologies to connect and communicate, as well as geographically (moving for training or schooling or employment). This mobility means youth are poised to diffuse innovations, exchanging ideas rapidly and adapting to current or changing situations.

Holistic systems, integrated programs, youth-friendly policies

A holistic systems strengthening approach can accelerate civic participation by young people and prepare them for all of life’s challenges and opportunities, including, and beyond health.

Integrated programs provide youth with adaptive and coping strategies that will reduce vulnerability and increase resilience. Young people must have opportunities for meaningful work and income generation so that they can be productive and contribute fully to improving living standards of their families and communities. Stable jobs ensure resilience to unexpected crises, such as natural disasters caused by climate change or epidemics such as the recent Ebola outbreak in West Africa. A groundbreaking multisectoral initiative, USAID’s YouthPower, will implement integrated programming that links health with other aspects of individual development -- rather than traditional programs that were implemented within specific sectors.

We need to go beyond engaging youth; we need to adapt policies and engage those currently in power to accept and facilitate youth participation and civic engagement. Adult leaders and decisionmakers must shift attitudes considerably to value youth input and inclusion in decision-making. Providers must be trained to provide a welcoming environment for young people to access health services -- ensuring privacy and upholding confidentiality; counseling in neutral, unbiased manners; reducing cost of services to make them more accessible.

We cannot go far without strong health systems and empowered youth. Together, we can achieve sustainable health outcomes. Those of us beyond our youth years must welcome emerging adults -- the frustrations, the boundless energy, and desire to be part of something larger than ourselves -- and engage young people as change agents for themselves, their communities, and their countries.

For health beyond 2015, youth lead now.