The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respond to the health and well-being challenges, opportunities and needs of adolescents.
The guidance provides the latest available data on adolescent health and well-being. It also outlines an updated list of core indicators that data should be collected on. Globally, road injury was the top cause of death for adolescent males in 2019. Among female adolescents, the leading causes of death were diarrhoeal diseases among the younger group (10-14 years) and tuberculosis (TB) in the older group (15-19 years).
Over the last 20 years, mortality rates have declined among adolescents globally, with the largest decline in older (15–19 years) adolescent girls. For non-fatal diseases, the burden has not improved over the past two decades, with the main causes of ill health in this category being: mental health conditions (depressive and anxiety disorders, childhood behavioural disorders), iron deficiency anaemia, skin diseases and migraine.
Adolescent well-being depends on a range of factors, including healthy food, education, life skills and employability, connectedness, feeling valued by society, safe and supportive environments, resilience, and the freedom to make choices. To take an appropriately holistic approach, the guidance outlines how to take crosscutting action to support adolescent health and well-being, with mutually reinforcing interventions across sectors, such as health, education, social protection, and telecommunications. Targeted efforts are also required to engage adolescents, as they trust health systems less than adults do and are especially vulnerable to modern-day trends, like online bullying and gaming.
There has been substantial progress since the launch of the guidance’s first edition in 2017. A range of World Health Assembly resolutions address these issues, spanning areas such as the health workforce, noncommunicable diseases (NCDs), emergencies, and water and sanitation. New initiatives have been established, such as the WHO Global Initiative for Childhood Cancer in 2018 and the Joint Programme on Mental Health and Psychosocial Wellbeing and Development of Children and Adolescents launched by WHO and UNICEF in 2020.
“Informed by the AA-HA! guidance, many more governments are investing in comprehensive and evidence-based adolescent health and well-being programmes, developed in close consultation with adolescents and youth,” said Dr Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent and Ageing. “The commitment to collaboration and working closely with young people catalysed by the first edition can be seen in WHO’s strengthened partnerships with other UN agencies and the newly created WHO Youth Council.”
This new version of the AA-HA! guidance also includes an updated package of evidence-based interventions and advises governments on how to set national priorities, implement programmes, and conduct monitoring, evaluation and research. Evidence shows that the smartest investments are coordinated investments in health and education that reinforce each other.
The second edition is distinct for integrating the concept of well-being, expanding from a largely health-centric to a more holistic approach to adolescents. It also incorporates learnings from both the application of the first edition and the COVID-19 pandemic. For example, the COVID-19 pandemic highlighted that the role of schools goes well beyond education to providing critical nutrition, social protection, mental health and other services.
The guidance also makes the case for investment in adolescent health and wellbeing. An investment of US$ 1 in adolescent well-being brings a return of US$ 5-10, sometimes more, and putting resources into preventing NCDs during adolescence would yield US$ 400 billion in economic benefits over 50 years globally.
This guidance was developed by WHO in collaboration with global partners, including UN Women, UNAIDS, UNESCO, UNFPA, UNICEF, WFP and PMNCH.
