- National and subnational governments need to identify and address adolescent health and well-being programming priorities because:
- the scope for adolescent health and well-being programmes is very broad;
- the nature, scale and impact of adolescent health and well-being needs are unique in each country;
- all governments face resource constraints, and so they must make difficult choices to ensure that resources are used most effectively.
- The process of national prioritization should be explicit, transparent and involve all relevant stakeholders across key sectors. This process should include:
- a needs assessment to identify which conditions have the greatest impact on adolescent health, well-being and development, both among adolescents by age, sex and part of the country and among those most vulnerable;
- a landscape analysis of existing adolescent health and well-being programmes, policies, legislation, capacity and resources within the country, as well as a review of current global and local guidance on evidence-based interventions; and
- setting priorities by applying explicit criteria such as the magnitude and public health importance of the issue; the potential to address the needs of vulnerable populations and poorly served groups; the existence of effective, appropriate and acceptable interventions to reduce priority burdens; and the feasibility of delivering the intervention(s) and potential to go to full scale.
- Over time, countries should reassess their priorities and programming for adolescent health and well-being to ensure that they still meet changing needs. New trends in health and health services, economic development, education, employment, migration, urbanization, conflict, environmental degradation and technological innovation should all be considered.
- While national and subnational priorities guide local action, further contextualization of programme activities should take place locally, based on local data, by identifying priority groups of adolescents, including the most vulnerable, and the best ways to reach them with interventions and services, while making the most effective use of local resources.
Programming for adolescent health and well-being starts with identifying priorities. This chapter explains why prioritization is necessary and describes the process of national prioritization and its steps. It provides examples of how this process is conducted so as to integrate considerations across all domains of well-being.
Governments have increasingly recognized that diverse and complex needs for adolescent health and well-being, as described in Chapters 1 and 2, require prioritization so that effective use of national resources is optimized. The national prioritization process consists of three steps: 1) needs assessment, 2) landscape analysis and 3) priority setting (see chart below). Time, human resource capacity and funding will often dictate the level and depth of these steps.
Mechanisms should be put in place to ensure that adolescents participate and are able to contribute meaningfully to each step.
Guided by the first edition of the AA-HA! guidance, many countries have applied these steps to achieve national consensus on priorities for adolescent health and well-being. As countries will now be developing a new generation of programmes that will better integrate considerations of well-being, it is important that needs are assessed, and the landscape analysis is conducted, across all domains of well-being.
What is new in this chapter?
- The process of national prioritization, explained through the lenses of all domains of well-being
- A sharper focus on gender analysis during needs assessment and landscape analysis
- Priority setting at subnational and local levels
- New case studies
