As stated earlier, accountability for contributing to adolescent well-being lies with various sectors and branches of the government. Health, education, social protection, labour, criminal justice, telecommunication, urban planning, energy and environment sectors all have important contributions to make to adolescent health and well-being. To contribute effectively, they need to normalize attention to adolescent-specific needs in all aspects of their work. This section describes implementation areas and strategies for sector-specific contributions to adolescent well-being.

5.3.1 Health

To achieve UHC, health systems need to become adolescent-responsive, meaning that they need to normalize attention to adolescent-specific needs in all aspects of their work. Adolescent-responsive health systems are the strategy to achieve UHC for adolescents. 

What is an adolescent-responsive health system? 

Figure 5-7

Implementation strategies to ensure adolescents’ protection from financial risk  

  1. Communicate the basic benefit package clearly to adolescent beneficiaries (and all beneficiaries) so that they understand their entitlements. Ensure monitoring of the boundary between the benefits packages and privately financed services to prevent providers from diverting adolescents to private services.  

  2. Ensure that adolescents and youth are covered by mandatory, prepaid and pooled funding to access the services they need.  

  3. Assess the impact of out-of-pocket payments at the point of use for adolescents accessing key services.  

  4. Design and implement measures specifically to protect adolescents from financial risk (for example, waivers, vouchers and exemptions or reduced co-payments) so that health services and commodities, including contraceptives, are free or more affordable to adolescents at the point of access.  

  5. Identify subgroups of adolescents that are not covered by mandatory, prepaid and pooled funding arrangements, and design mechanisms to maximize their coverage.  

  6. Monitor facilities to ensure that payment exemption policies are observed.  

  7. Provide incentives that are financial, such as pay-for-performance, or non-financial, such as recognition and awards, to motivate health workers to implement quality interventions that are essential for adolescent health, development and well-being.  

 

 

Implementation strategies for protective policies  

  • Align the national legal and regulatory frameworks with internationally recognized and accepted human rights principles and standards. Prioritize laws and policies
    • to promote SRHR.
    • that eliminate harmful practices including FGM and early and/or forced marriage.
    • that protect and support vulnerable adolescents
  • Protect equity and its aspects related to
    • adolescents’ access to the required health and well-being services package, regardless of gender, income, rural living, disability or sexual orientation.
    • specific access barriers faced by adolescent girls or boys.
    • inequalities and discriminatory practices (both real and perceived) in adolescents’ access to services.
  • Protect privacy and confidentiality:
    • establish procedures for health facilities
    • mandate that consultations with adolescent clients accompanied by parents or guardians should routinely include time alone with the adolescent.
    • indicate situations, clearly and unambiguously, when confidentiality may be breached, and establish procedures
  • Mandate age-appropriate and human rights-based approaches to consent and assent to health treatment or services

Implementation strategies to build an adolescent-competent workforce  

  1. Create a common understanding among key players about the importance of investing in an adolescent-competent workforce.  

  2. Define core competencies in adolescent health and development in line with WHO Core competencies for adolescent health and development for primary care providers.  

  3. Create and implement competency-based training programmes in pre-service and continuing professional education.  

  4. Support institutions teaching adolescent health and well-being to assess the quality of teaching and learning and to evaluate the progress of implementation of adolescent health competencies. Apply a quality assessment conceptual framework to support such assessments.  

  5. Establish a mechanism to consult health care providers about their training and education needs in adolescent health care and conduct capacity-building activities at national and district levels that respond to the reported needs. Facilitate providers’ access to online free-of-charge courses and use other effective pedagogy, such as peer education, simulation, reflection and blended learning.  

  6. Develop and review information and training materials, practice guidelines and other tools to support decision-making in adolescent health care.  

  7. Strengthen the capacity of community health workers in reaching adolescents, especially those out of school, with health education and services.  

  8. Set up a system for supportive supervision of adolescent health care and provide collaborative learning opportunities as a key strategy to improve providers’ performance.  

Implementation strategies to ensure that services for adolescent health and well-being are high quality 

  1. Develop a shared understanding of adolescent health and the need to improve the quality of health services for adolescents in the context of national quality improvement efforts.  

  2. Develop and implement national quality standards and monitoring systems in line with the WHO and UNAIDS Global standards for quality health-care services for adolescents.  

  3. Implement e-standards to automate data collection and analysis and use information technology to facilitate adolescents’ feedback to facilities.  

  4. As part of a robust quality improvement programme, establish performance-based incentives (financial and non-financial) to stimulate achievement of performance measures for adolescent health care. 

  5. Establish local, subnational and national learning platforms for quality improvement. 

  6. Implement context- and condition-specific models of the transition from paediatric to adult care of adolescents with chronic conditions to ensure therapeutic continuity, maintenance of good clinical outcomes and promotion of adolescent autonomy, empowerment and well-being. 

Implementation strategies to expand service delivery models that maximize coverage  

  1. Improve primary- and referral-level care capacity to deliver integrated, adolescent-centred services.  

  2. To ensure UHC, invest in well-child, well-adolescent visits for health promotion, prevention, anticipatory guidance and care interventions. 

  3. Implement and strengthen comprehensive SHS (school-based and school-linked) and their linkages with the health care system  

  4. Invest in telehealth consultations for adolescents.  

  5. Explore the potential of digital and mass communication platforms, including radio, television, mobile phones and the internet, to provide information through social and digital media, helplines, text messaging for health education and appointment reminders and online prescriptions.  

  6. Conduct regular assessments of services delivered through digital technology and mobile phones before they are expanded or before current care models are replaced.  

  7. Invest in “activated adolescent patients”, which is defined as having “the skills and confidence that equip patients to become actively engaged in their health care”.  

  8. Engage community health workers in reaching adolescents, especially those out of school, with health education and services.  

  9. Establish national and subnational mechanisms for formal engagement of NGOs in service delivery on behalf of the government in order to strengthen community-based platforms for service delivery and to reach underserved populations of adolescents in coordination with other health care providers.  

 

Make age- and sex-disaggregated data on adolescents visible in the HMIS 

National health management information systems rarely report data specific to adolescents. Even when these data are captured at the facility level, the reported data are often aggregated with data from other age groups as they move up from facility to district or national level. Age- and sex-disaggregated data on adolescents are rare in countries that most need them, that is, those with large adolescent populations, high adolescent disease burdens and relatively weak infrastructures. Instead, data are typically compiled in ways that obscure adolescents’ particular experiences, for example, using 5–14 year, 15–24 year and 15–49 year age bands.

Chapter 6 describes approaches to measurement, monitoring, evaluation and research on adolescent health and well-being across all well-being domains and across all types of programmes. In this section we cover only actions by the health sector.

Implementation strategies for adolescent-responsive health management and information systems 

  1. Identify and respond to specific weaknesses in national data collection systems, including a review of sources and mechanisms for data collection of impact, outcome, output, process and input indicators. 

  2. Improve the capacity of national and subnational statistics agencies to report regularly on the health, development and well-being of adolescents. At a minimum, data should be disaggregated by age and sex, and wherever possible other relevant stratifiers should be included. 

  3. Implement participatory monitoring approaches to engage adolescents themselves in designing M&E systems that captures their perspectives (on, for example, service quality and policy implementation) and to ensure that mechanisms are in place to hear the voices of young adolescents (10–14 years).  

  4. Ensure that facility data collection and reporting forms allow for an explicit focus on adolescents (including young adolescents), cause-specific utilization of services and quality of care.  

  5. Ensure that district and national reports address adolescents, including cause-specific utilization of services and quality of care. 

  6. Develop national capacity to conduct standardized surveys on key adolescent behaviours and social determinants, and conduct such surveys at regular intervals. Examples include the Global School-Based Student Health Survey, the Global Youth Tobacco Survey and the Health Behaviour in School-Aged Children survey.  

  7. Ensure that data collection systems cover out-of-school adolescents. 

  8. Develop national capacity to conduct standardized surveys to monitor inputs, processes and outputs of national school health programmes. 

  9. Increase the availability of disaggregated data and information to expose inequities. Use data to plan remedial actions. 

  10. Strengthen the capacity to conduct qualitative research to understand the underlying causes of trends.  

  11. Synthesize and disseminate the evidence base for action.  

To find out more about implementation strategies to achieve universal health coverage through adolescent-responsive health systems, read the AA-HA! full document.

5.3.2 Education

Why are actions by the education sector important for adolescent well-being?

Good health, nutrition and well-being are essential to maximize educational potential. Healthy, well-nourished, happy children and adolescents learn better and are more likely to lead healthy and fulfilling lives. The education sector is well-placed to deliver on this potential: 

  • The global progress in primary and secondary school enrolment since 2000 offers an unparalleled opportunity to reach many more adolescents with essential information and services.
  • Students spend an average of 7590 hours in the classroom over eight to 10 years during primary and lower secondary school. This prolonged contact offers opportunities for schools to contribute to better health and well-being in various ways.
  • Going beyond health promotion, schools can link students to health care services when needed. 

The school system represents an exceptionally cost-effective platform for such an investment. However, health promotion is not yet fully embedded in education systems. This is why WHO, UNESCO, UNICEF and other agencies promote a vision for education in which schools and the larger education community must be transformed to become more responsive to the health needs of learners and to ensure that their rights to health and well-being are met. WHO and UNESCO have developed global standards for health-promoting schools that provide a framework to help governments embed healthy development and nutrition in education systems. 

Implementation strategies to strengthen the education sector’s role in adolescent health and well-being 

1. Reinforce intersectoral coordination among government and stakeholders.

Establish structures and processes to facilitate and implement communication and coordination within and among all relevant sectors (education, health, social services and agriculture), local and national government departments and development partners. Establish a committee with a clear structure, roles and responsibilities for HPS that represents the major stakeholders. 

2. Develop or update the school health policy.

Review and update existing policies, strategies and plans for school health and well-being, following a systematic multistakeholder consultative process to identify, define and prioritize health and education needs and set targets, including how HPS can address them.

3. Strengthen school leadership and governance practices.

Define and implement an inclusive model of school leadership for HPS and a governance structure with representatives of the students, school management, the community and subnational and national government. 

4. Allocate resources.

  • Establish mechanisms for predictable and sustainable financing of school health programmes. 
  • Identify domestic resources that can be dedicated to supporting long-term and predictable financing of school health programmes.
  • Maximize investments by using available resources, including staff, information and infrastructure, and
    by exploiting synergies between various projects.
  • Embed flexibility in the use of national funds for health promotion in the form of grants and other mechanisms that schools can access according to their needs and contexts. 

5. Use evidence-informed practices.

Generate context-specific evidence to inform the initial design, continuous update and M&E of all HPS activities. Support a culture of evidence generation and sharing by routinely facilitating research and evaluation of HPS activities and establishing communities of practice or information-sharing networks for school communities and stakeholders. 

6. Strengthen partnerships between school and community.

Maintain an active partnership between school and community (for example, community members, local businesses, health services), with formal, well-documented and regularly reviewed roles, responsibilities and accountability for contributions to collaborative activities.

 

7. Invest in school infrastructure.

Establish national infrastructure requirements for maintenance of school physical and social–emotional environments in line with international guidelines. Support local government, school leaders and communities in maintaining and improving existing infrastructure to meet requirements.

8. Develop the curriculum and associated resources and ensure its implementation.

Develop, review and implement the curriculum (including content and pedagogy) and associated resources (for example, assessment tools, sample lesson plans, audio-visuals) to promote health and well-being in all subject areas.

9. Ensure inclusion of health and well-being in teacher training and professional learning.

Ensure inclusion of students’ health and well-being and principles of HPS in pre-service teacher education, professional learning for in-service teachers and graduate and in-service teacher standards and certification. 

10. Ensure access to comprehensive SHS.

Deliver comprehensive SHS in line with the WHO guideline, based on formal agreement between schools (or local education departments) and health service providers. Ensure competency-based professional education and development of school health personnel. 

11. Involve students.

Include students on school councils and governance boards and on school health/HPS design teams, along with parents, caregivers and local community members, and create equal opportunities for all students to be ethically and meaningfully involved in the governance, design, implementation and evaluation of school health/HPS programmes.

12. Involve parents, caregivers and the community.

Include parents, caregivers and representatives of the local community on the school council or governance board and on HPS design teams. Create opportunities for parents, caregivers and local community members to participate meaningfully in the governance, design, implementation and evaluation of school health/HPS programmes.

13. Monitor and evaluate.

Design, develop and share practices and tools for local, subnational and national approaches to collecting, storing and analysing data, generating reports, disseminating findings and adapting school health/HPS programmes accordingly.

To find out more about approaches to multisectoral action, read the AA-HA! full document. 

See also the additional resources school health

 

 

 

5.3.3 Social protection

Why are actions by the social protection sector important for adolescent health and well-being? 

Government-led social transfers have positive and significant impacts on adolescents’ school attendance and enrolment and on food security and nutrition. They also have a protective, negative impact on unpaid labour, as well as a potential to delay sexual debut and reduce the prevalence of multiple sexual partners. Depending on context, they have a short-term protective effect against early marriage, with an increase in the age of marriage, a reduction in migration for marriage and a positive effect on mental health outcomes. 

 

Implementation strategies for social protection 

  1. Scale up general social protection and antipoverty coverage so that more adolescents in poor and vulnerable households are covered.
  2. Expand coverage to include adolescents – for example, by raising age cutoffs on eligibility for child grants. Improve the adolescent-responsiveness of social protection programmes by exploring how payment schedules and modalities might be adapted to improve adolescent outcomes. 
  3. Strengthen civil registration programmes to ensure that adolescents have legal identity documents to claim benefits for which they are eligible. 
  4. Design programme components to respond to adolescent-specific vulnerabilities, including increasing transfer amounts to households with adolescents to offset the opportunity costs of attending school; and strengthening linkages between social protection and health services to address SRH and other needs. 
  5. Implement conditional and unconditional cash transfer programmes that create incentives to increase specific health-promoting behaviours (for example, nutrition, school attendance, medical check-ups and vaccinations).
  6. Invest in gender-transformative cash-plus approaches, which support programme beneficiaries and their families with cash while also linking them to programming, including health and social information and services. 
  7. Design demand-side interventions to increase adolescents’ use of health services, which may include reimbursing user fees and the costs that adolescents incur for transportation. 
  8. Increase the portability of social protection benefits so that health coverage is more responsive to the needs of increasingly mobile populations of older adolescents and young adults, who also may change employers frequently. 
  9. Tailor health and nutrition interventions to the developmental needs of adolescents at various ages, for example, ensure that in-kind transfers to improve nutrition take into consideration recommended calorific intake for adolescent boys and girls. 
  10. Invest in more research to understand the sustainability and impacts of integrated social protection programming (“cash-plus”) and other social protection interventions.

To find out more about implementation strategies for social protection, read the AA-HA! full document. 

 

 

 

5.3.4 Criminal justice system

Why are actions in criminal justice systems important for adolescent health and well-being? 

  1. More than one million children worldwide are deprived of their liberty by law enforcement officials.Most have committed petty crimes or minor offences such as truancy, begging or alcohol use. Often, children who engage in criminal behaviour have been used or coerced to do so by adults.
  2. Even one day in detention and incarceration has a devastating impact on a child’s physical, emotional and mental development.
  3. Child victims of crime have little knowledge of their rights. And they are often dependent on the adults around them to bring violators to justice. 

Implementation strategies for a child-friendly criminal justice system 

  1. Put in place programmes for prevention of offenses by children, including early interventions for children below the minimum age of criminal responsibility.
  2. Establish a minimum age of criminal responsibility that recognizes the evolving nature of maturity and the capacity for abstract reasoning in adolescence.  
  3. If there is no proof of age and it cannot be established whether the child is below or above the minimum age of criminal responsibility, give the child the benefit of the doubt and do not hold the child criminally responsible.  
  4. Establish comprehensive child justice systems with specialized units within the police, the judiciary system, the court system and the prosecutor’s office, as well as specialized services such as probation, counselling or supervision and specialized defenders or other representatives who provide legal or other appropriate assistance to the child. 
  5. Apply child justice systems to all children above the minimum age of criminal responsibility but below the age of 18 years at the time of commission of the offence. Extend this protection to children who were below the age of 18 at the time of the offence but who turn 18 during the trial or sentencing process. 
  6. Ensure systematic and continuous multidisciplinary training for all professionals involved in the child judiciary system on a variety of relevant topics, e.g. the social and economic causes of crime; the physical, psychological, mental and social development of children and adolescents; the special needs of the most marginalized children such as children in minority or indigenous groups.
  7. Avoid judicial proceedings for children above the minimum age of criminal responsibility by giving preference to diversion.
  8. Develop the competencies of police officers and prison staff to identify mental health problems and provide timely, culturally appropriate first-line care to these children. 
  9. When judicial proceedings are necessary, apply the principles of a fair and just trial and provide ample opportunities to apply social and educational measures and to strictly limit the use of deprivation of liberty, from the moment of arrest, throughout the proceedings and in sentencing.
  10. Put in place safeguards against discrimination from the earliest contact with the criminal justice system and throughout the trial, and institute active redress mechanisms if discrimination occurs against any group of children. 
  11. Enact legislation and ensure practices that safeguard children’s rights from the moment of contact with the system, including at the stopping, warning or arrest stage, while in custody of police or other law enforcement agencies; during transfers to and from police stations, places of detention and courts; and during questioning, searches and the taking of evidentiary samples. 
  12. Ensure that child rights to effective participation in judicial proceedings are upheld.
  13. Ensure children’s access to legal representation and to other appropriate assistance and support by a parent, legal guardian or other appropriate adult during questioning.  
  14. Take measures to ensure that deprivation of liberty is used only as a measure of last resort. In the minority of cases, when deprivation of liberty is deemed necessary, it should be conducted in accordance with the principles and procedural rights stipulated by the Committee of the Rights of the Child. 
  15. Children with developmental delays or neurodevelopmental disorders or disabilities (for example, autism spectrum disorders, fetal alcohol spectrum disorders or acquired brain injuries) should not be in the child justice system at all, even if they have reached the minimum age of criminal responsibility. If not automatically excluded, such children should be individually assessed.
  16. Systematically collect disaggregated data and ensure regular evaluations of national child justice systems, preferably carried out by independent academic institutions.

 

To find out more about implementation strategies for social protection, read the AA-HA! full document. 

 

 

 

5.3.5 Labour

Why are actions by the labour sector important for adolescent well-being? 

Employment is a strong determinant of health, manifested through income-mediated mechanisms such as the opportunity to live in wealthier (that is, often, safer, cleaner, greener) neighbourhoods, access to quality childcare and schooling, access to more nutritious food and through direct advantages such as better health insurance, safer work, injury insurance and access to workplace wellness programmes. 

Insecure employment, for example, informal or casual employment, is typical of employment patterns for many young adults and may contribute to psychological stress and mental illness. For both men and women, there is a strong positive association between the proportion of informal work in the country and DALYs for all diseases. Young adults are at a greater risk of work-related injuries than older workers, and young women are also at increased risk of unwanted sexual advances, physical contact, verbal suggestions or other forms of sexual harassment at their workplace. 

Failure to find stable, safe employment after leaving school can have lasting effects on future occupational patterns and income.  

Even when employed, older adolescents and young adults are less likely than older workers to have decent jobs.  

Implementation strategies for decent jobs for youth 

  1. Continue youth employment measures put in place during the COVID-19 pandemic (for example, training bonuses) with broader policy support and recovery strategies, including demand-side policies to increase the number of decent work opportunities that are available to young people.  
  2. Implement youth employment policies following internationally recognized good practices.  
  3. In collaboration with the social protection sector, contribute to the design, implementation and evaluation of youth labour policies that provide retraining and support for job-seeking, as well as schemes for income security to protect young adults from being disproportionally affected by unemployment.   
  4. Monitor the impact on youth psychosocial and physical health of labour market transformation driven by new technologies and the growing prevalence of flexible, temporary and irregular work among young workers, long working hours and blurred boundaries between home and work; and mitigate negative health and safety implications of new work practices.  
  5. Set up public–private partnerships to combat child labour in countries and sectors where a large number of children are working (for example, farming) by enhancing coordination with national child-labour committees and supporting the development and extension of community-based monitoring systems.  

To find out more about implementation strategies for social protection, read the AA-HA! full document. 

 

 

 

5.3.6 Telecommunications

Why is telecommunications important for adolescent well-being?  

Today, adolescents spend an increasing part of their lives online. Since 2011 the number of 12- to 15-year-olds who own smartphones has increased by more than 50%. With 69% of young people online in 2019, and one in every three children with internet access at home, the internet has become an integral part of adolescents’ lives.  

The digital environment offers tremendous benefits and opportunities to adolescents:

  • opening new channels for education, creativity and social interaction
  • facilitating daily interactions
  • maintaining links to culture, socializing, expressing oneself and one’s identity through the creation of digital content, engagement with political issues and as consumers 

But the digital world also holds serious risks, including cyberbullying, extortion and risks to privacy. Children and adolescent might be more vulnerable than adults to content, contact and conduct risk, as well as risks to them as consumers from unsafe products and breaches of digital security, data protection and privacy. Those who are more vulnerable offline are also more vulnerable online. Correspondingly, protective offline factors can also reduce exposure to online risks. 

 

Implementation strategies for adolescents’ digital world 

  1. Develop an inclusive, multistakeholder national child online protection strategy that aims to ensure a safe, inclusive and empowering digital environment. The strategy should be fully integrated with policy frameworks relevant to children’s rights and complement national child protection policies by offering a framework for all risks and potential harms for children in the digital environment. 
  2. Address online risks by implementing the following policy actions: 

Child rights 

  • For more consistent enforcement of protection from online abuse, standardize the definition of a child as anyone under the age of 18 in all legal documents.
  • With children’s participation, build on and collaborate with independent human rights institutions for children to ensure children’s protection online, through application of specialized expertise, investigation and monitoring, promotion, awareness raising, and training and education. 
  • Consult directly with children on the development, implementation and monitoring of any child online protection framework or action plan. 

Legislation 

  • Review the existing legal framework to see that all necessary legal powers exist to enable and assist law enforcement and other relevant actors to protect persons under the age of 18 from all types of online harms on all online platforms. 
  • Establish that any illegal act against a child in the real world is also illegal online.
  • Ensure that the online data protection and privacy rules for children are adequate. 
  • Align legal frameworks with existing international standards, laws and conventions related to children’s rights and cybersecurity, facilitating international cooperation through the harmonization of laws. 

Law enforcement 

  • Ensure that cases of children who harm others online are dealt with in line with child rights principles strongly favouring approaches other than the application of criminal law. 
  • Provide appropriate financial and human resources, as well as training and capacity-building, to fully engage and equip the law enforcement community. 
  • Ensure international cooperation among law enforcement agencies around the world, enabling quicker response to online-facilitated crimes. 

Regulation 

  • Consider the development of a regulatory policy. 
  • Place an obligation on businesses to undertake due diligence regarding child rights and to safeguard their online users. 
  • Establish monitoring mechanisms for the investigation and redress of children’s rights violations, with a view to improving the accountability of information and communication technology (ICT) companies and other relevant companies. 
  • Strengthen regulatory agency responsibility for the development of standards relevant to children’s rights and ICTs. 

M&E

  • Establish a multistakeholder platform to steer the development, implementation and monitoring of the national digital agenda for children. 
  • Develop time-bound goals and a transparent
    process to evaluate and monitor progress and ensure that the necessary human, technical and financial resources are made available for the effective operation of the national child online protection strategy and related elements. 

ICT industry 

  • Engage the industry in the process of developing child online protection laws and agreed metrics to measure all relevant aspects of child online safety. 
  • Establish incentives and remove legal barriers to facilitate the development of standards and technologies to combat content risks for children. 
  • Encourage industry to adopt a “safety and privacy by design” approach to their products, services and platforms, recognizing respect for children’s rights as a core objective. 
  • Ensure that the industry uses rigorous mechanisms to detect, block, remove and proactively report illegal content and any abuse (classified as criminal activity) of children. 
  • Ensure that the industry provides suitable and child-friendly reporting mechanisms for their users to report issues and concerns, including help finding further support.
  • Collaborate with industry stakeholders to promote awareness of hazards and correct problems with existing products and services. 
  • Support the industry to provide age-appropriate, family-friendly tools to help their users better protect their families online. 

Reporting 

  • Establish and widely promote mechanisms to easily report illegal content found on the internet. 
  • Establish a national helpline regarding online risks and harms or a child-friendly hotline/helpline specifically for victims themselves. 
  • Establish safe and easily accessible child-sensitive counselling, reporting and complaint mechanisms. 
  • Social services and victim support
  • Ensure that universal and systematic child protection mechanisms are in place that oblige all those working with children (for example, social workers, health care professionals and educators) to identify, respond to and report any sort of harm to children that
    occurs online. 
  • Ensure that social services professionals are trained for both preventative action and response to online harms to children, identifying child abuse and providing adequate specialized and long-term support and assistance for child victims of abuse. 
  • Develop child abuse prevention strategies and measures based on scientific evidence. 
  • Provide appropriate human and financial resources to ensure the full recovery and reintegration of victimized children and to prevent re-victimization. 
  • Ensure that children have access to adequate health care (including care for mental health as well as physical well-being) in the event of victimization, trauma or online abuse. 

Data collection and research 

  • Invest in and align the development and M&E of frameworks and activities. 
  • Undertake research with the spectrum of national actors and stakeholders to determine their opinions, experiences, concerns and opportunities with regard to child online protection. 

Education 

  • Ensure that educators and school administrators are trained to identify and adequately respond to suspected or confirmed cases of online child abuse. 
  • Develop a broad digital literacy programme
    to ensure that children can fully benefit from the
    online environment, are equipped to identify
    threats and can fully understand the implications
    of their behaviour online. Such a programme can
    be built upon existing educational frameworks.
    It should be age-appropriate and focused on skills and competencies.
  • Develop digital literacy components as part of the national school curriculum that are age-appropriate and applicable to children from an early age. 
  • Create educational resources outside the school curriculum that emphasize the positive and empowering aspects of the internet for children and promote responsible online behaviour. 
  • Avoid fear-based messaging. 
  • Consult children, as well as parents and carers, on the development of online educational programmes, tools and resources. 

National awareness and capacity

  • Develop national public awareness campaigns tailored to various groups (for example, parents, social media users, industry). These campaigns can address the wide range of issues related to the digital environment.
  • Enlist public institutions and mass media in the promotion of national public awareness. 
  • Harness global campaigns, as well as multistakeholder frameworks and initiatives, to build national campaigns and strengthen national capacities for child online protection.

 

To find out more about implementation strategies for telecommunication sector, read the AA-HA! full document. 

 

 

5.3.7 Roads and transportation

Why are actions by the roads and transportation sector important for adolescent health and well-being?  

Over 500 children and adolescents under the age of 18 years are killed on the world’s roads each day, and thousands more are injured. Road traffic injury is a leading killer of adolescents, and the vast majority (95%) of child road traffic fatalities are in LMICs. Limited by their physical, cognitive and social development, younger adolescents are more exposed to risk in road traffic than adults due to poorer perception of the proximity, speed and direction of moving vehicles. Older adolescents may be more prone to taking risks, such as speeding when driving.  

The roads and transportation sector has an important role to play since most road traffic injuries to young people are preventable by child- and adolescent-specific measures directed at speed management, supervision, infrastructure design and improvement, enforcing vehicle safety standards, traffic regulation laws and prompt trauma-response measures after a crash. 

Implementation strategies for improved road safety 

Speed management 

Implement low-speed zones (30 km/hr limits) around schools and other locations where many children are walking. Apply traffic-calming road designs (for example, road narrowing, speed bumps, signalized crossings). Enforce speed limits with measures such as automatic speed cameras. 

Leadership on road safety 

  • Improve data collection to advocate and inform effective policies and to target interventions. Collect data to identify high-risk areas where children are exposed to high-speed traffic and where safety infrastructure (such as fences, guard rails, sidewalks, bicycle lanes) is lacking. 
  • Ensure collaboration among, and build coalitions with, concerned institutions and stakeholders and across diverse sectors (for example, education, health, local government, transport and police) to improve protection for children on the roads. 
  • Engage schools and students in road safety policy decision-making. 
  • Establish supervision schemes, with the involvement of parents, teachers and caregivers, to protect children on the roads, particularly in poorer communities and in complex and risky road environments. Establish partnerships among communities, schools and the police to manage school crossing patrols and “walking-bus” initiatives (in which several adults accompany a group of children walking to school), particularly when parents are at work and unable to supervise children. 

Infrastructure design and improvement 

Prioritize provision of safe infrastructure (for example, sidewalks, safe crossings, traffic calming measures, speed bumps) to protect children going to and from school. Design or reconfigure the built environment in schools and densely populated neighbourhoods to prioritize pedestrians and cyclists as part of policies to promote child health and tackle obesity.

Vehicle safety standards 

Improve vehicle safety for child passengers by applying the UN minimum safety regulations to new vehicles and including safety features such as ISOFIX child restraint anchorage points. Promote consumer awareness and demand for higher standards of safety for all car occupants, including children. 

Enforcement of traffic laws 

  • Strengthen and enforce laws requiring the use of child restraints in cars and trucks and wearing helmets while riding two-wheeled or other open vehicles. Institute laws and regulations to ensure that school buses have seatbelts and that school vehicles are safe, as well as enforcing speeding and drink–driving legislation.
  • To promote public support for road safety enforcement, use communication and social marketing strategies focused on the need to protect children. 

Survival after a crash 

Improve trauma response to the needs of children, including training teachers and school transport drivers in safe immediate stabilization of injuries. Equip emergency vehicles with child-sized medical equipment and supplies and improve paediatric-specific rehabilitation services for children.

To find out more about implementation strategies for roads and transportation, read the AA-HA! full document. 

 

 

 

5.3.8 Housing, urban and industrial parks planning

Why are actions by the housing, urban planning and industrial park planning sectors important for adolescent well-being?  

More than ever before, young women and men are flocking to cities. It is expected that by 2030 as many as 60% of all urban dwellers will be under the age of 18. Despite this, young people have little voice in urban decision-making and face major obstacles to education, employment and safety in cities.  

In LMICs many youth work in industrial parks, especially in agro-food parks. Usually on the outskirts of cities, industrial parks are geographical areas zoned for industrial and business use “developed and subdivided into plots according to a comprehensive plan with or without built-up factories, sometimes with common facilities for the use of a group of industries”. While they can provide decent employment opportunities for youth, they can also put them at risk if safety nets are not in place and age-appropriate services are lacking. This is because many youth workers in industrial parks are migrants living apart from their families, with limited social networks to provide support and guidance. 

Implementation strategies for adolescent-friendly urban planning 

1. Ensure formulation of a national or city urban youth strategy, which encompasses skills development, creation of decent jobs and livelihoods for youth, sports and recreation. Employ a participatory process that gathers youth perspectives on urban planning to inform such a strategy.

2. Ensure that planning, designing and building industrial parks involves youth and addresses youth-specific needs, such as vocational training opportunities, age-adjusted labour conditions, occupational health and safety and meaningful participation in making decisions that affect them. 

3. Consider the adolescent-specific and gender-responsive aspects of the planning for health in urban and territorial planning and healthy recovery from COVID-19.

4. Ensure basic planning and legislative standards to avoid risk to health.

5. Enforce planning codes that limit or prohibit environments that detract from healthy lifestyles or exacerbate inequality. For example:

  • Restrict “hot food takeaways” near schools;
  • Limit isolated developments accessible only by private car;
  • To reduce youth violence, prevent urban physical degradation.
  • Provide good-quality, low-cost homes for vulnerable families in places with accessible schools and health care facilities.

6. Promote spatial planning that enables healthier lifestyles. For example:

  • Encourage city compactness and development near transport hubs;
  • Provide citywide access to safer walking to enable “walking school buses”.
  • Improve cycling infrastructure and cycle paths to schools with bike racks or bike storage, as well as public transport that is reliable and safe for boys and girls;
  • Improve access to playgrounds and recreational areas for adolescents and assure that they are safe;
  • Create green spaces around schools to provide shade and improve air quality;
  • Ensure women’s and girls’ safe and autonomous access to quality city services, public spaces and all forms of mobility.

7. Ensure urban and territorial processes to capture multiple co-benefits of “building in” health. For example:

  • Improve urban governance through accountable, inclusive, democratic and gender-responsive institutions and systems. Strengthen local institutions to enable women’s and girls’ active and meaningful participation in urban planning, management and governance.
  • Track policy decisions using urban health equity indicators that capture the social determinants of health (for example, percentage of subsidized enrolment in after-school programmes, percentage of youth participating in cultural programmes) to inform promotion of greater urban health equity for youth.
  • Work with multiple partners on systemic, holistic approaches. Examples include: active travel (walking or cycling); “slow city” initiatives, which seek to improve the quality of urban life by slowing its pace, especially in use of spaces and flow through them; age-friendly or child-friendly initiatives; peri-urban, urban and school food systems; as well as regional economic resilience strategies.

To find out more about implementation strategies for Housing, urban and industrial parks planning, read the AA-HA! full document. 

 

 

 

5.3.9 Energy

Why are actions in the energy sector important for adolescent well-being? 

Women and youth face structural disadvantage in the energy sector. Despite these barriers, they continue to develop creative sustainable energy solutions and strive for a more sustainable future. Young women and men are at the forefront of creating innovative approaches and demanding tangible actions from policy-makers and world leaders.  

However, in the energy job market, young people face structural education barriers related to a mismatch between what the education system offers and what the market needs. Also, employers often favour experience over creativity and diversity, which puts youth at a disadvantage. Due to the multiple barriers that young women and girls can face due to their age and gender, they are often exposed to double discrimination in the energy sector.  

Reliance on polluting fuels and technologies is associated with a substantial burden of chores and time loss for children – especially girls. Women and girls are the primary procurers and users of energy in the household, and they bear the largest share of the health and other burdens associated with reliance on polluting and inefficient energy systems. In sub-Saharan Africa household air pollution exposure due to indoor cooking is the single greatest health risk for women and girls. The never-ending job of feeding the stove prevents many girls from attending school and robs them of time for rest and socializing. 

Implementation strategies in the energy sector for adolescents and young people’s health and well-being  

1. Champion youth mainstreaming in Energy Compacts (national commitments to SDG7 – sustainable development) to accelerate a just, inclusive and sustainable energy transition. This can include:

  • Assess and strengthen national and regional ecosystems to promote and support youth empowerment and leadership in the energy sector, including meaningful adolescent and youth participation in policy- and decision-making.
  • Support youth to develop competencies relevant to the clean energy transition and the job markets of tomorrow in the fields of science, technology, engineering and mathematics.
  • Ensure girls’ equal access to relevant technical skills and digital literacy to use essential technology and digital tools for the clean energy transition.
  • Provide equitable access to productive resources, such as finance, technical knowledge, entrepreneurial training, technical skills development and business development services for youth-led enterprises.
  • Enlarge youth participation in the sustainable energy workforce through the provision of career advancement avenues and the increase in entry-level jobs in the energy sector and through training with a youth-centred approach.
  • Provide equal access to affordable financial mechanisms as well as tenders and other business opportunities for women and youth-led enterprises, nonprofit projects and other initiatives – for example, through gender-responsive procurement and budgeting.
  • Put women and youth at the centre of economic recovery. Integrate incentives into programme funding and green recovery packages to encourage employers to employ, retain and advance more women and youth in the clean energy sector.
  • Generate knowledge about and monitor and evaluate implemented measures of youth involvement in the energy sector and the energy transition.
  • Champion diversity, gender equality, women’s empowerment and inclusion in decision-making.

2. Ensure access to clean energy for cooking, heating and lighting in homes, schools and health facilities. Raise awareness of the health benefits of switching to clean energy for cooking, heating and lighting. Disseminate information on how to safely install, manage and maintain improved cooking stoves.

3. Support initiatives to implement energy-efficient public transport and cycle and pedestrian routes. 

Resource bank for adolescents and energy

Resource bank for adolescents and energy

To find out more about implementation strategies for energy sector, read the AA-HA! full document. 

 

 

 

5.3.10 Environment

Approximately 22% of the overall global disease burden can be attributed to environmental risk factors. Therefore, it is vital to address the environmental hazards that negatively affect adolescent health and well-being. Essential interventions include: providing safe drinking water at homes, improving sanitation facilities in schools, enhancing hygiene practices, better waste and toxic substance management, elevating urban and domestic air quality, and reducing the detrimental effects of climate change. These changes require coordinated actions from the energy, environment, transport, agriculture, industry and health sectors.

 

Why are actions by the environment sector important for adolescent well-being?

Schools are ill-equipped to provide healthy and inclusive learning environments for all children. Globally, 29% of schools lack basic drinking water services, which affects 546 million schoolchildren; 28% of schools lack basic sanitation services, affecting 539 million schoolchildren; and 42% of schools do not have basic hygiene services, affecting 802 million schoolchildren. An estimated 367 million children attend a school with no sanitation facilities at all.

Smaller hands, cheaper labour: the crisis of e-waste affects children’s health

An estimated 152 million children 5–17 years of age are involved in child labour, including 18 million children (11.9%) in the industrial sector, which includes waste processing. Some 73 million children worldwide engage in hazardous labour, with unknown numbers in the informal waste recycling sector. Children are particularly vulnerable to some of the toxicants found in, or produced by, e-waste and e-waste recycling activities. 

More than 90% of the world’s children breathe toxic air every day.

Air pollution, including household air pollution, is one of the greatest environmental risks to health. Every day around 93% of the world’s children under the age of 15 years (1.8 billion children) breathe air so polluted that it puts their health and development at serious risk. One billion children under 15 years of age are exposed to high levels of household air pollution, mainly from cooking with polluting technologies and fuels such as wood, charcoal and coal. Air pollution affects neurodevelopment, leading to lower cognitive test outcomes and impaired mental and motor development. 

Children and adolescents are particularly vulnerable to ill health due to exposure to chemicals.

Chemicals such as heavy metals, pesticides, solvents, paints, detergents, kerosene, carbon monoxide and pharmaceuticals cause unintentional poisoning at home and in the workplace. Children are particularly vulnerable to these exposures because of their developing systems and behaviours. Exposure to certain chemicals, such as lead, reduces neurodevelopment in children and increases the risk for attention deficit disorders and intellectual impairments.

Climate change has increased uncertainty about the future for the world’s 1.8 billion young people.

Children and adolescents are more vulnerable to climate and environmental shocks than adults for a number of reasons, including physical and physiological vulnerability. Globally, approximately one billion children under the age of 18 years (nearly half of the world’s children) live in countries with a high-risk Climate Risk Index. 

Young people may be victims of climate change, but they are also valuable contributors to climate action. They are agents of change, entrepreneurs and innovators. Whether in education, science or technology, young people are scaling up their efforts and using their skills to accelerate climate action.

 

Implementation strategies for adolescents’ and children’s health-promoting environment

1. Assess and mitigate the impact of e-waste on children and adolescents. For example:

  • Eliminate child labour and incorporate adult e-waste workers, including youth, into the formal economy with decent working conditions across the value chain of collection, processing, recycling and resale.
  • Ensure the health and safety of young e-waste workers, their families and communities through systems that train and protect workers and monitor exposures and health outcomes, with adolescents’ protection a high priority.
  • Advocate responsible recycling with policy-makers, communities, waste workers and their families.
  • Pursue better data and further research about women, children and adolescents involved with e-waste processing. 
  • Raise awareness of the health risks of e-waste recycling for women and children.

2. Prepare schools for future pandemics and provide disability-inclusive WASH services in schools. For example:

  • Build or upgrade education facilities that are child-, disability- and gender-sensitive 
  • Provide safe and effective learning environments with safe drinking water, sanitation and hygiene services. 

3. Improve air quality and minimize children’s exposure to polluted air and chemicals. For example:

  • Enable and ensure universal use of clean technologies and fuels for household cooking, heating and lighting, including making clean fuels and technologies affordable, available and accessible to low-income families through
    social transfers. 
  • Institute better waste management to reduce the amount of waste that is burned in communities, thus reducing community air pollution.
  • Train health professionals to recognize air pollution as a major risk factor for their young patients, to understand the sources of environmental exposure in their communities, to “prescribe” solutions to air pollution-related problems, such as switching to clean household fuels and devices, and to advocate solutions to policy- and decision-makers
    across sectors.
  • Control lead paint hazards in homes and ensure safe management of chemicals in the home, schools and community.
  • Reduce or prevent adolescents’ exposure to pesticides, toxic household chemicals and chemicals released through poor waste management and improper waste recycling, including e-waste and used lead-acid batteries. 
  • Investigate the health threats, to adolescents and across the life course, of emerging chemicals, such as endocrine-disrupting chemicals.

4. Encourage and support climate action by and for adolescents and children. For example:

  • Develop age-appropriate and engaging multimedia content and interactive features to inform, engage, educate and lead youth climate action.
  • Promote social and behavioural change and support sustainable education and youth-led environmental action with outreach campaigns and public engagement and formal and informal education activities that build knowledge and change attitudes, behaviours and norms to address the indirect drivers of biodiversity loss and the degradation of nature.
  • Enforce standard-setting and eco-labelling schemes to better inform consumers of the effects of products on biodiversity, and promote adolescents’ literacy in eco-labelling.
  • Strengthen environmental digital literacy and e-governance capacities of youth to engage in the environmental dimensions of the digital transformation.
  • Leverage youth activism and amplify youth voices to win support for positive environmental change, reducing and preventing pollution and promoting sustainable, healthier living.
  • Organize with health and education ministries to encourage and support more sustainable living (for example, lifestyle changes that reduce greenhouse gas emissions).

Resource bank for adolescents and environment 

Resource bank for adolescents and environment