ISLAMABAD: Though today there are 1.8 billion young people, the largest population of adolescents and young adults in human history across the globe, health services for this group are fragmented, poorly coordinated and uneven in quality. The wellbeing of the group is critical for the success of the Sustainable Development Goals and a sustainable future.

This has been revealed in a global study — Adolescent Health and Wellbeing: Current State of the Evidence —published as a series of articles in the Journal of Adolescent Health. The three-year review is written by eight Aga Khan University (AKU) researchers alongside academics from Canada, Australia, the United Kingdom and India.

The authors assessed the performance of adolescent health initiatives around the world in six key areas and found that health systems in the rich, middle income and poor countries were more geared towards adults and young children rather than adolescents.

Adolescence is a critical stage of life accompanied by rapid physical, emotional and social development. The need for interventions to boost youth health is particularly important since one in four people around the world is between the age of 10 and 24 years and represents a future adult — at a time of unparalleled economic and social change.

In 2012, 1.3 million young people lost their lives from preventable or treatable causes, “an unacceptable rate of mortality”. In South Asia, the odds of dying as a young person are almost two times higher than in other regions. This is particularly worrying for a Pakistan undergoing a youth bulge, where four out of 10 citizens are under the age of 18, according to Unicef.

Founding Director of the AKU’s Centre of Excellence in Women and Child Health Professor Zulfiqar Bhutta in a statement said: “Good adolescent health can result in a ‘triple dividend’ for society since healthy youngsters possess the physical and mental attributes to fully achieve their potential, live a healthier adult life and give birth to healthier children.

“Only by fully engaging and supporting our young people can Pakistan achieve its full economic potential. We need to understand the areas where interventions are working and highlight the areas where there are knowledge gaps, to deliver the knowledge that gives policymakers the evidence to enact change.”

The review authors analysed programmes and interventions in the vital areas of immunisation nutrition, mental health, substance abuse, sexual and reproductive health and injury prevention. Worryingly, they noted a number of areas where no research was available to inform health policy and suggested new research strategies to meet these needs.

Immunization programmes are not being evaluated and where they are, the focus is on young children rather than adolescents. There is a need for research on why adolescents miss being vaccinated and for integrated interventions where governments, schools and mobile healthcare workers can support the goal of protecting young people from preventable disease.

Reviews of nutrition programmes highlighted the severe problem of under-nutrition, with pregnant adolescent still-growing girls most at risk. Encouragingly, micronutrient supplements are helping decrease the prevalence of anemia leading to better birth outcomes. The authors called upon the academic community to pay greater attention to the problem of obesity in low and middle income countries and to investigate the association between better nutrition and improved learning skills and productivity.

Research on drug abuse found that school-based initiatives had delivered results, but most studies centered on the use of cognitive behavioral therapy (where people are encouraged to change their thinking patterns about issues).

Published in Dawn, September 23rd, 2016