Research Scientist, Department of Sexual and Reproductive Health and Research, World Health Organization/Human Reproduction Programme, Geneva, Switzerland.
Independent Expert, Geneva.
Sex Reprod Health Matters. 2020 Dec;28(1):1741495. doi: 10.1080/26410397.2020.1741495.
This commentary is in response to a paper published in the Lancet entitled: "Progress in adolescent health and well-being: tracking 12 headline indicators for 195 countries and territories, 1990-2016" (Peter Azzopardi et al, 2019). We agree with the authors' overall conclusions that although there has been progress in some health outcomes, health risks and social determinants, the situation has worsened in other areas. Other important messages emerge from studying the data with an adolescent sexual and reproductive health and rights (ASRHR) lens. First, notable - albeit uneven - progress in all the ASRHR indicators has occurred in multi-burden countries. Second, while we cannot assign a cause-effect relationship, it is reasonable to suggest that in addition to secular trends, deliberate global and national investment and action have contributed to and/or accelerated these changes. Third, progress in ASRHR in the multi-burden countries contrasts sharply with increases in rates of tobacco use, binge drinking and overweight and obesity, in all categories of countries. Based on these observations, we submit five implications for action: the adolescent health community must recognize the progress made in ASRHR; acknowledge that increasing investment and action in ASRHR has contributed to these tangible results, which has the potential to grow; build on the gains in ASRHR through concerted action and a focus on implementation science; expand the adolescent health agenda in a progressive and strategic manner; and contribute to wider efforts to respond to adolescents' health needs within the rapidly changing context of the worlds they live in.
这篇评论是对发表在《柳叶刀》上的一篇题为“青少年健康与福祉的进展:追踪 195 个国家和地区 1990-2016 年的 12 项主要指标”的论文的回应(Peter Azzopardi 等人,2019 年)。我们同意作者的总体结论,即尽管在一些健康结果、健康风险和社会决定因素方面取得了进展,但在其他领域情况却恶化了。从青少年性与生殖健康和权利(ASRHR)的角度研究这些数据,还会得出其他重要信息。首先,在多负担国家,所有 ASRHR 指标都出现了显著(尽管不均衡)的进展。其次,尽管我们不能确定因果关系,但可以合理地认为,除了长期趋势外,全球和国家的刻意投资和行动也促成了这些变化,或者加速了这些变化。第三,多负担国家的 ASRHR 取得了进展,而所有国家的青少年吸烟、狂饮和超重及肥胖率都在增加。基于这些观察结果,我们提出了五项行动建议:青少年健康界必须认识到在 ASRHR 方面取得的进展;承认增加对 ASRHR 的投资和行动有助于取得这些切实成果,这有可能进一步扩大;通过协调行动和注重实施科学,在 ASRHR 方面取得的成果的基础上再接再厉;以渐进和战略性的方式扩大青少年健康议程;并为更广泛地应对青少年在其生活世界迅速变化的背景下的健康需求做出贡献。
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