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通过变革性公共政策加速青少年的幸福感:行动框架。

Accelerating Well-being for Adolescents Through Transformative Public Policy: A Framework for Action.

机构信息

Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, D.C..

Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, D.C.

出版信息

J Adolesc Health. 2024 Oct;75(4S):S37-S46. doi: 10.1016/j.jadohealth.2024.03.013.


DOI:10.1016/j.jadohealth.2024.03.013
PMID:39293876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11825381/
Abstract

PURPOSE: As governments around the world are shaping policy responses to advance adolescent well-being and protect their rights, the tools and resources to strengthen policy foundations, and ultimately improve their effectiveness, remain limited. This paper proposes a framework to support policy action with an explicit adolescent focus and applies it to two illustrative case studies to unpack the underlying policy conditions for success. METHODS: We develop an analytic framework with an adolescent lens that focuses on the full policy life-course, from development, to implementation, to evaluation. We then choose two illustrative case studies to apply this framework - 1) abolition of secondary school fees policy in Kenya and 2) age of marriage law in Mexico. These cases were chosen based on the existence of rigorous causal evidence of effect, alignment of salience with expert opinions, broad-based implications for adolescents across contexts, and varied levels of success at achieving intended outcomes. RESULTS: Our framework identified six key components as critical foundations for adolescent-focused policies: (1) policy features and costs, (2) implementation considerations, (3) participatory approach, (4) inclusion and coverage, (5) policy appropriateness, and (6) monitoring and evaluation, each with key adolescent-specific elements. We find that the majority of the essential policy elements are addressed in the school fees abolition policy (Kenya), but are sparser in the age of marriage law (Mexico). The results also highlight the lack of decentralized monitoring as well as meaningful adolescent engagement at any level of policy development as potential drivers of ineffectiveness of adolescent-centric policies. DISCUSSION: Our adolescent policy analysis framework can serve as an important tool to define principles in the development of effective adolescent policies. It also can serve as a useful evaluation tool to unpack the 'black box' of policy effectiveness when combined with robustly estimated effects.

摘要

目的:随着世界各地的政府正在制定政策措施,以促进青少年的福祉并保护他们的权利,加强政策基础并最终提高政策效力的工具和资源仍然有限。本文提出了一个框架,以支持以明确的青少年为重点的政策行动,并将其应用于两个说明性案例研究,以剖析成功的潜在政策条件。

方法:我们开发了一个具有青少年视角的分析框架,该框架侧重于政策的整个生命周期,从制定、实施到评估。然后,我们选择了两个说明性案例研究来应用此框架-1)肯尼亚取消中学学费政策和 2)墨西哥婚姻法年龄。选择这些案例是基于存在严格的因果效应证据、与专家意见的一致性、对跨背景青少年的广泛影响以及在实现预期结果方面的不同程度的成功。

结果:我们的框架确定了六个关键组成部分,这些部分是青少年为重点的政策的关键基础:1)政策特征和成本、2)实施考虑因素、3)参与方法、4)包容和覆盖范围、5)政策适宜性和 6)监测和评估,每个部分都有关键的青少年特定要素。我们发现,大多数必要的政策要素都在学费取消政策(肯尼亚)中得到了解决,但在婚姻法年龄(墨西哥)中则较为稀疏。结果还强调了缺乏权力下放的监测以及在政策制定的任何层面上进行有意义的青少年参与,这可能是青少年为中心的政策无效的潜在驱动因素。

讨论:我们的青少年政策分析框架可以作为制定有效青少年政策的重要工具,用于定义原则。当与稳健估计的效果结合使用时,它也可以作为一个有用的评估工具,用于剖析政策有效性的“黑箱”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f67/11825381/de6e517a97c4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f67/11825381/de6e517a97c4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f67/11825381/de6e517a97c4/gr1.jpg

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本文引用的文献

[1]
"We have nice policies but…": implementation gaps in the Ghana adolescent health service policy and strategy (2016-2020).

Front Public Health. 2023

[2]
Re-orientating systematic reviews to rigorously examine what works, for whom and how: Example of a realist systematic review of school-based prevention of dating and gender violence.

Res Synth Methods. 2023-7

[3]
Framing and the formation of global health priorities.

Lancet. 2022-5-21

[4]
Between Rhetoric and Reality: Learnings From Youth Participation in the Adolescent and Youth Health Policy in South Africa.

Int J Health Policy Manag. 2022-12-19

[5]
Impact of Free/Subsidized Secondary School Education on the Likelihood of Teenage Motherhood.

Demography. 2021-8-1

[6]
The role of evaluation in iterative learning and implementation of quality of care interventions.

Glob Health Action. 2021-1-1

[7]
Policy foundations for transformation: a gender analysis of adolescent health policy documents in South Africa.

Health Policy Plan. 2021-6-3

[8]
A critical discourse analysis of adolescent fertility in Zambia: a postcolonial perspective.

Reprod Health. 2021-4-6

[9]
Adolescent health in the Sustainable Development Goal era: are we aligned for multisectoral action?

BMJ Glob Health. 2021-3

[10]
20 Years of the Evidence Base on What Works to Prevent Child Marriage: A Systematic Review.

J Adolesc Health. 2021-5

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