Adolescent and Young Adult Health
The Adolescent and Young Adult Health Unit (AYH) leads and coordinates WHO-wide efforts to improve the health and well-being of adolescents and young adults.
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Implementation guidance and case studies

Comprehensive programmes

This policy brief, prepared by the European Observatory on Health Systems and Policies (the Observatory) in collaboration with international experts, was commissioned by the Federal Office of Public Health of Switzerland. It explores how to improve access to health promotion and preventive services for vulnerable children and adolescents through a literature review and case studies of five selected European countries (Finland, Germany, the Netherlands, Portugal and the United Kingdom (England)).

This guidance is primarily aimed at policy makers and managers responsible for designing and managing health and wellbeing services for children and adolescents, and health and non-health care providers.

Adolescents are not simply old children or young adults. This deceptively simple observation lies at the heart of Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation, which reflects the coming of age of adolescent health within global public health.

The goal of the project is to protect the health and well-being of students and school personnel through:

  1. prevention and control of chemical exposure; and
  2. promotion of chemical safety.

The objectives of the study are to:

  • conduct a systematic assessment to help the school administration identify the available and needed resources needed for chemical safety;
  • establish an action plan for chemical safety in schools;
  • prepare an information, education and communication (IEC) plan; and
  • develop training modules on chemical safety to capacitate teachers and school personnel.

The purpose of this manual is to assist countries in planning, organizing and facilitating the process of developing national comprehensive multisectoral adolescent health strategies and plans aligned with the AA-HA! guidance. The manual describes an approach that was tested in several countries but is not intended to be prescriptive as processes should be adapted to suit the needs of the country or programmes where the approach is being used.

 

Environmental health

This brochure summarizes the process, outcomes and key findings of the children’s environmental health indicator projects implemented as part of the global initiative on Children’s Environmental Health Indicators. Discussions took place at the Children’s Environmental Health Indicators (CEHI) workshop “Children’s Environmental Health Indicators: Five Years After the Global Commitment at the World Summit on Sustainable Development” in Tunisia in 2008.

Climate change and health

COP26 Campaign aims - Bringing countries together to tackle shared climate challenges and accelerate progress towards a zero emission, resilient global economy.

Ear and hearing care

This publication: Vision and hearing screening for school-age children, implementation
handbook provides practical guidance to support the establishment of sensory
screening programmes for school-age children. 

Equity

This handbook for conducting an adolescent health services barriers assessment (AHSBA) with a focus on disadvantaged adolescents outlines how governments can assess health service equity and barriers at national and subnational levels in order to identify which adolescents are being left behind, and why. The handbook’s three objectives are:

  • To build in-country capacity to identify barriers which prevent disadvantaged adolescents from having effective coverage with health services;
  • To trigger remedial action to address the barriers in order to promote high levels of programme performance and more equitable health outcomes among adolescents;
  • To catalyze integration of a focus on who is being left behind and why into ongoing country-level monitoring and evaluation (M&E) of health services for adolescents

 

The Innov8 technical handbook is a user-friendly resource as part of the Innov8 approach for reviewing national health programmes to leave no one behind.

It gives detailed guidance and exercise sheets for each of the 8 steps of analysis that comprise the review process and includes background readings, country examples and analytical activities.

WHO encourages the adaptation of exercises and activities to best match the national and programmatic context, and align with ongoing national programmatic review and planning processes.

 

HIV

Specifically, this brief collates existing interventions via a scoping review; assesses key interventions through a realist evaluation lens, identifying what works, for whom, and in what contexts; and highlights emerging considerations, key gaps, and key actions.

The toolkit consists of the latest normative guidance, technical guidelines, policy briefs, case studies and advocacy resources to support efforts to achieve the AIDS Free targets in high-burden countries.

Materials included in this toolkit represents the work of several members of this group, including Adolescent Treatment Coalition (ATC), Clinton Health Access Initiative (CHAI), Children’s Investment Fund Foundation (CIFF), ELMA Philanthropies, United States President’s Emergency Plan for AIDS Relief (US PEPFAR), Joint United Nations Programme on HIV and AIDS (UNAIDS), United National Children’s Fund (UNICEF), Unitaid, and World Council of Churches (WCC).

 

This report details the learning session, co-hosted by WHO and the Coalition for Children Affected by AIDS which brought together 43 global thought leaders from the HIV, sexual and reproductive health, early childhood development, poverty reduction, rights, gender, exclusion and mental health sectors to develop an advocacy agenda for HIV-affected adolescent mothers and their children.

 

This publication primarily seeks to define and clarify the key elements of adolescent-friendly health services, summarize existing guidance on adolescent-friendly health services and differentiated service delivery for adolescents living with HIV while showcasing best-practice case studies based on country experience in implementing these services.

 

WHO's oral pre-exposure prophylaxis (PrEP) implementation tool serves as practical toolkit on how to consider the introduction of PrEP and start implementation. The series of modules support the implementation of PrEP among a range of populations in different settings. 

This module is for people who are interested in providing PrEP services to older adolescents and young adults who are at substantial risk for HIV. It provides information on: factors that influence HIV susceptibility among young people; clinical considerations for safety and continuation on PrEP; ways to improve access and service utilization; and inclusive monitoring approaches to improve the recording and reporting of data on young people.

 

HPV

This document is intended for use by national immunization programme managers and immunization partners involved in providing implementation support to countries. General guidance about planning the introduction of a vaccine into a national immunization programme is provided in the document Principles and considerations for adding a vaccine to a national immunization programme: from decision to implementation and monitoring published by the World Health Organization (WHO) in 2014 and available at http://www.who.int/immunization/ programmes_systems/policies_strategies/vaccine_intro_resources/nvi_guidelines/en/.

 

This guide presents communication guidance for countries introducing human papillomavirus (HPV) vaccine at the national or sub-national levels. HPV vaccination is a key strategy for comprehensive cervical cancer control and prevention. By the end of 2015, more than 65 countries introduced HPV vaccine into their national immunization programmes, with more than 30 of them were approved for Gavi-supported introductions.

 

 

There are few interventions targeting young adolescents and those that do exist are often not adequately reaching them. This is because the number of contacts between the health system and adolescents is generally low. Immunization programmes are well known for achieving good coverage and there is an opportunity that the introduction of HPV vaccination can provide an entry point for other health interventions targeting 9 to 13 year olds. A number of health interventions are suitable for joint delivery with HPV vaccination and can foster synergies between EPI and school and/or adolescent health programmes.

 

Around the world, immunization programmes are increasingly including, in their national immunization schedules, vaccines that target age groups beyond infancy and early childhood. This document is aimed at programme managers who are planning to introduce vaccines for older children and adolescents aged between 6 and 17 years. It provides information that should be considered when preparing guidance notes on the consent process, or for clarifying questions from the health workers who provide the vaccinations. The document is all the more important because this population group may present for vaccination without an accompanying parent or legal guardian.

 

Mental health

This document is designed to inform and inspire policy makers and others responsible for mental health services for children and young people, through introducing key issues to consider, important domains for standards of mental health care and by sharing a broad range of good practice approaches to developing or re-orienting services at community level. 

 

The Toolkit includes a core set of evidence-informed strategies to promote and protect adolescent mental health. These strategies focus on: the implementation and enforcement of laws and policies; environments to promote and protect adolescent mental health; the provision of support to parents and other caregivers; and psychosocial interventions for adolescents, including for groups exposed to vulnerabilities. Tools to guide implementation and examples of programmes already introduced in countries across regions are included.

 

The guide is for all countries, with or without a national suicide prevention strategy; national or local focal points for suicide prevention, mental health, alcohol or NCDs; and community stakeholders with a vested interest or who may already be engaged in implementing suicide prevention activities.

 

Nutrition

Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, WHO developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach. 

School health

This publication: Vision and hearing screening for school-age children, implementation
handbook provides practical guidance to support the establishment of sensory
screening programmes for school-age children. 

This case study explores the process and positive outcomes of piloting Immune Patrol, an innovative digital education package on vaccination and the immune system developed by the WHO Regional Office for Europe, in Armenia. It also outlines the steps being taken to integrate the platform into the country’s national school curricula. The case study provides insights, lessons learned and recommendations for implementation. The information is intended for policymakers, education organizers and other professionals interested in learning more about the package and its possible implementation in other contexts.

This publication is based on an extensive review of global evidence on the barriers to and enablers of implementation, maintenance and scaling-up of the health-promoting school approach. Its aim is to guide adaptation and implementation of the global standards for HPS.

 

No education system is effective unless it promotes the health and well-being of its students, staff and community. These strong links have never been more visible and compelling than in the context of the COVID-19 pandemic.

A health-promoting school (HPS) approach was introduced over 25 years ago and has been promoted globally since; however, the aspiration of a fully embedded, sustainable HPS system has not yet been achieved, and very few countries have implemented and sustained the approach at scale. How can we make every school a health-promoting school, and how can we implement, sustain and scale up the approach at country level, particularly in low- and middle-income countries?

All stakeholders involved in identifying, planning, funding, implementing, monitoring and evaluating the HPS approach will find some answers in this publication, which summarizes the experiences of eight countries spread across the world.

 

This new resource: School-based violence prevention: a practical handbook, is about schools, education and violence prevention. It provides guidance for school officials and education authorities on how schools can embed violence prevention within their routine activities and across the points of interaction schools provide with children, parents and other community members. If implemented, the handbook will contribute much to helping achieve the SDGs and other global health and development goals.

The three primary purposes of the School Vaccination Readiness Assessment Tool are:

1. To help Ministries of Health and Education determine, monitor, and improve their country’s overall readiness to conduct school vaccination activities.
2. To provide a simple-to-use assessment of a country’s overall capacity and specific strengths and weakness to implement school vaccination activities.
3. To guide a process to improve overall readiness and initiation of a new school vaccination programme or to improve an existing one.

While this Readiness Assessment Tool is specifically designed to assess country-wide readiness to implement school vaccination, it might also provide information useful for assessing and subsequently improving broader school health services. It may be appropriate in many countries to combine school vaccination activities with other school health services.

 

Substance use prevention

The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – termed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages.

A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture.

TB in children and adolescents

The WHO operational handbook on tuberculosis. Module 5: Management of tuberculosis in children and adolescents is the practical implementation guide to the 2022 WHO guidelines on the management of tuberculosis in children and adolescents. This handbook is part of a modular series of operational handbooks designed to facilitate the uptake and implementation of WHO recommendations as part of the programmatic management of TB in children (0-< 10 years) and adolescents (10-19 years included). It covers the full cascade of care, including TB screening, prevention, diagnostic approaches and treatment of TB, as well as special situations and models of care for TB service delivery.

Tuberculosis (TB) in children and adolescents affects a vulnerable population, which can no longer be ignored. The Roadmap for childhood tuberculosis: towards zero deaths, published in 2013, provided a strategic framework to address the TB epidemic in children. Significant progress has been made since the first Roadmap was published. It is critical to reflect on the lessons learned in the implementation of interventions at local, national, regional and global levels, to allow replication and scale-up of best practices, and to identify any remaining challenges

Ending TB in children and adolescents is an integral part of the End TB Strategy, which is aligned with the Sustainable Development Goals (SDGs) and has defined milestones and targets to end the global TB epidemic. Achieving these targets requires provision of TB care and prevention within the broader context of universal health coverage

Outstanding child and adolescent TB priorities include the need to: find the missing children with active TB and link them to TB care; prevent TB in children who are in contact with infectious TB cases (through implementation of active contact investigation and provision of preventive treatment); and advance integration within general child health services, including maternal and child health/ reproductive, maternal, newborn, child and adolescent health, HIV, nutrition and other programmes.

 

Violence prevention

Based on a global systematic review of evidence, Preventing violence against children: a social determinants framework for INSPIRE implementation presents a set of policies and laws that can support roll out of the interventions included within the INSPIRE framework. The policies and laws are selected based on evidence that they either directly prevent violence against children, or positively influence intermediary determinants that affect children’s risk of violence, including material circumstances, psychosocial, behavioural and biological factors, and the health system itself. For each policy and law, the report presents a rationale for inclusion, and a summary of the evidence available for each approach, focusing where possible on those with a greater level of evidence.

The INSPIRE handbook: action for implementing the seven strategies for ending violence against children explains in detail how to choose and implement interventions that will fit your needs and context. The seven strategy-specific chapters address the Implementation and enforcement of laws; Norms and values; Safe environments; Parent and caregiver support; Income and economic strengthening; Response and support services; and Education and life skills. The handbook concludes with a summary of INSPIRE’s implementation and impact indicators, drawn from the companion INSPIRE indicator guidance and results framework.

INSPIRE: Seven strategies for ending violence against children identifies a select group of strategies that have shown success in reducing violence against children. They are: implementation and enforcement of laws; norms and values; safe environments; parent and caregiver support; income and economic strengthening; response and support services; and education and life skills.

 

The handbook aims to help programme developers and implementers from nongovernmental organizations and other development agencies make better use of existing research and plan for evaluation when designing and implementing programmes to prevent violence against children. In doing so, it will help those groups as they apply for funding to ensure that their proposed programmes will ultimately contribute to the evidence base on what works to prevent such violence.