The right to a safe, healthy and meaningful adolescence
Every adolescent deserves the opportunity to have a safe and healthy transition into adulthood. Adolescence is a time of experimentation, but some behaviours may jeopardize health.
For example, one in four 15-year olds has had sex, and in some countries of the Region one in three do not use condoms or other kinds of contraceptives, thereby increasing the risk of unwanted pregnancy and sexually transmitted diseases.
The Republic of Moldova’s ‘Healthy Generation’ Project
The Republic of Moldova has been active in supporting healthy development during adolescence and preventing adolescents’ experimentation from becoming too risky. Through Project ‘Healthy Generation’, the country aims to provide adequate and relevant health information in the form of youth-friendly health services for adolescents.
The basic philosophy of the project is that health is not only a matter for the traditional health sector providers (doctors, nurses, hospitals etc.), but requires the cooperation of many different social sectors and actors such as social workers, teachers, family and staff from youth-friendly health clinics. The project trains relevant actors - nurses, psychologists, teachers, peer educators etc., in how to use the school context in a sensitive and open way for life-skills education and the promotion of healthy choices and behaviour. And finally, they promote and advocate for a positive attitude among parents and key social actors toward youth-friendly services.
Why are investments in youth-friendly health services necessary?
The Republic of Moldova has clearly identified the need to offer youth-friendly health services. It is one of the poorest countries in the Region and has high rates of unemployment. Many adults leave the country to work abroad to provide a better future for their family. Today, 1 in 10 adolescents in the Republic of Moldova grow up with both parents living abroad, and thus cannot ask their parents for health advice.
Cultural myths also play a role. Some religious organizations believe that the promotion of condoms among adolescents encourages promiscuity and therefore spread rumours that condoms don’t work.
“There are a lot of religious organizations who promote sexual abstinence with messages like ‘In many cases condoms are not efficient. Not 100 % helpful’. And, as a result, we don’t have many sexually abstinent adolescents, but we do have many sexually active adolescents who hear that condoms don’t work and that they don’t need to use them,”says Galina Lesco, director of the Health for Youth NGO, and leader of the Moldovan youth-friendly health centre ‘NEOVITA’.
Even if adolescents are well informed and know the risks, they might still engage in behaviour that undermines health. Condom use is just one example - it takes empowered girls to negotiate the use of a condom in an intimate situation if boys believe it decreases their pleasure.
Empowering girls to demand their rights and voice their opinions is therefore a key goal of Project Healthy Generation.
Experiences from the youth-friendly health centre ‘NEOVITA’
Galina Lesco explains that the adolescents she meets in her clinic are far from homogenous. Some come to seek non-judgemental advice, e.g. a 16-17 year old boy who visited the clinic to seek guidance on how best to ‘come out’ as a homosexual, girls who needed counselling on relationships etc. Others include more tragic and acute cases, including girls who had been victims of sexual violence and seek help to get tested for pregnancy and/or sexually transmitted infections.
Through NEOVITA, Galina Lesco is working towards her goal “to have more healthy adolescents who have the opportunity to rise and grow in a safe and healthy environment.”
Investing in children: the European child and adolescent health strategy 2015–2020: Supporting growth during adolescence
Supporting adolescents to enjoy a happy and healthy transition into early adulthood is a key focus of the new WHO strategy for children and adolescents in the European Region.
The determinants of adolescent health are now much better understood. The social values and norms of the immediate family, peer groups and school environments may expose adolescents to risk, as well as protect them. Health literacy must be promoted from childhood through adolescence, so that future citizens of Europe have the skills to make informed decisions. The challenge for policy is to balance risk and protection in favour of well-being and away from behaviour that may undermine health.
WHO has mapped youth friendly service delivery models, which can be inspire countries to develop their own models, and Project Healthy Generation serves as an example of how to translate the abstract concept of youth-friendly health services into real action.
Health risks for children and adolescents in the WHO European Region
- Injuries is one of the leading causes of mortality and morbidity among adolescents.
- One in ten adolescents have some form of mental ill health.
- By the age of 18, it is estimated that 9.6% of children and adolescents will have suffered sexual abuse and 22.9% physical abuse.
- In the European Region, 25 % of boys and 17 % of girls aged 15 drink alcoholic beverages at least once a week.
- One in four of all 15-year-olds have engaged in sexual intercourse, but in some countries more than 30 % do not use any kind of contraception increasing risks of contracting sexually transmitted infections (STIs) and unwanted pregnancies.
Being young is not always a healthy and happy time. Many suffer from depression, are victims of maltreatment or contract sexually transmitted infections or unplanned pregnancies. Youth friendly services are vital to help young people to a safe and healthy entry into adulthood by addressing the health and developmental needs of this age group.