Focus on adolescent health.

Author:Brandrup-Lukanow, Assia
Position:Special Report: HEALTH

Africa is a young continent, with a quarter of its population aged between 10 and 19, but how well do we take care of these adolescents, Africa's hope for the future? In this article two public health specialists, Assia Brandrup-Lukanow and Robert Thomson, reflect with two young professionals--Isma Benboulerbah, a gender and development specialist and Issouf Wende N'so de Clercq a recent law graduate--on the need for realistic legislative reform and a fair socio-economic investment in adolescent health.

In our work with United Nations, German and Swiss cooperation agencies in the region, we have been inspired by national efforts across Africa to improve the health and well-being of future generations.

Millions of adolescents and young Africans are alive today because their mothers' pregnancies were safely brought to term and their first months were marked by healthy choices.

Decades of commitment to new-born and child survival have seen maternal health programmes, sexual and reproductive rights, improved nutrition, breastfeeding, immunisation and regular monitoring at primary health care centres, widely adopted. These measures are based on realistic regulations, fashioning the way in which relatively simple interventions are managed.

Yet the sad reality is that instead of the continuing healthy development and well-being of all children, up to 1,500 adolescents across the region die needlessly from treatable or preventable causes every day. These include: HIV/Aids, pregnancy complications, anaemia andsickle cell disease, inter-personal violence and injuries. And with them, so many young African hopes and dreams perish. Why does this tragic situation persist?

Child survival is now a given, so can we not sustain health and well-being beyond childhood into adolescence and ensure a better life for them and their future families?

Indeed, the challenge to meet the needs and expectations of Africa's hundreds of millions of adolescents is ongoing. They are still unfairly burdened by infection, malnutrition, disease --and especially by the mortality and illness associated with child marriage and early pregnancy.

So yes, while we got it right on child survival and the management of child health, too many adolescents still face really poor health outcomes, particularly adolescent girls and young women. The vulnerability and harm increase when it comes to marginalised, disabled and underserved minority groups, who are particularly invisible in both service provision and the legislation.

Generally, pregnant women (of whatever age) and their young children are treated free or at preferential rates in public facilities. However, youngsters find themselves in a double bind - they are often neglected by health staff, systems and services, yet expected to provide for their own medical needs.

Clearly, adolescents generally have relatively meagre means. Therefore, the pricing of services and medication--and where they exist, insurance premiums--must be adapted to their purchasing power. The...

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