Strengthening Adolescent Health Programmes

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Strengthening Adolescent Health Programmes
in South-East Asia
Regional multi-sectoral meeting to strengthen adolescent health in the context of the Global Strategy and SDGs
22-26 April 2019 | Paro, Bhutan
Meeting Report

Regional multi-sectoral meeting to strengthen adolescent health in the context of the Global Strategy and SDGs SEA-CAH-36
© World Health Organization 2019
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Strengthening Adolescent Health Programmes
in South-East Asia
Regional multi-sectoral meeting to strengthen adolescent health in the context of the Global Strategy and SDGs
22-26 April 2019 | Paro, Bhutan
Meeting Report

Table of Contents





Proceedings of the meeting


Capacity building of regional experts (22nd and 23rd April)


Orientation and capacity building of national teams (24th to 26th April)




Regional Director’s Message




List of participants


Summary of Country Key Actions


Group photograph



There are about 360 million adolescents (10-19 years) in South-East Asia Region. SEAR member states initiated national Adolescent Health programmes since early 2000s and have strengthened these as per the guidance from the regional strategy for adolescent health (2011-2015). However, there have been implementation challenges in the countries and the progress in institutionalizing adolescent health services has been quite variable within and across the countries.
In the Global Strategy (2016-2030) adolescents have received prominent attention because health and sound development of adolescents and their ability to contribute to national development will be crucial for achieving the SDGs. Adolescent health and well-being is covered in several SDGs in addition to the health specific Goal 3 and in fact will contribute the achievement of these goals.
Accordingly, WHO-HQ along with partners has developed Global AA-HA! Guidance that was adopted in World Health Assembly in 2017. Subsequently, an operational guide has also been developed to enable countries to implement the global guidance based on local context.
At the same time Regional Strategic Guidance on accelerating actions for adolescent health has also been prepared in consultation with Member States. This emphasizes that countries should build upon their existing adolescent health programmes using the evidence-based interventions and strategies included in the global guidance. The emphasis is on implementing a broad evidence-based intervention package for comprehensive health and development of adolescents through innovative, multi-dimensional and multi-sectoral approaches. School health programme that is being implemented in the countries is a good prototype of inter-sectoral work on adolescent health and needs to be recalibrated and strengthened with appropriate collaboration with the education departments.
SEAR-Technical Advisory Group for Women’s and Children’s Health and Call to Action from the Regional Parliamentarians Meeting have also recommended strengthening of national programmes for comprehensive support to health and development of adolescents in the Region.
To operationalise the global AA-HA! and the Regional guidance in the countries, WHO-SEARO planned this meeting to build regional capacity. A pool of technical resource persons and experts were oriented to the global and regional adolescent health imperatives. Such regional capacity will be available for ongoing technical support to countries to plan and roll out the revised and renewed national adolescent health programmes. The regional meeting achieved twin purpose of building capacity of regional experts and orient the national programme managers to the global and regional guidance on adolescent health to renew and strengthen their national plans for adolescent health. The meeting also provided an opportunity to countries to review the progress in the implementation of the existing national adolescent health programmes and understand the evidence-based, multi-sectoral approaches like school health programmes.

The general objective of the meeting was ‘to promote health and development of adolescents in the Region, in line with the Global Strategy for women’s, children’s and adolescents’ health and Sustainable Development Goals’ while the specific objectives were as follows:
1. Review the existing national adolescent health and school health programmes and share experience in implementation across countries
2. Share evidence-based multi-sectoral approaches for adolescent health and health promoting school initiative.
3. Strengthen capacity of Member States for strengthening national programme for adolescent health including conducting landscape analysis, priority-setting, programming, monitoring & evaluation.
4. Prepare country-specific plan of action for strengthening national adolescent health and school health programmes.
Proceedings of the meeting
The 5-day workshop was designed to have two segments. The first two days (i.e. 22nd and 23rd April) the focus was on introducing the AA-HA framework and capacity building of the regional experts, and representatives from partner agencies. The latter three days (24th, 25th and 26th April) the focus was on capacity building of country teams consisting of multi-ministerial delegation from 10 countries on using the AA-HA guidelines and strategizing to implement the same in respective countries. The sessions were facilitated by the regional experts trained on the first two days.
Capacity building of regional experts (22nd and 23rd April)
The workshop started with an inaugural session with welcome addresses followed by a group photo. Dr Rajesh Mehta (WHO-SEARO) presented an overview of the regional adolescent health situation followed by a summary of adolescent health programmes in the region.

Dr Regina Guthold (WHO-HQ) presented a global overview of the adolescent health situation. She reiterated the global political commitment on adolescent health has been upheld in the updated Global Strategy for Women's, Children's and Adolescents' Health (2016-2030). She highlighted the important differences in causes of mortality and morbidity between ages, sexes, in different regions. Dr Valentina Baltag (WHO-HQ) gave an overview of the global AA-HA! package. She familiarised the participants with components of the package and provided details to some of them.
The group work activities on Day 1 and 2 were mock exercises to design the sessions and prepare the facilitation plan during the orientation of the country delegations on Day 3 to Day 5. The first group work was on ‘Needs Assessment’ where each group had to discuss the following aspects:
− Main health issues and challenges affecting adolescents − Adolescent behaviours and risk factors linked to these health issues − Harmful practices affecting adolescents − Social determinants (e.g. gender norms) − Subgroups of Adolescents who maybe in greatest need The second group was on ‘Landscape Analysis’ where each group discussed the following aspects: − What is being done and by whom (different actors in different sectors)? − What are the gaps? − Are youth involved in the design, implementation and monitoring of the specified
programmes? Day-2 began with the third group work on ‘National Prioritisation’. Each group discussed the prioritization of the adolescent health interventions based on the following criteria:
− Magnitude of the issue the intervention is addressing − Equity (Is the intervention likely to address the needs of vulnerable population/underserved
groups?) − The degree of the effectiveness of the interventions 7|Page

− Feasibility of delivering interventions (i.e. funds, infrastructure, personnel, acceptability, political support)
− Potential to go to scale Dr Valentina Baltag presented programmatic tools which can support implementation of adolescent health programmes. Then, she presented to explain the governance, financing and adolescent participation aspects of adolescent health programming. Dr Rajesh Mehta took a session on adolescent participation where he explained about the Youth Town Hall initiatives undertaken by WHO. Two youth representatives presented the youth declaration from the SEARO Youth Town Hall in Jakarta.
This was followed by a session on monitoring and evaluation where various indicators pertinent to adolescent health were presented including those included in the Sustainable Development Goals, Global Strategy and WHO General Program of Work. Each group discussed about elements of programming and identified actions under each of the following aspects:
− Adopt adolescent protective laws and policies − Decide on service delivery platforms − Workforce capacity and address weaknesses − Improve supply systems, technology and infrastructure − Improve health management information systems − Engage communities to build support for adolescents’ use of services − Establish leadership and governance arrangements for implementation − Estimate resource needs and secure funding for national, district and local actions The day concluded with brief workshops on Life Skills Education for adolescent health by Dr Patanjali Nair (WHO-SEARO) and Ms Karma Choden (Ministry of Education, Bhutan); and Role of Parenting in adolescent health by Dr Rajesh Mehta and Dr Swati Bhave (AACCI, an NGO in India).

Orientation and capacity building of national teams (24th to 26th April)
Inauguration: The meeting was inaugurated by the H.E. Dr Dechen Wangmo, Health Minister of Bhutan. WHO Representative welcomed the chief guest and delegates. Dr Neena Raina (Ag. Director FGL, WHOSEARO) shared the objectives of the meeting. Dr Pem Namgyal (DPM, WHO-SEARO) delivered the message from the Regional Director of WHOSEARO, Dr Poonam Khetrapal Singh. It was highlighted that the SEAR has young population and adolescents constitute about one-fifth of population. They will be able to contribute to national development maximally if nations are able to ensure their health and development to encash the demographic dividend that this young population presents in the Region. RD’s message highlighted the need for national health programs through multi-sectoral collaboration to address the health needs of all adolescents who live in a variety of circumstances, including those in school and colleges, and those out of school and those already in employment. The keynote address was delivered by H.E. Dr Dechen Wangmo, Health Minister of Bhutan. She requested delegates to observe a minute of silence in memory of the people of Sri Lanka who recently lost lives in the Easter bombings in Colombo. In her address she highlighted how the Government of Bhutan is health-driven and has recognized health as a human right in the country. She highlighted the importance of acting upon immediately on the agenda of adolescent health and how the region together can achieve great success. She highlighted the three building blocks of adolescent health programmes: Health and other services (adolescent-friendly and of good quality), an enabling environment, and empowerment of adolescents at societal level. She expressed confidence that the Regional workshop will be successful in providing opportunities for exchanging innovative ideas, wisdom and experience in delivering adolescent health programmes to enrich the knowledge across the whole Region. Dr Rajesh Mehta (WHO-SEARO) introduced the participants from ministries of health and education, and representatives from academia, subject experts and partner agencies. In the first technical session of the day, the situation of adolescent health in the South East Asia region was presented by Dr Neena Raina.

The global overview on adolescent health was presented by Dr Regina Guthold (WHO-HQ) who explained the burden of adolescent health issues in terms of causes of mortality and morbidity between ages, sexes, regions of the world. Dr Valentina Baltag (WHO HQ) presented an overview of the Global AA-HA! package including the various components. This session was followed by poster presentations on national adolescent health and school health programmes by delegations from 10 SEAR countries. H.E. the Health Minister took keen interest in the presentations from all countries and visited the national posters for discussions. Dr Valentina Baltag presented Global Standards for Health Promoting Schools. She highlighted the need for making every school as ‘health promoting school’ and outlined the key features and the ways of implementation of this WHO-UNESCO initiative.
Mr. Kabir Singh (UNESCO, Bangkok) made a presentation on Comprehensive Sexuality Education Guidelines that have been launched in 20018. He explained the need and purpose of these guidelines, main elements along with the evidence of effectiveness, and country implications for large scale implementation.
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Strengthening Adolescent Health Programmes