Optimising adolescent sexual and reproductive health in the SADC region Trisha Ramraj, Darshini Govindasamy, Cathy Mathews and Ameena Goga A 50-year global review (1955–2004) conducted in 2011 showed stark differences between reductions in child mortality compared with adolescent mortality: between 1995 and 2004, adolescent mortality was significantly higher than child mortality; additionally, all-cause mortality decreased by 85–93 per cent in one–four-yearolds, 80–87 per cent in five–nine-year-olds, but only 68–78 per cent in ten- to 14-year-olds, with Sub-Saharan Africa (SSA) having the worst adolescent health profile (Viner et al., 2011). In 2012 the global mortality rate and disability-adjusted life years (DALYs) among all adolescents was 110.7 and 21,949 per 100,000 people, respectively, with the African region accounting for the highest rates of both (282.5 and 38,297 per 100,000 people, respectively; WHO, 2014). HIV/AIDS, lower respiratory infection, meningitis, diarrhoeal diseases and road injury were among the top five causes of adolescent death and DALYs in Africa (ibid). This highlights the urgent need to provide appropriate adolescent-centred health services that care for physical, mental and social health. Adolescence, a phase characterised by psychosocial, physiological, mental and biological change among ten- to 19-year-olds, poses unique challenges and increases vulnerability to risky behaviours. Adolescent health should be viewed from a life-course perspective: childhood health impacts on adolescent health outcomes; health outcomes and behaviours initiated during adolescence impact on adulthood and on the health of the next generation. The link between health outcomes and behaviours during adolescence and its two contiguous life phases, childhood and adulthood, should therefore influence the design of health programmes and policies (WHO, 2014). The sexual and reproductive health (SRH) strategy for the Southern African Development Community (SADC) region (2006–15) identifies adolescent health as one of four main focal areas. It emphasises that adolescent vulnerability in the region is due to transitional issues (including the need to exercise independence and develop self-identity), poor parental and community support, Commonwealth Health Partnerships 2015 53 Adolescents often struggle to access confidential sexual and reproductive health services Gilles Paire / Shutterstock.com
Commonwealth Health Partnerships 2015
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