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“Connecting Conversations” Series Launches

Setting the Stage for Understanding and Investing in Adolescent and Youth Reproductive Health

On July 15, Knowledge SUCCESS and FP2020 launched our new webinar series, "Connecting Conversations"—a series of discussions on adolescent and youth reproductive health. Missed the first webinar? Our recap is below, and so are links to watch for yourself and register for future sessions.

Did you know, although our brains reach their adult weight when we are young children, they aren’t fully developed until our mid-20s? This affects a person’s cognitive development, emotional regulation, peer relationships, and health behavior—including voluntary contraceptive use and reproductive health.

This is just one of the many insights shared by Professor Susan Sawyer, featured speaker in the first session of the FP2020 and Knowledge SUCCESS online series “Connecting Conversations.” She is the Chair of Adolescent Health at The University of Melbourne, Director of the Centre for Adolescent Health at the Royal Children’s Hospital, and President of the International Association for Adolescent Health (IAAH). Focusing on the transformative importance of adolescence, Professor Sawyer spoke on July 15 about fascinating topics like social determinants of health for adolescents, investing in the triple dividend, and why definitions of adolescence and youth matter for policy.

Professor Susan Sawyer discussing social determinants of health for adolescents during our first “Connecting Conversations” session on July 15.
Professor Susan Sawyer discussing social determinants of health for adolescents during our first “Connecting Conversations” session on July 15.

Social Determinants of Health

Professor Sawyer discussed the importance of understanding the dynamic nature of young people’s social environments. Adolescence is a time when peer and media influences are strong, and social norms and transitions—from education to employment, and around families—offer a unique set of circumstances that must be accounted for as we plan programs for youth.

The “Triple Dividend”

In explaining the “triple dividend,” Professor Sawyer described the tremendous three-fold benefits of investing in adolescents. First, these investments directly result in a healthier cohort of young people. Secondly, as these young people mature, we will eventually have a healthier adult population. Finally, there are intergenerational benefits of investing in adolescents: Young women who delay childbirth into their 20s often have higher levels of education, greater agency within relationships, and healthier families.

Professor Susan Sawyer explaining the concept of the “triple dividend” during our first “Connecting Conversations” session on July 15
Professor Susan Sawyer explaining the concept of the “triple dividend” during our first “Connecting Conversations” session on July 15.

Defining “Adolescence”

Professor Sawyer also provided a case for extending the definition of adolescence from ages 10-19 years (the current definition that dates from the mid-1960s), up to 10-24 years to be more consistent with contemporary knowledge of brain development and timing of social role transitions. Policies and programs for young children focus on care and protection, which adolescents also need. Yet as adolescents get older, they also benefit from approaches that seek their engagement and empowerment around decisions that affect them. How we define and conceptualize adolescence matters, as it influences the scope and nature of the laws, policies, and programs that both protect and empower young people. This concept is detailed further in the paper Sawyer co-authored in The Lancet, “The Age of Adolescence.”

Summary of Questions and Answers

After her presentation, Professor Sawyer conversed with moderator Cate Lane (Director of the Adolescent and Youth Portfolio at FP2020) to answer questions from participants on a range of topics, including: partnership, Positive Youth Development, changing investment levels for adolescents, the importance of advocacy, youth participation in programs, and the balance between protecting and empowering young people.

When asked about applying findings in programs, Professor Sawyer advised: “Think multi-sectorally. Go beyond health.” This is how we start to invest not just in health problems, but also to prevent health risks associated with social determinants of health—education, family, transforming gender roles and social norms, and supporting positive youth development.

Similarly, we tend to think about youth programming (or any programming) in vertical silos. We often address health problems through the health system. However, “positive youth development” (PYD) programs cut across these vertical silos. PYD programs empower youth by providing safe spaces for young people to develop life skills and to promote healthy behaviors—for example, homework clubs not only support girls’ educational aspirations, but develop protective social relationships and create links to wider opportunities and health care. PYD also allows us to look at root causes of poor health outcomes—child marriage, for one—and support factors that can mitigate these risks. Another example is education: Among the best investments to be made for adolescent health is quality education.

Advocacy is required to increase investment in adolescent health. With under 2% of development health assistance going to adolescent health, despite adolescents making up a significant proportion of populations in these countries, there hasn’t been sufficient global leadership or funding for adolescent health. Country by country, we need to build professional capacity around adolescent health, including public health, clinical services, and research. Building capacity and supporting individual leaders—including youth leaders—is important for moving this agenda forward. Advocacy is also important to keep adolescents’ needs in mind as we design and implement programs. Most experts focus on younger children or adults, often forgetting adolescents.

Engaging young people is also important. When young people are empowered to speak up about their own health needs, they can come up with solutions that can provide important insights to policymakers and program developers. Within these efforts, it is important to be inclusive and intentionally include young people’s voices that are harder to hear—for example, disabled, poor, and marginalized youth. Collaboration with a range of partners is key to ensuring that many different young opinions can be incorporated into program design.

One participant asked, “How can we protect young people, while still respecting the diversity of adolescents?” Sawyer responded that one thing to consider is the importance of laws. We need to change laws to bring down the legal age of engaging in relatively safe behaviors so young people can more fully participate in society (for example, voting) while thinking how laws can protect them in other ways (for example, increasing the legal age for alcohol consumption). She summed it up by saying, “Thinking about how to balance protection and support with engagement and empowerment—has been transformative in the way I’ve started to think about developing legal frameworks and policies for adolescents.”

Additional Questions and Answers from Professor Susan Sawyer

Since we weren’t able to answer all the questions during the hour, Professor Sawyer has kindly agreed to provide written responses to additional questions below.

What about the use of digital health for PYD?

Positive youth development (PYD) programs help adolescents and youth to build life skills and social assets, foster agency, and develop healthy relationships with families and peers. Many different platforms can be used to develop these competencies, including digital platforms. Digital platforms may not successfully create these competencies, unless there is an intentional focus on doing so, and key to the use of digital platforms is to engage young people in the design of such efforts. As digital technology continues to grow and expand around the world, young people will need to learn how to safely and successfully navigate online communication as part of developing healthy relationships. So yes, digital platforms should be taken into consideration in developing PYD programs—and not just during COVID! For more information, please see a summary of the following article by Catalano et al in the Journal of Adolescent Health: “Positive Youth Development Programs in Low-and Middle-Income Countries: A Conceptual Framework and Systematic Review of Efficacy.” 

During COVID 19 urban adolescents are using social media for information on reproductive health and contraception. What about the rural adolescents who can’t easily access social media?

There is no one size fits all approach, in any country. And there is also no single right way to equip young people with the knowledge, skills and resources they need whether about relationships or contraception. There are likely to be many different groups of adolescents who don’t have access to information and are vulnerable to poor reproductive health outcomes, besides just rural adolescents. These include adolescents living with disabilities and adolescents whose living situations are not safe, or very young adolescents who are less likely to use social media. Schools are often important sources of support for young people, whether in rural or urban areas, but social media cannot replace the protective aspects of schools, and in some instances may be a source of misinformation! Just because schools might be physically shut doesn’t mean we can assume that social media will provide students with the information they desire or need—in my experience, many students struggle to navigate the overwhelming, and sometimes conflicting, information that is available online. With school closures and limits to their mobility, young people may turn to social media for information, but many young people report they would like to get this kind of information and support from their families, especially their parents. Programs can help parents become more comfortable communicating with their children about health risks and healthy behaviors and can engage with communities to ensure safe and supportive environments for adolescents. Finding ways of highlighting reliable social media sites is an important role for families, schools and communities.

Missed the First Session? Watch the Recording!

Did you miss the first session? You can watch the webinar recording (available in both English and French) and get caught up before the second session on July 29, “A Historical Overview of Adolescent and Youth Reproductive Health.”

About “Connecting Conversations”

Connecting Conversations” is a series of discussions on adolescent and youth reproductive health—hosted by FP2020 and Knowledge SUCCESS. Over the next year, we will be co-hosting these sessions every two weeks or so on a variety of topics. You may be thinking, “Another webinar?” Don’t worry—this is not a traditional webinar series! We’re using a more conversational style, encouraging open dialogue and allowing plenty of time for questions. We guarantee you will be coming back for more!

The series will be divided into five modules. Our first module, which started on July 15 and runs through September 9, will focus on a foundational understanding of adolescent development and health. Presenters—including experts from organizations such as the World Health Organization, Johns Hopkins University, and Georgetown University—will offer a framework for understanding adolescent and youth reproductive health, and implementing stronger programs with and for young people. Subsequent modules will touch on themes of improving young people’s knowledge and skills, providing services, creating supportive environments, and addressing the diversity of young people.

Register for “Connecting Conversations”

This blog post is made possible by the support of the American People through the United States Agency for International Development (USAID) under the Knowledge SUCCESS (Strengthening Use, Capacity, Collaboration, Exchange, Synthesis, and Sharing) Project. Knowledge SUCCESS is supported by USAID’s Bureau for Global Health, Office of Population and Reproductive Health and led by the Johns Hopkins Center for Communication Programs (CCP) in partnership with Amref Health Africa, The Busara Center for Behavioral Economics (Busara), and FHI 360. The contents of this website are the sole responsibility of CCP. The information provided on this website does not necessarily reflect the views of USAID, the United States Government, or the Johns Hopkins University. Read our full Security, Privacy, and Copyright Policies.

Sarah V. Harlan

Partnerships Team Lead, Knowledge SUCCESS

Sarah V. Harlan, MPH, has been a champion of global reproductive health and family planning for nearly two decades. She is currently the partnerships team lead for the Knowledge SUCCESS Project at the Johns Hopkins Center for Communication Programs. Her particular technical interests include Population, Health, and Environment (PHE) and increasing access to longer-acting contraceptive methods. She is a co-founder of the Family Planning Voices storytelling initiative and a co-author of several how-to guides, including Building Better Programs: A Step-by-Step Guide to Using Knowledge Management in Global Health.

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