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Kågesten AE, Marsh AD, Storey S, Abduvahobov P, Adebayo E, Amezquita Velásquez AI, Azzopardi PS, Ba MG, Bose K, Camara MK, Cardona M, da Cruz J, Dastgiri S, Fagan L, Ferguson BJ, Giyava CR, Karna P, Keogh SC, Melkumova M, Moller AB, Newby H, Swai E, Tchandana M, Uzma Q, Yoffo GJ, Zainal Abidin Z, Zbelo M, Guthold R. Exploring a Preliminary Set of Indicators to Measure Adolescent Health: Results From a 12-Country Feasibility Study. J Adolesc Health 2024; 74:S66-S79. [PMID: 38762265 DOI: 10.1016/j.jadohealth.2024.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To explore data availability, perceived relevance, acceptability and feasibility of implementing 52 draft indicators for adolescent health measurement in different countries globally. METHODS A mixed-methods, sequential explanatory study was conducted in 12 countries. An online spreadsheet was used to assess data availability and a stakeholder survey to assess perceived relevance, acceptability, and feasibility of implementing each draft indicator proposed by the Global Action for Measurement of Adolescent health (GAMA). The assessments were discussed in virtual meetings with all countries and in deep dives with three countries. Findings were synthesized using descriptive statistics and qualitative thematic analysis. RESULTS Data availability varied across the 52 draft GAMA indicators and across countries. Nine countries reported measuring over half of the indicators. Most indicators were rated relevant by stakeholders, while some were considered less acceptable and feasible. The ten lowest-ranking indicators were related to mental health, sexual health and substance use; the highest-ranking indicators centered on broader adolescent health issues, like use of health services. Indicators with higher data availability and alignment with national priorities were generally considered most relevant, acceptable and feasible. Barriers to measurement included legal, ethical and sensitivity issues, challenges with multi-sectoral coordination and data systems flexibility. DISCUSSION Most of the draft GAMA indicators were deemed relevant and feasible, but contextual priorities and perceived acceptability influenced their implementation in countries. To increase their use for a more comprehensive understanding of adolescent health, better multi-sectoral coordination and tailored capacity building to accommodate the diverse data systems in countries will be required.
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Affiliation(s)
- Anna E Kågesten
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Andrew D Marsh
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland
| | - Simone Storey
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Parviz Abduvahobov
- Health and Education Section, Division for Peace and Sustainable Development, Education Sector, UNESCO, Paris, France
| | - Emmanuel Adebayo
- Adolescent Health Unit, Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Peter S Azzopardi
- Department of Paediatrics, Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia; Adolescent Health and Wellbeing Program, Telethon Kids Institute, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Mariame Gueye Ba
- University Cheikh Anta Diop of Dakar, Faculty of Medicine, Pharmacy and Odontology/Gynecology and Obstetrics Clinic, University Teaching Hospital, Dakar, Senegal
| | - Krishna Bose
- Bill and Melinda Gates Institute for Population and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Marcelo Cardona
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland; Center for Eating and feeding Disorders Research, Mental Health Center Ballerup, Copenhagen University Hospital - Mental Health Services, Copenhagen, Denmark
| | | | - Saeed Dastgiri
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Lucy Fagan
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | | | | | - Priya Karna
- WHO Country Office for India, New Delhi, India
| | - Sarah C Keogh
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland
| | - Marina Melkumova
- Arabkir Medical Centre, Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Ann-Beth Moller
- Department of Sexual and Reproductive Health and Research World Health Organization includes the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Holly Newby
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland
| | - Edwin Swai
- Universal Health Cluster- Live Course, WHO Country Office for the United Republic of Tanzania, Dar-es-Salaam, United Republic of Tanzania
| | - Makilioubè Tchandana
- Division Santé Maternelle Infantile et Planification Familiale, Ministère de la Santé de l'hygiène publique et de l'accès universel aux soins, Lomé, Togo
| | - Qudsia Uzma
- Reproductive, Maternal, Newborn, Child and Adolescent Health Programme, WHO Country Office for Pakistan, Islamabad, Pakistan
| | - Gboboto Jérôme Yoffo
- Programme National de la Santé Scolaire et Universitaire Santé Adolescents et Jeunes, Ministère de la Santé de l'Hygiène Publique et de la Couverture Maladie Universelle, Abidjan, Côte d'Ivoire
| | - Zamzaireen Zainal Abidin
- Adolescent Health Sector, Family Health Development Division, Ministry of Health, Putrajaya, Malaysia
| | - Mesfin Zbelo
- Health Services and Policies, WHO Country Office for Lesotho, Maseru, Lesotho
| | - Regina Guthold
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland.
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Melkumova M, Movsesyan Y, Sargsyan S, Storey S, Keogh SC. Challenges and Opportunities to Advance Adolescent Health Measurement in Armenia: Alignment Between Global Priority Indicators and National Policies, and Feasibility of Collecting Sexual, Reproductive, and Mental Health Indicators. J Adolesc Health 2024; 74:S80-S93. [PMID: 38762266 DOI: 10.1016/j.jadohealth.2024.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To assess alignment of the Global Action for Measurement of Adolescent health (GAMA) draft adolescent health indicators with national policies and explore challenges and opportunities for collecting data on adolescent sexual, reproductive, and mental health in Armenia. METHODS We reviewed Armenia's national laws, decrees, policies, strategies, and programs for content related to the draft indicators. We conducted three focus group discussions with government and nongovernmental stakeholders and youth representatives on the feasibility of collecting the draft indicators, and analyzed the discussion segments related to sexual, reproductive, and mental health indicators. RESULTS The policy review included 22 documents. Armenia's national laws, policies, strategies, orders, and decrees mention a range of tracking and monitoring activities in adolescent health, and many draft GAMA indicators are already incorporated into national statistics and are collected in ongoing surveys. However, policies and strategies often lack specificity around how to measure and report indicators. Sexual, reproductive, and mental health indicators were particularly sensitive to collect due to Armenian cultural norms and expectations, especially for younger adolescents under the age of 15 years. DISCUSSION Guidance should be developed to facilitate the formulation of relevant policies with well-defined indicators and complete tracking and reporting information. Data collection should be further harmonized within the overall health information flow to avoid data overlap. While sensitization work and interviewer training can help address some issues around collecting data on sexual, reproductive, and mental health, it may be necessary to adapt certain indicators to be culturally acceptable in Armenia, such as by limiting the age range to above 15 years for highly sensitive indicators.
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Affiliation(s)
- Marina Melkumova
- Arabkir Medical Centre, Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Yeva Movsesyan
- Arabkir Medical Centre, Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Sergey Sargsyan
- Arabkir Medical Centre, Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Simone Storey
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Sarah C Keogh
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organization, Geneva, Switzerland.
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Kobeissi L, Pyone T, Moran AC, Strong KL, Say L. Scaling up a monitoring and evaluation framework for sexual, reproductive, maternal, newborn, child, and adolescent health services and outcomes in humanitarian settings: A global initiative. DIALOGUES IN HEALTH 2022; 1:None. [PMID: 36569812 PMCID: PMC9767412 DOI: 10.1016/j.dialog.2022.100075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/02/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Background Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent (SRMNCAH) data from humanitarian settings are often sparse and variable in quality across different settings due to the lack of a standardised set of indicators across the different agencies working in humanitarian settings. This paper aims to summarise a WHO-led global initiative to develop and scale up an SRMNCAH monitoring and evaluation framework for humanitarian settings. Methods This research revolved around three phases. The first and the last phase involved global consultations with lead international agencies active in SRMNCAH in humanitarian settings. The second phase tested the feasibility of the proposed indicators in Afghanistan, Bangladesh, the Democratic Republic of the Congo, and Jordan, using different qualitative research methods (interviews with 92 key informants, 26 focus group discussions with 142 key stakeholders, facility assessments and observations at 25 health facilities or sites). Results Among the 73 proposed indicators, 47 were selected as core indicators and 26 as additional indicators. Generally, there were no major issues in collecting the proposed indicators, except for those indicators that relied on death reviews or population-level data. Service availability and morbidity indicators were encouraged. Abortion and SGBV indicators were challenging to collect due to political and sociocultural reasons. The HIV and PMTCT indicators were considered as core indicators, despite potential sensitivity in some settings. Existing data collection and reporting systems across the four assessed humanitarian settings were generally fragmented and inconsistent, mainly attributed to the lack of coordination among different agencies. Interpretation Implementing agencies need to collaborate effectively to scale up this agreed-upon set of SRMNCAH framework to enhance accountability and transparency in humanitarian settings.
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Affiliation(s)
- Loulou Kobeissi
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Thidar Pyone
- Science Division, World Health Organization, Geneva, Switzerland
| | - Allisyn C. Moran
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Kathleen L. Strong
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Lale Say
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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