NIHR Global Health Research Group on Adolescent Health and Wellbeing

The UN Global Strategy for Women’s, Children’s and Adolescents’ Health (2015 – 2030) outlines how countries need to realise rights to physical and mental health and wellbeing in combination with social and economic opportunities to shape prosperous and sustainable societies. Embedded within the UN Sustainable Development Goals, and recognising national disparities, this strategy is especially pertinent to the adolescent population, as it is set against a backdrop of unparalleled global change, shaping the health and wellbeing of the largest population of adolescents in human history.

Adolescence is recognised as a critical phase in life for achieving human potential, influenced by interaction with the social environment, shaping and supporting the acquisition of physical, cognitive, emotional, social, and economic resources which form the foundation for later life health and wellbeing, and influence future generations. Despite their key role in society, adolescents and young adults have until recently been overlooked in global health and social policy.

This may be a key reason why fewer concrete health gains from economic development can be identified for them relative to other age groups. The literature points to a need for contextualised research that can inform intervention strategies to mitigate adverse conditions and nurture elements that can provide material and social protection and resilience for adolescents, enabling them to maximise their life chances.

In Malawi, the setting for this research, despite some efforts there has been limited progress towards meeting the needs of adolescents (26.1% of the population). For example, programming intended to extend health services to adolescents remains problematic, with essentially no universal health coverage for the youngest age groups, adverse social norms that preclude the use of contraception before the first birth, and many service-side barriers in achieving ‘Youth Friendly’ health services.

The COVID-19 pandemic also magnified these challenges, and the impacted service provision in health and education sectors has had disastrous impacts on adolescents through school closures and exacerbation of poverty owing to economic shutdown.

With this backdrop in mind, our interdisciplinary group will use a socio-ecological model to focus on the health and wellbeing of adolescents in Malawi. We will take a multifaceted transdisciplinary approach to understanding the context of both urban and rural settings through a formative research phase, generating new knowledge on the best preventive and nurturing strategies for adolescent health and wellbeing.

This formative work will support the co-creation, testing and evaluation of pilot interventions and prototypes in collaboration with adolescents, influencers, parents, and other sector stakeholders, building on established linkages and with full participation of youth through our engagement programme. Interventions will focus on (1) water, sanitation and hygiene, (2) gender, sexual and reproductive health rights, and (3) inspiring social and emotional wellbeing including mental health.

These areas will be supported by an examination of policy and economic frameworks needed to support long term synergy of investments and real change. A key outcome will be to ensure more effective peer, parental and multisectoral support, and novel approaches to contextualise and trial multi-sectoral intervention strategies which can be taken to scale