Adolescent Health & Immunization: Insights from Latin America and the Caribbean
Immunization plays a critical role in keeping preteens and teens healthy and protected from vaccine-preventable diseases, including influenza, whooping cough, tetanus, diphtheria, meningococcal disease and cancers caused by human papillomavirus. The Sabin Vaccine Institute recently concluded a series of regional workshops around the world focused on promoting adolescent health and immunization.
In July, 30 adolescent health and immunization experts from 14 countries across Latin America and the Caribbean gathered in São Paulo, Brazil, for the final of three workshops in the series. The two-day workshop focused on exploring, promoting and integrating adolescent health as part of a strategy to improve health from infancy to adulthood. The workshop provided a space for thought leaders to share country-specific experiences with implementing an adolescent immunization program and current challenges and opportunities in establishing an effective adolescent health platform.
Previous workshops were held in the Middle East and Asia. By bringing together government health officials, adolescent health advocates and primary care physicians with immunization experts, the workshops gave participants an important opportunity to collaborate and identify tangible approaches they can take to achieve the promise of adolescent immunization.
Adolescents account for approximately 30 percent of the population in Latin America and the Caribbean. Investments in adolescent health help drive economic growth and contribute to healthy behaviors and outcomes of future adult populations. Dr. Sonja Caffe, regional adolescent health advisor for the Pan American Health Organization (PAHO), opened the workshop with a discussion on adolescent health priorities and interventions. While a significant portion of PAHO member states have a plan of action to improve adolescent health, countries often face insufficient funding and staffing, fragmentation across the region, and legal, policy and societal barriers to accessing adolescent health services. Adolescents are not typically engaged in program planning to identify and address their needs.
Participants discussed key components of establishing an integrated, multi-sector approach to adolescent health to address barriers and fragmentation within established systems. There was unified consensus that the focus should be school, community and family interventions that cover the spectrum of early to late adolescence. In order to move an agenda forward, there needs to be cross-sectoral buy-in, political will and integration of institutional knowledge from leading health experts, ministries of health and education, community health care workers, parents and adolescents.
To move health priorities forward, every country has to assess their own vulnerabilities and challenges, as social factors affecting adolescent health are country-specific and complex. As part of this process, health providers must communicate directly with adolescents to better understand risk perceptions and gaps in services. Adolescents need to understand their rights to health and, in a similar regard, take ownership of their health behaviors. By creating a space for dialogue – whether in a community health center or through a social media platform – health care workers can distribute important scientific data in a tailored manner and adolescents can vocalize questions and concerns. Representatives from Brazil, Chile and Peru spoke about current strategies being utilized to reach adolescents and youth, including an Instagram campaign about skin cancer and targeted commercials to raise awareness on health issues that matter to today’s youth.
Participants explored how best to reach adolescents, including primary care services and school-based programs. Youth tend not to think they need annual check-ups, so primary care facilities seeking to reach adolescent populations may need to adapt their strategies and actively market themselves to youth. School-based programs benefit from easy access to adolescent populations, offer a multi-sector approach and the ability to have a broad reach over a short period of time. However, bureaucracy, excessive regulation and restricted funding make this approach difficult, especially since many schools do not have a robust health care structure in place to implement a successful program. Despite the barriers that persist, participants acknowledged that existing school-based and primary care programs can be modified and improved by strengthening monitoring and evaluation tools. Bearing in mind that opportunities to measure impact are largely dependent on funding, participants agreed that health providers must work in a concerted effort to drive the implementation of measured and timely programs.
Workshop participants concluded that in order to establish a systematic, coordinated approach to adolescent health services at the regional and national level, greater investments are needed in financial and human resources, robust data to make evidence-based decisions, and policy initiatives that target adolescents. There was consensus that the healthcare provider community needs to identify a target age to immunize adolescents in order to close the gap on missed opportunities. National standards are urgently needed to implement interventions that are evidence-driven and scaled appropriately to equitably benefit all adolescents.
Looking ahead, Sabin is continuing conversations with key experts, exploring ideas generated through this workshop and the previous meetings held in the Middle East and Asia, and preparing to publish meeting reports from each workshop in an effort to generate further discussions and action to facilitate the integration of adolescent health services.