Medical Research Council
World Health Organization
Health Systems Trust
2011-2012 Education Sector HIV and AIDS: Global Progress Survey- Progression, Regression or Stagnation?UNAIDS
If your interest in youth health has been aroused by the escalating figures of the prevalence of HIV infection amongst South African youth, you would be convinced that the epidemic has managed to send a wake up call to all organisations and institutions targeting youth health.
In reality youth health has been on the agenda for both researchers and service providers for quite some time. Prompted by high rates of teenage pregnancies, research was undertaken in an attempt to gain insight into factors around this problem. As a result, youth health centres were established in a number of areas within the country. While these centres had their merits, lack of male involvement and a targeted focus on pregnancy prevented these centres from giving a truly comprehensive service and limited their usefulness to a particular time and place.
Service utilisation is directly related to how services are organised. Sexual health concerns are often the main reason for youth to seek health services. Due to socio - cultural sensitivities around sexual health, it is critical that service providers aknowledge that the sexual health needs are part of the overall health needs of the youth, in todays reality. Such acknowledgement tends to reassure the youth that its okay to take responsibility for ones sexual health. While health services may not provide the complete panacea for addressing youth health problems, they still remain part of the solution.
Most adults could make a shopping list of the needs of their youth with ease. Such needs may range from understanding the implications of physical changes at puberty to the development of self sufficiency. However, developing integrated day to day interventions for addressing such needs remains the greatest challenge for the adult community. Hence most adults acknowledge the role of professional workers in complementing their own.
Young people are often alienated from sources of support and information. Often youth lack a supportive environment and other basic services such as access to education, skills, employment and health care as well as respect, shelter, food and protection from abuse (especially sexual abuse) which puts their health at risk. As a result, young people are vulnerable.
It is against these challenges that a number of initiatives targeting youth health have been proposed and underway for quite some time. Typically these tend to reflect the underlying ideology of the service provider.
Initiatives underpinned by the health promotion paradigm tend to advocate a spectrum of preventative approaches. These range from increasing access to information, increasing access to services that are youth centered and building skills. Within such an approach, skills which will enable young people to make informed decisions are taught. While such an approach may sound like a magic bullet for youth health, it has some deficiencies. Deeply entrenched attitudes within societies diminish the effectiveness of this approach, such as the unequal power relations between the sexes, and the consequent dominance of violence in these relationships.
Proponents of this approach tends to see youth health services that are removed from the main stream health services as the most effective vehicle for delivery of comprehensive health services to youth. Reconciliation of this approach with the philosophy of the district health system, which emphasis the integration of services, remains a challenge.
There are a number of initiatives whose pragrammes are centred around the premise that health is a development issues and therefore should be dealt with within the broader context of development. There is clear evidence of a relationship between factors such as level of education, number of people within households etc., and health status. The adverse effects of such conditions tend to force the youth to start fending for themselves at a tender age. In this way youth tend to practice and be exposed to high risk behaviour that increases their vulnerablility.
The development of enabling policies in areas like education, housing, and employment may seem only distantly related to health. However, proponents of this approach see the redress of such socio-economic imbalances as a fundamental step towards addressing youth health issues. Developing income generating skills as well facilitating the development of enabling legislation and policy frameworks are often their main intervention strategies.
While everybody acknowledges the need for a multi-sectoral approach in addressing the health needs of the youth, it still remains a challenge to define the best sector combination that is likely to provide a comprehensive strategy for addressing the health needs of the youth of South Africa.
In my view, HIV/AIDS pandemic has helped us to realise the effects of using a disease profile in crafting health care responses. Within the South African context, the single disease approach will not be particularly helpful in addressing the health needs of the youth. Instead a broad based strategy reflecting a partnership between all relevant sectors would be a logical approach in addressing youth health, irrespective of prevailing diseases.