Health and education are interdependent pillars of human capital development, yet they are often treated in isolation within policy and economic models. This study presents a conceptual and empirical framework that integrates health and education interventions to assess their joint impact on educational attainment, population health, productivity, and economic development. Using a human capital approach, the study models the effects of four school-based health interventions-nutrition, deworming, water, sanitation, and hygiene (WASH), and mental health programmes-on education outcomes in 75 low- and middle-income countries. It also quantifies the long-term health benefits from reduced adolescent pregnancies, due to increased years of schooling, in the form of lower under-five and adult mortality. The immediate health benefits for adolescents of these school-based programmes are not modelled. Using an updated version of an education model combined with an employment benefits model, the study estimates the costs and returns of investing in these interventions from 2025 to 2050. Results show the interventions alone yield over 422 million additional school completions, with economic benefits exceeding US$15.3 trillion and a benefit-cost ratio (BCR) of 7.0. When health benefits of education in the form of reduced mortality are included, benefits rise to over US$25.2 trillion, with a BCR of 11.5. These findings demonstrate the powerful bidirectional relationship between health and education and support the case for integrated investments. The study also outlines methodological advancements in modelling the combined impact of education and health, while acknowledging limitations such as the focus on market-based outcomes and assumptions of uniform intervention effectiveness. Future research should include immediate economic benefits of health interventions, broader dimensions of human development, including equity, institutional quality, and social capital. The findings offer compelling evidence for policymakers to prioritize coordinated, cross-sectoral strategies that yield high returns in both education and health.
Adolescence is a critical period for the emergence of mental health disorders. The prevalence of depression and anxiety among adolescents in high- and middle-income countries has increased over the past three decades. According to the Global Burden of Disease Study (2025), mental disorders account for 21.4% of the adolescent burden of disease in high socio-demographic index (SDI) countries and 16.1% and 18.6% in the middle- and low-SDI countries. Despite the high and rising burden, adolescent mental health remains less prioritized in policy and funding. Treatment rates in low- and middle-income countries are low, with fewer than one in ten affected adolescents receiving care in some settings. Poor mental health in adolescence is associated with long-term losses in educational attainment, productivity and social participation. There is growing evidence suggesting that mental health interventions for depression and anxiety can be cost-effective even in resource constrained settings. This paper presents new evidence on the return on investment from scaling up interventions for adolescent depression and anxiety in two middle-income countries: Colombia and South Africa. Using the OneHealth tool and an economic model previously applied in global adolescent investment cases, we estimate health, education and economic benefits under a scale-up scenario. Scaling-up treatment for depression and anxiety in Colombia results in a benefit-cost ratio (BCR) for economic benefits alone of 13.9 and for combined economic and social benefits of 15.4. For South Africa the BCRs are 13.0 and 13.9, respectively. Our findings offer policy-relevant evidence to support increased investment in adolescent mental health in settings where data and resources remain limited.
Adolescents aged 10-19 years represent the largest cohort in human history and a critical global resource-yet realizing their potential requires deliberate, sustained investment in their health and well-being. This editorial introduces a six-article supplement in Health Policy and Planning addressing key priorities for adolescent health and well-being policy and programming, with particular attention to young people's own perspectives and evidence from low- and middle-income countries. The supplement opens with findings from the 'What Young People Want Survey', drawing on responses from over 1.5 million young people across 89 countries. Results reveal that adolescents' priorities span multiple domains-especially learning and employability, safety and supportive environments, and health and nutrition-underscoring the necessity of multi-sectoral approaches. Three articles address financing. Together, they demonstrate that integrated health-education interventions can yield returns of at least 11 dollars per dollar invested and that scaling up treatment for adolescent depression and anxiety produces benefit-cost ratios of 15.4 and 13.9 in Colombia and South Africa, respectively-while cautioning that investments must be designed with an explicit equity focus to avoid deepening existing inequalities. Another article presents new World Health Organization and Partnership for Maternal Newborn and Child Health guidance for monitoring adolescent health and well-being holistically across the five domains of the UN conceptual framework, supported by an Excel-based data tool that maximizes use of existing data. The supplement concludes with an early assessment of commitments made at the 2023 Global Forum for Adolescents across four countries, finding that progress is hindered by fragmented systems, funding gaps, and insufficient disaggregated data. The evidence presented in this supplement makes clear that improving adolescent health and well-being is neither aspirational nor unaffordable-it is an investment with compelling returns. Realizing those returns demands that adolescents' voices shape policy and that progress is rigorously monitored.
Adolescents in many countries face serious challenges in realizing the level of well-being that is their human right. Many factors-deep-seated inequality within and between countries, rapid change in skill requirements for employment, climate change, and social media-are driving these deepening challenges. This paper develops three points about the need for an urgent response to this situation. First, there is now evidence that a powerful suite of cost-effective investments is available to improve adolescent well-being. To support this claim, we draw on recent modelling of investments for many low- and middle-income countries (LMICs), as well as on detailed case studies of three countries (India, South Africa, and Colombia). In all these studies, most of the investments are highly cost-effective, with benefit-cost ratios over 6, and in many cases much higher. However, the cost of these investments is substantial, especially for those that involve the education system, raising major financing issues for most countries. Second, the case studies highlight, at least for South Africa and Colombia, the extent to which within-country inequality harms adolescent development. For example, if school quality is poor for low-income groups or regions, schooling can perpetuate rather than arrest inequality, which in turn can lead to disruptive violence for these groups or regions. Third, countries with limited fiscal space, high debt levels, and inequality and violence curtailing growth rates will find it hard to fund the investments needed to transform adolescent well-being. Major reforms to development finance are necessary, such as those outlined at the Fourth International Conference on Financing for Development at Seville in mid-2025, as well as changes to the priority given to domestic investments. Steps to reduce income inequality by new fiscal measures are also important, to fund the investments in adolescent well-being and to make them more effective.
Abstract Food retail environments in Southeast Asia are undergoing a significant transformation, marked by the rapid expansion of modern retail formats and simultaneous decline in traditional outlets. Despite the health implications of this shift, the political economy and governance dynamics shaping retail environments have received little attention from researchers and health policy makers. This study addresses that gap by analysing the institutional factors and actors interests that influence food retail policy. Semi-structured interviews were conducted with key policy actors across four case study countries (Indonesia, Malaysia, The Philippines, and Thailand). In total, 115 policy actors agreed to participate. The 3-i framework was used to inform the analysis on how and why food retail policies are made or change over time, through the interaction of interests, institutions and ideas. Interview data were analysed using a thematic analysis technique. This study found that across the four Asian countries nutrition was not prioritised by governments because food retail policies were largely shaped by institutional mandates focused on economic growth and food safety, while strong industry relationships, unequal power dynamics, and fragmented governance limited the integration of nutrition into policy development. Particularly, dominant institutional power of non-health ministries, long-standing government-industry ties, and development narratives centered on economic growth limited governments’ ability to address unhealthy food retail environments. This study suggests that strengthening the health sector’s influence in multisectoral food retail governance, broadening and balancing stakeholder representation, and reframing nutrition as a core development consideration. This should be supported by regional networks that can facilitate cross-country learning, coalition-building, and technical guidance. Together, these actions can help create a more policy space for advancing healthier food retail environments and nutrition-focused reforms across the region.
