Primary prevention of human papillomavirus (HPV) infection is particularly important in Africa, where there is a high and accelerating burden of cervical cancer. Stakeholders have increasingly called for integration of other services with HPV vaccination in low- and middle-income countries, yet successful and sustainable integration requires intensive resource inputs, and few countries in Africa have tested integrated approaches. We describe co-author experience and previously published assessments to present the experiences of four African countries, Senegal, Togo, Tanzania, and Lesotho, with integrating HPV vaccine services with other programmes and services. The resulting case series explores how countries are operationalizing the concept of integration and describes contextual factors for success and sustainability. A simple three-level framework for describing HPV vaccine integrated service delivery has emerged to guide future endeavors.

Recognizing the multiple and intergenerational benefits of investing in adolescent well-being, a Call to Action for Adolescent Well-being was launched in 2020 and endorsed by an unprecedented coalition of governments, UN agencies, nongovernmental organizations, and academic institutions. Signatories to the Call committed to engage adolescents in all legal, policy, and program processes that affect them; develop multisectoral, whole-of-government policy approaches that address adolescent well-being; and strengthen political commitment and funding for adolescents. To further support these efforts, the 1.8 Billion Young People for Change Campaign was launched in 2022 [ [1] The Partnership for Maternal, Newborn and Child Health1.8 billion young People for Change Campaign and the Global Forum for Adolescents. https://pmnch.who.int/news-and-events/campaigns/1-8-billionDate accessed: May 26, 2023 Google Scholar ].

As we are approaching the three-year mark of the initial wave of the pandemic, the world continues to grapple with the lasting impacts of COVID-19. Governments all over the world have taken unprecedented steps to fight the pandemic through farreaching public health measures and widespread lockdowns as well as fiscal and monetary policies to restart their economies. The United Nations Population Fund (UNFPA) defines young people as individuals between the ages of 10 and 24 years old: adolescents (aged 10–19) and youth (aged 15–24).* Young people felt the impact of the pandemic directly and immediately. With almost no notice, 1.6 billion young people in 188 countries were being kept away from school and universities due to physical distancing measures. They found themselves in the middle of an experiment in new ways of teaching and learning, or shut out of the education system altogether. Even as the pandemic entered its third year, 405 million schoolchildren in 23 countries continued to be affected by full or partial school closures. This large-scale interruption of learning has severe consequences – from compromising nutrition to limiting access to health care, raising school dropout rates, and depriving young people of social support and resources. It has also significantly impacted our ability to equip young people with the information and skills to make wellinformed decisions about their lives and bodies and develop healthy relationships via the provision of comprehensive sexuality education (CSE). Responding to adolescents’ and youth’s sexual and reproductive needs and rights during their transition towards adulthood is key in supporting evolving capacities to advance youth agency and empowerment. CSE equips young people with the foundation to make well-informed decisions about their lives and bodies and develop healthy relationships. Continuation of CSE delivery during a crisis such as the pandemic is critical to realise young people’s sexual and reproductive health and rights. This commentary aims to examine the COVID19 disruptions to CSE programming, responses, and strategies from countries and organisations to overcome challenges caused by COVID restrictions, and to explore the potential for digital technologies to deliver information and education in new ways.

A WHO global strategy launched in November 2020 sets out an ambitious pathway towards the worldwide elimination of cervical cancer as a public health problem within the next 100 years. Achieving this goal will require investment in innovative approaches. This review aims to describe integrated approaches that combine human papillomavirus (HPV) vaccination and cervical cancer screening in low- and middle-income countries (LMIC), and their efficacy in increasing uptake of services. A systematic review was conducted analyzing relevant papers from Embase, Medline, CINAHL and CAB Global Health databases, as well as grey literature. Narrative synthesis was performed on the included studies. Meta-analysis was not appropriate due to the heterogeneity and nature of included studies. From 5,278 titles screened, 11 uncontrolled intervention studies from four countries (from Africa and east Asia) were included, all from the past 12 years. Four distinct typologies of integration emerged that either increased awareness of HPV and/or cervical cancer screening, and/or coupled the delivery of HPV vaccination and cervical cancer screening programs. The synthesis of findings suggests that existing HPV vaccination programs can be a useful pathway for educating mothers and other female caregivers about cervical cancer screening; through in person conversations with care providers (preferred) or take-home communications products. Integrated service delivery through outreach and mobile clinics may overcome geographic and economic barriers to access for both HPV vaccination and cervical cancer screening, however these require significant program and system resources. One study promoted HPV vaccination as part of integrated service delivery, but there were no other examples found that examined use of cervical cancer screening platforms to promote or educate on HPV vaccination. This review has demonstrated gaps in published literature on attempts to integrate HPV vaccination and cervical cancer screening. The most promising practices to date seem to relate to integrated health communications for cervical cancer prevention. Future research should further explore the opportunities for integrated health communications to support the efforts towards the new global cervical cancer elimination agenda, and costs and feasibility of integrated service delivery for underserved populations.

Integration of vaccination against human papillomavirus (HPV) with other essential health services for adolescents has been proposed in global strategies and tested in demonstration projects in low- and middle-income countries (LMIC). Published experiences, global guidance, and one key example, the implementation of "HPV Plus" in Tanzania, all demonstrate the need for greater operational evidence to guide future implementation and policy. Review of experiences earlier in the life course, integrating post-partum family planning with infant immunization, show lessons from 13 LMICs that can apply to provision of adolescent health information and services alongside HPV vaccination. Three distinct models of integration emerge from this review comprising: 1) multiple tasks and functions by health staff providing vaccination and other care, or 2) secondary tasks added to the main function of vaccination, or 3) co-location of matched services provided by different staff. These models, with strengths and weaknesses demonstrated in family planning and immunization experiences, apply in different ways to the three main platforms used for HPV vaccination: school, facility or community. For HPV vaccination policy and programming, an initial need is to combine the existing evidence on vaccine service delivery - including coverage, efficiency, cost, and cost-effectiveness information - with what is known on how integration works in practice; the operational detail and models employed. This synthesis may enable assessment which models best suit the different service delivery platforms. An additional need is to link this with more tailored local assessments of the adolescent burden of disease and other determinants of their well-being to develop new thinking on what can and cannot be done to integrate other services alongside HPV vaccination. New approaches placing adolescents at the center are needed to design services tailored to their preferences and needs. The potential synergies with cervical cancer screening and treatment for older generations of women, also require further exploration. Coordinated action aligning HPV vaccination with broader adolescent health and wellbeing will generate social, economic and demographic benefits, which in themselves are sufficient justification to devote more attention to integrated approaches.

Danielle Engel and colleagues call for an increased focus on adolescents in scaled up programmes for child protection and gender based violence prevention

The adolescent well-being framework identifies Safety and a Supportive Environment as one of five domains underpinning adolescent well-being, with sub-domains on Safety and Security, Material conditions, Equity, Equality, Nondiscrimination, Privacy, and Responsiveness. Against this theoretical backdrop, the present paper describes the widespread and diverse threats to adolescents’ safety including various forms of violence - interpersonal, collective, and self-directed. The long-term and multidimensional negative impacts of violence on adolescents’ well-being are discussed, underscoring the importance of ensuring adolescents’ safety as a precondition to achieving well-being across other domains. The paper goes on to describe gaps in ensuring supportive environments including inadequate material conditions linked to poverty, unequal and inequitable access to information, products, and services, discriminatory and gendered social norms, lack of physical and online privacy, and inadequate opportunities for leisure and personal development. Drawing upon an extensive body of past research, the paper identifies key interventions at various levels of the socioecological framework to mitigate these risks and promote a safe and positive development of adolescents. Interventions at the individual or interpersonal level include safe spaces for the empowerment of adolescent girls, group education programmes for building positive masculinities among boys, and parent-child programmes that improve parenting skills and communication. Community-level interventions include those that aim to change behaviors by changing social norms, increase the quality school environments, and improve the responsiveness of health and protection systems. Structural interventions include poverty-reduction and social protection strategies, improving the built environment, legal reform, and careful implementation and enforcement of laws. The paper closes by arguing that synergies between different domains of wellbeing are required to ensure adolescents’ safety and to foster a supportive environment necessary for their positive development.

The introduction of the Human papillomavirus (HPV) vaccine has shown potential to not only prevent cervical cancer but also drive adolescents’ access to other health care services, even in low-income countries. Few studies have been conducted to date to identify best practices and estimate the acceptance, operational challenges and benefits of including broader adolescent health interventions into immunization efforts, knowledge which is essential to supporting widespread integration. In this paper we review the efforts undertaken by the government of Togo to integrate adolescent health programming with the HPV vaccination roll out. With the support of partners (GAVI, WHO, UNFPA and UNICEF), the country successfully completed, in 2017, two years of an HPV vaccine demonstration project, which entailed vaccinating 10-year-old girls against HPV in two selected districts of the country and integrating a health education component focused on puberty education / menstrual hygiene and hand washing practice. Our study is a post-implementation program evaluation, using mixed methods to assess key questions of feasibility and acceptability of an integrated adolescent package of care. It showed that the HPV vaccination in conjunction with the health education sessions was well received by the majority of health care providers, teachers and parents. Our study confirmed that in Togo it proved feasible to combine education and HPV vaccination in school-based service delivery. However, more operational research is neded to understand how to increase the impact and sustainability of the co-delivery of interventions. We did not analyze the health impact and cost implications of the intervention, which will be an important consideration for scaling up such integration efforts alongside routine immunization.

This commentary is in response to a paper published in the Lancet entitled: "Progress in adolescent health and well-being: tracking 12 headline indicators for 195 countries and territories, 1990-2016" (Peter Azzopardi et al, 2019). We agree with the authors' overall conclusions that although there has been progress in some health outcomes, health risks and social determinants, the situation has worsened in other areas. Other important messages emerge from studying the data with an adolescent sexual and reproductive health and rights (ASRHR) lens. First, notable albeit uneven - progress in all the ASRHR indicators has occurred inmulti-burden countries. Second, while we cannot assign a cause-effect relationship, it is reasonable to suggest that in addition to secular trends, deliberate global and national investment and action have contributed to and/or accelerated these changes. Third, progress in ASRHR in the multi-burden countries contrasts sharply with increases in rates of tobacco use, binge drinking and overweight and obesity, in all categories of countries. Based on these observations, we submit five implications for action: the adolescent health community must recognize the progress made in ASRHR; acknowledge that increasing investment and action in ASRHR has contributed to these tangible results, which has the potential to grow; build on the gains in ASRHR through concerted action and a focus on implementation science; expand the adolescent health agenda in a progressive and strategic manner; and contribute to wider efforts to respond to adolescents' health needs within the rapidly changing context of the worlds they live in.

In 2015, all the member states of the United Nations signed up to the 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals (SDGs) [1United NationsSustainable development goals. New York, United Nations.https://www.un.org/sustainabledevelopment/sustainable-development-goalsDate accessed: April 21, 2020Google Scholar]. SDG 3 aims to "ensure healthy lives and promote well-being for all at all ages." Central to this goal are the concepts of health and well-being. This is at least as true for adolescents (10–19 years) as for any other age group. The United Nations Secretary General's Global Strategy for Women's, Children's and Adolescents' Health (2016–2030), which aims to "ensure health and well-being for every woman, child and adolescent" within the context of the SDGs, recognizes that adolescents will be central to the overall success of the strategy [2The global strategy for women's, children's and adolescents' health 2016–2030. Every woman every child. 2015http://www.everywomaneverychild.org/globalstrategyDate accessed: April 21, 2020Google Scholar]. Similarly, the World Health Organization (WHO)–United Nations International Children's Fund–Lancet Commission calls for children (defined as <18 years of age) to be at the center of the SDGs [3Clark H. Coll-Seck A.M. Banerjee A. et al.A future for the world's children? A WHO–UNICEF–Lancet Commission.Lancet. 2020; 395: 605-658Abstract Full Text Full Text PDF PubMed Scopus (542) Google Scholar]. A recent call was also made for Universal Health Coverage to take a comprehensive approach to addressing the health and well-being needs of adolescents [4WHO, UNICEF, Plan International, International Association for Adolescent Health, Partnership for Maternal, Newborn & Child Health, Child Health Initiative, UN Major Group for Children and Youth, UNFPAAdolescent health – the missing population in universal health coverage.2019https://plan-uk.org/file/plan-adolescent-health-reportpdf/download?token=VVsY-cTpDate accessed: June 3, 2020Google Scholar]. Adolescent well-being is a personal and societal good in its own right, and at the same time, adolescence is a critical period of the life course when many of the factors that contribute to lifelong well-being are, or are not, acquired or solidified. The direct and indirect effects on adolescents' well-being of the coronavirus disease 2019 pandemic and the responses to it have reinforced the importance of systems being in place to support the well-being of adolescents. But what is adolescent well-being? And how do adolescent well-being and adolescent health relate to each other? As a contribution to answering these questions, the Partnership for Maternal, Newborn & Child Health and the WHO are leading an initiative of the United Nations H6+ Technical Working Group on Adolescent Health and Well-Being to develop a consensus framework for defining, programming, and measuring adolescent well-being [5WHOPromoting health through the life-course. H6: Harnessing the collective strengths of the UN system to reach every woman, child and adolescent. World Health Organization, Geneva2016https://www.who.int/life-course/partners/h4/en/Date accessed: June 24, 2020Google Scholar]. This framework adds to recent work to develop a Nurturing Care Framework for early child development [6WHO, UNICEF, World Bank GroupNurturing care for early childhood development: A framework for helping children survive and thrive to transform health and human potential. World Health Organization, Geneva2018https://apps.who.int/iris/bitstream/handle/10665/272603/9789241514064-eng.pdfDate accessed: April 23, 2020Google Scholar]. It is also part of a broader program of work that includes a multistakeholder Call to Action to prioritize adolescent well-being [7UN Major Group for Children and Youth, Partnership for Maternal, Newborn & Child Health, WHO, UNFPA, UNICEF, Plan International UK and the Child Health InitiativeMake adolescent well-being a priority: An urgent call to action (Version 3.0).www.adolescents2030.orgDate accessed: June 3, 2020Google Scholar], building momentum for a 2022 "Global Summit on Adolescents," which will review progress and aim to increase political and financial investments for this population group [8Partnership for Maternal, Newborn and Child HealthPMNCH calls for action on adolescent wellbeing at the ICPD25 Summit, 12 November 2019, Nairobi Kenya.https://www.who.int/pmnch/media/news/2019/ICPD25-call-for-action/enDate accessed: April 21, 2020Google Scholar]. Many descriptions of well-being have been developed [9Dodge R. Daly A. Huyton J. et al.The challenge of defining wellbeing.Internat J Wellbeing. 2012; 2: 222-235Crossref Google Scholar]. Two conceptual approaches dominate discussions: subjective and objective well-being. Subjective constructs emphasize personal experiences and individual fulfillment, which include eudaemonic well-being (e.g., finding meaning in life and experiencing a sense of personal growth), hedonic well-being (e.g., feeling happy and being satisfied with one's own life), as well as others (e.g., optimism) [10Martín-María N. Miret M. Caballero F.F. et al.The impact of subjective well-being on mortality: A meta-analysis of longitudinal studies in the general population.Psychosom Med. 2017; 79: 565-575Crossref PubMed Scopus (146) Google Scholar,11Steptoe A. Deaton A. Stone A.A. Subjective wellbeing, health, and ageing.Lancet. 2015; 385: 640-648Abstract Full Text Full Text PDF PubMed Scopus (1340) Google Scholar]. In contrast, objective approaches define well-being in terms of quality of life indicators such as material resources (e.g., income, food, and housing) and social attributes (education, health, political voice, social networks, and connections) [12Western M. Tomaszewski W. Subjective wellbeing, objective wellbeing and inequality in Australia.PLoS One. 2016; 11: e0163345Crossref PubMed Scopus (113) Google Scholar]. Such objective indicators commonly reflect capabilities, which include both an individual's functioning and the opportunities provided in a given environment, as argued by Sen [13Sen A. Human rights and capabilities.J Hum Dev. 2005; 6: 151-166Crossref Scopus (1111) Google Scholar]. "Relational well-being" emphasizes that an individual's well-being is heavily influenced by their relationships, with well-being seen as emerging "...through the dynamic interplay of personal, societal, and environmental structures and processes…" [14White S. Relational wellbeing: Re-centring the politics of happiness, policy and the self.Policy Polit. 2017; 45: 121-136Crossref Scopus (144) Google Scholar]. Indicators to measure adolescent well-being reflect these two concepts to differing degrees. Measures of subjective well-being apply indicators such as the subjective well-being measure used in the Gallup World Poll [15Diener E. Tay L. Subjective well-being and human welfare around the world as reflected in the Gallup World Poll.Int J Psychol. 2015; 50: 135-149Crossref PubMed Scopus (121) Google Scholar] and psychological need satisfaction and frustration scales [16Chen B. Vansteenkiste M. Beyers W. et al.Basic psychological need satisfaction, need frustration, and need strength across four cultures.Motiv Emot. 2015; 39: 216-236Crossref Scopus (1293) Google Scholar], whereas measures of objective well-being use indicators such as the Global Youth Development Index [17Commonwealth SecretariatGlobal Youth Development Index and Report 2016. Commonwealth Secretariat, London2016Crossref Google Scholar], positive youth development indicators [18Hinson L. Kapungu C. Jessee C. et al.Measuring positive youth development toolkit: A Guide for implementers of youth programs. YouthPower Learning, Making Cents International, Washington DC2016Google Scholar], or developmental assets scores [19Search InstituteUser guide for the developmental assets profile. Search Institute, Minneapolis, USA2016https://www.search-institute.org/wp-content/uploads/2018/01/DAP-User-Guide-1-2016.pdfDate accessed: April 21, 2020Google Scholar]. Based on a scoping of the literature and consultations across the UN H6+ Technical Working Group, youth networks, and adolescent-serving organizations, we propose a short and an expanded definition of adolescent well-being (Box 1). We also propose five interconnected domains for adolescent well-being and the requirements for adolescents to achieve well-being within each of these domains (Table 1). The five domains encompass both subjective and objective constructs and include health as one of the five domains. The domains are also underpinned by gender, equity, and rights considerations. An individual's degree of independence to access opportunities that foster their own well-being will vary across the decade of adolescence. Although important at all ages, adolescent well-being may, therefore, require greater adult support at younger ages.Box 1DefinitionsProposed definition of adolescent well-being.Adolescents thrive and are able to achieve their full potential.Expanded definition.Adolescents have the support, confidence, and resources to thrive in contexts of secure and healthy relationships, realizing their full potential and rights.Table 1The five domains of adolescent well-being that underpin the adolescent well-being frameworkNo.DomainSubdomainsRequirements includeType of well-being1.Good health and optimum nutrition•Physical health and capacities.•Mental health and capacities.•Optimal nutritional status and diet•Information, care, and services: access to valid and relevant information and affordable age-appropriate, high-quality, welcoming health services, care, and support, including for self-care.•Healthy environment: such as safe water supply, hygiene, sanitation and without undue danger of injury in the home, safe roads, management of toxic substances in the home and community, access to safe green spaces, and no air pollution. Skills to navigate the environment safely.•Physical activity: Has access to opportunities for adequate physical activity.•Diet: Has access to local, culturally acceptable, adequate, diversified, balanced, and healthy diet commensurate to the individual's characteristics and requirements, to protect from all forms of malnutritionPhysicalNutritionalEmotionalSociocultural2.Connectedness, positive values, and contribution to society•Connectedness: Is part of positive social and cultural networks and has positive, meaningful relationships with others, including family, peers, and, where relevant, teachers and employers.•Valued and respected by others and accepted as part of the community.•Attitudes: Responsible, caring, and has respect for others. Has a sense of ethics, integrity, and morality.•Interpersonal skills: Empathy, friendship skills, and sensitivity.•Activity: Socially, culturally, and civically active.•Change and development: Equipped to contribute to change and development in their own lives and/or in their communities.•Connectedness: Has access to opportunities to become part of positive social and cultural networks and to develop positive, meaningful relationships with others, including family, peers, and, where relevant, teachers and employers.•Valued: Has opportunities to be involved in decision-making and having their opinions taken seriously, with increasing space to influence and engage with their environment commensurate with their evolving capacities and stage of development.•Attitudes: Has access to opportunities to develop personal responsibility, caring, and respect for others and to develop a sense of ethics, integrity and morality.•Interpersonal skills: Has access to opportunities to develop empathy, friendship skills, and sensitivity.•Activity: Has access to opportunities to be socially, culturally, and civically active that are appropriate to their evolving capacities and stage of development.•Change and development: Has access to opportunities to develop the skills to be equipped to contribute to change and development in their own lives and/or in their communities.EmotionalSociocultural3.Safety and a supportive environment•Safety: Emotional and physical safety.•Material conditions in the physical environment are met.•Equity: Treated fairly and have an equal chance in life.•Equality: Equal distribution of power, resources, rights, and opportunities for all.•Nondiscrimination.•Privacy.•Responsive: Enriching the opportunities available to the adolescent.•Safety: Protection from all forms of violence and from exploitative commercial interests in families, communities, among peers and in schools, and the social and virtual environment.•Material conditions: The adolescent's rights to food and nutrition, water, housing, heating, clothing, and physical security are met.•Equity: There is a supportive legal framework and policies and equitable access to valid and relevant information, products, and high-quality services.•Equality: Positive social norms, including gender norms, to ensure equal rights and opportunities for all adolescents.•Nondiscrimination: Free to practice personal, cultural, and spiritual beliefs and to express their identity in a nondiscriminatory environment and have the liberty to access objective, factual information, and services without being exposed to judgmental attitudes.•Privacy: Their personal information, views, interpretations, fears, and decisions, including those stored online, are not shared or disclosed without the adolescent's permission.•Responsive: Has access to a wide range of safe and stimulating opportunities for leisure or personal development.PhysicalEmotionalSociocultural4.Learning, competence, education, skills, and employability•Learning: Has the commitment to, and motivation for, continual learning.•Education.•Resources, life skills, and competencies: Has the necessary cognitive, social, creative, and emotional resources, skills (life/decision-making) and competencies to thrive, including knowing their rights and how to claim them, and how to plan and make choices.•Skills: Acquisition of technical, vocational, business, and creative skills to be able to take advantage of current or future economic, cultural, and social opportunities.•Employability.•Confidence that they can do things well.•Learning: Receives support to develop the commitment to, and motivation for, continual learning.•Education: Has access to formal education until age 16, and opportunities for learning through formal or nonformal education or training beyond.•Resources, life skills, and competencies: Has opportunities to develop the resources, skills (life/decision-making), and competencies to thrive.•Skills: Has opportunities to develop relevant technical, vocational, business, and creative skills.•Employability: Is given the opportunity to participate in nonexploitative and sustainable livelihoods and/or entrepreneurship appropriate for their age and stage of development.•Confidence: Is given the necessary encouragement and opportunities to develop self-confidence and is empowered to feel that they can do things well.EmotionalCognitive5.Agency and resilience•Agency: Has self-esteem, a sense of agency and of being empowered to make meaningful choices and to influence their social, political, and material environment and has the capacity for self-expression and self-direction appropriate to their evolving capacities and stage of development.•Identity: Feels comfortable in their own self and with their identity(s), including their physical, cultural, social, sexual, and gender identity.•Purpose: Has a sense of purpose, desire to succeed, and optimism about the future.•Resilience: Equipped to handle adversities both now and in the future, in a way that is appropriate to their evolving capacities and stage of development.•Fulfilment: Feels that they are fulfilling their potential now and that they will be able to do so in the future.•Agency: Has opportunities to develop self-esteem, a sense of agency, the ability to make meaningful choices and to influence their social, political and material environment, for self-expression and self-direction.•Identity: Has the safe space to develop clarity and comfort in their own self and their identity(s), including their physical, cultural, social, sexual, and gender identity.•Purpose: Has opportunities to develop a sense of purpose, desire to succeed, and optimism about the future.•Resilience: Has opportunities to develop the ability to handle adversities both now and in the future, in a way that is appropriate to their evolving capacities and stage of development.•Fulfilment: Has opportunities to fulfill their potential now and to be able to do so in the future.EmotionalCognitive Open table in a new tab Proposed definition of adolescent well-being. Adolescents thrive and are able to achieve their full potential. Expanded definition. Adolescents have the support, confidence, and resources to thrive in contexts of secure and healthy relationships, realizing their full potential and rights. The examples that are given in the subdomains and the requirements to achieve these are illustrative and not exhaustive. The definition of adolescent well-being and its five domains applies everywhere and is relevant for all adolescents, including males and females, wealthy and poor, and the able-bodied and those with chronic disability, for example. They also emphasize the multidimensional nature of well-being. Therefore, programming to improve adolescent well-being will require a multisectoral approach, and the measurement of adolescent well-being will require multidimensional indicators that encompass all five domains and include both subjective and objective measures. It is for this reason that in addition to working toward a consensus set of health indicators, the multiagency Global Action for Measurement of Adolescent Health initiative led by WHO involves assessing indicators of adolescent well-being, with a view to agreeing on a core set of well-being indicators [20Guthold R. Moller A.B. Azzopardi P. et al.The Global Action for Measurement of Adolescent Health (GAMA) initiative—Rethinking adolescent metrics.J Adolesc Health. 2019; 64: 697-699Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar]. Maintaining and improving the well-being of its citizens is the fundamental duty of all governments, supported by the United Nations, civil society organizations, private sector, families and communities, adolescents, among many others. This requires a clear definition and measurable indicators. Given the multidimensional nature of well-being, spanning five domains, it will be essential that multiple sectors unite behind the common objective of improving well-being, using a common set of definitions, concepts, and indicators. Here, focusing on adolescents, we have proposed the first two of these requirements—a clear definition and description of five domains that underpin a conceptual framework for adolescent well-being, whereas work continues on the development of the common set of indicators and the policy and programming implications of this framework.

In 1994, the International Conference on Population and Development (ICPD) put forward a groundbreaking call to place adolescent1 sexual and reproductive health and rights (ASRHR) on the agenda. Sp...

Adolescence is a dynamic life phase with rapid physical growth and sexual development and acquisition of neurocognitive and socioemotional skills. It is in adolescence that the foundations for future health and well-being are laid; assets acquired across adolescence (such as health, social, and emotional well-being and education) have profound implications for lifelong health, well-being, life chances, and choices, as well as for a country's social and economic development [ 1 UN Committee on the Rights of the Child (CRC)General comment No. 20 (2016) on the implementation of the rights of the child during adolescence. United Nations, Geneva6 December 2016 Google Scholar , 2 Sawyer S.M. Afifi R.A. Bearinger L.H. et al. Adolescence: A foundation for future health. Lancet. 2012; 379: 1630-1640 Abstract Full Text Full Text PDF PubMed Scopus (1299) Google Scholar , 3 Gribble J. Bremner J. The challenges of attaining the demographic dividend. Population Reference Bureau, Washington, D.C.2012 Google Scholar ]. Given adolescents' sensitivity to their environments, deliberate, well-targeted, and well-funded policies and programs designed to promote supportive, safe, learning environments can be particularly beneficial.

The worst rates of preventable mortality and morbidity among women, adolescents, and children occur in humanitarian and other crises. Sarah Zeid and colleagues discuss the specific attention that is needed for women, adolescents, and children in crises and fragile settings