Universal Health Coverage and the Forgotten Generation
The editorial focuses on the overlooking of adolescents when it comes to Universal Health Coverage, stating that the political declaration on the UN General Assembly on September 23rd overlooked this generation.
The three core indicators of universal health care(coverage, quality, and avoidance of poverty due to expenditure) are rarely achieved in adolescent health.Young adults face low health coverage, miss out on essential elements of a minimally sufficient health system, and are particularly vulnerable to catastrophic health expenditure. With 1·2 billion adolescents worldwide (defined by WHO as those aged 10–19 years),universal health coverage seems impossible without adequate consideration of the specific health needs of adolescents and young adults,” stated the editorial as per The Lancet.
The editorial stresses a one size fits for all approach does not work for adolescents citing examples such as reduction in childhood HIV incidence over the past ten years has not been replicated in adolescents(50% vs 5% reduction). These vulnerabilities are often exacerbated by reduced health literacy and hostile health services, such as antenatal care in which adolescent mothers tend to engage less than older mothers.
Key factors mentioned
- The lack of adolescent-specific country data
- The need for national quality standards for adolescent-responsive health systems
- Need for investing in adolescent-responsive workforces and evidence-based adolescent-specific interventions (including harnessing the potential of digital health and school-based approaches)
- The systematic removal of barriers and consideration of factors beyond the health system
- Tackling laws that disproportionately reduce young people’s access to health services (eg, the illegality of prescribing contraception for sexually active unmarried adolescents in some countries) and societal attitudes (eg, stigma surrounding menstruation, mental illness, and homosexuality)
- Comprehensive health systems for adolescents going beyond the focus on a single issue such as mental health
The authors conclude with stating that “Universal health coverage has enormous potential if we invest in adolescents and adapt our health systems to meet their needs. If we fail in that, we fail 1·2 billion people.”