South Africa


‘Female adolescent struggles are often overlooked’ – health and wellbeing experts

‘Female adolescent struggles are often overlooked’ – health and wellbeing experts
From left: ​​Dr Shakira Choonara, technical specialist at the World Health Organization and Lancet commissioner on adolescent health and wellbeing. | Daily Maverick journalist Suné Payne. | Surabhi Dogra, a commissioner on adolescent health at Lancet. (Photos: Supplied)

Despite significant global investment in programmes for adolescent girls and young women, this group continues to carry the burden of HIV, child marriages, female genital mutilation, unmet needs for contraception and high levels of teenage pregnancy. Dr Shakira Choonara and Surabhi Dogra discuss some of these struggles.

“When it comes to any global issue, whether it’s nutrition, national policies, mental health or climate change, somehow we always miss the adolescent age group. As an adolescent ambassador working in public health now, I can see how adolescents’ health issues are often overlooked.”

These were the opening remarks of Surabhi Dogra, a commissioner on adolescent health at Lancet, one of the leading pathology laboratories in Africa.

Dogra was speaking during a webinar discussion on the challenges adolescent women face and the issues that shape adolescent girls and young women’s health and wellbeing. 

Joining the discussion were ​​Dr Shakira Choonara, technical specialist at the World Health Organization and Lancet commissioner on adolescent health and wellbeing, and Daily Maverick reporter Suné Payne.

For Choonara, the starting point for a discussion of this nature is by way of a definition of adolescents: 

“Essentially, when we talk about an adolescent, we are talking about a teenager … someone in the early phase of life between childhood and adulthood, from ages 10 to 19. Of course, what we can also see is that you cannot only focus on the 10 to 19 cohort – we do extend to 24 years old. Globally, we look at youth up to the age of 24, but on the African continent we do extend this to 35 years,” said Dogra.

“As it stands, we have the largest adolescent group in history … facing greater health challenges compared with the adolescent generation of 25 years ago, and, obviously, we can see that investments, policies and programmes are not keeping up with the growth in this age group.”

Situation between 1990 and 2016

Dogra says: “Interestingly, we can see that there is an increase of about 118 million adolescents who are overweight or obese – and 75 million living with anaemia – and when it comes to figures of completing secondary education, 300 million, which has not changed much since 1990. 

“Overall, whether it’s India or Africa, young women and girls are being left behind and tend to have worse health outcomes than men in areas like the prevalence of anaemia, child marriage and secondary education completion.”

Read more in Daily Maverick: The road to ending female genital mutilation must be paved in partnership with men and boys

“South Africa has one of the highest unemployment rates in the world and young people, in particular, are affected by this. Through your research, Dr Choonara, what can you tell us about how this affects women, mainly?” Payne asked.

“The situation is dire … There are so many unemployed young men and women – not just in South Africa. What does this then mean for a young woman’s health? We have ‘poverty-driven diseases’ … You are either forced into prostitution or transactional sex with older men (sugar daddies) which increases the risk of contracting HIV,” said Choonara. 

“Because of unemployment, these young women will not have good nutrition, which results in non-communicable diseases. The interlinkage is extremely strong and increases vulnerability.

“It’s an unequal playing field … not to say that other populations are not important, but the trends and vulnerability suggest girls and young women are two or three times more at risk in different contexts across the world.”

According to Choonara, the first steps in dealing with some of the challenges faced by adolescents are to fix the legal system and implement contextual solutions. DM


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