Start with a Girl: A New Agenda for Global Health

"When adolescent girls win, everyone wins. The primary motivation to improve the health of and health care for adolescent girls must always be the wellbeing of girls themselves. But girls are also agents of positive change for their future families and communities."

This study is part of the Girls Count series of the Coalition for Adolescent Girls. The purpose of the series is to "uncover adolescent girl-specific data and insights to drive meaningful action," as a poverty reduction strategy. As the Coalition notes: when an adolescent girl "stays in school, remains healthy, and gains real skills, [she] will most likely marry later, have fewer and healthier children, and earn an income that she will invest back into her family."

This report shows that a girl who reaches adolescence typically begins it in good health. But a variety of health issues during her adolescent years will determine her future - and the wellbeing of her family for generations to come. Among the things that negatively impact adolescent girls:

• Girls' disadvantaged social position relative to boys and men
• Forced sexual initiations
• Limited employment options that are unsafe and exploitative
• Early marriage before physical and emotional maturity
• School drop-out rate

The authors contend that the health of girls is primarily shaped by social factors, not biological. The authors describe the positive multiplier effect of including adolescent girls in global health programmes and policies - and the risks if they continue to be left out in a comprehensive action agenda. Some communication-related strategies from this agenda are listed below:

• Youth-health services that include health worker training outreach to adolescents, and the use of peer workers.
• A "twelve-year-old check" scheduled for every girl living on less than US$2 per day with a wellness check-in and referrals for further treatment, at some point between the ages of 10 and 14.
• Offer community education and mobilisation to reduce child marriage and female genital cutting in countries with high prevalence of these risky practices.
• Engage boys and young men through programmes to overcome gender inequalities in health and to reduce gender-based violence and HIV/AIDS.
• Use media and education to promote physical activity and improve diets in countries where the prevalence of overweight among economically poor people is high and/or rapidly growing.
• Introduce media-based "enter-education/edutainment" programming on sexual and reproductive health, gender-based violence, and other relevant health challenges, to reach both girls and their social networks.
• Create or explained smoking reduction and prevention campaigns, including through bans on tobacco advertising and through school- and media-based education.
• Provide school-based sexuality, gender, and human rights education.

To accomplish this agenda, adolescent girls themselves can be organised to serve as their own champions. Ministers of Health can play a public role to bring girls' health to the forefront of public attention. Advocacy-based non-governmental organisations have a role in advocating for the entire agenda to governments, donors, and the population itself.

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