Africa: Reframing Child and Adolescent Health for the SDG Era

Over the past two decades, the epidemiology of global child health has changed markedly, alongside our understanding of what works to improve the health and wellbeing of children and adolescents. As countries seek to recover and rebuild from the COVID-19 pandemic, a series of papers published today in the British Medical Journal (BMJ) supplement calls for a substantial evolution in this thinking, to meet the changing needs of all of today's young people.

Patterns of childhood death and disease are changing dramatically

Trends show that preventable deaths are now highest in the newborn period, though pneumonia, diarrhoea and malaria, compounded by malnutrition, continue to take a heavy toll on children under the age of five. This is particularly the case among the most marginalized populations in countries of sub-Saharan Africa ─ where the child population is expected to grow in the coming decades.

In some countries, however, mortality is increasing in older adolescents (15-19 years) due to road traffic accidents, interpersonal violence and self-harm. An increasing number of children and adolescents survive, but are affected by injuries, developmental disabilities, non-communicable diseases and poor mental health. Overweight and obesity among children and young people are rapidly on the rise, as many countries face a double burden of malnutrition from both under and over-nutrition.

These challenges are likely to be compounded by demographic shifts. An increasing number of children will be living in urban centres in coming years, limiting opportunities for clean air and physical activity and leading to serious strains on healthcare services in these areas without other interventions.

The health and wellbeing of children and adolescents must be at the center of efforts to achieve the Sustainable Development Goals (SDGs) by 2030

Countries can only thrive and prosper if they invest in early childhood and adolescence, and optimize support for the key formative moments for a child's future health - by using what is called a 'lifecourse approach'.

With this in mind, improving a child's health can no longer be thought of as purely a matter for the health sector, the series shows. Policies, services and information must be put in place as part of whole-of-government, and whole-of-society solutions.

The papers in this series highlight the challenges and opportunities that now need to drive the global, regional and national child and adolescent health agendas.

WHO and UNICEF are working together to re-envision the global child health agenda, with work underway to design and update the tools that will help countries put the new vision into practice.

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