(September 2010) With almost half of the world’s population under age 25, investments in young people are vital to improve economic and social outcomes and achieve the Millennium Development Goals (MDGs). Recognizing the importance of harnessing the energy and initiative of the world’s youth to contribute to development efforts, the United Nations proclaimed Aug. 12, 2010, the start of an International Year of Youth. This proclamation offers new and exciting opportunities for governments, civil societies, individuals, and communities to create awareness about the diverse health needs of young people and develop effective policies that address these needs.

What are some of the challenges facing youth? How can greater policy and programmatic investments in adolescent reproductive health help countries mitigate these challenges and achieve the MDGs? How can policymakers, practitioners, and advocates work together to mobilize and engage new partners in youth development, including youth themselves?

During a PRB Discuss Online, Jenny Truong, youth reproductive health advisor at USAID; Alexandra Hervish, policy analyst at the Population Reference Bureau; and Brad Kerner, adolescent reproductive health senior specialist at Save the Children, answered questions from participants about the importance of investing in youth development and adolescent reproductive health policies and programs. This Discuss Online session was sponsored by the BRIDGE project, a cooperative agreement between USAID’s Global Health Bureau and PRB.


Sept. 23, 2010 1 PM EDT

Transcript of Questions and Answers

Remi Akinmade: How can the developing countries leaders (especially Sub-Saharan Africa) attention be drawn to the mass unemployment of youths – leading to hunger, neglect and being used as instruments of violence to foment communal clashes, political unrest . . . ? Their future is being destroyed.
Brad Kerner: Maybe civil society can start putting more pressure on governments and making them more accountable for the survival and wellbeing of youth. This International Year of the Youth provides and excellent platform for this.
Alexandra Hervish: Please see my response to Sanjay Mishra. For addition information, see International Alert’s publication entitled Rethinking the nexus between youth, unemployment and conflict – Perspectives from Sri Lanka at http://www.international-alert.org/pdf/LEO_Sri_Lanka.pdf.

C S Radhakrishnan: The latest UN initiative to have yet another International Year of the Youth is timely. There seems to be an excessive weighting of the discussions on the sexual Health side. Without minimizing the need for such discussions, isn’t it necessary that we address the problems of youth in coping with emotional problems of growth, need for a proper orientation towards social responsibility at the crucial stage of personality development of the young persons?
Jenny Truong: Dear C S, Thank you for your insights. The International Year of Youth is a fabulous opportunity to bring all issues to the attention. Reproductive health issues continue to be important because the risks of mortality and morbidity related to pregnancy and childbirth, particularly in sub-Saharan Africa, remain one of the highest risks for young women. Comprehensive sexuality education programs often address emotional issues related to growth and puberty. Various U. N Agencies have created guidance to help schools, teachers, and health educators design such curricula. See http://unesdoc.unesco.org/images/0018/001832/183281e.pdf  
Brad Kerner: Thanks for your insights. I agree with you, this is a very exciting time. Since 1999, we have been celebrating the International Youth Day on August 12, but to have a full year declared by the UN that focuses on Youth Development adds to the momentum we are currently experiencing. This momentum is signaled by an increased recognition of the role youth play in the development of their societies (viewing youth as assets and contributors) as well as increased investment in youth. As an Adolescent Sexual and Reproductive Health specialist, I am quite pleased by the US government’s commitment to women and girls in their Global Health Initiative. It might seem that there is an excessive emphasis on the sexual and reproductive health side this year, but that is because we have some facts:

• Complications due to pregnancy and childbirth as well as unsafe abortions are still the number one killer of girls 15 to 19 years old with young women aged 15 to 19 are twice as likely to die in childbirth as adult women.

• Young people have the highest levels of unmet need for contraception; less than 5% of the poorest sexually active young people use modern contraceptive methods.

• Half of all new HIV infections occur in young people between the ages of 15 and 24.

These are just a few statistics but it is important to note that such negative sexual and reproductive health outcomes have economic and social consequences that affect young people throughout their lives, as well as their families and communities. I would also argue that working with youth on coping with emotional problems of growth and the need for a proper orientation towards social responsibility is all part of a young person’s emotion, physical and sexual development. It’s all linked together. So yes, young peoples’ needs and contributions extend way beyond sexual and reproductive health. So go for it. This is the International Year of Youth. Create an event with youth that looks into these issues. See the UN framework for the year at: http://social.un.org/youthyear/unapproach.html
Alexandra Hervish: You bring up some very pertinent points. You are quite right that youth development is interdisciplinary. A holistic, life-cycle approach to youth development recognizes that the physical, emotional, and cognitive needs of young people evolve as they transition from childhood to adulthood. From this perspective, while discussions about sexual health often examine the physical elements of reproductive health, they are not necessarily exclusive of the cognitive and emotional aspects of adolescent development. Increasingly there are more and more integrated youth policies and programs that focus on the implications of gender on health, empowering young people to make healthy decisions and realize their personal goals, or developing young people’s life skills to respond to complex challenges in particular socio-cultural contexts. One example is Instituto Promundo, a Brazilian NGO that conducts research, promotes programs, and advocates for positive changes in gender norms and behaviors among individuals, families, and communities. For more information, visit http://www.promundo.org.br/en/.

Issa Almasarweh: Do you think that investing in youth implies revising education and training curricula to make them more relevant to developing countries and youth survival needs? Million of children and youth in these countries spent their whole summer learning how to memorize religious scripts they don’t understand their meaning in stead of learning skills that will help them do their daily life duties, work, earn income and survive.

Brad Kerner: Dear Issa, Yes, I think we can definitely do a better job at making curricula more relevant to the needs of youth. When was the last time we talked to youth involved in our programs and initiatives to see what they like and don’t like about what they are learning? Are we afraid of what we might hear? Moreover, so many national curricula are still void of health and development issues that would give children the real skills they need in their lives. When these issues are included in a national curriculum, especially sexual and reproductive heath topics, training for teachers often fail to adequately prepare them to comfortably address and teach these issues. There are lots of great resources out there on how to integrate SRH issues for youth from a religious perspective. Check them out: http://info.k4health.org/youthwg/trainingmaterials.shtml
Alexandra Hervish: Thank you for your question. Looking at education from a holistic perspective, basic life-skills training on livelihood and workforce development, sexual and reproductive health, and the transition from childhood to adulthood can prepare young people to contribute to national development and improve their lives. While life skills education does not necessarily need to replace formal school curricula, it certainly offers a complementary type of learning. It can build young people’s skills in problem-solving, leadership, decision-making, interpersonal communication, self-awareness, and coping with challenging situations. It can provide information about how to participate in civic life, protect oneself from HIV, or manage money. When considering life skills education programs, it is important to define which skills should be taught, why they need to be taught, and how they are used in particular life situations. In addition, life skills programs require an understanding of the local context and the realities in which young people live their lives. While formal schools may offer one learning environment, it may be more effective to offer non-formal or informal programs to reach the large numbers of young people who are not in school.
Jenny Truong: Thank you Issa for your question. I agree with you that curricula have to be made relevant in order for them to be effective at imparting knowledge and skills that will help them earn income and not just survive, but flourish. See the link I included in my response to C S.

jin in: This timely and exactly what we need to focus on. Unfortunately in too many societies, youth are NOT valued, particularly girls. It’s why I started a global organization dedicated to girls’ leadership development AND a “glocal” (think global, act local) social change MOVEMENT to value and invest in the world’s poorest girls. Thus, how can we work towards transforming traditional societies to first value young people esp girls? If you have models/recommendations, I’d be delighted to learn. Thank you.
Jenny Truong: Dear Jin: Congratulations on your “glocal” social change movement! I think you’re exactly right that this needs to be a movement, and know that you are part of one. There are many organizations who are dedicated to the same goals you are. A lot can be done when we share the successes we achieved and challenges we face. I second Brad’s suggestion to check out the Girl Effect and the Coalition for Adolescent girls – you’ll be glad you did!
Alexandra Hervish: Thank you for your important question. Transforming the position of youth, especially girls, involves understanding their lives, challenges, and opportunities. Part of this process includes educating families and communities and creating awareness about how young people can contribute positively to development. In a sensitized and enabling environment, it is easier to promote youth and girl leadership, allowing youth to be agents of change. A great example of an organization that supports community-led development and has empowered communities to bring about change for young people is Tostan. For example, Tostan has been very successful in raising awareness about female genital mutilation and placing communities in charge of the decision-making process. For more information, visit http://www.tostan.org/.  
Brad Kerner: Well, it sounds like you should be teaching us as your experiences would be so helpful to the global community who cares about girls. I love that you focus on girls’ leadership development and call it a global social change movement! Because that is what we really need, first families, then communities, that countries to start to see the value of girls and how they have so much to contribute to society. I don’t personally know models but I think you can find all your answers at: http://www.girleffect.org/. Watch the opening video. It will give you the chills and make you cry; then it will inspire you to keep on doing your amazing work. Then, within the site, you can find many resources to help you with your work. Also consider joining the Coalition for Adolescent Girls and share all that you are doing because you might have the solution we are all looking for! http://www.coalitionforadolescentgirls.org/  

Dr. Anima Sharma: As we all know, curent demographic trends show an inclination towards the increase in the youth population, especially in the developing countries. Children and youths are the future of the society hence we also see a global trend of investing resources on the youths and making youth centered programmes, policies and development strategies. The focus of all these are usually health and education. These are the important areas for the healthy development but as a Social Scientist I am also concerned about the restoration of non-material, cultural aspects. Youth is the most vulnerable phase of life, which determines the future trends of not only one’s own life but the entire social system. Hence, I think we need to inculcate the basic values and virtues of humanity in them. The youths are becoming independent, which is good but with that they are also becoming insensitive towards their duties and responsibilities. In several cases I have found that they lack basic civic sense, patriotic values and spirit of fulfilling the expectations of others. There are studies suggesting that modernization and industrialization has brought tremendous change in the social structure and social system, which has affected the psychological growth of all the people across the demographic borders but youths in particular. Hence, I want to suggest that would it not be better that rather than focussing on their physical growth only we should also focus on their psycho-social development to make their personality balanced, wholistically?
Brad Kerner: Dear Dr. Sharma, Yes, you are correct about the demographic trends. Today’s generation of young people is the largest in history — nearly half of the world’s population is under the age of twenty-five. This large demographic of young people presents the world with an unprecedented opportunity to accelerate economic development and reduce poverty. I do not think anyone would argue with you, that we need to invest in young people’s psycho-social development from a holistic perspective. We all have examples when youth, with the support of caring adults, have created civic movements that benefit all. And in doing so, youth have gained life-long skills. But I would like to turn your question back to you: Do youth lack basic civic sense, patriotic values and spirit of fulfilling expectations of others? Or are they picking up these values from the adults and society’s resistance to change? I think we need to challenge ourselves as adults and question what kind of role models are we being for young people. I also think we need to challenge what the “expectations” are of young people. I think it is great if youth challenge certain social expectations; like the expectation of girls to marry early, bear many children and serve her family and husband before developing her own capacities. These are expectations worth challenging through social movements like the one our colleague, Jin In, is trying to do.
Jenny Truong: Dr. Sharma, thanks for your questions. You’re right about the demographic transition and its implications for the large population of young people that need to have access to education and health information and services. The world is constantly modernizing and will constantly change the environment in which generations of young people grow, mature, gain values, and form opinions about their role in society. What remains are the social networks in place, which includes this requires engaging parents, family members and community members. You might appreciate “Growing Up Global”, a comprehensive compilation of essays of how the transition to adulthood has changed in the past twenty years http://www.nap.edu/catalog.php?record_id=11174  
Alexandra Hervish: Thank you for your question. Please see my response to Issa Almasarweh on holistic youth development.

Sanjay Mishra: Investment in youth needs to be increased or reanalyzed the ways and methods it has been done as of now. If we look at trends, in Africa lots of youths are deprived of technical education which can efficiently make them able to earn livelihood therefore, HIV/AIDS prevalence is still high, child mortality is staggering high, malaria, malnutrition and hunger a giant issue. Besides in central and north/west Africa – due to low investment in education – mass-killings and other blasphemous events are happening. Similarly in Asia/South East Asia more or less the situation is same. So is there any specific measurement to prevent youths from going in hands of illegal mentors who are converting them into a mass killer or deviating them from the mainstream of the society? Also what is the current global investment trends in the these affected societies?
Brad Kerner: Dear Sanjay, This is a hard question for me to answer as my professional career has truly been focuses on Adolescent Sexual and Reproductive Health. But it does seem that with an increased investment in giving young people economic skills and making education and trainings relevant to their lives and the job market, while improving employments rates, is just one (simplified) solution to making young people feel less marginalized and contributors to their societies. When more young people have money in their hands and are contributing to an economically stable society, and feel values and mentors by pro-social adults, they will be less likely to fill their hands with stones. I use this example, because it seems like this is the image the media wants us to see; frustrates and violent youth throwing stones and crating chaos. But we all know this does not represent the actions of all youth, but possibly a shared frustration. I would love to hear other peoples thought on this as this is a tough debate that one should have over a very long meal with good food and friends!
Jenny Truong: Sanjay: While I am not an expert in violence prevention and have not worked directly young people in conflict settings, we know that having at least one caring adult in a young person’s life makes a difference. Many international studies have shown that young people who are close to one adult, whether it be a parent, aunt, grandmother, teacher or religious leader, are more likely to have positive outcomes, including more likely to stay in school and to avoid risky behaviors.
Alexandra Hervish: Thank you for your question. You highlight an interesting issue that has garnered greater attention from the international community: the relationship between young people and violence. Large numbers of young people are not necessarily a destabilizing force in society; in fact, young people play a critical role in achieving sustainable peace. Yet in some contexts, jobless youth – particularly young men – who have few opportunities to participate meaningfully in society are recruitment targets for individuals engaged in extremist or violent activities. Other factors may shape decisions to engage in violence, including social exclusion, discrimination, or gender, political, or geographic identities. From a broad perspective, it is critical to create an enabling environment that supports positive and constructive roles for youth. This includes providing educational and economic opportunities, skills training, and reproductive health programming for young people. The Inter-Agency Network for Education in Emergencies’ (INEE) Adolescent and Youth Task Team (AYTT) is comprised of a group of individuals from UN-agencies, international and national NGOs, practitioners, researchers and policymakers who work together to ensure a coordinated, evidence-based response to the needs of adolescents and youth affected by crisis. You can learn more about the Task Team here: http://www.ineesite.org/index.php/post/adolescence_and_youth_task_team/. In addition, the United Nations Development Program published a document about youth and violent conflict, which includes a review of policy frameworks and programming. It can be found here: http://www.undp.org/cpr/whats_new/UNDP_Youth_PN.pdf.  

Dr. Victoria I. Ngomuo: Youth population without any activity to do in developing countries is increasing. This is due to lack of financial support in developing the activities for those trained and unemployed ones as well as for those uneducated ones. How can we talk on youth development, if even the possible agricultural activities in these countries cannot been employed for providing employment and industrial development due to lack of technical and finacial support to even develop agricultural activities and industries in rural areas for sustainance?
Brad Kerner: Dear Dr. Victoria, I think we do need to get better at how we invest in the livelihoods of young people. And I really wish we had a youth livelihoods expert as a part of this discussion. There two US based organizations that do great youth livelihoods work: Making Cents International and International Youth Foundation. My own organization, Save the Children, has also embarked on a project called Youth Save, which will look at new models of economic strengthening activities for youth. Through my work on Sexual and Reproductive Health, I have seen health programs that want to also work on livelihood development of young people but they often fail to be successful. I think this is because sexual and reproductive health should stick to what they are good at, SRH, and link up with other organizations that have the expertise in programming livelihoods activities with youth. I have also seen livelihoods initiatives fail when youth are given seed money to start up an income generating activity, then profits from the first cycle of their income generating scheme is not reinvested. But I also have seen Village Savings and Loans groups with youth that have been very successful as well as micro-lending institutions who have adopted more youth-friendly policies and mentor youth they are lending to. I have a lot to learn as to what makes one intervention more successful than the other but my sense is that the Village Savings and Loans groups are appropriate because of the incentive to pay back the loan and receive a large micro-loan. We all need to learn more about economic strengthening and what types of interventions are appropriate depending on individuals’ level of poverty. I learn more and more about this everyday from some amazing colleagues here at Save the Children.
Jenny Truong: Dr. Ngomuo, thank you for your question. I agree that any youth development approach needs to include discussions about how young people can gain employment in both agricultural and industrial settings. Governments can play an important role. First they can consider how to ensure young people can stay in school long enough so that they can gain the appropriate knowledge and skills, have opportunities to enter the labor market, and once in, be able to move to new jobs and earn new skills.
Alexandra Hervish: This question is outside of my expertise. Rural economies do offer an opportunity to generate employment, particularly for young people. However, appropriate training, professional development, and technical and vocational education are needed to provide young people with the proper skills and knowledge. Addressing barriers such as insufficient numeracy and literacy skills requires the collaboration of donors, governments, and communities to improve young people’s access to general education opportunities whether it is through formal or non-formal education systems. Perhaps most importantly, it is critical to invest in agriculture in ways the meet the demand of young people’s aspirations. This factor is especially important for girls and young women who have limited social and business networks.

Dr. Victoria I. Ngomuo: The development gap between the developed and developing countries is extremely high and the most affected ones are the youth migrating from rural areas to urban areas seeking for green pastures. Why can’t the developed and industrialised countries assist in developing the agricultural and industrial sector in rural developing counties for betterness of youth future?
Jenny Truong: Dr. Ngumuo, I wish my colleagues at USAID who work in agriculture and workforce development could join this discussion as I think the programs they would tell you about would interest you. This is an important area of priority for the agency and I am confident that these issues have particular priority because they relate to youth. See http://www.usaid.gov/our_work/economic_growth_and_trade/
Brad Kerner: Thank you for this question. I fear the answer to your question is more difficult than I can formulate and can become political. And I think all of us who have worked in International Development ask these same questions. I will not attempt to pretend I am an expert on this subject, but thanks for raising this issue.
Alexandra Hervish: Thank you for your question. Again, agricultural development is outside of my area of expertise. You are right that creating better employment opportunities for youth requires greater investment in the agricultural and industrial economies. It is also important to match the technical skills of youth to labor market demands. As mentioned earlier, this requires delivering education and training opportunities for young people and addressing existing discrimination in the labor market. Recognizing the place of the informal economy is also important, especially when considering what economic opportunities are available for young women. Informal jobs do offer more economic options for youth, but low earnings and unsafe working conditions provide limited economic security. Thus incorporating vulnerable populations into value chains and strengthening microenterprises is important to improve youth employment opportunities. An example of an organization utilizing a value chain approach to improve growth opportunities for adolescent girls is Cadno Emerging Enterprises (http://www.cardnoem.com/Services.aspx?ServiceID=82c370e5-ee36-46ac-baa8-02674af5dab9&Article=Microenterprises%3A+Incorporating+Vulnerable+Populations+into+Value+Chains).  

Dr. Benson Gabriel: The issue of youth is a growing concern for some of us especially in developing countries. Several challenges face the youth. Unfortunately, most of these are man-made. Now how do we address the challenge of our parents’ inability to accept that youth are not necessarily infants but can have the capacity for independent decisons? How do we address the inability of our parents to accept the present is different from the past and as such, their ways are not longer the ways of the youth? In other words, how do we address the inability of our parents especially in Africa to accept that they need to change their perceptions abut how youth should be allowed to grow – not necessary according to their wishes?
Jenny Truong: Dr. Gabriel, thank you for your insights and questions. Parents can be one of the most powerful agents of change for their children. There are various programs working to help parents communicate better with their children, particularly in healthy decision-making. See this guide from the World Health Organization for examples of models: http://www.who.int/child_adolescent_health/documents/9789241595841/en/index.html  
Brad Kerner: First, I think a good frame work of thinking is what is laid out in the Convention on the Rights of the Child and is known as the “Evolving Capacity of a Child”. This concept is embodied by the idea that as children grow, have new life experiences and acquire enhanced competencies, there is a diminishing need for protection and a greater capacity of children (i.e. children means those up to the age of 18 in the case of the CRC) to take responsibility for decisions affecting their lives. This all has to be contextualized and take into account that children in different environments and cultures face a diverse set of life experiences, and will acquire competencies at different ages. So yes, in many of the countries we all work in, the adolescent life stage is completely ignored and children are expected to turn into adults without recognizing the process and transition they must go through, included a gradual independence to make decisions for them selves. I am not sure if I can directly answer your question of how we can work with parents so they realize that things are changing and youth need more independence, but I think it is a “two-way street”. There is so much young people can learn from caring adults and their parents, and so much these adults can learn from children. Approaches that can help bridge this gap, I think will me most successful in having norm change and adults who understand the evolving capacities of their own children.
Alexandra Hervish: Thank you for your question. Part of this transformation involves educating and creating awareness among parents about the needs, challenges, and aspirations of young people. Obviously, community-led engagement will vary depending on the local context.

Kofi Awusabo-Asare: The title of the presentation, A Call to Action, sum up what is needed. But sexual and reproductive health is one dimension of the debate. What I would like to hear is the strategies needed to engage young people so that they are active participants of the “Call”.
Jenny Truong: Getting the perspectives of youth is so vital to designing programs that are relevant, in demand and successful. Several organizations have developed guidance and models for how best to do this, including USAID’s YouthNet Participation Guide and Restless Development. http://www.fhi.org/en/youth/youthnet/rhtrainmat/ypguide.htm and http://www.restlessdevelopment.org/youth-participation-guide. In August 2010, President Obama also met with 115 young leaders from 46 sub-Saharan African nations at the Whit