The status of adolescent medicine: building a global adolescent workforce

Abstract

Remarkable public health achievements to reduce infant and child mortality and improve the health and well-being of children worldwide have successfully resulted in increased survival and a growing population of young people aged 10–24 years. Population trends indicate that the current generation of 1.8 billion young people is the largest in history, but there is a scarcity of dedicated resources available to effectively meet the health needs of adolescents and young adults worldwide. Growing recognition of the pivotal roles young people play in the cultures, societies, and countries in which they live has spurred an expanding global movement to address the needs of this special population. Building an effective global workforce of highly-skilled adolescent health professionals who understand the unique biological, psychological, behavioral, social, and environmental factors that impact the health of adolescents is a critical step in addressing the health needs of the growing cohort of young people. In this review, we aim to: 1) Define a global assessment of the health needs for adolescents around the world; 2) Describe examples of current training programs and requirements in Adolescent Medicine; 3) Identify existing gaps and barriers to develop an effective adolescent health workforce; and 4) Develop a call for targeted actions to build capacity of the adolescent health workforce, broaden culturally relevant research and evidence-based intervention strategies, and reinforce existing interdisciplinary global networks of youth advocates and adolescent health professionals to maximize the opportunities for training, research, and care delivery.

The Impact of Youth-Friendly Structures of Care on Retention Among HIV-Infected Youth

“…19,41,42 Developing a more robust adolescent health care workforce capable of responding effectively to important adolescent health issues such as mental health illness, sexual health, and to address complex psychosocial needs may be an important approach to increase engagement in care and strengthen self-efficacy around important healthy behaviors among YLHIV. [43][44][45] Physicians in adult primary care specialties (internal medicine and family practice) generally are not required to receive adolescent or young adult-specific training, whereas all pediatric residency programs are required to have a minimum 4-week clinical experience in adolescent medicine. 46 Providers, including pediatricians, have reported feeling inadequately prepared to discuss sensitive adolescent health issues such as mental health illness, reproductive health, and violence.…”

Educational Curricula and Programs in Adolescent Medicine for Health Workers in Low- and Middle-Income Countries: A Scoping Review

“…Key players in global health have issued calls to promote adolescent health in LMICs. [2][3][4][5] This is increasingly important as the proportion of adolescents grows. Public health interventions including immunizations, improvement in primary care, and provision of safe water in LMICs have improved survival for children under 5 years of age, with under-5 mortality decreasing by 56% from 1990-2016, 6 and we are now facing the largest population of adolescents in history.…”

“…8 Unfortunately, many health professionals may not feel comfortable providing care to adolescents, and they may not have received training in developmentally appropriate adolescent-friendly services. 5,8 From 2002-2015, only 2.2% of aid dollars were directed toward adolescent health, reflecting the lack of attention adolescents have received in global health. 9 While there have been attempts to promote adolescent-friendly health care services and improve services for adolescents, education in adolescent medicine is a largely unmet challenge in countries with limited resources.…”

Adolescent medicine in the USA: a perspective on progress and lessons learnt

“…There are now 27 accredited 3-year fellowships in adolescent medicine. However, the number of sub-board-certified physicians in adolescent medicine, including those with primary certification in internal medicine and in family medicine, total 883 as of 2014,10 fuelling concerns about the future of the specialty given the demands for training health professionals to care for adolescents. Fellowship programmes in adolescent medicine are accredited by the Accreditation Council for Graduate Medical Education (ACGME).…”

“…The complexity and depth of problems presented by the most vulnerable adolescents require more than the traditional model of healthcare. The recognition of governmental and certifying professional organisations of the unique requirements for training healthcare professionals to care for adolescents is a core requirement for the credibility and status of the specialty 10. Training programmes will never be able to meet the workforce supply demands alone, consequently training multiple tiers of health professionals is the most likely strategy to provide the appropriate expertise to a larger number of adolescents 28.…”