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Youth Can Take the Lead in Health Governance and Accountability

Dozens of young people participated in the 67th World Health Assembly last month in Geneva, including young people from HIV positive communities, sexual minority communities, and health professional students and recent graduates.

Throughout the meeting, the World Health Organization (WHO) and partner leaders championed the cause of involving young people in local, national, and global health agendas. Panels on universal health coverage, HIV/AIDS, and health systems included youth speakers. The young people added energy, vibrancy, and new ideas to the meetings.

Yet beneath the enthusiasm lay some discontent.

During a session on youth engagement, organized by the International Federation of Medical Student Associations, the young people in attendance expressed a desire for more meaningful engagement. They felt that their participation in most WHO events, although well-intentioned, was mere tokenism. They had no vote, they had no meaningful voice.

They explained that what they had to offer was a unique, fresh perspective. A perspective “unjaded” by bureaucratic obstacles, decades of work in the field, or the responsibilities of families, mortgages, and jobs.

We were surprised to find there was almost no mention of what the youth groups in attendance had accomplished. Everyone likes to give advice. But the hard work is showing results on the ground. We stayed late on Friday evening to attend the side session with hopes to learn from our younger colleagues  about their cutting edge approaches and fresh solutions to the health challenges we all face.  It is always tempting to use the rare opportunity behind the mic to advocate for greater visibility, wider inclusion, and more opportunities to contribute.  However, if the youth representatives had resisted that temptation and shared the results from their work, they would have had greater impact. An opportunity missed.

From our perspective at IntraHealth International—a global NGO looking to increase youth engagement—we need the viewpoints of young people. But more importantly, we need their action on the ground.

Youth in Action

This sentiment was well expressed by session panelist, Dr. Anders Nordstrom, Swedish Global Health Ambassador and former WHO Assistant Director General. Dr. Nordstrom felt that young people’s  main value added would be their accomplishments rather than their advice. Rather than recommendations on how to do things better, contributions that actually make things better are always valued and far more sustainable.

Contributions like those from the student innovators who presented at IntraHealth International’s annual SwitchPoint event.

For instance, Ian Connolly and Jeffrey Yang, from Stanford University, developed the MiracleFeet brace to improve the quality of treatment for infants with club foot. Nickson Nyakambi, a medical student in Kenya, developed a mobile phone application that provides women and health workers in rural, low-resource settings local, rapid, and accurate risk assessment and treatment advice for cervical cancer. And “Eddie” Ti-chieh Tseng, a computer science graduate student at New York University, and his colleague Rebecca Hillegass created a map of aid investment in Uganda to track the impact of international health aid.

These youth and many others like them were not at conference tables in Geneva last week, but they are at the leading edge of actively improving health systems and health outcomes around the world. We’re hearing their voices. Let’s add more to the chorus.

In an era of static or shrinking budgets for health and a rising concern on how effectively that money is spent, young people have a unique opportunity.

They reside in every community. In fact, the poorest nations and communities with the least access to health care have the greatest numbers of young people. Half of sub-Saharan Africa’s population, and more than half of India’s, is below the age of 25.

Countries that have great numbers of young people entering the workforce are said to have the opportunity of taking advantage of the “youth dividend” to expand their economies. We propose that the true “youth dividend” is the power of youth to act and to hold their governments and institutions accountable.

Youth can demand that budgets of health facilities be posted so their managers can be held to account. They can demand that the number and type of workers assigned to a health facility be made public so planners—that include youth as part of their planning teams—can address issues of absenteeism and ghost workers. One huge advantage that youth have as activists is their status as “digital natives” who have never known a time without almost universal access to mobile phones. With their comfort with and knowledge of mobile phones, youth can crowdsource health systems data that formal health systems have been unable to obtain.

The global health community will continue to support young voices. But when youth are able to report the impact they have had, then will they be taken more seriously and have true equal seats at the table.

Young people, we invite you: share with us the results you have achieved on the ground. And lead the way and do even more.