Developing a Global Approach for Measurement of Adolescent Well-Being

Recognizing the multiple and intergenerational benefits of investing in adolescent well-being, a Call to Action for Adolescent Well-being was launched in 2020 and endorsed by an unprecedented coalition of governments, UN agencies, nongovernmental organizations, and academic institutions. Signatories to the Call committed to engage adolescents in all legal, policy, and program processes that affect them; develop multisectoral, whole-of-government policy approaches that address adolescent well-being; and strengthen political commitment and funding for adolescents. To further support these efforts, the 1.8 Billion Young People for Change Campaign was launched in 2022 [1].

A definition and conceptual framework, developed by the Partnership for Maternal, Newborn and Child Health, the World Health Organization, and the UN H6+ partner agencies, are bolstering the recent advancements of adolescent well-being [2]. This Adolescent Well-being Framework defines adolescent well-being as their ability to ‘thrive and achieve their full potential’, is underpinned by five interconnected domains (Figure 1) [3], and was endorsed during a series of youth and regional stakeholder consultations [4,5].

Figure 1.

Development of a measurement approach for adolescent well-being.

Advancing measurement of the components of the framework is crucial for tracking progress and guiding action. A collection of papers on adolescent well-being by the British Medical Journal (BMJ) [3], particularly an article by Newby et al. [6], underlined challenges in measuring adolescent well-being (Figure 1). They include current fragmentation of measurement approaches, with many initiatives focusing only on some aspects of well-being; limited intergroup collaboration leading to duplication, failure to identify and address important gaps, and confusion around necessary actions; and variation in context-specific meanings of the broad concept of well-being.

To focus data collection on the most important issues and to produce streamlined guidance for adolescent well-being measurement, the World Health Organization, the Partnership for Maternal, Newborn and Child Health, and partners have embarked on the development of a measurement approach, supported by an Expert Consultative Group and managed by a Coordination Team (Appendix Table 1) [7]. The 28 experts deliberately selected from multiple disciplines (e.g., sociology, psychology, economics, public health) [8] have measurement expertise across all framework domains and represent a diversity of the world, with gender balance and inclusion of early-career experts.

Key principles and considerations for the measurement approach were discussed and agreed upon during the first meeting of the Expert Consultative Group in October 2022 and in subsequent smaller working group exchanges and included [5]:

• •The measurement approach will address the well-being of all adolescents across developmental stages, ensuring that the needs of disadvantaged groups are considered. It will be standard but adaptable to different contexts.
• •The approach will include objective (e.g., material conditions) and subjective (e.g., adolescents’ own evaluations) indicators and measures of psychological well-being (e.g., autonomy, optimism).
• •Measures will center on positive youth development rather than risks or negative outcomes, to support actions to strengthen adolescents’ resources.
• •The measurement approach will build on existing initiatives, such as the Data and Monitoring Initiative of the School Meals Coalition [9], and the Global Action for Measurement of Adolescent Health Advisory Group that recommends priority indicators for adolescent health measurement [10].
• •Learnings from similar approaches for other life stages, such as the Nurturing Care Framework [11], are being examined to maximize measurement continuity over the life course.

A core principle embedded in the approach is inclusive engagement of young people. This started with their engagement in the Call to Action, and intentional steps are being taken to include their voices and perspectives throughout the process (Figure 1).

Parameters for determining key concepts to measure in each domain were also established. To take into account different policy needs and audiences, the approach focuses on developing two sets of clearly defined priority indicators: one to measure individual-level adolescent well-being status and key concepts across the five domains and the second one to measure national-level policies, financing, and service coverage for adolescents. The indicators are intended to be used at country level and incorporated into existing global measurement initiatives and tools when possible.

Work on indicator selection is underway, using a three-stepped approach: identification of key concepts to be measured within and across domains, indicator mapping for key concepts, and indicator selection based on specified criteria. The selection of concepts and indicators includes a modified Delphi approach and partner consultations. A draft list of key concepts with selected indicators that are already being measured through large-scale, cross-country surveys will be presented at the Global Forum for Adolescents in October 2023 for partner input, particularly youth. In 2024, these indicators will be reviewed, including through feasibility assessments in countries, and refined as necessary. Subsequently, a full list of indicators and guidance on data generation and use will be available for use in countries, in accountability monitoring, and in systems and program planning.

Measuring adolescent well-being in a comprehensive and consistent way is complex. Well-being is a broad multifaceted concept, and capturing all aspects is challenging. Furthermore, adolescents of different ages, genders, and cultures may have different views of their own well-being and different priorities. However, agreement on a consistent approach to measuring priority indicators globally—while also proposing additional indicators to meet the needs of particular settings or population groups—is essential for tracking progress toward the Call to Action, identifying gaps, and defining actions that will improve adolescent well-being everywhere.

Funding Sources

This work is funded by Fondation Botnar [Investment ID IMG-21-004].