People aged 15-29 years old make up nearly one-quarter of the world’s total population, yet less than 2% of global development assistance for health is allocated toward young people and their needs.
Universal health coverage, as part of the Sustainable Development Goals, cannot be achieved if anyone is left behind. But if the global development community is to follow the mantra “nothing about us, without us,” the health care needs of today’s young people must be catered for and they should be a part of conversations around how to improve their own access to health care.
Technology is becoming ever more present within health facilities and digital health is a key component in improving health care delivery. As digital natives, young people can bring a different perspective to global discussions on how to best integrate, engage, and get the most out of it so that all ages are able to reap the benefits of a health care system integrated with digital components.
How do young people envision digitization playing a role within a health care system? What needs do they want it to address? How could it best serve them? These are key questions that Devex, working with Fondation Botnar, the Partnership on Maternal, Neonatal and Child Health, PATH, and Women Deliver, set out to ask in order to tap into their thinking ahead of the upcoming U.N. High-level Meeting on UHC in New York on September 23. The meeting aims to bring together heads of state, political and health leaders, and policymakers to advocate for health for all.
In “Health & Technology: What young people really think,” more than 1,500 young people around the world were asked for their thoughts on the intersection of health care and technology. Although limitations in the methodology mean that the results are not representative of all young people and averages mask the vastly different realities of young individuals around the world, here are the four things we learned that could help better explain young people’s views on health, technology, and youth participation.
1. The cost of health care is a problem for young people.
The survey was commissioned by Fondation Botnar, PATH, the Secretariat of the Partnership for Maternal, Newborn & Child Health, and Women Deliver as part of a new coalition that aims to convene people, organizations, and governments around the shared belief that digital technologies can be used to push forward progress in achieving UHC.
Following this survey, the coalition partners call for young people and youth-led organizations to have their say on how digital innovation can uphold quality primary health for all. To give young people a platform to amplify their voices, shape and contribute to the vision and mission of the coalition, and help guide a youth-led agenda around UHC 2030, the coalition will fund and support the setup of an independent Youth Council in the coming months.
More than one-third of young people said that they have difficulty accessing health services, and they cited cost as the biggest reason why. In the survey, 64% of respondents said that a lack of medical insurance and the fee that might incur from a visit to a health care facility are enough to delay access to care.
UHC is designed to address this problem and ensure that all people have access to promotive, preventive, curative, rehabilitative, and palliative health services without causing financial hardship to an individual or family. With only 11 years to go to attain the 2030 U.N. targets, countries will have to find new ways of providing people — including young people — with affordable health care services.
Technological solutions such as mtiba — a health financing platform that has been rolled out in Kenya, Tanzania, and Nigeria — could be the way forward. It allows people to save, send, receive, and pay for health services. Once the money is transferred via a phone, there is no way to withdraw it unless it is being used to pay for services via an identification card at one of the private facilities registered with mtiba. Improved insurance and access to generic medicines could be other solutions.
“Although health care is technically affordable, the bribe practice still exists in order to compensate for low wages for the health care personnel, and the services lack quality,” said a respondent, signaling that more also needs to be done to stop corruption and limit out -of-pocket expenses.
Limited information around services and the time it takes to reach health services are other barriers that respondents believe limit their access to health services. All of these have scope to potentially be addressed by digital technology.
2. In terms of their health, young people are most concerned about their mental health.
According to the latest global figures, over 2.6 million young people aged 15-29 died in 2016 — that’s over 7,100 a day. Road traffic accidents were the biggest killer, followed by self-harm — defined as self-poisoning or self-injury, irrespective of the apparent purpose of the act — violence, maternal conditions, and HIV/AIDS.
However, none of these factors rank highly as major causes for concern among the young people surveyed. Instead, the majority of respondents (63%) said mental health issues are their primary concern. This was followed by sexual and reproductive health (50%), tobacco and substance abuse (42%), diet and nutrition (40%), and environmental health issues such as air pollution, toxic waste, and water (29%). This is part of what seems to be a more holistic view of health care that many young people have and the belief that taking care of yourself now will yield better health outcomes in the future — 83% believe that is the case.
3. Young people are aware of the government’s role in ensuring health care access and will hold them accountable.
“The government works for the people, and I believe it is their role to provide access to affordable and quality health care through policies and services. Health care should not be politicized — it is a basic human right to live well,” said one respondent.
The majority of respondents believe governments are not doing as much as they could to improve access to services and that they, together with global institutions and the broader international community, have largely neglected investments in young people’s health.
This is why 88% of respondents said governments must do more in order to ensure young people are not left behind as other population groups see progress toward UHC agenda.
Some have made efforts to address this: India has tried to address the needs of adolescent girls with increased access to sanitary products. Brazil established a community-wide strategy to reduce alcohol-related violence among high-risk youth. Mozambique created peer support groups to promote treatment adherence among young people living with HIV. But others need to work harder to focus on the marginalized and disadvantaged, invest in facilities, training, and education, and address emerging health challenges among young people such as mental health, respondents said.
One respondent suggested governments develop a database linked to citizens’ national identity numbers to make accessing health care easier. “More so, focus should first and foremost be on saving lives than putting patients through lengthy data capturing processes and payment.”
4. They want to be involved in the decision-making, and technology can help with that.
In the survey, 83% of respondents believe that their involvement in the decisions that governments make about health care is necessary, and that as a large component of any population, their voices should be heard in regards to building health systems that serve everyone — for the U.N. member states, UHC is a national agenda and target.
Involving young people in the decision-making processes — perhaps via youth-led groups such as Global Citizen, World Youth Alliance, Restless Development, and ONE Youth Ambassadors — can lead to a better understanding of challenges and needs, and ultimately help improve policies and solutions. This also needs to be extended to the national level.
Digital technology and mental health
Many digital solutions to help improve mental health are already in circulation in the areas of telepsychiatry applications, data collection, and diagnosis.
For example, MoodGym allows for remote access to a psychiatrist via a smartphone or tablet. Video calls, texts, and emails can be used to communicate around appointments and further advice.
A new application called Mobilyze aims to collate data on people’s mental well-being so that they might be better served by their health systems. With built-in sensors, an ambient light, and information on recently made calls, it attempts to predict patients’ moods, emotions, and activities.
Trust Circle, a digital mental health startup, is working with local governments and charities to check for signs of mental illness among young people.
There is increasing recognition that engaging young people in discussions is critical to tap into this transformative potential — and many have taken center stage at global events such as the Women Deliver conference earlier this year, and the U.N.’s Global Strategy for Women’s, Children’s and Adolescents’ Health, which considers young people in the strategy, launched in 2015. But more concrete steps need to follow.
As the generation that is increasingly most familiar with technology, engaging young people through digitization is a logical solution. In fact, the majority agreed that in five to 10 years, technology will be at the forefront of ensuring access to quality health services. A full 84% of young people said that in the future, they will use more digital, web-based technologies, and/or apps to track their health and inform health-related decisions.
“Technology provides better access, quicker answers, and the opportunity to be more engaging to young people who rely so much on technology for other things in their life,” said one respondent.
Young people believe the top benefit of integrating technology will be its ability to tackle costs and make health care more accessible and affordable, which would help tackle their primary barrier of the high cost of care. The digitization of health records, mobile phone applications such as Safe Delivery, and new technologies such as Philips Healthcare’s tele-ultrasound solution are already challenging traditional doctor-patient relationships and helping create more patient-focused and affordable health care systems. Artificial intelligence is another game-changer, offering personalized treatment plans, promising new levels of efficiency in patient care, and providing the opportunity for further health promotion and prevention.
Despite having concerns about data protection — 67% cite personal data security as their biggest concern when using apps and technology for health, while 46% cite inaccurate information — young people think technology has not yet reached its full potential. But such concerns have the potential to be barriers to better adoption of digital health technologies, and they must be properly addressed.
Read the full report and find out just how far reaching health-related work can be.
Update, Aug. 13: The story was updated to note that the age range was 15-29 year olds, and in 2016 over 2.6 million young people died