Jeske Paijmans YHP Global Programme Manager, Plan International UK
As one of YHP’s founding partners, Plan International has played a central role in developing the YHP approach to NCD programming and currently implements the largest and the longest-running YHP programmes.
Plan International believes that a holistic approach is most effective to address NCD prevention and promote long-term health for young people; an approach which goes beyond the recognised 5 NCD risk factors and includes the advancement of gender equality, sexual and reproductive health and rights (SRHR) and mental health of young people. In this way the programmes address underlying social, economic, cultural and psychological determinants that can cross over with NCD risk factors, and creates an environment in which young people have access to the support, information and services they need.
Sexual and Reproductive Health and Rights (SRHR)
The transition from childhood into adulthood is a critical time in the lives of young people. Their bodies change, they may become sexually active, and they take on more personal and family responsibilities, all things that influence their behaviours and the choices they make.
Plan YHP programmes include activities and health information on sexual and reproductive health because of the significant cross over and influence of this area on NCD risk behaviours. Plan International believes and has learned that it is much more impactful to take a holistic approach when addressing health promotion and NCD prevention with young people. Also, best practice approaches determine that the integration of SRHR and NCD prevention increase the reach and effectiveness with this age group.
Gender inequality is a fundamental barrier to girls leading healthy lives. Gender norms and roles put girls and boys at different levels of exposure and vulnerability to NCD risk factors. Girls and boys’ levels of physical activity, diet, tobacco and alcohol consumption, and exposure to air pollution, are heavily influenced by what constitutes masculine and feminine behaviours and associated societal expectations and discrimination.
Gender norms and roles also affect girls and boys’ health-seeking behaviours and ability to access health information and services. Gender biases also affect the provision of services as staff are often not trained to consider gender norms and power imbalances in their service delivery.
Plan YHP programmes have a gender equality focus which ensures that gender disparities are identified and addressed, enabling girls as well as boys to access information and services so that the health of all young people can be improved.
Mental and neurological disorders (MNDs) can be a precursor or a consequence of NCDs. They frequently occur together; people who have certain MNDs can be at a higher risk of developing NCDs, and vice versa. MNDs and NCDs have similar risk factors including genetics, age, tobacco, drug and alcohol use, physical inactivity and unhealthy lifestyles, and can arise from common determinants, such as childhood abuse, neglect, violence or trauma. They can also share similar consequences, and both can be associated with social stigma. For these reasons Plan International implements an integrated approach which understands and can respond to these relationships, rather than addressing NCD prevention in isolation.
Addressing mental health in the YHP is also relevant from the perspective of holistic adolescent health and well-being. For these reasons the Plan YHP programmes include mental health as both an NCD in its own right (alongside cancer, cardiovascular diseases, chronic respiratory diseases, diabetes) and also a cross-cutting theme which has a relationship to other NCDs and to young people’s health and wellbeing more generally.
The causes of mental health issues are complex and cannot be addressed through the programme model alone; they will often require specialist professional support. However, the YHP supports the delivery of information about mental health and signposting to relevant services for young people – so that they can gain further support if needed.