Islamabad - Road accidents, suicides and various infections are the main causes of deaths of adolescents in Pakistan, says a global health study conducted for the first time on adolescent health and wellbeing.

According to Lancet Commission on Adolescent Health and Wellbeing launched in London, intestinal infectious diseases, road injuries, diarrheal diseases, tuberculosis, drowning, other unintentional injuries, lower respiratory infections, meningitis, leukaemia, congenital anomalies are the top ten causes of deaths among Pakistanis aged 10 to 14 years old in 2013.

About 3,029 adolescents of age 10 to 14 years died of intestinal infectious diseases in 2013, 1,137 from road injuries, and 876 from diarrheal infections in Pakistan, it says.  Among the age group of 20 to 24, road accidents were the major cause with 4,363 number of deaths during the same period, followed by interpersonal violence with 2204 deaths, and tuberculosis with 2063 deaths.

The analysis reveals that HIV/AIDS, road traffic accidents, and drowning caused a quarter of deaths in 10–14 years old globally in 2013, with diarrhoeal and intestinal infectious diseases, lower respiratory infections, and malaria contributing to a further 21% of deaths. Road traffic accidents, self-harm and violence were the leading causes of death for 15–19 years old and 20–24 years old respectively. Depression resulted in the largest amount of ill health worldwide in 2013, affecting more than 10% of 10–24 year olds, followed by the rising burden of skin and subcutaneous diseases like acne and dermatitis.

Decades of neglect and chronic underinvestment have had serious detrimental effects on the health and wellbeing of adolescents aged 10–24 years, says the study. Two-thirds of young people are growing up in countries where preventable and treatable health problems like HIV/AIDS, early pregnancy, unsafe sex, depression, injury, and violence remain a daily threat to their health, wellbeing, and life chances.

Our current health system does not meet the requirement of this age group as the health professionals are not trained to treat the mental and psychological states of adolescents, Dr. Zulfiqar Bhutta.  Founding Director, Centre for Excellence in Women and Child Health, Aga Khan University, Pakistan.

The lack of proper information regarding reproductive health leads them to unauthentic sources and quakes causing lifelong damages, he said stressing the need to bring them into health systems.  Evidence shows that behaviours that start in adolescence can determine health and wellbeing for a lifetime. Adolescents today also face new challenges, including rising levels of obesity and mental health disorders, high unemployment, and the risk of radicalization, the study points out.

Adolescent health and wellbeing is also a key driver of a wide range of the Sustainable Development Goals on health, nutrition, education, gender, equality and food security, and the costs of inaction are enormous, warn the authors.

Adolescents aged 10–24 years represent over a quarter of the population (1.8 billion), 89% of whom live in developing countries. Their number is set to rise to about 2 billion by 2032. Adolescence is a critical time of formative growth and brain development second only to infancy. “Puberty triggers a cascading process of brain development and emotional change that continues through to the mid-20s. It brings a different and more intense engagement with the world beyond an adolescent’s immediate family. These processes shape an individual’s identity and the capabilities he/she takes forward into later life. It profoundly shapes health and wellbeing across the life-course,” explains Commission’s lead author Professor George Patton, University of Melbourne, Australia.

The Commission finds that some of the most effective actions to improve adolescent health and wellbeing lie in sectors beyond health services. “The single best investment we can make is guaranteeing access to free, quality secondary education,” said Professor Patton. “Every year of education beyond age 12 is associated with fewer births for adolescent girls and fewer adolescent deaths for boys and girls. A healthy, educated workforce has the potential to shape a country’s economic prospects.”

It is crucial to involve young people in transforming their wellbeing, personal development, and health, say the authors. Digital media and new technologies offer remarkable opportunities to engage and empower young people to drive change. There is also a pressing need to ensure that all young people have opportunities and access to universal health coverage regardless of age, gender, sexual orientation, and marital, and socioeconomic status, particularly the marginalised.

The Commission authors also recommend to get serious about the laws that empower and protect adolescents such as guaranteeing 18 years as the minimum age for marriage; and continue gathering better evidence for action particularly around mental health and violence. Other recommendations include collecting and reporting on a minimum set of priority indicators for adolescent health reflecting the burden of disease and risk factors, and for robust, transparent governance and accountability for adolescent health.