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Adolescents (ages 10 – 19) and young adults (ages 20 – 24) together compose about 21% of the population of the United States. As consecutive life stages, adolescence and young adulthood mark periods of developmental transition from childhood to full-fledged adulthood; the experiences that take place and the behavioral patterns that form during these years can have lasting effects on adult health, well-being and productivity. In general, young people who have sound health and rich developmental experiences during these years are well on their way to a thriving adulthood. Too many young people, however, encounter harsh social adversities and may engage in behaviors that jeopardize their health and safety; the trajectory of their adult lives may be marred by the development of serious chronic disease, poverty, foregone opportunities, and a variety of legal and social problems that place a financial burden on them as well as society.
The Adolescent and Young Adult Health Program aims to:
Through a set of national centers and partners, the Adolescent and Young Adult Health Program reaches a wide variety of health professionals, program administrators, and policy makers with the intent of providing information and resources to assist them in the development of sound programs and policies at community, state, and national levels that will help adolescents and young adult to thrive. It functions as part of the National Initiative to Improve Adolescent Health by the Year 2020 (NIIAH), a set of organizational and university partners that work on achieving the listed goals. NIIAH partners collaboratively seek to address the core adolescent and young adult objectives of Healthy People 2020 as well as the objectives of its Adolescent Health topic area, which has a strong focus on such social determinants of health as education and connections to adults. http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=2
The National Adolescent Health Information and Innovation Center (NAHIC) collects, synthesizes, coordinates and disseminates information relevant to the health, safety, development, and social and economic well-being of school-aged children in transition to adolescence, adolescents, and young adults.
The Public Policy Analysis and Education Center for Adolescent and Young Adult Health (Policy Center) analyzes the effects of public policies, regulations and practices at the community, state and federal levels on the health, safety, development, and social and economic well-being of school-aged children transitioning to adolescence, adolescents and young adults. The Policy Center disseminates its findings and products in formats useful to policy- and decision-makers and works to ensure the active transfer of knowledge about effective policies and programs to these leaders.
The Adolescent Health Resource Center for State Maternal and Child Health promotes State Title V Maternal and Child Health (MCH) Program core capacity in adolescent and young adult development, health, safety and well-being, and assists states in developing strategies for improving measurable health, safety and developmental outcomes for these population groups.
The Partnership to Promote Adolescent Health in States supports a national membership association to assist its members and affiliates in developing improved approaches for delivering adolescent and young adult public health programs at the state level. The grantee works to promote the importance of investing in adolescent and young adult health among state officials and administrators who serve youth and their families.
The concept of orphans and vulnerable children (OVC) does not adhere to a universal definition and varies across countries in sub-Saharan Africa. The following definitions of a child, an orphan and of vulnerability have been adopted:
Defined by the UN Convention on the Rights of the Child as “every human being below the age of eighteen years unless under the law applicable to the child, majority is attained earlier.”
The official definition of an orphan is a child aged zero to 17 years whose mother, father, or both have died (World Bank OVC Toolkit). There are, however, other children who are referred to as social orphans even though one or both their parents may still be alive but who have been unable to perform parental duties because of illness or acute poverty among other reasons.
Vulnerability is viewed as “a high probability of a negative outcome” (World Bank OVC Toolkit), or an expected welfare loss above a socially accepted norm, which results from risky or uncertain events, and the lack of appropriate means to deal with them. Vulnerability leaves one at risk of exposure to stressful situations. The degree and type of vulnerability however, varies in each context and overtime.
A vulnerable child is defined as being under the age of 18 years and currently at high risk of lacking adequate care and protection. Accordingly, all children are vulnerable by nature compared to adults, but some are more critically vulnerable than others. “Child vulnerability is a downward spiral where each shock leads to a new level of vulnerability, and each new level opens up for a host of new risks. In other words, the probability of a child experiencing a negative outcome rises with each shock.” (World Bank OVC Toolkit)
All vulnerable children have one common denominator: they have no reliable social safety networks on hand to depend upon in order to adequately manage the risk to which they daily exposed.
In this section we define some key terms related to OVC and describe the main OVC categories. To learn more on how to define OVC, see the attached OVC presentation. For a list of the main shocks to which OVC are particularly vulnerable, see the section on SRM.
OVC (Orphans and Vulnerable Children)
The concept generally refers to orphans and other groups of children who are more exposed to risks than their peers. In an operational context we can say that they are the children who are most likely to fall through the cracks of regular programs, or, using social protection terminology: OVC are groups of children that experience negative outcomes, such as the loss of their education, morbidity, and malnutrition, at higher rates than do their peers. To be protected from negative outcomes and/or allowed participation, OVC need to be given special attention to remove the barriers that stand in the way of their equal participation in projects designed to benefit all children, or through special project components and targeting strategies tailored to their needs.
The widely ratified UN Convention on the Rights of the Child states that a “child means every human being below the age of eighteen years unless under the law applicable to the child, majority is attained earlier”. The World Bank’s draft document “investing in Children and Youth: A Strategy to Fight Poverty, Reduce Inequality and Promote Human Development” defines children as age 0-14 and youth as 15-24. With regards to OVC, appropriate age definitions tend to be category specific. Orphans, for instance, are mainly counted as 14 and younger. Child soldiers, on the other hand, normally include children up to the age of 18, since the great majority of child soldiers are between the ages of 15 and 18. In projects for street children it is even common to include youth up to the age of 22. For assessing child vulnerability issues in general, we suggest using the UN definition (under 18), adjusting for important group specificities and being sensitive to definitions used by local government and implementing partners.
The UNICEF, UNAIDS and USAID joint report on orphan estimates and program strategies, Children on the Brink [NB! Heavy!], defines an orphan as a child 0-17 whose mother (maternal orphans) or father (paternal orphans) or both (double orphans) are dead. This remains the official definition. The concept of “social orphans” is sometimes used to describe children whose parents might be alive but are no longer fulfilling any of their parental duties (e.g., drug addicts who are separated from their children with little chance of reunion, parents who are sick or abusive or who, for other reasons, have abandoned or largely neglect their children).
In this toolkit we understand vulnerability to mean “a high probability of a negative outcome”, or an expected welfare loss above a socially accepted norm, which results from risky/uncertain events, and the lack of appropriate risk management instruments. This is consistent with the definition used in the Bank’s social protection framework for social risk management (Holzmann and Jorgensen 2001). Vulnerability is shaped by risk and stress characteristics such as magnitude, frequency, duration, and scope, to which individuals, households and communities are exposed. Therefore, the degree and type of vulnerability vary overtime and between countries and are highly contextual. This implies that vulnerability is a relative state – a multifaceted continuum between resilience and absolute helplessness.
The Downward Spiral of Child Vulnerability
Compared to adults, all children are vulnerable by nature, but some children are more critically vulnerable than others. Child vulnerability is a downward spiral where each shock leads to a new level of vulnerability, and each new level opens up for a host of new risks. In other words, the probability of a child experiencing a negative outcome rises with each shock. At the bottom of this spiral we find children who live outside of family care or in situations of severe family abuse and neglect. OVC interventions can be made at all levels to prevent (a further) increased vulnerability, or to mitigate the effect of likely shocks. The higher up in the spiral the intervention is made, the more cost-effective it is likely to be. OVC should preferably be assisted before they have reached the most critical stages of vulnerability, because interventions aimed to rescue and rehabilitate the most critically vulnerable children tend to be too expensive to be sustainable and moreover have low rates of success.
The downward spiral of child vulnerability might look like this:
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