Navigating Adolescence in Crisis: Prioritizing Needs and Reducing Risks
"A deep dive into the challenges faced by young people in humanitarian settings and how targeted programs can make a life-changing difference."
Adolescence is a period of immense change and vulnerability, especially when it unfolds amidst conflict and displacement. In humanitarian settings, very young adolescents (VYAs), aged 10-14, often face unique risks and challenges that are frequently overlooked. Understanding their experiences is crucial for designing effective interventions and ensuring their well-being.
Between 2013 and 2014, a series of research efforts were undertaken in three conflict-affected communities: Syrian refugees in Lebanon's Bekaa Valley, Somali refugees in Kobe Refugee Camp, Ethiopia, and migrant communities from Myanmar settled in Tak Province, Thailand. These studies sought to understand the lived experiences of VYAs during emergencies, focusing on their needs, risks, and the impact of displacement on their development.
This article summarizes the key findings from these research initiatives, highlighting the crucial role of education, the pervasive sense of insecurity, existing knowledge (or lack thereof) about body changes and fertility, the importance of peer and family relationships, and specific concerns like child marriage, child labor, and evolving gender roles. By exploring these themes, we aim to provide actionable insights for humanitarian actors and policymakers working to support adolescents in crisis.
What the Data Measures
Adolescent health data cover demographics, mortality, morbidity, health risk factors, policies, and the responsiveness of health systems. In the United States and its territories, the HHS Office of Population Affairs provides interactive tools based on publicly available federal data. The CDC’s Division of Adolescent and School Health collects information on youth health and school health policies and practices, while UNICEF compiles international indicators from household surveys, administrative data, and partner agencies.
Coordinated Assessment and Response
The WHO operational guide recommends practical, action-oriented planning for child and adolescent health in humanitarian emergencies. A coordinated needs assessment should begin at the start of an emergency to identify evolving needs, response gaps, and operational constraints. The approach recognizes that delivering basic health care is difficult in humanitarian settings and that effective protection requires attention to both services and program management. Its emphasis on monitoring and evaluation also reflects the need to adapt interventions as conditions change.
From Recognition to Action
The field of adolescent health has developed through decades of work by experts, researchers, advocates, and institutions, including the American Academy of Pediatrics. WHO’s operational guidance reflects a later shift toward practical management, implementation, monitoring, and evaluation in emergencies. UNICEF’s humanitarian work emphasizes that adolescents’ rights, needs, and contributions have often been overlooked during conflicts, disasters, and prolonged crises. More recent humanitarian thinking stresses that health responses should be locally anchored and adapted to context, while children, schools, homes, and communities must be protected from warfare.
Key Challenges and Needs of Adolescents in Humanitarian Settings
The research across these diverse settings revealed several common challenges and needs among VYAs. These can be broadly categorized as:
- Syrian Refugees (Lebanon): Limited access to education due to safety concerns, financial constraints, and integration challenges.
- Somali Refugees (Ethiopia): High enrollment rates initially, but challenges persist regarding distance to school, household duties (especially for girls), and early marriage.
- Myanmar Migrants (Thailand): Relatively high enrollment, but economic pressures and household responsibilities often lead to dropout, particularly for older daughters.
What Recent Reviews Examine
Recent reviews examine adolescent interventions across crisis settings, including low- and middle-income countries, with adolescents defined as ages 10–19 and youth as ages 20–25 in one review. Sexual and reproductive health interventions have been identified as an overlooked area in humanitarian crises. Other research maps mental health and psychosocial support programs for children, adolescents, and youth affected by conflict. Qualitative work in crisis-hit Lebanon has also examined how social determinants shape mental health among adolescents and their families living in adversity.
Barriers and Long-Term Costs
Discussions of adolescent health in humanitarian crises identify barriers to healthcare access alongside the need for response strategies that support adolescents’ ability to take charge of their health. Humanitarian emergencies include famine, armed conflict, and natural disasters, and their effects can extend beyond the immediate crisis. Research on these situations examines impacts on adolescents’ lives over the long term, indicating that emergency-related harms should not be evaluated only through short-term service delivery. These challenges make access, continuity, and adolescent empowerment important tests of whether a response is effective.
Comparing Crisis Responses
A useful comparison of adolescent health responses should consider how well each approach identifies needs, reaches adolescents, and adapts to changing conditions. It should also examine whether responses address immediate healthcare access as well as longer-term effects on adolescents’ lives. Because no sources were provided for this subsection, these criteria are best treated as a general framework rather than as a comparison supported by specific outcome data.
Recommendations for Humanitarian Programs
The research findings underscore the urgent need for comprehensive programs that address the unique needs of adolescents in humanitarian settings. These programs should:
A Needs-Based Synthesis
Taken together, the topic calls for responses that treat adolescents as a distinct population with health, psychosocial, social, and protection needs. A needs-based approach should prioritize safety, access to appropriate services, and attention to the conditions shaping adolescents’ well-being. Without subsection-specific sources, this synthesis remains a general interpretation rather than a claim about the effectiveness of any particular program.
From Crisis Management to System Correction
Future adolescent health policy is increasingly linked to climate action, humanitarian response, debt management, and regulation of civic space. These policy choices can shape access to services, health-system resilience, and accountability for women, children, and adolescents. Recent reviews also continue to assess major adolescent health trends and the influence of cultural, societal, and public health developments since 2010. UNICEF warns that disinvestment can weaken current health outcomes while eroding the foundations of public health systems and long-term development.
Different Risks, Unequal Protection
Adolescents do not experience humanitarian crises in the same way. UNICEF emphasizes the need to distinguish the experiences of adolescent girls and boys and to examine the different risks and opportunities they face. Adolescents with disabilities are particularly vulnerable to violence, abuse, and neglect in humanitarian contexts. Understanding these differences is therefore essential to designing protection and health responses that do not overlook groups facing heightened risk.
Adolescents Behind the Indicators
Adolescents in crisis are individuals whose health and safety may be shaped by displacement, disrupted services, violence, and prolonged uncertainty. Effective responses should therefore consider not only measurable outcomes but also adolescents’ dignity, agency, relationships, and ability to participate in decisions affecting them. Because no sources were provided for this subsection, these points are presented as general considerations rather than source-specific findings.
<ul> <li><b>Promote health and well-being:</b> Focus on physical and emotional safety, engagement in learning, positive self-image, and life skills development.</li> <li><b>Provide comprehensive SRH services:</b> Include care for survivors of sexual violence, menstrual hygiene management, life skills training, and age-appropriate fertility education.</li> <li><b>Engage with families and communities:</b> Collaborate with parents, teachers, and community leaders to create supportive environments for adolescents.</li> <li><b>Advocate for the right to education:</b> Ensure safe and equitable access to education for all adolescents, regardless of gender or displacement status.</li> <li><b>Prioritize protection:</b> Strengthen protection mechanisms to address the various forms of violence that adolescents face, including sexual violence, trafficking, and child marriage.</li> <li><b>Foster coordination:</b> Improve communication and collaboration among health, education, and protection actors to create holistic and effective interventions.</li> </ul>
By prioritizing the needs and well-being of adolescents in crisis, humanitarian actors can help these vulnerable young people navigate the challenges of displacement and build a brighter future.