Evidence map›Paper›PMID 42815151›Full record

ArticleHealth policy and planning2026

Meeting the challenges to adolescent well-being: context, returns on investment, and financing.

Peter Sheehan, Bruce Rasmussen, David A Ross, Anshu Mohan, Susan Sawyer, Bhavya Nandini, Levi Singh, Kim Sweeny, John Symons, Rose September

Abstract read
In one paragraph

Article in Health policy and planning, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Peter SheehanVictoria Institute of Strategic Economic Studies, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia.ORCID 0000-0001-9450-8371
Bruce RasmussenVictoria Institute of Strategic Economic Studies, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia.ORCID 0000-0001-5779-0339
David A RossStellenbosch University, Institute for Life Course Health Research, Im Kloster 28, 76332 Bad Herrenalb, Germany.ORCID 0000-0001-6353-6951
Anshu MohanWorld Health Organization South-East Asia Regional Office, Family and Gender Health, World Health House, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110 002, India.ORCID 0009-0002-5825-8576
Susan SawyerCentre for Adolescent Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, Victoria 3052, Australia.ORCID 0000-0002-9095-358X
Bhavya NandiniPartnership for Maternal, Newborn and Child Health, 20, Avenue Appia, Geneva 1211, Switzerland.ORCID 0009-0002-2215-5161
Levi SinghThe RHR Africa Trust, 225 Jan Smuts Avenue, Parktown North, Johannesburg 2196, South Africa.ORCID 0009-0000-4618-4122
Kim SweenyVictoria Institute of Strategic Economic Studies, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia.ORCID 0000-0001-6948-809X
John SymonsVictoria Institute of Strategic Economic Studies, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia.ORCID 0000-0002-9832-4462
Rose SeptemberAccelerated Programme of Action for Children, The Presidency of the Republic of South Africa, Union Buildings, Government Street Arcadia, Pretoria 0001, South Africa.

Funding

Bill and Melinda Gates FoundationPartnership for Maternal, Newborn and Child Health 2022/1310680-0Victoria University
6 · The paper itself

Abstract

Adolescents in many countries face serious challenges in realizing the level of well-being that is their human right. Many factors-deep-seated inequality within and between countries, rapid change in skill requirements for employment, climate change, and social media-are driving these deepening challenges. This paper develops three points about the need for an urgent response to this situation. First, there is now evidence that a powerful suite of cost-effective investments is available to improve adolescent well-being. To support this claim, we draw on recent modelling of investments for many low- and middle-income countries (LMICs), as well as on detailed case studies of three countries (India, South Africa, and Colombia). In all these studies, most of the investments are highly cost-effective, with benefit-cost ratios over 6, and in many cases much higher. However, the cost of these investments is substantial, especially for those that involve the education system, raising major financing issues for most countries. Second, the case studies highlight, at least for South Africa and Colombia, the extent to which within-country inequality harms adolescent development. For example, if school quality is poor for low-income groups or regions, schooling can perpetuate rather than arrest inequality, which in turn can lead to disruptive violence for these groups or regions. Third, countries with limited fiscal space, high debt levels, and inequality and violence curtailing growth rates will find it hard to fund the investments needed to transform adolescent well-being. Major reforms to development finance are necessary, such as those outlined at the Fourth International Conference on Financing for Development at Seville in mid-2025, as well as changes to the priority given to domestic investments. Steps to reduce income inequality by new fiscal measures are also important, to fund the investments in adolescent well-being and to make them more effective.

Indexed as

Adolescent HealthInvestmentsAdolescentAdolescent DevelopmentColombiaCost-Benefit AnalysisDeveloping CountriesHumansIndiaSouth Africaadolescent well-beingbenefit-cost ratio (BCR)economic modellinghealth and educationhuman capitallow- and middle-income countries (LMICs)

Identifiers

PMID42815151
PMCPMC13626655

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.