Assessing the health, social, educational and economic impact of the COVID-19 pandemic on adolescents in low- and middle-income countries: a rapid review of the literature.

COVID-19 has caused profound health, social, educational and economic devastation around the world, especially among the lives of adolescents in low- and middle-income countries. This paper looks at a wide array of outcomes impacting adolescents' daily lives including health (mental, physical, sexual and reproductive health, vaccine perceptions and overlap between these topics), social relationships (family and peer), education and socio-economic disparities. Both scientific and grey literature between December 2019 and February 2022 were sought from PubMed, Google Scholar and organisations conducting research among adolescents, and coded. A total of 89 articles were included, 73% of which were peer-reviewed; 37% of the articles were from WHO's Western Pacific region; 62% of the articles were cross-sectional; 75% were quantitative. Three major topics emerged in more than half the articles: mental health (72%), education (61%) and socio-economic ramifications (55%). However, there were regional differences in topics and many of them overlapped. The results indicate that, where there has been research, almost all findings have been linked to worse mental health during the pandemic. Overall, remote education was seen as a negative experience. The ramification of school closures on future aspirations, in particular early school leaving, highlights the importance of prioritising education during future pandemics based on the situation within the country. Gender and other disparities have made marginalised adolescents vulnerable to the economic ramifications of containment measures. Given the risks identified, there is a pressing need to put adolescents at the centre of establishing priorities for their health agenda for post-pandemic recovery.

Telehealth in cancer care during the COVID-19 pandemic.

INTRODUCTION: The Victorian COVID-19 Cancer Network (VCCN) Telehealth Expert Working Group aimed to evaluate the telehealth (TH) experience for cancer patients, carers and clinicians with the rapid uptake of TH in early 2020 during the COVID-19 pandemic. METHODS: We conducted a prospective multi-centre cross-sectional survey involving eight Victorian regional and metropolitan cancer services and three consumer advocacy groups. Patients or their carers and clinicians who had TH consultations between 1 July 2020 and 31 December 2020 were invited to participate in patient and clinician surveys, respectively. These surveys were opened from September to December 2020. RESULTS: The acceptability of TH via both video (82.9%) and phone (70.4%) were high though acceptability appeared to decrease in older phone TH users. Video was associated with higher satisfaction compared to phone (87.1% vs 79.7%) even though phone was more commonly used. Various themes from the qualitative surveys highlighted barriers and enablers to rapid TH implementation. DISCUSSION: The high TH acceptability supports this as a safe and effective strategy for continued care and should persist beyond the pandemic environment, where patient preferences are considered and clinically appropriate. Ongoing support to health services for infrastructure and resources, as well as expansion of reimbursement eligibility criteria for patients and health professionals, including allied health and nursing, are crucial for sustainability.

COVID-19 Experiences and Health-Related Implications: Results From a Mixed-Method Longitudinal Study of Urban Poor Adolescents in Shanghai.

PURPOSE: This analysis aimed to investigate gender differences in adolescents' concerns and the health implications of COVID-19. METHODS: We used two rounds of the Global Early Adolescent Study (GEAS) collected in Shanghai in 2018 and 2020. We analyzed data from 621 adolescents, comparing boys' and girls' concerns about COVID-19 and examining trends in general health and mental health by sex between the pre-COVID-19 and COVID-19 periods. Changes in health indicators over time were assessed using generalized estimating equation (GEE) models. RESULTS: Adolescent girls reported more health concerns (52.0% vs. 42.7%) and educational concerns (61.0% vs. 46.3%) than boys, whereas boys expressed more worries about the economic consequences of COVID-19 (32.9% vs. 25.4%). Changes in health-related outcomes during the pandemic compared to the prepandemic era differed by sex and varied by COVID-related experiences. Boys reported improved overall health (OR: 1.54, 95% CI: 1.00, 2.35) in the COVID-19 period relative to the pre-COVID-19 period. Such improvements were only observed among boys who reported no family economic hardships (OR: 2.10, 95% CI: 1.24, 3.58). We found no significant change for girls (OR: 1.14, 95% CI: 0.83, 1.55), regardless of COVID-19 economic impacts. In contrast, girls reported increased anxiety (OR: 1.63, 95% CI: 1.09, 2.45), especially among those who were concerned about their academic performance (OR: 1.85, 95% CI: 1.16, 2.97). Boys experienced no such increase (OR: 0.92, 95% CI: 0.55, 1.54), regardless of their education concerns. DISCUSSION: Adolescents' COVID-19 experiences are highly gendered and result in increased health inequalities, with greater mental health implications for girls.

Uniting for adolescents in covid-19 and beyond

Adolescents and young adults are also experiencing a crisis of connection to family, community, and society, with increasing numbers living on the streets or dropping out of school.34 Between 2003 and 2015, development assistance for adolescent health accounted for only 1.6% of total development assistance for health,5 despite a third of the total global burden of disease estimated to have roots in adolescence.6 Mental health problems affect 10-20% of adolescents, and many more experience symptoms that diminish wellbeing.7 Furthermore, this is the age at which the gender inequalities that underlie and pose major barriers to wellbeing emerge clearly and is when programmes can transform these inequalities. In 2017, 34% of young women and 10% of young men aged 15-24 years were not in employment, education, or training, with more pronounced disparities in northern Africa and southern Asia.68 Even among employed adolescents and young adults, an increasing proportion have poor job security, variable weekly earnings, and minimal or no health or social security coverage.8 These examples show that, as a global community, we have paid insufficient attention to the multidimensional and intersectional nature of adolescent wellbeing and the importance of the transition to young adulthood. In 2019, for a more concerted and collaborative approach to adolescents’ wellbeing, an unprecedented coalition of governments, United Nations agencies, non-governmental organisations, and academic institutions—working closely with adolescents and young people—committed to a call to action for adolescent wellbeing.9 Underpinning this call to action is a new agreed definition and conceptual framework for adolescent wellbeing to inform policies and programming.10 The framework emphasises the importance of integrating five interconnected domains in adolescent programming: good health and optimum nutrition;connectedness, positive values, and contribution to society;safety and a supportive environment;learning, competence, education, skills, and employability;and agency and resilience.