Utilization of adolescent health services during the COVID-19 pandemic: evidence on impact and adaptations from a rapid assessment survey in the Philippines.

BACKGROUND: Due to the COVID-19 pandemic, many challenges in adolescent health have been exacerbated including increased cases of early marriages, domestic violence, higher rates of anxiety and depression, and reduced access to sexual and reproductive health services for adolescents. This study examines the impacts of the pandemic on adolescent health services utilization and potential adaptations in the Philippines. METHODS: The data used in this study was from a rapid telephone assessment survey of 148 adolescent-friendly health facilities (rural health units) in the Philippines. We employed a mixed-methods research approach comprising both quantitative and qualitative analyses in three phases. First, we conducted a descriptive analysis of the status of adolescent healthcare access and utilization during COVID-19. Next, we examined using multivariate ordered logistic regressions how staff availability and adolescent health (AH) service provision modalities influenced AH service utilization in terms of the average number of adolescents served per week during compared to before the pandemic. We also conducted a complementing qualitative analysis of the challenges and corresponding adaptive solutions to ensuring continuity of AH services in facilities. RESULTS: We find that two months into the pandemic, 79% of adolescent-friendly trained staff were reporting for duty and 64% of facilities reported no staff disruptions. However, only 13% of facilities were serving the same number of adolescents or greater than before COVID-19. The use of more modalities for AH service provision (including telehealth) by facilities was significantly associated with increased likelihood to report serving the same number of adolescent or greater than before COVID-19 compared to those who used only one modality. CONCLUSION: Investments in multiple modalities of care provision, such as telehealth could improve AH services utilization and help sustain connection with adolescents during shocks, including future outbreaks or other stressors that limit physical access to health facilities.

Economic impacts of overweight and obesity: current and future estimates for 161 countries.

INTRODUCTION: The scope of the challenge of overweight and obesity (OAO) has not been fully realised globally, in part because much of what is known about the economic impacts of OAO come from high-income countries (HICs) and are not readily comparable due to methodological differences. Our objective is to estimate the current and future national economic impacts of OAO globally. METHODS: We estimated economic impacts of OAO for 161 countries using a cost-of-illness approach. Direct and indirect costs of OAO between 2019 and 2060 were estimated from a societal perspective. We assessed the effect of two hypothetical scenarios of OAO prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS: The economic impact of OAO in 2019 is estimated at 2.19% of global gross domestic product (GDP) ranging on average from US$20 per capita in Africa to US$872 per capita in the Americas and from US$6 in low-income countries to US$1110 in HICs.If current trends continue, by 2060, the economic impacts from OAO are projected to rise to 3.29% of GDP globally. The biggest increase will be concentrated in lower resource countries with total economic costs increasing by fourfold between 2019 and 2060 in HICs, whereas they increase 12-25 times in low and middle-income countries. Reducing projected OAO prevalence by 5% annually from current trends or keeping it at 2019 levels will translate into average annual reductions of US$429 billion or US$2201 billion in costs, respectively, between 2020 and 2060 globally. CONCLUSION: This study provides novel evidence on the economic impact of OAO across different economic and geographic contexts. Our findings highlight the need for concerted and holistic action to address the global rise in OAO prevalence, to avert the significant risks of inaction and achieve the promise of whole-of-society gains in population well-being.

Economic impacts of overweight and obesity: current and future estimates for eight countries.

BACKGROUND: Obesity is a growing public health challenge worldwide with significant health and economic impacts. However, much of what is known about the economic impacts of obesity comes from high-income countries and studies are not readily comparable due to methodological differences. Our objective is to demonstrate a method for estimating current and future national economic impacts of obesity and apply it across a sample of heterogeneous contexts globally. METHODS: We estimated economic impacts of overweight and obesity for eight countries using a cost-of-illness approach. Direct and indirect costs of obesity from 2019 to 2060 were estimated from a societal perspective as well as the effect of two hypothetical scenarios of obesity prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS: In per capita terms, costs of obesity in 2019 ranged from US$17 in India to US$940 in Australia. These economic costs are comparable to 1.8% of gross domestic product (GDP) on average across the eight countries, ranging from 0.8% of GDP in India to 2.4% in Saudi Arabia. By 2060, with no significant changes to the status quo, the economic impacts from obesity are projected to grow to 3.6% of GDP on average ranging from 2.4% of GDP in Spain to 4.9% of GDP in Thailand. Reducing obesity prevalence by 5% from projected levels or keeping it at 2019 levels will translate into an average annual reduction of 5.2% and 13.2% in economic costs, respectively, between 2020 and 2060 across the eight countries. CONCLUSION: Our findings demonstrate that the economic impacts of obesity are substantial across countries, irrespective of economic or geographical context and will increase over time if current trends continue. These findings strongly point to the need for advocacy to increase awareness of the societal impacts of obesity, and for policy actions to address the systemic roots of obesity.