Adolescent girls and the SDGs: acting at the midpoint milestone
Authors: Lauren Rumble, Suzanne Petroni, Ruth Graham Goulder, Lauren Pandolfelli
Journal: The Lancet Child & Adolescent Health (2023)

When global leaders met at the UN in September, 2023, marking the midpoint to the Sustainable Development Goals (SDGs) 2030 deadline, they agreed that progress must be accelerated. For adolescent girls (aged 10–19 years) in particular, progress is falling short. Yet global leaders failed once again to devote the necessary attention to ensuring that adolescent girls are not left behind. Data show that adolescent girls are not receiving the support they need to thrive and are continuously disadvantaged by inattention and broad inequalities that limit their tremendous potential. Although maternal mortality has decreased by a third since 2000,1WHOTrends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/ Population Division. Feb 23, 2023.https://www.who.int/publications/i/item/9789240068759Date accessed: December 6, 2023Google Scholar progress stalled globally between 2016 and 2020. In the UN-designated SDG regions of Europe and Northern America, as well as Latin America and the Caribbean, maternal mortality has actually increased. As reported in the 2019 WHO Global Health Estimates, maternal conditions remain a leading cause of death for girls aged 15–19 years. The UNAIDS Global AIDS Update 2023 reports that girls account for seven in ten new HIV infections among adolescents globally. According to data available on the UNICEF adolescent data portal, adolescent girls are far more likely than adolescent boys to be without education, employment, or training, and to engage in unpaid domestic and care work. Only 10% of adolescent girls and young women (aged 15–24 years) in low-income countries use the internet.2UNICEFBridging the gender digital divide. May, 2023.https://data.unicef.org/resources/ictgenderdivide/Date accessed: December 6, 2023Google Scholar Worldwide, more than a third of adolescents aged 15–19 years believe that intimate partner violence is acceptable; one in five ever-partnered girls in the same age group have experienced intimate partner violence in the past year. Child marriage has become less common globally, with one in five girls marrying today, compared with one in four in 2000. However, child marriage rates are stagnant in many countries and regions, and 12 million girls still become brides each year.3UNICEFProgress on children's well-being: centring child rights in the 2030 agenda; for every child, a sustainable future. Sept 17, 2023.https://data.unicef.org/resources/sdg-report-2023/Date accessed: December 6, 2023Google Scholar Adolescent girls in west and central Africa face especially stark circumstances, as do those living with disabilities, in extreme poverty, in humanitarian or climate crises, in marriage or forced unions, or on the move (ie, migrants or refugees). Nevertheless, our calculations of UNICEF-supported Multiple Indicator Cluster Survey data from 2017 to 2021 indicate that adolescent girls remain hopeful about the future—in more than 30 countries with comparable data, 80% or more girls aged 15–19 years believe that life will get better in the next year (unpublished). The world has a unique opportunity to prove them right. First, we need better data. Data points for half of the 48 child-related SDG indicators are missing, and self-reported data for girls aged 10–14 years are rare.3UNICEFProgress on children's well-being: centring child rights in the 2030 agenda; for every child, a sustainable future. Sept 17, 2023.https://data.unicef.org/resources/sdg-report-2023/Date accessed: December 6, 2023Google Scholar, 4UNProgress on the sustainable development goals: the gender snapshot 2022.https://www.unwomen.org/en/digital-library/publications/2022/09/progress-on-the-sustainable-development-goals-the-gender-snapshot-2022Date accessed: December 6, 2023Google Scholar Available data are not always disaggregated by sex or age, and they are not used appropriately to inform policies and programmes. National capacity to collect and analyse data on challenging issues, such as sexual violence, girls' decision making, and gender norms, must expand alongside opportunities to translate data into action. Despite stark challenges facing adolescent girls, just 5·6% of overseas development assistance is dedicated to gender and adolescents.5Devonald M Guglielmi S Jones N Investing in adolescent girls: key changes in the bilateral donor funding landscape. January, 2023.https://www.gage.odi.org/wp-content/uploads/2023/01/Investing-in-Adolescent-Girls-1.pdfDate accessed: December 6, 2023Google Scholar Yet the world's 1·3 billion adolescents make up 16% of the global population, with substantially higher proportions in low-income and middle-income countries. More money is needed, and money must be better spent. Some of the transformative solutions needed to accelerate progress are outlined in UNICEF's Adolescent Girl Strategy.6UNICEFAdolescent girl programme strategy, 2022–2025. October, 2022.https://www.unicef.org/reports/adolescent-girls-programme-strategy-2022-2025Date accessed: December 6, 2023Google Scholar These solutions include generating reliable data and evidence on what works, supporting girls' leadership and agency, and forming partnerships with girl-led networks and organisations. The strategy also calls for partners to move past project-based funding and towards long-term financing of multisectoral, gender-transformative, age-responsive, and large-scale initiatives to accelerate results across a range of outcomes. There are examples to learn from. In Tanzania, adolescents aged 14–19 years living in households that receive support from the national social protection system are offered life skills training, a small grant, mentoring, and links to sexual and reproductive health services from the Ujana Salama programme. The programme has improved knowledge of HIV and sexual and reproductive health, strengthened gender-equitable attitudes among boys, and reduced sexual and physical violence.7UNICEF Office of Research-InnocentiA cash plus model for safe transitions to a healthy and productive adulthood. Midline report. June, 2020.https://www.unicef-irc.org/publications/1100-cash-plus-model-for-safe-transitions-to-healthy-and-productive-adulthood-midline.htmlDate accessed: December 6, 2023Google Scholar In Kenya, the Adolescent Girls Initiative-Kenya (AGI-K) tested combinations of support, including community dialogues, cash transfers, safe spaces for sessions on health and life skills, and financial education and inclusion. Girls who received AGI-K support were more likely to have delayed sexual debut and pregnancy, complete school, and acquire financial literacy and savings. The combined interventions were more cost-effective than single-sector interventions.8Austrian K Soler-Hampejsek E Kangwana B et al.Adolescent Girls Initiative—Kenya: endline evaluation report. May, 2020.https://knowledgecommons.popcouncil.org/departments_sbsr-pgy/998/Date accessed: December 6, 2023Google Scholar The Bangladesh Rural Advancement Committee's Empowerment and Livelihood for Adolescents initiative is another example of a multifaceted, multisectoral, girl-focused programme that has successfully increased adolescent girls' engagement in income-generating activities and rapidly reduced early marriage or cohabitation across diverse country contexts.9Bangladesh Rural Advancement Committee (BRAC) and UNFPAAdolescent empowerment at scale: successes and challenges of an evidence-based approach to young women's programming in Africa. Feb 1, 2023.https://www.unfpa.org/publications/adolescent-empowerment-scale-successes-and-challenges-evidence-based-approach-youngDate accessed: December 6, 2023Google Scholar Achieving the SDGs for adolescent girls also requires changes in the way that many of us do business. The UNFPA–UNICEF Global Programme to End Child Marriage, the Global Programme for Education, and only a few other programmes are specifically focused on adolescent girls. Girls, in all their diversity, are otherwise largely invisible from major funding initiatives for climate, health, and humanitarian action. Funding for adolescent girls all too often relies on gender-related funding mechanisms that are already stretched and have little capacity for quality investments in adolescent girls' needs. Funding should not only be increased, but also be applied in a multifocal manner to comprehensively address the needs of adolescent girls. Support for feminist organisations, girl leadership, and girl-led groups must be strengthened in recognition of the pivotal roles these girls and young women play in fostering sustainable change in their communities and through national dialogues. Despite the inadequate attention to adolescent girls in policies, programmes, data, and funding, their potential is enormous—as is their belief in a better future. The best way to honour that optimism and deliver on a just and liveable world is by investing in adolescent girls. SP is a consultant for UNICEF's gender team. All other authors declare no competing interests.