Leveraging global tools for adolescent and youth health planning and programming: process and lessons learnt from Madagascar

Madagascar, with a significant proportion of its population aged 10-24 years, has developed a comprehensive National Strategic Plan for Adolescent and Youth Health (2025-2030) to improve adolescent and youth health and well-being. This process applied the second edition of Accelerated Action for the Health of Adolescents (AA-HA!) guidance and the Global Action for Measurement of Adolescent Health (GAMA)-recommended indicators to ensure an evidence-based approach. Moving beyond the traditional focus on sexual and reproductive health, the strategy adopted a multi-sectoral approach that involved government ministries, non-governmental organizations (NGOs), and youth associations, among other stakeholders. Key steps included stakeholder engagement, establishing a steering committee, mapping and analyzing data for GAMA-recommended indicators, assessing health needs, reviewing policies, and setting priorities through participatory, data-driven methods. Findings revealed major challenges, including high rates of adolescent fertility and early marriage, thinness among adolescent girls, and substance abuse. Integrating GAMA-recommended indicators with adolescent perspectives provided a holistic view of health needs, enabling the development of an inclusive strategic plan. Lessons learned highlight the importance of robust data use, multi-sectoral collaboration, and active youth involvement in planning and programming. Madagascar's experience demonstrated that applying AA-HA! guidance and GAMA-recommended indicators is essential for a comprehensive approach to adolescent and youth health planning and programming. This process identified real needs and informed evidence-based strategies, reinforcing the value of inclusive, data-driven planning for improving health outcomes among adolescents and youth.