| Health systems drivers with a governance focus | Health system levels |
| Macro | Meso | Micro |
| Service delivery lens |
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|
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Existence of adolescent health committee/unit85
Constitution and functioning of committee/unit Location and linkages of the committee/unit within sectoral hierarchies Availability and authority to deploy resources
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Profile of policy champions: profession, seniority, age, gender Competency of all stakeholders in adolescent health and multisectoral actions Capacity to generate and use evidence on mutlisectoral action86
|
| Society lens |
Political prioritisation Accountability dynamics Interpersonal dynamics
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Adolescent leadership and participation and mobilisation overall Social determinants of health including, gender, diversity and socioeconomic and political context Framing and alignments of sector goals
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Incentives and constraints of stakeholders, including adolescents Leadership and organisational cultures supporting multisectoral action40
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Social networks and histories between policy advocates Trust, communication and credibility between policy advocates
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| Systems lens |
Dis/equilibria Feedback loops Eventuality of change Emergence
(Dynamics can link across micro, meso and macro levels) |
Policies that prohibit adolescent girls from being pregnant while being in school, inhibits early care seeking for pregnancy care by these adolescents and has a negative impact on their future education and health38
Not including adolescents in leadership and participation during the design, implementation, monitoring and evaluation of adolescent health programme will contribute to a negative feedback loop in terms of nature, quality and impact of the programme87
Initial gains on collaborating on health education or HPV at schools, builds trust and relationships between sectors, that enables further work on more complex mutual aims such as mental health or comprehensive sexual and reproductive health programmes or violence prevention38
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