Disability-Inclusive Adolescent Care
Many national adolescent health policies mandate inclusion on paper, but funding and infrastructure lag behind on the ground. Whose job is it to close this gap the disability-rights organizations, health implementers, or adolescent health researchers?
Using a systems-thinking lens, I would say it is a shared responsibility. Disability-rights organizations bring lived experiences and advocacy, health implementers translate policies into accessible services, while adolescent health researchers generate evidence to identify gaps and inform better interventions.
@stacy I completely agree, Stacy asking how the system works together hits the nail on the head.
The challenge is that without a structured accountability mechanism, shared responsibility often becomes no one's responsibility. If researchers, implementers, and advocates are to close this loop together, who do you see as the anchor holding the mandate (and budget) to bring everyone to the same table?
@Nonvicks Ochieng, on the anchor question: I would be cautious about naming a single anchor, because the actor with the budget is rarely the actor with the credibility, and the actor with the credibility rarely has the budget. What if the accountability mechanism doe not require one anchor but a pairing, a funder with a mandate and a DPO with a veto or review role? That way neither can quietly drop inclusion without the other noticing. Does that feel workable, or does it just create a new coordination problem?
@stacy, your systems framing is right, but I would push on one thing: "shared responsibility" and "no one's responsibility" are not the only two options. There is a third responsibility that is shared but asymmetrically so, where one actor holds the mandate and budget while others hold complementary roles. The question @Nonvicks asks, who anchors it , is really asking which actor has both the authority to convene and the resources to sustain the table. In most settings that is a government body, but disability rights organizations are usually the ones with the lived experience legitimacy to keep it honest. Those two things rarely sit in the same place.