The youth bulge in sub-Saharan Africa offers promise for a long-term ‘demographic dividend.’ Yet in the near term, the youth bulge is a major driver of several complex, interrelated development challenges. The ﬁrst is the massive and growing employment crisis, as a steadily increasing population of youth entering the labor force each year far exceeds the number of jobs created, especially in the formal economy. The effects are disproportionately severe for economically marginalized adolescent girls and young women, who are at higher risk for HIV than males of the same age. However, education and economic empowerment have shown promise in mitigating that risk.
The second key challenge is the threat of a rollback in controlling the HIV epidemic, driven by the swelling population of adolescents and young adults who have a disproportionately higher risk of HIV acquisition. The health and social service workforce is inadequate to meet population needs in many countries. The UNAIDS goal of placing 90% of people living with HIV on antiretroviral therapy globally by 2030 may be threatened by the emergence of a projected gap of 18 million health workers over the same period, primarily in low and middle-income countries, according to the WHO.
The assessment identiﬁed and analyzed several examples of effective programs that already support disadvantaged youth for growing health and social services professions, such as the Kheth’Impilo Pharmacy Assistant program. The box on the front page identiﬁes four key drivers of program success (drawn from those models), which should be more broadly adapted and replicated. A much more numerous groups of youth employment programs provide youth with foundational skills and support to enter the workplace more broadly. Such programs could be adapted to include stronger links to health and to facilitate youth entry into this growing labor market. Many programs could incorporate low-cost ways to educate and expose a larger number of youths to careers in health, for example through guest speakers by health professionals or businessowners and site visits to employers. More directly, programs that already specialize in training and placing youth in retail jobs could develop a pharmacy track – recruiting youth who show interest and aptitude -- leading to entry-level positions behind the counter at pharmacies. Successful candidates may then advance to careers as professionally certiﬁed pharmacist assistants, following further employer-sponsored training.
• career exposure and education for health and social
• math and science skill development for youth interested in
• careers in health;
• access to quality health training programs (e.g. expanding
• accreditation and financial aid);
• Technical and Vocational Education Training system capacity
• building and reform;
• improved public sector management practices that
• promote youth employment in paraprofessional occupations; and
• job creation and entrepreneurship initiatives within health
• value chains showing high potential, such as pharmaceuticals and medical tourism.