Adolescent Health-An Overview
10/3/2015
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THREE STORIES WITH SIMILAR ENDING
RESHMA
RURAL ADOLESCENT
DEVELOPING RAPIDLY
EARLY MARRIAGE
TEENAGE PREGNANCY
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NINA
URBAN ADOLESCENT
EXPERIMENTING
SEXUALLY
APPARENTLY HEALTHY
SON OF A DOCTOR
TEENAGE PREGNANCY
ABORTION R.M.P.
DEATH
CHETAN
ADOLESCENT BOY
NEVER SCREENED
+HISTROY OF CHD
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Adolescent Health-An Overview
ALL THESE EVENTS ARE THE
EXAMPLES OF SYSTEM FAILURE
SYSTEM WHICH IS INSENSITIVE TO
THE NEEDS OF ADOLESCENT
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DOUBLE DISADVANTAGE
CARRY THE BURDEN OF PRE EXISTING DISEASES OF CHILD HOOD
DEVELOPING RAPIDLY AND HAVING EXTREME DEGREE OF PRESSURE
FROM PEERS, PARENTS, SOCIETY AND SELF
LACK KNOWLEDGE AND SKILL TO COPE UP
WITH PRESSURE
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Adolescent Health-An Overview
No longer Children, Not Yet Adults
Young people
Adolescence
10-24 Years
10-19 years
Youth
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15-24 Years
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Adolescent Health-An Overview
Population Profile: Ages 10-24 Years in India
Population age-10-24 (Millions)
284.2
10-24 years as % of total population
30
% Male enrolled in secondary school
59
% Female enrolled in secondary school
38
Average age at first marriage
20
Total fertility rate
3.4
% TFR contributed by 15-19 years
9
% using contraceptives
7
10/3/2015
Population Reference Bureau. Inc.
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Adolescent Health-An Overview
India: Country of Diversity
5,000 year old civilization
325 languages spoken – 1,652 dialects
18 official languages
29 states, 5 union territories
3.28 million sq. kilometers - Area
7,516 kilometers - Coastline
1,000,000,000 people in 2000
207 Million Adolescents
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Adolescent Health-An Overview
Adolescents: A Very diverse population segment
•
•
•
•
Different stages of development
Different circumstances
Different needs and
Diverse problems
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Adolescent Health-An Overview
Adolescents have important
subgroups with markedly different
needs:
Urban
Rural
Slum
Street Children
Those in specially difficult
circumstances
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Adolescent Health-An Overview
Why Focus on Adolescents?
• Large number >22% of the population
(Approximately 207 Million of our
population);
• Adolescence is a period of rapid physical
growth, sexual and psycho-social
changes;
• Habits and behavior picked up during
adolescence (Risk taking behavior,
substance abuse, eating habits, conflict
resolution) have life long impact.
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Adolescent Health-An Overview
Why Focus on Adolescents?
• Adolescence is the last chance to correct
growth lag and malnutrition;
• Many adolescent boys and girls are sexually
active but lack information and skills for self
protection (Low level of information on FP, low
contraception use);
• Have simple, but wide pervading and crucial
RH needs – menstrual hygiene, contraception;
(including Emergency Contraception), safety
from STI/HIV;
• Communication gap exists with parents and
other adults (Lack of family
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“Connectedness”);
Public Health Implications
• 70% of mortality in adulthood is linked to habits
picked up during adolescence. (Risk taking
behavior, substance abuse, eating habits, conflict
resolution);
• Prevailing malnutrition, anemia, stunting and lack
of immunization has adverse impact on MMR, IMR,
morbidity and have inter- generational effects;
• Adolescent sexuality: leads to adolescent
pregnancy, unsafe abortions, RTI, STI/HIV and
social problems;
• Adolescent pregnancy : Risk of ADVERSE
outcome (IMR, MMR, LBW babies) is higher;
• Lack of “connectedness” with parents and other
adults prevents transmission of health messages
and crucial skills, leading to adoption of risky
behavior- substance abuse, early sexual debut,12
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STI/HIV etc.
Adolescent Health-An Overview
Characteristics
•
•
•
•
•
•
•
•
•
•
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A – Aggressive Anaemic Abortion
D – Dynamic,Developing,Depressed
O – Overconfident,Overindulging,Obese
L – Loud but lonely,& Lack information
E – Enthusiastic,Explorative,& Experimenting
S – Social,Sexual, & Spiritual
C – Courageous,cheerful, &concern
E – Emotional,Eager,& Emulating
N - Nervous,Never say no to peers
T – Temperamental,Teenage pregnancy
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Ill Health Recipe: “Ye Dil Mange
More” Lifestyle of Adolescents
Tobacco/
Alcohol
Excess
dietary FAT
Lack of vegetables
& fruits
Sedentary
habits
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Sexual behavior/
poor genital hygiene
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Adolescent Health-An Overview
Adolescent Health-An Overview
A Common Scenario
• 14 Year old school girls in a big City X:
• Out of 100 girls:
– 60 have never had sex;
– 15 have had sex, but are not currently sexually
active;
– 25 are sexually active more or less regularly
– 8 have had health problems;
– 2 have been coerced into having sex;
All these girls have different needs for
health information, services and social
support
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Adolescent Health-An Overview
Evidence of Common Roots*
Risk & Protective factors for
adolescents
Early Sex Substance Depression
Use
A positive relationship with
parents
Conflict in the family
A positive school
environment
Friends who are negative role
models
A positive relationship with
adults in the community
Having spiritual beliefs
Engaging in other risky
behaviours
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*”Broadening the Horizon” Evidence from 52 countries
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Adolescent Health-An Overview
Priority Health Problems
•
•
•
•
•
Sexual and reproductive health problems
Nutritional problems
Mental health problems
Substance abuse
Accidental and intentional violence
Clustering of problems
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PREVALENCE OF ANAEMIA IN ADOLESCENT-MEERUT
70%
60%
50%
40%
42
30%
34
36
20%
10%
0%
BOYS
GIRLS-R
NORMAL
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GIRLS(U)
ANAEMIC
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Adolescent Health-An Overview
Health problems
• Large number are malnourished, and anaemic –
(56% Baroda study, 95% SWACH study), or
stunted (59% boys, 37% girls- NNMB 2000);
• Obesity is increasing,8-10% in public schools of
Meerut and Delhi.
• Adolescent pregnancy – common (50%of women
in india had a child before reaching the age of 20IP-JAN 2004)
• Large number of adolescents are – still unimmunized. (TT,RUBELLA );
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Adolescent Health-An Overview
HEALTH PROBLEMS
•One out of 10 children in India is sexually
abused at any given point of time (WHO)
•Sexual problems;25%of patients attending
Government STI clinics are Younger than 18
Year old (Ramasubban-1995)
Increasing vulnerability to HIV/AIDS,Over 50%of
all new HIV cases in india are among 1024years (UNAIDS-2002)
Substance abuse is quite common
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PROGRAMMES FOR ADOLESCENTS
KISHORI SHAKTI YOJANA –To improve the health and
nutritional status of girls
BALIKA SAMRIDHI YOJANA –To Delay the age of marriage
NEHRU YUVA KENDRA – ACT AS HEALTH AWARENESS
UNIT-Through active participation
of youth
MAHILA SAMAKHYA PROGRAMME- Equal access to education
facilities for adolescent girls
and young women
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Adolescent Health-An Overview
PROGRAMMES FOR ADOLESCENTS
SCHOOL AIDS EDUCATION, UNIVERSITY TALKS AIDS
TRAINING OF RURAL YOUTH FOR SELF EMPLOYMENT
REPRODUCTIVE AND CHILD HEALTH PROGRAMME
? WHERE ARE THE BOYS
NO COMPREHENSIVE PROGRAMME
ADDRESSING
ALL
NEEDS
OF
ADOLESCENT
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Adolescent Health-An Overview
Programming
To promote healthy
development to meet needs
and build competencies
Safety,
Belonging,
Self
Esteem,
Caring
relationship
Physical
eg eating habits
Psychological
eg communication
To prevent and respond to
health problem from:
– Early, unprotected,
unwanted sex
– Use of tobacco and misuse of
alcohol and other substances
– Accidents
– Violence
– Poor nutrition
– Endemic disease
Moral
eg personal responsibility
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Vocational
eg entrepreneurial skills
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STRATEGIES FOR PROMOTION OF ADOLESCENT HEALTH
A =ADOPTION OF HEALTHY LIFE STYLE
D=DEVELOP APPROPRIATE I.E.C. STRATEGY
DISCOURAGE EARLY MARRIAGE AND TEENAGE PREGNANCY
O=ORGANIZE ADOLECENT/ YOUTH FRIENDLY CLINIC
L=LIFE SKILL EDUCATION , LEGAL SUPPORT, LIASIAN WITH PEERS , PARENTS
E=EDUCATE ABOUT SEXUALITY,SAFE SEX,SPIRITUALITY,RESPONSIBLE
PARENTHOOD
S=SAFE, SECURE AND SUPPORTIVE ENVIRONMENT TO BE PROVIDED
C=COUNSELLING / CURRICULM IN SCHOOL INCUSIVE OF FAMILY
LIFE EDUCATION
E=ENABLE &EMPOWER FOR RESPONSIBLE CITIZENSHIP
N=NETWORKING FOR EXPERIENCE SHARING
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T=TRAINING
FOR INCOME GENERATION,TEEN CLUBS
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Adolescent Health-An Overview
IAP HAS MADE AN ADOLESCENT
CHAPTER
EXISTING HEALTH FACILITIES
MUST BE MADE ADOLESCENT
FRIENDLY
IAPSM HAS GOT THE INSIGHT
LET US JOIN TOGETHER AND
TAKE APPROPRIATE ACTION
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LET US WORK WITH YOUTH
NOT MERELY FOR YOUTH
AND MAKE THEM CHANGE
AGENTS
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Adolescent Health-An Overview
THE CHALLENGES ARE THERE BUT
POTENTIAL IS FAR GREATER
10/3/2015
Thank You!
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Adolescent Health-An Overview