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Adolescent Health-An Overview

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Title: Adolescent Health-An Overview


1
Adolescent Health-An Overview
DR.HARIVANSH CHOPRA MD.,D.C.H. ASSOCIATE
PROFESSOR LLRMMC MEERUT
2
THREE STORIES WITH SIMILAR ENDING
NINA URBAN ADOLESCENT
CHETAN ADOLESCENT BOY
RESHMA RURAL ADOLESCENT

APPARENTLY HEALTHY SON OF A DOCTOR

EXPERIMENTING SEXUALLY
DEVELOPING RAPIDLY
TEENAGE PREGNANCY
NEVER SCREENED
EARLY MARRIAGE
ABORTION R.M.P.
HISTROY OF CHD
TEENAGE PREGNANCY
DEATH
3
Adolescent Health-An Overview
ALL THESE EVENTS ARE THE EXAMPLES OF SYSTEM
FAILURE
SYSTEM WHICH IS INSENSITIVE TO THE NEEDS
OF ADOLESCENT
4
DISADVANTAGE
  • 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
Adolescent Health-An Overview
5
Adolescent Health-An Overview
No longer Children, Not Yet Adults
Young people 10-24 Years
Adolescence 10-19 years
Youth 15-24 Years
6
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
Population Reference Bureau. Inc.
7
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

8
Adolescent Health-An Overview
Adolescents A Very diverse population segment
  • Different stages of development
  • Different circumstances
  • Different needs and
  • Diverse problems

9
Adolescent Health-An Overview
Adolescents have important subgroups with
markedly different needs Urban Rural Slum Street
Children Those in specially difficult
circumstances
10
Adolescent Health-An Overview
Why Focus on Adolescents?
  • Large number gt22 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.

11
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 Connectedness)

12
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,
    STI/HIV etc.

13
Adolescent Health-An Overview
Characteristics
  • 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

14
Ill Health Recipe Ye Dil Mange More Lifestyle
of Adolescents
Tobacco/Alcohol
Excess dietary FAT
Lack of vegetables fruits
Sedentary habits
Sexual behavior/ poor genital hygiene
Adolescent Health-An Overview
15
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

16
Adolescent Health-An Overview
Evidence of Common Roots
Risk Protective factors for adolescents
Early Sex
Substance Use
Depression
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
Broadening the Horizon Evidence from 52
countries
17
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

18
PREVALENCE OF ANAEMIA IN ADOLESCENT-MEERUT
42
36
34
Adolescent Health-An Overview
19
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 (50of women in
    india had a child before reaching the age of 20-
  • IP-JAN 2004)
  • Large number of adolescents are still
    un-immunized. (TT,RUBELLA )

20
Adolescent Health-An Overview
HEALTH PROBLEMS
  • One out of 10 children in India is sexually
    abused at any given point of time (WHO)
  • Sexual problems25of patients attending
    Government STI clinics are Younger than 18
  • Year old (Ramasubban-1995)
  • Increasing vulnerability to HIV/AIDS,Over 50of
    all new HIV cases in india are among 10-
  • 24years (UNAIDS-2002)
  • Substance abuse is quite common

21
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
Adolescent Health-An Overview
22
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
23
Adolescent Health-An Overview
Programming
  • To promote healthy development to meet needs
    and build competencies
  • 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

Safety, Belonging, Self Esteem, Caring relationship Physical eg eating habits
Psychological eg communication
Moral eg personal responsibility
Vocational eg entrepreneurial skills
24
STRATEGIES FOR PROMOTION OF ADOLESCENT HEALTH
A ADOPTION OF HEALTHY LIFE STYLE DDEVELOP
APPROPRIATE I.E.C. STRATEGY DISCOURAGE EARLY
MARRIAGE AND TEENAGE PREGNANCY OORGANIZE
ADOLECENT/ YOUTH FRIENDLY CLINIC LLIFE SKILL
EDUCATION , LEGAL SUPPORT, LIASIAN WITH PEERS ,
PARENTS EEDUCATE ABOUT SEXUALITY,SAFE
SEX,SPIRITUALITY,RESPONSIBLE
PARENTHOOD SSAFE, SECURE AND SUPPORTIVE
ENVIRONMENT TO BE PROVIDED CCOUNSELLING /
CURRICULM IN SCHOOL INCUSIVE OF FAMILY LIFE
EDUCATION EENABLE EMPOWER FOR RESPONSIBLE
CITIZENSHIP NNETWORKING FOR EXPERIENCE
SHARING TTRAINING FOR INCOME GENERATION,TEEN
CLUBS
25
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 LET US WORK WITH
YOUTH NOT MERELY FOR YOUTH AND MAKE THEM CHANGE
AGENTS
26
Adolescent Health-An Overview
THE CHALLENGES ARE THERE BUT
POTENTIAL IS FAR GREATER
Thank You!
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