Gender, reproductive health and psychological development for Adolescent Dr. Sultan Muhammad Razzak Forum for Culture and Human Development 292/1-B, Bhuianpara Road, Dhaka-1219 Bangladesh

Adolescent’s brain is not like adult brain Cornell University, University of Rochester, USA

Research now supports —that the teenager’s brain is different than the adult brain. Recent research by scientists at the National Institute of Mental Health (NIMH) using magnetic resonance imaging (MRI) has found that the teen brain is not a finished product, but is a work in progress.

Research now supports —that the teenager’s brain is different than the adult brain.

Recent research by scientists at the National Institute of Mental Health (NIMH) using magnetic resonance imaging (MRI) has found that the teen brain is not a finished product, but is a work in progress.

Until recently most scientists believed that the major "wiring" of the brain was completed by as early as three years of age and that the brain was fully mature by the age of 10 or 12. New findings show that the greatest changes to the parts of the brain that are responsible for functions such as self-control , judgment , emotions , and organization Occur between puberty and adulthood. This may help to explain certain teenage behavior that adults can find mystifying, such as poor decision-making, recklessness, and emotional outbursts.

Until recently most scientists believed that the major

"wiring" of the brain was completed by as early as three

years of age and that the brain was fully mature by the age

of 10 or 12. New findings show that the greatest changes to

the parts of the brain that are responsible for functions such

as self-control , judgment , emotions , and

organization Occur between puberty and adulthood.

This may help to explain certain teenage behavior that adults

can find mystifying, such as poor decision-making,

recklessness, and emotional outbursts.

The brain is still developing during the teen years Dr. Jay Giedd of the NIMH has reported that brain “maturation does not stop at age 10, but continues into the teen years and even into the 20’s.

The brain is still developing during the teen years Dr. Jay Giedd of the NIMH has reported that brain “maturation does not stop at age 10, but continues into the teen years and even into the 20’s.

Adolescents defined by WHO as the period between 10and 19 Years, is an important formative time which, to a large extent, shapes the future course of ‘Girls and boys lives. During adolescents, the physical, intellectual and emotional characteristics and patterns of childhood are gradually replaced by adult ones, and girls and boys progressively evolve into a state of relative socio-economic independence. While these changes are occurring, adolescent needs, on the one hand, to be supported as children and on the other, to be helped to achieve the independence, which they desire.

According to the UNCRC adolescents are children The concept of the child as subject of rights, entitled to respect as an individual is embedded in the entire philosophy of the convention and expressed, explicitly or implicitly, in many of its articles: Article 5 – appropriate direction and guidance should be provided in accordance with respect for children’s evolving capacity Article 9- children should not be separated from their families without the right to make their views known Article 13 - right to freedom of expression Article 14 - right to freedom of conscience, thought and religion Article 15 - right to freedom of association Article 16 - right to privacy and respect Article 17 - right to information Article 29 - right to the education that promotes the fullest possible development, and respect for human rights, peace and tolerance.

The concept of the child as subject of rights, entitled to respect as an individual is embedded in the entire philosophy of the convention and expressed, explicitly or implicitly, in many of its articles:

Article 5 – appropriate direction and guidance should be provided in

accordance with respect for children’s evolving capacity

Article 9- children should not be separated from their families without the

right to make their views known

Article 13 - right to freedom of expression

Article 14 - right to freedom of conscience, thought and religion

Article 15 - right to freedom of association

Article 16 - right to privacy and respect

Article 17 - right to information

Article 29 - right to the education that promotes the fullest possible

development, and respect for human rights, peace and tolerance.

Problems Encountered in Adolescents Adolescence is characterized by conflicts of values, Emotional stress and readiness to extreme attitudes, which invariably leads to several psycho-social problems of adolescents.

Adolescence is characterized by conflicts of

values, Emotional stress and readiness to

extreme attitudes, which invariably leads

to several psycho-social problems

of adolescents.

What Types of Problem encountered? Personal and social problems. Problems of health and physical self-esteem. Sex and reproductive health problems. Home and family related problems.

What Types of Problem encountered?

Personal and social problems.

Problems of health and physical self-esteem.

Sex and reproductive health problems.

Home and family related problems.

Why Adolescents are Important? Adolescents are an important resource for their family, communities and the Nation. As junior members of the households, they make a valuable contribution to the family’s economics well-being through paid work or household activities which free other adults to earn. All adolescents represent the hope for the future development of a nation. With proper support, guidance and nurturing, their contribution and participation can be greatly enhanced.

Why Adolescents issues are important? Adolescents are not widely recognized in Bangladesh as the distinct phase of life. Adolescents most of whom moved straight from childhood to marriage around the time of puberty. Last decade there has been an increasing interest in Adolescent based on a recognition of their special needs. Their particular vulnerability which is primarily linked to their reproductive role and the low value placed on them by society. It is not possible to formulate appropriate polices and interventions to improve the lives of Adolescents girls without accurate and details data.

Why Adolescents issues are important?

Adolescents are not widely recognized in Bangladesh as the

distinct phase of life.

Adolescents most of whom moved straight from childhood to marriage around the time of puberty.

Last decade there has been an increasing interest in Adolescent based on a recognition of their special needs.

Their particular vulnerability which is primarily linked to their reproductive role and the low value placed on them by society.

It is not possible to formulate appropriate polices and interventions to improve the lives of Adolescents girls without accurate and details data.

Adolescents between 10-19 years almost 23% of Bangladesh population( WHO) There is no specific health care services for Adolescent girls or boys. Teenagers lack easy access to contraceptives and feel guilty and embarrassed to use them. Cultural practices often involve sexual abuse or exploitation, and act as barriers to responsible sexuality. Boys and girls reveal a poor understanding of their sexuality and information sources seem to be media and peers. Adolescents : Some Facts and Perceptions

Adolescents between 10-19 years almost 23% of Bangladesh population( WHO)

There is no specific health care services for Adolescent girls or boys.

Teenagers lack easy access to contraceptives and feel guilty and embarrassed to use them.

Cultural practices often involve sexual abuse or exploitation, and act as barriers to responsible sexuality.

Boys and girls reveal a poor understanding of their sexuality and information sources seem to be media and peers.

Extent and Nature of Adolescent Girls' Work; Many Adolescents girls work-mainly to supplements the family income Compared to Boys, girls have fewer opportunity to work for wages. Girls living in Urban areas are more likely to be unemployed than girls Larges numbers of Adolescents girls work in Agriculture, although they are frequently unpaid for the work they do. 400000 adolescents girls aged 14+19 are working in the garments industry. Their working environment is far from ideal, but many have more autonomy and independence from their families than other girls. It is estimated that there are 225,000 female child domestics in Dhaka city,90% of whom are between 9 and 16 years old. Girls working in domestic services are isolated. Their vulnerability to various kinds of abuse from their employers is very high.

Reproductive Health & Adolescents: Adolescent Girls have a limited understanding of sex and reproductive health, little access to information, and rarely discuss these matters, mostly because of social taboos. One study found that less than half of married adolescents girls knew about sex before having intercourse with their husbands. About half of adolescent girls do not know that they can get pregnant after having sex only once. More adolescent mothers die during pregnancy and childbirth than mothers who are older. Also there is a higher death rate among babies born to adolescent mothers. The main risks to young mothers are toxemia, abortion, hemorrhage and obstructed labour. 70% of adolescent mothers receive no ANC. The rate is even higher for adolescent girls living in rural area and those with no education.

Reproductive Health & Adolescents:

Adolescent Girls have a limited understanding of sex and reproductive health, little access to information, and rarely discuss these matters, mostly because of social taboos.

One study found that less than half of married adolescents girls knew about sex before having intercourse with their husbands.

About half of adolescent girls do not know that they can get pregnant after having sex only once.

More adolescent mothers die during pregnancy and childbirth than mothers who are older. Also there is a higher death rate among babies born to adolescent mothers.

The main risks to young mothers are toxemia, abortion, hemorrhage and obstructed labour.

70% of adolescent mothers receive no ANC. The rate is even higher for adolescent girls living in rural area and those with no education.

If an unmarried adolescent girl gets pregnant, she is more likely to have a secret and illegal abortion or commit suicide because of the social stigma. Adolescents account for a higher number of abortion-related complication and deaths. Adolescents girls know less about symptoms, modes of transmission and methods of prevention of STDs than boys. 45% unmarried adolescents and 43% of married adolescents suffered from RTIs Adolescents girls know little about HIV/AIDS and the ways in which it can be transmitted and prevented. Only 17% of ever married adolescents aged 15-19 had heard of AIDS , although the proportion was significanly higher for urban and more highly educated women.( UNAIDS-1998)

If an unmarried adolescent girl gets pregnant, she is more likely to have a secret and illegal abortion or commit suicide because of the social stigma.

Adolescents account for a higher number of abortion-related complication and deaths.

Adolescents girls know less about symptoms, modes of transmission and methods of prevention of STDs than boys.

45% unmarried adolescents and 43% of married adolescents suffered from RTIs

Adolescents girls know little about HIV/AIDS and the ways in which it can be transmitted and prevented.

Only 17% of ever married adolescents aged 15-19 had heard of AIDS , although the proportion was significanly higher for urban and more highly educated women.( UNAIDS-1998)

Violence against Adolescents Many different kinds of violence faced by adolescents in Bangladesh Acid throwing, Dowry related, Kidnapping, Rape, Suicide, Trafficking Sexual Abuse and commercial sexual exploitation.

Violence against Adolescents

Many different kinds of violence faced by adolescents in Bangladesh

Acid throwing, Dowry related, Kidnapping, Rape, Suicide, Trafficking Sexual Abuse and commercial sexual exploitation.

Adolescent Health and Guidance Services Broad Objective To provide health and psycho-social services for adolescents through a comprehensive Adolescent Health Programme. Specific Objectives To assess health and psychological needs and problems of adolescents through differential diagnosis; To support adolescents to cope with problem behavior, by providing psychotherapy, guidance and counselling; To promote positive attitudes and values in adolescents for healthy sexual behavior; To enhance adolescent’s potential through various strategies of life skills education; To establish linkages with schools, PTIs and civil service organizations in order to strengthen services for the adolescents; and To provide referral services for adolescents with specific health related problems.

Sources Of Daily Stress Too many things to do. Concerns about weight / physical appearance. Doing Home Work / Assignments. Parental nagging Frequent scolding Meeting deadlines Making many decisions. Attending Tutions/ Tutorials Responsibilities outside home. Arguing with friends and family

Sources Of Daily Stress

Too many things to do.

Concerns about weight / physical

appearance.

Doing Home Work / Assignments.

Parental nagging

Frequent scolding

Meeting deadlines

Making many decisions.

Attending Tutions/ Tutorials

Responsibilities outside home.

Arguing with friends and family

Major Identified Problem Behavior. Withdrawn Behavior Somatic complaints Anxious/ Depressed Social Problems Thought Problems Attention Problems Delinquent Behavior Aggressive Behavior

Major Identified Problem Behavior.

Withdrawn Behavior

Somatic complaints

Anxious/ Depressed

Social Problems

Thought Problems

Attention Problems

Delinquent Behavior

Aggressive Behavior

Physician Multi-Disciplinary Service Delivery Team Clinical Psychologist Counsellor Psychiatrist (Referral) Social Worker Gynecologist (Referral) Nutritionist Child Development Expert