THREE STORIES WITH SIMILAR ENDING NINA CHETANRESHMA URBAN ADOLESCENT ADOLESCENT BOYRURAL ADOLESCENT EXPERIMENTING APPARENTLY HEALTHY DEVELOPING RAPIDLY SEXUALLY SON OF A DOCTOR EARLY MARRIAGE TEENAGE PREGNANCY NEVER SCREENED TEENAGE PREGNANCY ABORTION R.M.P. +HISTROY OF CHD06/27/12 DEATH 3
Adolescent Health-An OverviewALL THESE EVENTS ARE THEEXAMPLES OF SYSTEM FAILURESYSTEM WHICH IS INSENSITIVE TO THE NEEDS OF ADOLESCENT06/27/12 4
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 PRESSURE06/27/12 5 Adolescent Health-An Overview
Adolescent Health-An Overview No longer Children, Not Yet Adults Young people Adolescence 10-24 Years 10-19 years Youth06/27/12 15-24 Years 6
Adolescent Health-An OverviewPopulation 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 06/27/12 7 Population Reference Bureau. Inc.
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 200006/27/12 207 Million Adolescents 8
Adolescent Health-An OverviewAdolescents: A Very diverse population segment • Different stages of development • Different circumstances • Different needs and • Diverse problems06/27/12 9
Adolescent Health-An Overview Adolescents have important subgroups with markedly different needs: Urban Rural Slum Street Children Those in specially difficult circumstances06/27/12 10
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.06/27/12 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”);06/27/12 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,06/27/12 13 STI/HIV etc.
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 pregnancy06/27/12 14
Ill Health Recipe: “Ye Dil Mange More” Lifestyle of Adolescents Excess Tobacco/ Alcohol dietary FAT Lack of vegetables & fruits Sedentary Sexual behavior/ habits poor genital hygiene06/27/12 15 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 support06/27/12 16
Adolescent Health-An Overview Evidence of Common Roots* Risk & Protective factors for Early Sex Substance Depression adolescents Use A positive relationship with parents Conflict in the familyA positive schoolenvironmentFriends who are negative rolemodelsA positive relationship withadults in the community Having spiritual beliefs Engaging in other risky behaviours 06/27/12 17*”Broadening the Horizon” Evidence from 52 countries
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 problems06/27/12 18
PREVALENCE OF ANAEMIA IN ADOLESCENT-MEERUT 70% 60% 50% 40% 42 30% 34 36 20% 10% 0% BOYS GIRLS-R GIRLS(U) NORMAL ANAEMIC06/27/12 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 (50%of 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 );06/27/12 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 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 10- 24years (UNAIDS-2002) Substance abuse is quite common06/27/12 21
PROGRAMMES FOR ADOLESCENTSKISHORI SHAKTI YOJANA –To improve the health and nutritional status of girlsBALIKA SAMRIDHI YOJANA –To Delay the age of marriageNEHRU YUVA KENDRA – ACT AS HEALTH AWARENESS UNIT-Through active participation of youthMAHILA SAMAKHYA PROGRAMME- Equal access to education facilities for adolescent girl and young women 06/27/12 22
Adolescent Health-An Overview PROGRAMMES FOR ADOLESCENTSSCHOOL AIDS EDUCATION, UNIVERSITY TALKS AIDSTRAINING OF RURAL YOUTH FOR SELF EMPLOYMENTREPRODUCTIVE AND CHILD HEALTH PROGRAMME ? WHERE ARE THE BOYS NO COMPREHENSIVE PROGRAMMEADDRESSING ALL NEEDS OF ADOLESCENT06/27/12 23
Adolescent Health-An Overview ProgrammingTo promote healthy To prevent and respond todevelopment to meet needs health problem from:and build competencies – Early, unprotected, unwanted sexSafety,Belonging, – Use of tobacco and misuse ofSelf Physical alcohol and other substancesEsteem, eg eating habits – AccidentsCaring – Violencerelationship – Poor nutrition Psychological – Endemic disease eg communication Moral eg personal responsibility Vocational06/27/12 24 eg entrepreneurial skills
STRATEGIES FOR PROMOTION OF ADOLESCENT HEALTHA =ADOPTION OF HEALTHY LIFE STYLED=DEVELOP APPROPRIATE I.E.C. STRATEGY DISCOURAGE EARLY MARRIAGE AND TEENAGE PREGNANCYO=ORGANIZE ADOLECENT/ YOUTH FRIENDLY CLINICL=LIFE SKILL EDUCATION , LEGAL SUPPORT, LIASIAN WITH PEERS , PARENTSE=EDUCATE ABOUT SEXUALITY,SAFE SEX,SPIRITUALITY,RESPONSIBLE PARENTHOODS=SAFE, SECURE AND SUPPORTIVE ENVIRONMENT TO BE PROVIDEDC=COUNSELLING / CURRICULM IN SCHOOL INCUSIVE OF FAMILY LIFE EDUCATIONE=ENABLE &EMPOWER FOR RESPONSIBLE CITIZENSHIPN=NETWORKING FOR EXPERIENCE SHARING 06/27/12 25T=TRAINING FOR INCOME GENERATION,TEEN CLUBS
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 AGENTS06/27/12 26
Adolescent Health-An Overview THE CHALLENGES ARE THERE BUT POTENTIAL IS FAR GREATER06/27/12 Thank You! 27
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