1. Published on Department of Health (http://www.doh.gov.ph)Home > Printer-friendly PDF > Printer-friendly PDFAdolescent and Youth Health Program (AYHP)Submitted by april2011 on May 6, 2011 - 11:01A Situationer on Adolescents HealthNon-communicable diseases account for more than 40% of the deaths in young people (10-24 years old) and injuries arethe causes of death in almost one third of people in this age group. Assault and transport accidents are the leading causesof mortality among young people with a mortality rate of 9.7 and 5.8 deaths per 100,000 populations, respectively(Philippine Health Statistics, 2003). Other significant causes of death among the 10-24 years old Filipinos includecomplications related to pregnancy, labor and puerperium; epilepsy; chronic rheumatic heart disease; intentional selfharm; and accidental drowning and submersion (Philippine Health Statistics, 2003).Of the 1.67 M live births registeredin 2003, 35.7% (596, 076 LB) were by women £24 years old. Teenage pregnancy accounted for 8% of all births(National Demographic Health Survey, 2003). Of the 1,798 maternal deaths registered for the same year, 22.3% werewomen £24 years old. The proportion of malnutrition among those 11 – 19 years of age (underweight and overweight)were noted to increase from 1993 to 2003 (FNRI Survey 1993, 1998 and 2003).About 4% of Filipinos 10 – 24 years ofage have some form of disability. The most common of this are speaking and hearing disabilities. MOST COMMON CAUSES OF DEATH AMONG 10-24 YEARS OLD PER 10,000 POPULATION. Philippine Health Statistics, 2003 Male Female Both Rank Cause of Death No. Rate No. Rate No. Rate 1 Asssault 2,240 17.6 183 1.5 2,423 9.7 2 Transport Accidents 1,146 9.0 303 2.5 1,449 5.8 3 Event of undetermined 570 5.3 300 2.5 970 3.9 intent
2. 4 Symptoms, signs & abnormal clinical 602 4.7 352 2.9 954 3.8 findings not elsewhere classified 5 Pneumonia 527 4.1 355 2.9 882 3.5 6 Tuberculosis of the Respiratory 537 4.2 340 2.8 877 3.5 System 7 Chronic Rheumatic Heart Disease 447 3.5 426 3.5 873 3.5 8 Accidental drowning and submersion 596 4.7 215 1.7 811 3.2 9 Nephritis, nephrotic syndrome and 385 3.0 332 2.7 717 2.9 nephrosis 10 Other accidents & late effects of 518 113 0.9 631 2.5 transport/other accidents 4.1Leading Threats to Adolescents HealthAccidents and other inflicted injuriesAmong 10- 24 age groups, this threat caused 27% of the total deaths (2003 data). Young males always exlusivelysuccumb to injuries and females have the increasing mortality due to complications of pregrancy, labor delivery andpuerperium. These data have been on the uptrend, a challenge to community-based or DOH-led programs. The threat iscaused by the adolescent’s exposure to poorly maintained roads and poorly managed traffic systems. Adolescents’increased mobility to urban areas needs a correspondidng physical and infrastructre support in their quest for betteropportunities and education pursuits. Another is the inability of the state to provide adequate number of police personnelleading to an increasing number of assault and transport accidents among the young males.Tubercolusis, Pneumonia, and Accidental drowningClose to 6% of young Filipinos who died in 2003 died of various forms of tuberculosis, followed by pneumonia thatcaused 4% of deaths. This health issue among the young has been declining through the years due to sustainenationwide programs that began in 1987 and has somehow caused to keep deaths down, hence efforts to continsustaining becomes the challenge.The threat of HIV and other sexually – related diseasesReported cases increased substantially increased over the past year.Among the 15-24 year olds, reported HIV infectionsnearly tripled between 2007 and 2008 from 41 cases to 110 per year, which is substantial cause for alarm. In 2009, 15-24year olds make 29% of all new infections; in 2009, the number of new infections among 20-24 equals the number of newinfections among 25-29; with 10 cases see July DoH AIDS Registry Report. The substantial increase from the past yeacan be traced from the adolescents’ early engagement in health risk behaviour, due to serious gaps of the knowledgthe dangers of drugs, as well as the cause as well as causes on the transmission of STD and HIV AIDS , dangerindiscriminate tattooing and body- piercing and inadequate population education. Under this threat, young malesprone to engaging in health risk behaviour and more young fermales are also doing the same without protection andprone to aggressive or coercive behaviours of others in the community such that it often results to significant numberunwanted pregrancies,septic abortion and poor self-care practices.In addition, there are also other less common but significant causes of disease and deaths namely;Intentional self- harm – 9th leading cause of death among 20-24 years old. In this age group, seven out of 10 who thedied of suicide were males. In age group of 10-24 years old took up 34% of all deaths from suicide in 2003Substance Abuse - 15-19 years old group has the claim of drug use; more males than females who are drug users adrug rehabilitaiton centers claim that majority of clients belong to age group of 25-29 years old. According to the SW
3. survey, 1996- 1.5M youth Filipinos and 1997- grew into 2.1M youth Filipinos are into substance abuse Nutritional Deficiencies –there are no specific rates for adolescent and youth, but there is the prevalence of anemia and vitamin A deficiency which may be also high for the adolescents and youth as those known for the younger and pregnant women. Disability – Filipinos aged 10-24 years old has an overall disability prevalence of 4%. The most common disability among this age group affected are speaking (35%), hearing (33%) and moving and mobility (22%) There are also vulnerable Filipino adolescents which can be classified in their respective areas of vulnerability VULNERABLE YOUNG FILIPINOS Sub-groups Vulnerability areas Young among the Common infections, physical abuse or assault, street-dwellers sexual exploitation, drug use, road accidents Out- of- school High risk behaviour; smoking, alcohol use, drug adolescents and youth abuse, high risk sexual behaviour, risky work conditions leading to injuries and diseases Urban –based male High risk behaviour; transport accidents , other youth inflicted injuries Female adolescents Sexual abuse, sexual exploitation , unwanted pregranancies, abortion, unsafe pregnancy and insecure motherhood Not living with Nutritional disorders, substance use and risky sexual parents or family behaviour, other inflcited injuriesFactors Causing Threats to Adolescents HealthThe alarming patterns of health issues affecting adolescents health is caused by the following factors operating in asystemic manner reinforcing further complexities in the health issues affecting adolescents .Socio-Cultural FactorsDemographic FactorsContinuing Rapid Population GrowthThe rapid population growth of the youth creates pressure to the state to expand education, health and employment FOrhtis age group. The pressure creates an imbalance to the distribution and allocation of resources to various sectorsespecially the youth. The imbalance reinforces deeper the marginalization and deprivation of some sectors to basicservices. A viscious cycle is created and more are having difficulties to access provision on health service delivery.Increased population movementThe scarctiy of local employment has triggered the participation of the youth in overseas work. The movemente ofsector has caused displacement from families and love ones increase youth’s vulnerability to exploitation, low paying jobAccording to a study in 2001, there were more tha 6,000 workers in the teenage group overseas workers and it is mostlikely that they would land in overseas low paying work. Attitudes, Lifestyles, Sense of Values, Norms and Behaviours of Adolescents Health Risk Behaviors
4. A significant proportion of young people engage in high-risk behaviors – 23% ever had pre- marital sex, 57% of first sexexperience was unplanned and unplanned. About 70% - 80% of their most recent sexual experiences were unprotected(YAFS, 2002).The 2002 Young Adult Fertility and Sexuality Survey showed that the proportion of 15-24 year olds who were currentlysmoking, drinking and using drugs were 20.9%, 41.4% and 2.4%, respectively. The proportion is higher among malescompared to females. A comparative data (1994 and 2003) showed that among 15 – 24 year olds, smoking increased by23%; drinking increased by 10%; drug use increased by 85%; and pre martial sex increased by 30% (YAFSS, 2003).The likelihood of engaging in pre-marital sex is higher among those who smoke, drink alcohol or take drugs. As aconsequence of substance and alcohol abuse, some have mental and neurological disorders; others spend the productiveyears of their life behind bars with hardcore lawless adults.Health Seeking BehaviorAdolescents are more likely to consult the health center (45%) or government physician (19%) for their health needs(Baseline Survey for the National Objectives for Health, 2000). The most common reasons for not consulting were thelack of money, lack of time, fear of diagnosis, distance and disapproval of parents. Dental examination and BPmonitoring were the most common reasons for consultation (62.4% and 37.8%, respectively).Similalry, Conditionsrelating to pregnancy, childbirth and post partum were among the leading reasons for utilization of in-patient,emergency room and out patient health services at DOH-Retained Tertiary General Hospitals.Low Contraceptive UseThe overall use of contraception among sexually active adolescents is at 20%. Non- desire for pregnancy and highawareness of contraceptive methods were not enough to encourage adolescents to use contraceptives. Among thereasons cited for the low contraceptive use were: Contraceptives were given only to married individuals of reproductive age Even if they were made available to adolescents, the culture says that it is taboo for young unmarried individuals to avail of contraceptive services and commodities. Condom use is perceived mainly for STIs, HIV/AIDS prevention rather than contraceptionThe practice Abortion and Unmet need for ContraceptionIn 2000, induced abortion among adolescents reached 319,000. This is due to the inadequate knowledge on preventingunwanted pregnancies. Consequences of teen-age pregnancies among young mothers include not being able to finishschool and reduced employment options and opportunities. In addtion, the social stigma and fear brought about byunwanted pregrancy pushes the young mother to resort to abortion. Although the disapproval rating for abortion remainsto be high, there is an increasing trend among those who approve of it (from 4% to 6% in males and 3.5% to 4% infemales).On contraceptive use , adolescents also dont use condoms for prevention of HIV,its not only that they dontuse them for contraception.Risk of HIV/AIDS due to Unprotected Sex Adolescents including children living in exteme conditons and great exposure to sexual exploitation and abuse belong tohigh-risk categories threatened by unprotected sex. Latest data on these shows that majority of people engaged in sexwork are young and 70 % of HIV infections involve male-to-male sex. The proportion of young people reported to haveSTDs/HIV and AIDS is increasing. The YAFS survey showed that although awareness about STDs is increasing,misconceptions about AIDS appear to have the same trend. The proportion of those who think AIDS is curable morethan doubled (from 12% in 1994 to 28% in 2002). Many adolescents also resort to services of unqualified traditionalhealers, obtain antibiotics from pharmacies or drug hawkers or resort to advices from friends (e.g. drinking detergentdissolved in water) without proper diagnosis to address problems of STDs. Improper or incomplete treatment may maskthe symptoms without curing the disease increasing the risk of transmission and development of complications. The
5. limited use of condoms to protect adolescents from risk of HIV is an issue to reflection for condom use is not only to prevent pregranancy but also preventing sexually transmitetd disease. r The YAFS 2002 survey showed that Filipino males and females are at risk of STIs, HIV/AIDS. It was reported that 62 % of sexually transmitted infections affect the adolescents while 29 % of HIV positive Filipino cases are young people. In addition, it was revealed that thirty seven percent (37%) of Filipino males 25 years of age have had sex before they marry with women other than their wives. Some will have paid for sex while others will have had five or more partners.Political and Economic Factors Marginalization and PovertyThe disturbing poverty situation of households and families where majority of the adolescents belong brings in difficultiesto meet adolescents’.needs. Poverty is closely link to adolescent health issues. It reinforces to the situation of adolescenvulnerability to health risks due to the lack of access to various services and unsupportive social, political and economicenvironment. The following are some of the consequences of poverty faced by the youth. Limited Access to Information -among the greatest challenges for Filipino youth is access to correct and meaningful information on sexual and reproductive issues. Limited access to services and commodities -The lack of access to contraceptive services and supplies was among the most frequently articulated concerns with regard to adolescent SRH. Programs such as the AYHDP do recognize adolescents’ need for access to contraception. Limited awareness of pertinent policies-While the AYHP Administrative order was issued in 2000, few key informants knew of its existence. In fact, many key informants said that no ARH policy existed at the time they were interviewedTechnological Factors Rapid Advancement of CommunicationThe value of technological advancement could never be discounted. However, to the curious and adventurous adolescevarious modes of communications are oftentimes abused and misused such as the use of internet and mobile phones.Adolescents then become vulnerable to exploitation, in cybersex and pornography exposing them deeper into riskybehaviour. In addtion the digital dependence and addiction causes alienation of adolescetns to personal and closer modeof communciation resulting to a distorted image of the adoelscents relationships to the social environment. This alsodeprives the adolescents from productive activities where they can develop themselves fully grown up and matureconomic and socail being Moreover, communcation advantcement has also produced adverstisements and televisioncommercials whose image are not adoelsent- friendly are paving the way for so much consumerism, distorted personaland family values THE ADOLESCENTS HEALTH PROGRAM IN THE PHILIPPINES. International Policies, Passages and Laws as anchorsn International Laws UN Convention on the Rights of Children UN Convention the Action for the Promotion and Protection of the health of adolescents Convention on the Elimination of all forms of discrimination againts women 1994 International Conference on Populaiton and Development ( ICPD) 1995 Fourth World Conference on Women World Programme of Action for Youth 2000 MDG Goals :
6. Goal 2:Achieve Universal Primary Education Goal 3:Promote Gender Equality Goal 4 : Reduce Child Mortality Goal 5: Improve Maternal Health Goal 6:Combat HIV/AIDS, Malaria and other diseases National Laws and Policies o National Objectives for Health o Fourmula One for Health o Adolescent and Youth Health Policy (AYH) o Adolescent and Youth Health and Develoment Program o National Directional Plan for reaching the Un reahced Youth Population o Reproductive Health Program AO#1 s1998 o Local Government Code WHO, together with countries and areas in the Region and partner agencies, are working to promote healthy development of adolescents and reduce mortality and morbidity. In the Western Pacific Region, several technical units are working to implement interventions that improve adolescent health in the Region. The Philippines belong to the Western Pacific Region and is committed to: Recognize adolescents as ‘vulnerable and a ‘group in need’ o Address Issues that have an evidence base o Socio- Cultural perspectives o Develop Innovative mechanisms to reach out to adolescents. o Encourage collaboration and partnerships o Program implementation is monitored and evaluated. The Adolescent Health ProgramThe Adolescents Youth and Heath Development Programs was established in 2001 under the oversight of the Department of Health in partnership with other government agencies with adolescent concerns and other stakeholdres. The programtargeting youth ages 10–24, and the program provides comprehensive implementation guidelines for youth-friendlycomprehensive health care and services on multiple levels—national, regional, provincial/city, and municipalThe program is solidly achored on International and laws, passages and polices meant to address adolescent’s healthconcerns. It is operating then within the facets and adolescents and youth health that includes disability, mental andenvironmental health, reproductive and sexuality, violence and injury prevention and among others.It employed strategies to ensure integration of the program intothe health care system in addition, broader society such asbuilding a supportive policy environment, intensifying IEC and advocacy particularly among teachers, families, andpeers, building the technical capacity of providers of care, and support for youth; improving accessibility and availabilityof quality health services, strengthening multi-sectoral partnerships, resource mobilization, allocation and improved datacollection and management.