<ul><li>The term adolescence is derived from the Latin word “adolescere” meaning to grow, to mature.
It is a time of physical and emotional change as the body matures and the mind becomes more questioning and independent.
These are the formative years of life of an individual when major physical, psychological & behavioural changes takes place.
Period of preparation for undertaking greater responsibilities including healthy responsible parenthood. </li></li></ul><li>SOME FACTS<br />• 225 million adolescent comprise 22% of India’s<br />total population.<br />• Of this 12%-10-14year age group<br />10%-15-19 year age group<br />• Female comprise 47% of adol.population<br />• About 20% of total adol.female population are<br />married before the age of 15 years are already<br />mother.<br />
>70% girls between 10-19 year age group suffer from severe or moderate anemia.<br />• Mortality rate is higher in 15-19 year then 10-14 year age group.<br />• Unmet need of contraception is much higher in this age group.<br />• Over 35%of all reported HIV infection occur among 15-24 years age group.<br />• Indicating young people are highly vulnerable and majority of them infected by unprotected sex.<br />
Why invest??????<br />Investments in young people will yield dividents in term of delaying age of marriage, reducing incidence of pregnancies meeting unmet needs of contraception and reducing incidence of STI/HIV/AIDS<br />CATCH THEM YOUNG<br />
10 -19 years a critical phase<br />Risks<br />Inadequately prepared for life<br />Enter adult hood in poor health<br />Unintended unwanted pregnancy/unsafe abortion<br />Maternal mortality higher for young women<br />Infant mortality higher for young mothers <br />Sexual abuse /violence and unwanted sexual activity<br />STIS including HIV/AIDS<br />10-19 YEARS CRITICAL PHASE<br />
Reproductive and Child Health-II<br />Adolescent Reproductive and Sexual Health(ARSH)<br />
Package of services<br />Promotive services:<br /><ul><li>Focused care during antenatal period
Counselling & provision of emergency contraceptives
Counselling & provision of reversible contraceptives
Information/advice on SRH services</li></ul>Preventive services:<br /><ul><li>Services for TT and prophylaxsis against nutritional anemia
TFR -2.1</li></li></ul><li>ARSH Strategy<br />Objective is to contribute to RCH II goals of reduction of IMR,MMR,and TFR by:<br />Reducing teenage pregnancies<br />Meeting unmet contraceptive needs<br />Reducing number of teenage maternal deaths<br />Reducing incidence of STIs<br />Reducing proportion of HIV positive in 10 – 19 years age group<br />ARSH STRATEGY<br />
Interventions by ARSH<br />Services for adolescents to cover preventive , promotive ,curative and counseling services <br />Capacity building of on meeting needs of adolescents<br />Communication activities to be undertaken<br />MIS indicators identified as per specific objectives<br />Inter-sectoral linkages with NACP and NRHM<br />
Training package<br />Orientation programme for MOs and ANMs(AWW and counselors)<br />“How to treat differentially a client who is 16 not 6 or 26<br /><ul><li>Developing sensitivity towards adolescent clients
Non judgmental, friendly, competent provider</li></ul>How to deliver friendly services within “public health system”<br />Training of ASHA- adolescent health included<br />
Implementation guide<br />Part 1:Background<br /> - purpose of implementation guide<br /> -ARSH in RCH II<br />Part 2: What to implement?<br /> - standards for adolescent friendly reproductive and sexual health services<br />Part 3:How to implement?<br /> Service delivery package<br /> Organizing effective services<br /> Conducive environment at health facilities<br /> Capacity building of providers <br /> Environment building<br /> Communication with adolescents<br /> Monitoring and supervision<br />Sample implementation<br />Part 4 moving ahead<br />Conclusion<br />
Convergence between ARSH and HIV<br /><ul><li>Addressing common challenges
Understanding the need to address common risk factors
Utilizing capacity for optimum utilization of resources
Pro active participation of key stake holders to mainstream programme with public healthsystem
Common communication strategy for access to services
Preventing overlap of interventions- avoid duplication</li></li></ul><li><ul><li>Establishing linkages with regard to services
Developing institutional and service linkages within ARSH framework to address HIV concerns</li></li></ul><li>Strategies for promotion of adolescent health<br />A =Adoption of healthy life style <br />D =Develop appropriate i.e. strategy discourage early marriage and teenage pregnancy <br />O =Organize adolescent/ youth friendly clinic<br />L =Life skill training, legal support, liasion with peers, parents <br />E =Educate about sexuality, safe sex, spirituality, responsible parenthood <br />S =Safe, secure and supportive environment to be provided <br />C =Counseling / curriculum in school inclusive of family life education <br />E =Enable & empower for responsible citizenship <br />N =Networking for experience sharing <br />T =Training for income generation, teen clubs <br />