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Concept of Adolescent Sexual &
Reproductive Health (ASRH),
Problems, Control & Prevention
Training Course in Sexual and Re...
Topics
• What is ARSH and meaning of adolescence?
• What are the physical and emotional changes that take place
during ado...
1. What do we mean by the
term
'adolescents' ?
What is Adolescence?
• A phase which involves -
Transition period between childhood and
adulthood where physical and cogn...
What is early, middle and late
Adolescence?
• Early (10 – 14)
– Growth Spurt, Beginning of Sexual Maturity and Start to
th...
The second decade:
No longer children, not yet adults !
Adolescents 10 - 19 years
Youth 15-24 years
Young people 10-24 yea...
Adolescents are a diverse
population group
Different needs
Changing needs
Adolescents are a diverse
population group
সম্পেকর্ মধুরতা বজায় রাখেত দুজেনর মােঝই থাকেত হেব েয গুণগুেলা
Factors Shaping Adolescence
10
Race
Family
Socio-
economic
status
EthnicityReligion
Peers
What is special about adolescence ?
(What makes it different from childhood & adulthood ?)
Adolescence is a unique time in...
What is special…..cont’d
• A time of rapid physical and psychological
(cognitive and emotional) growth and
development.
• ...
2. What do we mean by the
term
'health' and Adolescent
health?
“Health is a state of complete
physical, mental and social well-being
and not merely the absence of disease
or infirmity."...
3. What are the main health
problems of adolescents ?
Many adolescents move from childhood
through adolescence into adulthood in
good health.
Key Health Problems
Sexual & Reproductive health
- Too early pregnancy
 risks to mother
 risks to baby
- Health problems...
Other Adolescent Health Problems?
Young Adolescents
•Menstrual Problems for girl
•Men’s reproductive issues-
•Teen Pregnan...
This lack of proper education induces gender based violence in
the community, which mainly affects the adolescent girls.
E...
Menstrual Problems
– No prior knowledge
– Fail to understand normal and to recognize
menstrual problems
– School Health Ch...
Mental Health Problems
– May first become apparent in Adolescence
– Shock appears from friends and lovers
– More often not...
Early and Unprotected Sex
 Sexual activity is more common than available
official data
 Evidenced by increased no. of-
...
Predisposing Factors for Early and
Unprotected Sex
 Adolescents live in Increasingly sexualized
societies
 Impact of Med...
4. What do adolescents need
to grow & develop in good
health ?
What adolescents
need & why?
• Information & skills
(they are still developing)
• Safe & supportive
environment
(they live...
 Involve young people as key decision-makers in
program design, implementation, and evaluation
 Provide comprehensive,
a...
MYTH
Sexual and reproductive health information promotes
promiscuity and early sexual activity.
REALITY
Sexuality educatio...
5. Who needs to contribute
to meeting these needs &
fulfilling these rights ?
Politicians
Journalists
Bureaucrat
sRelatives
Friends
Family friends
Teachers
Sports coaches
Healthcare
providers
Religiou...
6. Why should we invest in
the health and
development of
adolescents ?
• Demographic rationale
• Public health rationale
• Economic rationale
• Human rights rationale
• One in five individuals
in the world today is
an adolescent (around
1.2 billion).
• The largest number of
adolescents in...
Demographic rationale – 2/2
• There are around
2.6 million deaths
among the 10-24
year age group
worldwide every
year.
• 97% occur in low
and middle i...
Source: UNAIDS/UNICEF, 2002
Public health rationale: morbidity – 3/5
38%
62%
South Asia
1.1 million
Industrialized
Countri...
Public health rationale:
behaviours – 4/5
• Nearly two thirds of
premature deaths and
one third of the total
disease burde...
Health
problems /
health-related
behaviours
during
adolescence
Age when this has its major impact
Adolescence Adulthood Ch...
Economic
rationale – 2/4
The need to make full use
of the demographic
dividend when one can.
Economic rationale - 4/4
Socio-economic deprivation: a cause & consequence of
adolescent pregnancy
Too early
pregnancy
Los...
Convention on the rights
of the child
• Article 24: The right to the highest
level of health possible & to
access the requ...
6. Frameworks for
addressing the health and
development of
adolescents
First lens: Broadening opportunities for young
people to develop skills and use them
productively.
Second lens: Helping ...
Concept of Adolescent Sexual & Reproductive Health (ASRH), Problems, Control & Prevention
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Concept of Adolescent Sexual & Reproductive Health (ASRH), Problems, Control & Prevention

Concept of Adolescent Sexual & Reproductive Health (ASRH), Problems, Control & Prevention

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Concept of Adolescent Sexual & Reproductive Health (ASRH), Problems, Control & Prevention

  1. 1. Concept of Adolescent Sexual & Reproductive Health (ASRH), Problems, Control & Prevention Training Course in Sexual and Reproductive Health Research Geneva 2010 [Dr] Amzad Ali Email: ali.amzad@gmail.com Skype: ali.amzad Cell: +8801713 004696
  2. 2. Topics • What is ARSH and meaning of adolescence? • What are the physical and emotional changes that take place during adolescence? • The health problems that adolescents face • What adolescents need to grow & develop in good health • who needs to meet the needs & fulfil the rights of adolescents • Why we should invest in the health & development of adolescents • Frameworks for addressing the health & development of adolescents
  3. 3. 1. What do we mean by the term 'adolescents' ?
  4. 4. What is Adolescence? • A phase which involves - Transition period between childhood and adulthood where physical and cognitive changes prepare us for adult responsibilities Progression from appearance of secondary sexual characteristics (puberty) to sexual and reproductive maturity Development of adult mental process and identity Transition from total social-economic dependence to relative independence
  5. 5. What is early, middle and late Adolescence? • Early (10 – 14) – Growth Spurt, Beginning of Sexual Maturity and Start to think abstractly. • Middle (14 – 15) – Main Physical Change Completed, Develop stronger sense of Identity, relates strongly to peer group, Thinking becomes reflective. • Late (16 – 19) – Body takes adult form, has distinct identity and more settled ideas and opinions.
  6. 6. The second decade: No longer children, not yet adults ! Adolescents 10 - 19 years Youth 15-24 years Young people 10-24 years Source: A picture of health? A review and annotated bibliography of the health of young people in developing countries (WHO, UNICEF, 1995).
  7. 7. Adolescents are a diverse population group Different needs Changing needs
  8. 8. Adolescents are a diverse population group সম্পেকর্ মধুরতা বজায় রাখেত দুজেনর মােঝই থাকেত হেব েয গুণগুেলা
  9. 9. Factors Shaping Adolescence 10 Race Family Socio- economic status EthnicityReligion Peers
  10. 10. What is special about adolescence ? (What makes it different from childhood & adulthood ?) Adolescence is a unique time in life requiring special attention- •Characterized by: – Physical, emotional, psychological and developmental changes – Emerging sexuality – Awareness of gender identification and sexual orientation
  11. 11. What is special…..cont’d • A time of rapid physical and psychological (cognitive and emotional) growth and development. • Distinct from both childhood and adulthood • A time in which new capacities are developed. • A time to test independence from the family • A time of changing new relationships-peers, partners, parents, social relationships, expectations, roles and responsibilities.
  12. 12. 2. What do we mean by the term 'health' and Adolescent health?
  13. 13. “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Source: Constitution of the World Health Organization, 1948.
  14. 14. 3. What are the main health problems of adolescents ?
  15. 15. Many adolescents move from childhood through adolescence into adulthood in good health.
  16. 16. Key Health Problems Sexual & Reproductive health - Too early pregnancy  risks to mother  risks to baby - Health problems during pregnancy & child birth (including unsafe abortion) - Sexually Transmitted Infections including HIV - Harmful traditional practices e.g. marriage, Sexual coercion Source: United Nations. World Youth Report 2005. Young people today, and in 2015. United Nations. 2005. ISBN 92-1- 130244-7. Other issues - Injuries from accidents & intentional violence - Mental health problems - Substance use problems - Endemic diseases: malaria, HIV schistosomiasis, tuberculosis - Under/over-nutrition
  17. 17. Other Adolescent Health Problems? Young Adolescents •Menstrual Problems for girl •Men’s reproductive issues- •Teen Pregnancy •Mental Health Problems •Early and Unprotected Sex •Addictive Behaviors •Accidents and violence •Sexual Abuse •Depression and Suicide •Eating Disorders. •Nutrition issues and eating habits
  18. 18. This lack of proper education induces gender based violence in the community, which mainly affects the adolescent girls. Eve-teasing, sexual abuse of female adolescent girls, dowry related violence, sexual harassment at the workplace or in the educational institutions become headache of the government time to time.
  19. 19. Menstrual Problems – No prior knowledge – Fail to understand normal and to recognize menstrual problems – School Health Checkups are usually not performed to identify these – Parental support & reassurance is a must need. – Lack of proper information and management
  20. 20. Mental Health Problems – May first become apparent in Adolescence – Shock appears from friends and lovers – More often not considered as a problem – Thus fail to • Recognize and • Seek medical treatment
  21. 21. Early and Unprotected Sex  Sexual activity is more common than available official data  Evidenced by increased no. of-  Unwanted Pregnancies  Unsafe Abortions  Steep Rise in HIV  Early and unprotected sexual experience is not planned, and with no knowledge of consequences lead to social problem.
  22. 22. Predisposing Factors for Early and Unprotected Sex  Adolescents live in Increasingly sexualized societies  Impact of Media – Electronic and Print  Rapid Growth of cities and breakdown of traditional family structure – Erode protective cultural layer  Conflict and forced migration – put them at risk  Pressured in to desperate situations – forced into sex for survival sp. during economic hardships etc.  Trend – earlier sexual maturation while late marriage
  23. 23. 4. What do adolescents need to grow & develop in good health ?
  24. 24. What adolescents need & why? • Information & skills (they are still developing) • Safe & supportive environment (they live in an adult world) • Health & counselling services (they need a safety net)  Access to economy and decision making options
  25. 25.  Involve young people as key decision-makers in program design, implementation, and evaluation  Provide comprehensive, accurate information in a manner appropriate to their age group and sex  Address barriers to accessing health and information services  Empower adolescents to make life choices that are best for them  Use information/Services thru Media Adolescent sexual and reproductive health education for adolescents must:
  26. 26. MYTH Sexual and reproductive health information promotes promiscuity and early sexual activity. REALITY Sexuality education contributes to: higher levels of abstinence later initiation of sexual activity Sexuality education can help protect young people from some of the potential risks of sexual activity.* *Conclusion from a multi-country study carried out by UNAIDS greater use of contraception fewer sexual partners Providing adolescents with sexual and reproductive health education adolescent sexual and reproductive health ( 7 )
  27. 27. 5. Who needs to contribute to meeting these needs & fulfilling these rights ?
  28. 28. Politicians Journalists Bureaucrat sRelatives Friends Family friends Teachers Sports coaches Healthcare providers Religious leaders Traditional leaders Parents Brothers/Sisters Adolescents Musicians Film stars Sports figures
  29. 29. 6. Why should we invest in the health and development of adolescents ?
  30. 30. • Demographic rationale • Public health rationale • Economic rationale • Human rights rationale
  31. 31. • One in five individuals in the world today is an adolescent (around 1.2 billion). • The largest number of adolescents in the history of mankind. • 2/3rd of total pop in Bangladesh Demographic rationale – 1/2
  32. 32. Demographic rationale – 2/2
  33. 33. • There are around 2.6 million deaths among the 10-24 year age group worldwide every year. • 97% occur in low and middle income countries. Public health rationale: mortality – 1/5
  34. 34. Source: UNAIDS/UNICEF, 2002 Public health rationale: morbidity – 3/5 38% 62% South Asia 1.1 million Industrialized Countries 240,000 67% 33% Middle East & North Africa 160,000 31% 69% Central and Eastern Europe 430,00035% 65% 49% 51% East Asia & Pacific 740,000 31% 69% Latin America & Caribbean 560,000 38% 62% Sub-Saharan Africa 8.6 million There are over 10 million young people (15-24) living with HIV/AIDS
  35. 35. Public health rationale: behaviours – 4/5 • Nearly two thirds of premature deaths and one third of the total disease burden in adults are associated with conditions or behaviours that began in youth. World Development Report 2007 0 0.02 0.04 0.06 0.08 0.1 0.12 0 10 20 30 40 50 60 70 Age female male Age of smoking initiation
  36. 36. Health problems / health-related behaviours during adolescence Age when this has its major impact Adolescence Adulthood Childhood (next generation) Injuries and violence +++ + Too-early pregnancy ++ + ++ Human Papilloma Virus infection + +++ Tobacco use + +++ + Public health rationale – 5/5 sound reasons for investment for this generation
  37. 37. Economic rationale – 2/4 The need to make full use of the demographic dividend when one can.
  38. 38. Economic rationale - 4/4 Socio-economic deprivation: a cause & consequence of adolescent pregnancy Too early pregnancy Loss of educational & employment opportunities Poverty " We young women are not prepared to become mothers. I would like to continue my studies. But since I have had my daughter, my options have changed because I have many more obligations now." Source: World Development Report 2006 (World Bank, 2006.)
  39. 39. Convention on the rights of the child • Article 24: The right to the highest level of health possible & to access the required health services • Article 17: The right to access appropriate information from the media & to be protected from harmful information • Article 13: The right to seek, receive and impart information and ideas of all kinds Choices: A guide for young people Gill Gordon, 1999. Human rights rationale -1/2
  40. 40. 6. Frameworks for addressing the health and development of adolescents
  41. 41. First lens: Broadening opportunities for young people to develop skills and use them productively. Second lens: Helping them acquire the capabilities to make good decisions in pursuing those opportunities Third lens: Offering them second chances to recover from bad decisions, either by them or by others. World Bank framework: Youth transitions seen through three lenses

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