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Introduction to adolescence & to
adolescent health
WHO Department of Child and Adolescent Health
and Development
Topics
1. The meaning of adolescence
2. The health problems that adolescents face
3. What adolescents need to grow & develop in good health
4. Who needs to meet the needs & fulfil the rights of adolescents
5. Why we should invest in the health & development of adolescents
6. Frameworks for addressing the health & development of
adolescents
1. What do we mean by the term
'adolescents ' ?
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).
Adolescents are a diverse
population group
Different needs
Changing needs
What is special about adolescence ?
(What makes it different from childhood & adulthood ?)
• A time of rapid physical and psychological
(cognitive and emotional) growth and
development.
• A time in which new capacities are developed.
• A time of changing social relationships,
expectations, roles and responsibilities.
2. What do we mean by the term
'health' ?
“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.
3. What are the main health
problems of adolescents ?
Many adolescents move from childhood through
adolescence into adulthood in good health.
Key health problems in adolescence.
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. female genital
mutilation
-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,
schistosomiasis,
tuberculosis
- Under/over-nutrition
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 in an adult
world)
• Health & counselling
services
(they need a safety net)
5. Who needs to contribute to
meeting these needs & fulfilling
these rights ?
Politicians
Journalists
Bureaucrats
Relatives
Friends
Family friends
Teachers
Sports coaches
Healthcare providers
Religious leaders
Traditional leaders
Parents
Brothers/Sisters
Adolescents
Musicians
Film stars
Sports figures
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 the
history of mankind.
Demographic rationale – 1/2
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 income
countries.
Public health rationale: mortality – 1/5
A Picture of Health, WHO/UNICEF (1995)
Death by condition by 5 year age group, 1999
100,000
200,000
300,000
400,000
500,000
600,000
700,000
MF5-9 MF10-14 MF15-19 MF20-24
Communicable,
maternal, perinatal
and nutritional
conditions
Noncommunicable
diseases
Injuries
Public health rationale: mortality 2/5
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
430,000
35%
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
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
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
+ +++ +
HIV infection
+ +++ ++
Public health rationale – 5/5
sound reasons for investment for this generation
1. The benefits of
investing in
adolescents
2. The cost of not
investing in
adolescents
Economic rationale – 1/4
Economic
rationale – 2/4
The need to make full use
of the demographic
dividend when one can.
Economic rationale – 3/4
The need to act
before
the
demographic
transition
closes doors.
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."
Eylin 19, Honduras January 2006.
Source: World Development Report 2006 (World Bank, 2006.)
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
Human rights rationale – 2/2
For many adolescents the world
is in fact 'flat':
• Greater access to education
• Greater access to information
about the world
• Greater ability to make personal
& professional choices
For many other adolescents, the
reality is very different
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 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
Source: World Bank. World Development Report 2007. Development and the next generation. World Bank. Washington,
USA. 2007.
WHO: Delineating & strengthening
the contribution of the health sector
S
Strengthening &
supporting
other sectors
S
Services &
commodities
S
Strategic
information
S
Supportive
evidence-informed
policies
WHO. Strengthening the health sector response to adolescent health & development. WHO. Geneva. 2009.
UNFPA framework for action
on adolescents & youth
1. Supportive policy making that
applies the lens of population
structure & poverty dynamics
analyses
2. Gender & life-skills based sexual &
reproductive health education
3. Sexual & reproductive health
services
4. Young people's leadership and
participation
Source: UNFPA framework for action on adolescents and youth. Opening doors with 4 keys. UNFPA. New York, USA. Undated.

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adolescent and youth friendly healthservic.pptx

  • 1. Introduction to adolescence & to adolescent health WHO Department of Child and Adolescent Health and Development
  • 2. Topics 1. The meaning of adolescence 2. The health problems that adolescents face 3. What adolescents need to grow & develop in good health 4. Who needs to meet the needs & fulfil the rights of adolescents 5. Why we should invest in the health & development of adolescents 6. Frameworks for addressing the health & development of adolescents
  • 3. 1. What do we mean by the term 'adolescents ' ?
  • 4. 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).
  • 5. Adolescents are a diverse population group Different needs Changing needs
  • 6. What is special about adolescence ? (What makes it different from childhood & adulthood ?) • A time of rapid physical and psychological (cognitive and emotional) growth and development. • A time in which new capacities are developed. • A time of changing social relationships, expectations, roles and responsibilities.
  • 7. 2. What do we mean by the term 'health' ?
  • 8. “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.
  • 9. 3. What are the main health problems of adolescents ?
  • 10. Many adolescents move from childhood through adolescence into adulthood in good health.
  • 11. Key health problems in adolescence. 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. female genital mutilation -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, schistosomiasis, tuberculosis - Under/over-nutrition
  • 12. 4. What do adolescents need to grow & develop in good health ?
  • 13. 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)
  • 14. 5. Who needs to contribute to meeting these needs & fulfilling these rights ?
  • 15. Politicians Journalists Bureaucrats Relatives Friends Family friends Teachers Sports coaches Healthcare providers Religious leaders Traditional leaders Parents Brothers/Sisters Adolescents Musicians Film stars Sports figures
  • 16. 6. Why should we invest in the health and development of adolescents ?
  • 17. • Demographic rationale • Public health rationale • Economic rationale • Human rights rationale
  • 18. • 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. Demographic rationale – 1/2
  • 20. • 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
  • 21. A Picture of Health, WHO/UNICEF (1995) Death by condition by 5 year age group, 1999 100,000 200,000 300,000 400,000 500,000 600,000 700,000 MF5-9 MF10-14 MF15-19 MF20-24 Communicable, maternal, perinatal and nutritional conditions Noncommunicable diseases Injuries Public health rationale: mortality 2/5
  • 22. 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 430,000 35% 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
  • 23. 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
  • 24. 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 + +++ + HIV infection + +++ ++ Public health rationale – 5/5 sound reasons for investment for this generation
  • 25. 1. The benefits of investing in adolescents 2. The cost of not investing in adolescents Economic rationale – 1/4
  • 26. Economic rationale – 2/4 The need to make full use of the demographic dividend when one can.
  • 27. Economic rationale – 3/4 The need to act before the demographic transition closes doors.
  • 28. 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." Eylin 19, Honduras January 2006. Source: World Development Report 2006 (World Bank, 2006.)
  • 29. 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
  • 30. Human rights rationale – 2/2 For many adolescents the world is in fact 'flat': • Greater access to education • Greater access to information about the world • Greater ability to make personal & professional choices For many other adolescents, the reality is very different
  • 31. 6. Frameworks for addressing the health and development of adolescents
  • 32. 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 Source: World Bank. World Development Report 2007. Development and the next generation. World Bank. Washington, USA. 2007.
  • 33. WHO: Delineating & strengthening the contribution of the health sector S Strengthening & supporting other sectors S Services & commodities S Strategic information S Supportive evidence-informed policies WHO. Strengthening the health sector response to adolescent health & development. WHO. Geneva. 2009.
  • 34. UNFPA framework for action on adolescents & youth 1. Supportive policy making that applies the lens of population structure & poverty dynamics analyses 2. Gender & life-skills based sexual & reproductive health education 3. Sexual & reproductive health services 4. Young people's leadership and participation Source: UNFPA framework for action on adolescents and youth. Opening doors with 4 keys. UNFPA. New York, USA. Undated.