health problems of adolescents, burden on health services, prevention of adolescent health problems

1. Adolescent health
burden
Prof. Dr. Amany R.Aboel-Seoud
Community Medicine
Zagazig University

2. Objectives:
• Identify major health problems of adolescents & risk
factors
• Assess needs of adolescents
• Explain the components of preventive health program for
adolescents

3. Definition:
• Adolescence is the period of life between
puberty and maturity. Roughly between 10
to 19 years. It is characterized by:
• Rapid physical growth (called adolescent
spurt).There is increase in height, weight,
sexual development due to hormonal
changes.
• Mental (cognitive) change: from concrete
operational thinking to abstract, deductive,
reasoning thinking. Understand risk and
benefit and appreciate future consequences
of choices.
• Psychological change: developing peer
relationship, sexual intimate relation,
determination of educational goals,
establishing identity and self responsibility.
Sensation of independency.

4. Adolescent burden
Why ?????

5. Health
burden
Population
number
Health
problems
magnitude
Availability
of
solutions
Health
needs

6. Demographic
data
• Population in Egypt: 94,666,993 (July 2016
est.)
Age structure
• 0-14 years: 33.21% (male 16,268,862/female
15,169,039)
15-24 years: 19.24% (male 9,371,819/female
8,839,999) around 18 millions
25-54 years: 37.47% (male 18,020,332/female
17,448,871)
55-64 years: 5.91% (male 2,771,399/female
2,826,094)
65 years and over: 4.17% (male
1,937,119/female 2,013,459)

7. Population pyramid of Egypt

8. Global
burden of
adolescent
health
• Around 1.2 billion people, or 1 in 6 of the world’s population, are
adolescents aged 10 to 19.WHO reports
• Estimated 1.2 million adolescents died in 2015, over 3000 every
day, mostly from preventable or treatable causes.
• Road traffic injuries were the leading cause of death in 2015.
Other major causes of adolescent deaths include lower
respiratory infections, suicide, diarrheal diseases, and drowning.
• About 15% of global maternal death occurs among adolescent
girls.There are 44 births per 1000 to girls aged 15 to 19 per year.
• Nearly 35% of the global burden of disease has roots in
adolescence. Half of all mental health disorders in adulthood
start by age 14, but most cases are undetected and untreated.
• There is an increasing global trend in adolescent obesity due to
great shift in diet and activity pattern

9. Adolescent health problems

10. Main health problems of adolescents
A) Morbidity:
• Infections : pharyngitis, lower respiratory tract infections,
measles, mumps, meningitis, AIDS, typhoid, viral
hepatitis, food poisoning, ascaris, schistosoma and
enterobius.
• Reproductive system problems: hydrocele, varicocele,
breast and menstrual disorders.
• Complication of early maternity and sexual abuse

11. • Accidents and injuries.
• Behavioral problems: cigarette smoking, addiction
• Dermatological problems: acne, tenia, scabies,
conjunctivitis.
• Eating disorders: over eating or severe anorexia, for
body shape, malnutrition: anemia, vitamin deficiency
and obesity.
• Psychological problems: depression, adolescent abuse.
• Musculo skeletal problems: scoliosis, kyphosis
• Dental problems

12. B) Mortality
Adolescent mortality in general is minimal except after:
• Accidents (mainly motor vehicle), injuries, homicide,
suicide, drowning, substance abuse
• Complications of severe infections as pneumonia,
tuberculosis, sexually transmitted diseases (HIV),
diarrhea, meningitis
• Cancer, chronic disease complications

14. Risk factors

15. Risky lifestyle that lead to
adolescent problems
• Behaviors that contribute to unintentional injury and violence.
• Tobacco ,alcohol and other drug use.
• Unhealthy eating, sleeping
• Inadequate physical activity.
• Sexual behaviors that can result in HIV infection, other sexually
transmitted diseases (STDs), and unintended pregnancy.
• Internet addiction

16. Addiction is major problem

17. Objectives:
• Identify major health problems of adolescents & risk
factors
• Assess needs of adolescents
• Explain the components of preventive health program for
adolescents

18. Adolescent needs

19. Needs of
adolescents
• Needs to accept autonomy, to find way to develop a life style
• Needs for trust , confidentiality and love
• Education needs: special teachers understanding adolescent
psychology. Adjusted curricula to meet their needs. Sex and
family education.
• Needs for good family relationship.
• Need for healthy sufficient diet.
• Support safe motherhood for married adolescents by frequent
antenatal care visits, safe attended labor and use of suitable
family planning method.
• Prevention of child labor by law, supportive working
environment, ensure nutritional and health care for working
adolescents. Prevention of employing adolescents in hazardous
occupations.
‫المراهقون‬ ‫يحتاج‬
‫لالحترام‬.‫واإلنصات‬..‫والحب‬‫والتفهم‬.‫االحتواءوالحنان‬
..‫الثقة‬
‫و‬‫الوقت‬ ‫نفس‬ ‫فى‬‫والتوجيه‬ ‫الحزم‬‫والرقابةالمسئولة‬
‫والصدق‬‫الحسنة‬ ‫والقدوة‬
•

20. Objectives:
• Identify major health problems of adolescents & risk
factors
• Assess needs of adolescents
• Explain the components of preventive health program for
adolescents

21. Prevention and control of adolescent’s
health problems
• What to do?Who is responsible? where? When?
indicators of success?

23. What to do?
I) Prevention
Screening : by physical, psycho-social and laboratory examinations to
assess normal development, early detection of problems. .
 Weight, height measurements, screening for vision, hearing and
speech defects. Screening tests for smokers and drug abuse,
vulnerability for suicide, screen for tuberculosis, hypertension and
diabetes and nutritional deficiency and parasitic infections.
 These examinations are done at school entry, at beginning of prep.
and secondary schools

24. • Immunization:
MMR at entry of preparatory school.Tetanus and diphtheria vaccine
booster dose, BCG for tuberculin negative adolescents.
Meningococcal meningitis andTAB vaccine for typhoid in outbreaks
and booster dose of hepatitis B.

25. Health education
for general hygiene, use seat belts and helmets in driving cars or
motor cycles.
e.g. Do not use drugs and drive. Do not smoke cigarettes or shisha.
Nutritional health education, eat low fat diet, avoid junk foods.
Physical exercise regularly.
Appropriate sex education with abuse prevention skills at schools,
colleges and also in the community to bridge the knowledge gap in
adolescent.With this approach, sexual abuse and unsafe sexual
practice can be reduced. This in turn prevents unwanted pregnancy,
AIDS/STIs and its complications.
Health education can be part of school curriculum or by teacher,
doctor or conference with community leader in school.

26. • Safe (school, home) environment:
Away from pollutants, safety measures against accidents, proper
lightening, safe water supply, safe waste disposal, proper size
desks, sufficient space for playground

27. Protection by law:
• Delay age of marriage through advocacy, counseling and
strict enforcement of law.
• Strict enforcement of laws related to traffic rules,
prohibiting sale of tobacco, alcohol and other substance
of abuse to minors.
• Restricting advertisement related to junk food products.

28. II)Control of health problems
• First aid and emergency services at school or near hospitals.
• Control of diseased adolescents: rheumatic heart, infections, drug
abuse, skin infections , parasitic infection, anemia, obesity and
psychological troubles.

29. III) Rehabilitation
• Rehabilitation of handicapped adolescents: special aids,
• psychological support,
• special educational programs
• special schools, training skills.

30. Who is
responsible
• Parents, family, friends, relatives
• Community as a whole including:
school, health care giver, scientific research, law &
policies, religion, media, clubs, recreational
activities, job vacancies, social workers,
education, environment

31. Family role
• Supplying good nutrition, safe home, education and
health care
• Good communication and strong bonds with
adolescents, love, acceptance
• Supervision and sharing with their adolescents' activities,
supply opportunities, patience
• Give trust , confidence and respect

32. Health care provider role (WHO)
1. Understand normal adolescents development and its impact
on health
2. Effectively interact with an adolescent client
3. Deliver quality health care services for adolescents
4. Apply in clinical practice the laws and policies that affect
adolescents
5. Provide clinical care to adolescents with developmental
delay and puberty conditions

33. 6. Provide immunization
7. Manage common conditions during adolescence,
proper counseling
8. Manage chronic conditions and disability
9. Provide sexual and reproductive health care
10.Provide HIV prevention, management and care
11. Detect and manage mental health problems

34. 12. Assess and manage substance use and its disorders
13. Assess nutrition status and manage nutrition related disorders
14. Detect violence and provide first-line support to the victim
15. Prevent and manage unintended injuries
16. Promote physical activity
17. Detect and manage endemic diseases

35. Media role
 Increased focus on the use of positive youth development
interventions. providing all youth support, relationships,
experiences, resources, and opportunities needed to become
successful and competent adults. Adolescents who are
exposed to media portrayals of violence, sexual content,
smoking, and drinking are at risk for adopting these behaviors
 Online consultation and counseling can be considered. It will
be accessible and gives a feel of security and confidentiality for
adolescent population

36. Religion
• Positive instructions for religious commitment , preying,
fasting, avoid smoking, addiction, illegal sexual
relationship.
• Build good personality, adopt honesty, manhood, tender,
responsibility, how to make decision etc..

37. Thank you