Adolescent health Problems Commmunity Medicine India

1. ADOLESCENT
HEALTH
PROBLEMS
Usheem Syed

2. Defining the word “Adolescent”.
A statistical statement
Common Adolescent health problems
Prevention

3. ADOLESCENCE
Transition from childhood to adulthood.
WHO= 10- 19 years.
Early/Late (Mid)
Young people= 10-24 years
Youth= 15-24 years

4. NORMAL GROWTH AND
DEVELOPMENT
Physical
Skeletal growth spurt
Increase in weight,
muscle mass
Reproductive
maturation
Psychosocial
development
Mood swings
Increased cognition
Need for privacy
Sexual changes
Development of
Secondary sexual
characteristics

5. WHERE DO WE STAND?
J&K India
Women married <18y 8.7% 26.8%
Men married <21 y 10.5% 20.3%
INDIA
Around ¼ women married before 18 years.
7.8% of 15-19 year olds are pregnant or mothers.

6. DEATHS
1. Road traffic injuries
2. H.I.V
3. Suicide
4. LRTIs
5. InterpersonalViolence
6. Diarrhoea
7. Drowning
8. Meningitis
9. Epilepsy
10. Endocrinological
DALYs
1. Depression
2. RoadTraffic Injuries
3. Iron deficiency Anaemia
4. H.I.V
5. Self Harm
6. Back/Neck pain
7. Diarrhoea
8. Anxiety
9. Asthma
10. LRTIs

7. INJURIES
Mostly Road traffic injuries.
Risk taking behaviour
SubstanceAbuse
Sports Injuries
Drowning
This Photo by Unknown Author is licensed under CC BY

8. VIOLENCE
“Globally 1/3 adolescent girls has been a victim of
emotional, physical or sexual violence perpetuated by their
husband/partner.”
Promote nurturing of family relations
Train in life skills
Limit alcohol and firearms.

9. MENTAL HEALTH
 Depression, Underlying:
 Violence
 Poverty
 Humiliation
 Build life skills
 Provide Psychological support
 Behavioural disorders
 ADHD
 Conduct/oppositional defiant Disorder
 Eating disorders

10. RTI AND HIV/AIDS
HIV related deaths have > tripled since 2000.
Barrier Contraceptives
Treatment of STIs
IDUs at an increased risk of HIV

11. EARLY PREGNANCIES
 Dangerous for the mother
 Preeclampsia
 Anaemia
 PPH
 HIV
 Unsafe abortions
 Dangerous for the child
 Preterm
 LBW
 Asphyxia
 Adversely affects the community
 Leave school
 Emotional stress

12. SUBSTANCE ABUSE
 Underlying most injuries, violence.
 Prevention
 Minimum age for buying and consuming
 Prohibit sale to minors
 Vast majority of smokers began as adolescents
 India= Alcohol>Tobacco>Cannabis
(21%) (14%) (3%)
 Peer pressure, Stress Relief, Risky behaviour,
Mental disease.

13. NUTRITION
 Needs increase
 Boy: 2500 kcal
 Girl:2200 kcal
 Proteins: 45-60g
 Ca: 1200 mg
 Avoid foods with trans fats, junk food(Obesity)
 Undernutrition
 Eating disorders

14. PREVENTION
 Primary
 Promoting healthy
lifestyles
 Policies/Legislation
 Information
 Education
 Secondary
 Screening
 Counselling
 Tertiary
 Curative + Education
 Rehabilitation

15. THE 5 RMCH+A COMPONENTS
1. Address teenage pregnancies and contraception in adolescents
2. Introduce community based services through “Peer Educators”.
3. Strengthen ARSH Clinics (AFHC)
4. Roll out WIFS
5. Promote Menstrual Hygiene

16. AFHC
 Routine check-ups at all levels of care
 On Fixed Day clinics
 Facility based Counselling services
 Nutrition, puberty, STIs, Contraception
 Outreach Activities
 Schools,Colleges,Village Health and Nutrition Day
 Services provided at the AFHC..
 Examination, monitoring, STI screening,ANC, Contraception
 Life Skills Education

17. PEER EDUCATORS
 Peer educators- Saathiya
 Usually 4; 2 boys and 2 girls/Village(1000)
 Each form a group of 15-20
 Weekly sessions, 1-2 hours
 Adolescent Friendly Club Meetings once a month at the
Subcentre level
 Quarterly Adolescent Health Days

18. WIFS
 Target
 School going adolescents- 6th to 12th Class
 Out of School Adolescent girls
 100 mg Iron and 500µg Folic Acid
 Fixed Day Approach x 52 weeks
 Screen for moderate to severe anaemia
 Biannual Deworming with 400mg Albendazole
 Information and Counselling

19. MENSTRUAL HEALTH SCHEME
 10-19 year olds, rural areas
 6 napkins- “Freedays” at ₹6/ 6 napkins
 Distribution by ASHA
 Incentive ₹ 1/Pack
 Free pack/month
 Monthly IEC (Aganwadi Centre )
 Promote menstrual hygiene
 Bathing,Washing, Cloth
 10 districts in J&K

20. THANKYOU

21. Sources
• https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-
solutions
• https://www.msdmanuals.com/professional/pediatrics/problems-in-adolescents/behavior-
problems-in-adolescents
• https://www.gfmer.ch/SRH-Course-2012/adolescent-health/pdf/Introduction-adolescence-
adolescent-health-WHO-2012.pdf
• Taghizadeh Maghaddam H, BahreiniA, AjilianAbbasi M, Fazli F, Saeidi M. Adolescence
Health: the Needs, Problems and Attention. Int J Pediatr 2016; 4(2): 1423-38.
• https://nhm.gov.in/nhm/index1.php?lang=1&level=2&sublinkid=818&lid=221
• https://www.slideshare.net/Gopalrao123/adolescent-health-28192962
• https://www.slideshare.net/nishantprabhakar75/adolescent-health-problems
• Park's textbook of PSM 23rd