This document provides an outline and introduction to adolescent reproductive and sexual health. It discusses the global and Indian scenario of adolescent health risks and determinants. Some key points:
- India has over 253 million adolescents aged 10-19 years.
- Adolescents face numerous health risks such as early pregnancy, HIV, violence, and malnutrition.
- Factors like early marriage, gender inequality, and economic pressures disadvantage many adolescents in India.
- The WHO guidelines emphasize improving adolescent health across healthcare levels and involving adolescents in related decisions. Government initiatives in India include programs like SABLA and RKSK.
- Adolescent friendly health services aim to provide sexual and reproductive healthcare to adolescents in a
Adolescent Sexual and Reproduction Health PresentationDeepak TIMSINA
ADRA worked to scale-up ASRH programme in Kalikot District through its Strengthening Reproductive Health (SRH) project. I worked as a 'Training Officer' in ADRA from 2012-2013.
This was a short lecture on teenage pregnancy given during the Phil Pediatric Society Central Visayas chapter Postgraduate Course last November 19, 2015 at the Marriott Hotel, Cebu City.
Adolescent Sexual and Reproduction Health PresentationDeepak TIMSINA
ADRA worked to scale-up ASRH programme in Kalikot District through its Strengthening Reproductive Health (SRH) project. I worked as a 'Training Officer' in ADRA from 2012-2013.
This was a short lecture on teenage pregnancy given during the Phil Pediatric Society Central Visayas chapter Postgraduate Course last November 19, 2015 at the Marriott Hotel, Cebu City.
Sexual and Reproductive Health and Rights of Women in Nepal (SRHR)WOREC Nepal
The purpose of this brief is to highlight the status of sexual and reproductive health rights of women in Nepal, discuss the gaps and challenges in the policies to address the ground realities of women with sexual and reproductive needs and to ensure their rights. As the brief includes the ‘voices’ of grassroot women and stakeholders, it is expected to demand accountability and changes in direction where it is urgently needed and suggest changes or strengthening as necessary at different levels, including the upcoming International Conference on Population and Development. (ICPD)+20.
Definition and components of reproductive health?
Demographic trends and fertility determinants
Family planning
Impact of reproductive patterns on child health
Impact of reproductive patterns on women health
Mechanisms to reduce morbidity and mortality
Sexual and Reproductive Health and Rights of Women in Nepal (SRHR)WOREC Nepal
The purpose of this brief is to highlight the status of sexual and reproductive health rights of women in Nepal, discuss the gaps and challenges in the policies to address the ground realities of women with sexual and reproductive needs and to ensure their rights. As the brief includes the ‘voices’ of grassroot women and stakeholders, it is expected to demand accountability and changes in direction where it is urgently needed and suggest changes or strengthening as necessary at different levels, including the upcoming International Conference on Population and Development. (ICPD)+20.
Definition and components of reproductive health?
Demographic trends and fertility determinants
Family planning
Impact of reproductive patterns on child health
Impact of reproductive patterns on women health
Mechanisms to reduce morbidity and mortality
Sexual reproductive health rights and SDGsMartin Ayanore
Whats the implications of SDGs for sexual reproductive rights globally? Panelist at the University of Utrecht during a recent symposium talk about the just adopted SDGs for health
The cards also contain recommendations for inclusion of SRHR in the post-2015 development framework. The briefing cards were developed by partners in the Universal Access Project, which aims to bolster the U.S. government’s support for international reproductive health and family planning. However, the cards are not specific to a U.S. policy context so their content will be useful for a wide range of advocates as we move toward intergovernmental negotiations and continue to make the case with governments about the importance of ensuring the comprehensive inclusion of sexual and reproductive health and rights within the post-2015 development framework.
Brief overview of group 2 final PowerPoint presentation pertaining to the affects of macro-trends on the U.S.Healthcare Systems and potential job growth/opportunities that will come from them.
This power-point includes content on brief introduction and classification & management of pneumonia based on Integrated Management of Neonatal & Childhood Illness (IMNCI).
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
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Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
3. Outline
1. Health risks of Adolescents
2. Global and Indian scenario
3. Determinants of adolescent health
4. Health services & interventions - WHO guidelines
5. ARSH in RCH II
6. RMNCH+A
7. Sexual & Reproductive health concerns
8. Role of health system - Adolescent friendly health services
9. Government initiatives in other sectors
4. Introduction
• Adolescence- 10-19 yrs
GOI in National Youth Policy: 13-19 yrs
Early 10-13
Mid 14-16
Late 17-19
• Youth: 15-24y GOI:15-35y
• Young people: 10-24y
• Young adults: 20-24y
5. Adolescents profile in India
1) Adolescents: 253 million -Census 2011
2) Adverse sex ratio- 898
3) Early marriage
4) Female mortality rates higher
5) Rural adolescents and girls are disadvantaged
6) Economic compulsions force many to work
7) Malnutrition affects development
8) Drug abuse
9) Crime
10) Unmet need for contraceptives
11) Trafficking and prostitution
12) Premarital sexual relations
13) HIV/ AIDS
7. Health for the world’s adolescents- WHO 2014 for the year 2012
8. Health for the world’s adolescents- WHO 2014 for the year 2012
9.
10.
11. Health for the world’s adolescents
Extending
improvements in
MCH to
adolescents
Universal health
coverage for
adolescents
Combining forces
for adolescent
health
Health during
adolescence:
impact across life-
course
Policies play a key
role in protecting
adolescents’ health
Adolescents need
to be involved in
decisions and
actions
Moving beyond
the status quo
12. Providing health services
Collecting and using the data
needed to advocate, plan
and monitor health sector
interventions
Developing and implementing
health-promoting and health-
protecting policies
Mobilizing and supporting
other sectors
State-of-the-art overview of
four core areas for health
sector action
Health for the world’s adolescents
13. ARSH in RCH II
1. Two-pronged strategy
2. Policy & institutional framework
3. Coverage
4. Operational framework
5. Key interventions for operationalising ARSH
6. Evaluation & operations research
7. Logical framework
14. RMNCH+A: Why invest in adolescent health?
A healthy adolescent becomes a healthy adult
• Strong foundation
• Builds self-esteem
• Capacity building
• Preparation for adult life
• Improves productivity
• Averts future health cost
• Not just an investment but also a basic human right
15. ACROSS LIFESTAGES
ACROSS LEVELS OF CARE
Health facilities
at various
levels : PHCs,
FRUs, DH
Outreach
services
Family /
home and
community
care
Appropriate Referral & Follow up
RMNCH+A …a new approach
16. Heath Systems strengthening :
Infrastructure, Human
resources, drugs &
commodities, referral transport
Five high impact interventions
across five key life stages
Prioritisation of investments :
High Priority Districts, tribal
blocks, marginalised
populations in underserved
areas …also urban slums
Integrated monitoring and
accountability through good
governance, use of data,
communitisation & grievance
redressal
Convergence & partnerships
with other Ministries/
departments, development
partners, civil society
organisations & other
stakeholders
RMNCH+A approach… key features
17.
18. • Normal growing up
• Breast development
• Oily skin
• Desire to be thin
Physical
development
• Development of identity
• Very curious
• Peer pressure
Emotional &
social
development
• Desire to have sex
• Ejaculation
• Menstruation
Sexual
development
Adolescent growth and development
19. Nutritional needs and anaemia
1. Balanced diet
2. RDA of nutrients for adolescence
3. Eating right & nutritious food
4. Factors influencing adolescents’ nutrition
5. Nutritional anaemia
6. Other deficiency states
20. Special attention
groups of
adolescents
“Out of
school” &
street
adolescents
Sexually
abused
Commercial
sex workers
Those in
conflict with
law
Working
adolescents
Orphans,
those in
foster care
&
institutions
Physically &
mentally
disabled
21. Implications of early
sexual involvement
• More likely to have
sex with high risk
partners/ multiple
partners
• Less likely to use
condoms
• Contraceptive usage
likely to be low
Consequences of
unsafe sexual
behaviour
• Early pregnancy &
parenthood
• LBW babies,
increased infant
mortality &
morbidity
• Abortions & related
complications
• RTI/STI including
HIV/AIDS
• Emotional, social and
economic impact
Negative impact due to
lack of awareness and
skills related to
sexuality and HIV
• More in case of
adolescents even if it
is safe sex as they are
not mature enough
to handle these
consequences
Adolescent sexual behaviour and health implications
22. Provide accurate
information
Provide needed
services in a
friendly manner
Address adolescent
groups, teachers,
parents, schools,
colleges, clubs
Facilitate the provision
of ‘LSE’, help postpone
early marriage & early
pregnancy
Utilize the
media
Role of health system
23. • GATHER approach
• Counselling on
sexuality, sexual
abuse and/or
violence
• Tips for effective
communication
• Barriers to
communication
Feelings of
an
adolescent
Establishing
trust
Verbal vs non-
verbal
communication
Counselling
Communicating with adolescent client
24. Adolescent friendly health services
1. Adolescent friendly programmes/ policies
2. Adolescent friendly service providers
3. Adolescent friendly health centre
4. Needs of adolescents and barriers that prevent their service
utilization
5. Best delivery of services to adolescents
25. Life skills
1. Core life skills
2. Relevance of Life Skills Education to adolescents
3. Impact of LSE interventions
4. Role of health sector in promoting LSE
26. Broad areas of life skills
Social skills
Thinking/
reflective
skills
Negotiation
skills
28. Adolescent pregnancy
• Magnitude of problem
• Factors influencing adolescent pregnancy
• Pregnancy related complications
– Antenatal period
– During labour & delivery
– Postpartum period
– Problems affecting baby
• Care of adolescents during pregnancy
30. Contributing factors to post- abortion
complications
1. Delay in seeking care
2. Negative attitudes of trained providers
3. Resorting to untrained providers
4. Use of dangerous methods
5. Laws relating to abortion
6. Service delivery factors
7. Complications following spontaneous abortions
31. Medical
• Major short
term
• Major long
term
Psychological
• Guilt
• Depression
Socio-
economic
• Disapproval,
rejection
• Economic
burden
Complications and consequences
32. Unsafe abortions
• Diagnosis & Management
– H/O missed menstrual period followed by an attempt to
terminate pregnancy or spontaneous
– Emergency resuscitation
– Evacuation of uterus
– Prevention of further complications
– Post-abortion care
– Post-abortion contraception counselling
• Prevention of unsafe abortions
33. Contraceptive use
Barriers to contraceptive use
Effectiveness
Providing adolescents information and education
Contraceptive services and counselling
Contraception
36. To make the clinics adolescent friendly,
states have branded the clinics as:
Maitry in Maharashtra
UDDAN in Uttrakhand
Sneha in Karnataka and so on
Teen clinics
42. Strategies for promotion of adolescent health
A :Adoption of healthy life style
D :Develop appropriate strategy
O :Organize adolescent friendly clinic
L :Life skill training, legal support
E :Educate
S :Safe, secure & supportive environment
C :Counselling, curriculum inclusive of family life skills
E :Enable & empower
N :Networking
T :Training
1 -2Health for the world’s adolescents
3 : Why invest in adolescent health?
4 Nutritional needs and anaemia
Latin word adolescere means to grow ,to mature
Adolescence- “to emerge or achieve identity
Population (2011) 253 mn (225 mn)
Decadal growth (2001-11) + 12.5%
Sex Ratio (2011) 898 (882)
Key facts
An estimated 1.3 million adolescents died in 2012, mostly from preventable or treatable causes.
Road traffic injuries were the leading cause of death in 2012, with some 330 adolescents dying every day.
Other main causes of adolescent deaths include HIV, suicide, lower respiratory infections and interpersonal violence.
Globally, there were 49 births per 1000 girls aged 15 to 19, according to 2010 figures.
Half of all mental health disorders in adulthood appear to start by age 14, but most cases are undetected and untreated.
Around 1 in 6 persons in the world is an adolescent: that is 1.2 billion people aged 10 to 19.
A :Adoption of healthy life style D :Develop appropriate strategy O :Organize adolescent friendly clinic L :Life skill training, legal support, liasion with peers, parents E :Educate about sexuality, safe sex, responsible parenthood S :Safe, secure and supportive environment to be provided C :Counselling / curriculum in school inclusive of family life skills E :Enable & empower for responsible citizenship N :Networking for experience sharing T :Training for income generation, teen clubs
