Concept of adolescent, youth and representative health

1. CONCEPT OF ADOLESCENT, YOUTH
AND SEXUAL REPRODUCTIVE
HEALTH
BY
Nr. Yusuf A. Y
RN, CRNA, BNSc, PGDE

2. Key Messages of
Presentation:
 Who are the adolescents and young
people we are talking about?
 What is Adolescent Sexual and
Reproductive Health and what
challenges face us in assuring it?
 What are the factors contributing to these
challenges?
 Overview
 Introduction

3. Key Messages of Presentation:
…..
 Concept and Definitions
 How sexuality is shaped
 Adolescent and Youth Sexual and
Reproductive Health
 Sexual violence
 Current status of sexual & reproductive
health in Nigeria
 Key fact

4. Why “Adolescent Sexual and
Reproductive Health” ?
 It is a “population” issue:
 Over 30 million Nigerians are between the
ages of 10-19 years and nearly one third
of Nigeria’s total population is between
the ages of 10-24 years i.e. about 50
million people.
 It is a “health” issue:
 More than half of all new HIV infections
occur in people under the age of 25 with
girls disproportionately affected.

5. Why “Adolescent Sexual and
Reproductive Health” ?
 It is a “natural resources” issue:
 Two of the least “resourced” northern
regions of the country account for 42% of
Nigeria’s 15 to 19 year old girls—yet
these girls— demonstrably among the
least educated and empowered in Nigeria
account for 71% of all births in this age
group—with a fertility rate (7.3) higher
than Nigeria’s average (5.2)

6. Why “Adolescent Sexual and
Reproductive Health” ?
 It is a “governance” issue:
 These youth need to work constructively
to improve their conditions
 These youth will govern—but need
education and—for women—need power
and means to manage their own fertility
 The answer to the ASRH challenges
facing us implicates the public sector—all
sectors, not just health

8. OVERVIEW
 Adolescence is one of life's most complex
stages, when young people take on new
responsibilities and experiment with
independence. When engaged and
supported, adolescents thrive and
contribute to communities and families.

9. Cont.d
 When encouraged, they have the potential
to change negative social norms and pave
a brighter future for themselves and their
future families. Yet as adolescents around
the world enter puberty, taboos, discomfort
and fear prevent parents and other trusted
adults from teaching relevant information to
help adolescents navigate the complexities
of their emerging sexuality.

10. Cont.d
 Yet adolescents typically do not have
access to high quality sexual and
reproductive health information and
services.

11. Introduction
 Young people are not problems to be
solved: they are resources to be
developed
 Young people represents a positive force
in the society
 They face dangers more complex than
previous generations faced and often with
less support
 Health service play a specific role in
preventing health problems and
responding to them
 Many changes are needed in order for

12. Concepts and Definitions
Reproductive health
 … is a state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity, in all
matters relating to the reproductive
system and to its functions and
processes…”

13. Sexual health
 “… is a state of physical, emotional,
mental and social well-being in relation to
sexuality; it is not merely the absence of
disease, dysfunction or infirmity. Sexual
health requires a positive and respectful
approach to sexuality and sexual
experiences, free of coercion,
discrimination and violence. For sexual
health to be attained and maintained, the
sexual rights of all persons must be
respected, protected and fulfilled’ (WHO

14. Human Sexuality
 … A general term for the feelings &
behaviors of human beings concerning sex
 “… is grounded in biological functioning,
emerges in each of us as we develop, and
is expressed by cultures through rules
about sexual contact, attitudes about morel
and immoral sexuality, habits of sexual
behavior, patterns of relations between the
sexes, and so on” – Carroll, 2005

15. Expression of Sexuality
 Sexuality is experienced and expressed
in thoughts, fantasies, desires, beliefs,
attitudes, values, behaviors, practices,
roles and relationship.

16. SEXUAL VIOLENCE

17. Sexual violence
 Sexual violence is any sexual act or
attempt to obtain a sexual act by violence
or coercion, acts to traffic a person or acts
directed against a person's sexuality,
regardless of the relationship to the victim.
It occurs in times of peace and armed
conflict situations, is widespread and is
considered to be one of the most traumatic,
pervasive, and most common human rights
violations.

18. How Sexuality is shaped
It is influenced by the interaction of factors:
 Biological
 Psychological
 Social, economic
 Political. Cultural
 Ethical
 Legal
 Historical
 Religious/Spiritual

19. Adolescent and Youth Sexual and
Reproductive Health
Why is SRH a priority in adolescent
health?
 Early sexual engagement high in many
countries
 Age at marriage generally increasing –
leaving “gap” for premarital sexual
experience
 Sexual activity among young people
“taboo” – as a result, little accurate data &
political will to design effective

20. Sexual violence
 Sexual violence is under-reported: many
women feel shame and fear rejection by their
families and communities as ‘dishonored’,
soiled or unmarriageable
 Sexual violence by husband is more common
in child marriages
 Victims of sexual violence often suffer severe
long-term health damage: fistulas (tears in the
vagina, bladder and rectum that cause
incontinence); uterine prolapse or ruptures;
infertility; STI’s, HIV, as well as post-traumatic
stress disorder and other psychological
damage.

22. Supporting adolescents’ health and
rights
 Adolescents’ sexual and reproductive
health must be supported. This means
providing access to comprehensive
sexuality education; services to prevent,
diagnose and treat STIs; and counselling
on family planning. It also means
empowering young people to know and
exercise their rights – including the right to
delay marriage and the right to refuse
unwanted sexual advances.

23. Current status of sexual and
reproductive health in Nigerians
 Following the global trend of strong advocacy for the
domestication of the tenets of SRH in respective
countries and societies of the world, Nigeria was one of
the first nations in Sub -Saharan Africa to make
adoptive policy statements. The series of
pronouncements and policy initiatives include the fact
that in 1998 Nigeria adopted the Regional Reproductive
Health Strategy and endorsed all the components of
SRH as entrenched in the ICPD platform for action
except "the provision of safe abortion services," which is
against the law in Nigeria.

24. Current status of sexual and
reproductive health in Nigerians………
 Highly vulnerable to HIV infection:
Represent majority of new infections.
Young girls aged 15-24 are 3 times more
likely to be HIV-positive compared to boys
the same age.
 Burdened by unplanned and unwanted
pregnancies too early and at great risk
teenage mothers typically physically,
emotionally or economically unprepared to
care for their children; lose life options

25. Current status of sexual and
reproductive health in Nigerians………
 evidence on the ground shows that teen
mothers are twice as likely as older women
to die of pregnancy related causes and the
children are more likely to die in infancy.
 54% of females have given birth to a child
by age 20
 Hospital based studies show adolescent
girls make up over 60% of women treated
for complications from unsafe abortion—
many resulting in death or permanent injury
or infertility

26. Key facts
 More than 1.1 million adolescents aged 10-19
years died in 2016, over 3000 every day,
mostly from preventable or treatable causes.
 Road traffic injuries were the leading cause of
death among adolescents in 2016. Other
major causes of adolescent deaths include
suicide, interpersonal violence, HIV/AIDS and
diarrhoeal diseases.
 Half of all mental health disorders in adulthood
start by age 14, but most cases are
undetected and untreated.
 Globally, there are 44 births per 1000 to girls
aged 15 to 19 per year.

27. Conclusion and
Recommendation
 Evidence-based advocacy urgently
needed to launch action on multiple fronts
supporting application at scale of tested,
appropriate SRH interventions for
Nigeria’s adolescent population
 Continued rigorous evaluation and
sharing of lessons learnt thus far about
effective strategies should inform
programming at scale to improve the
sexual and reproductive health of

28. Conclusion and Recommendation……
 Programming should be cognizant of and
responsive to the varying needs of Nigerian
adolescents based on their life circumstances,
contexts, age and developmental levels
 State and federal level governments need to
lead the way by making statutory annual
budgetary allocations for relevant evidence-
based programming
 Multi-disciplinary, public-private collaboration
and coordination is required to facilitate
greater synergy in programming

29. Conclusion and Recommendation……
 Civil Society actors, non governmental
professional bodies with substantial
experience in work with adolescents,
gender issues, etc. should be included in
accountability mechanisms or processes
to support government efforts.