Adolescent health issues were discussed including mental health, malnutrition, infectious diseases, early pregnancy, social media risks, substance abuse, and tobacco smoking. Adolescents face increased risks of mental illness, malnutrition, early pregnancy and contracting infectious diseases. Peer influence and environment play a major role in adolescent risky behaviors like substance abuse and tobacco smoking. Programs aim to educate adolescents and support healthy behaviors through schools, community programs, and healthcare services.

1. ISSUES IN ADOLESCENT
HEALTH
A B D U L R A H M A N R A M D Z A N
A M M A R A M S YA R A B D U L H A D D I
S A F I A H AT I Q A H A D A N A N
N AT R A H A B D U L R A N I
1

2. INTRODUCTION
S A F I A H AT I Q A H A D A N A N
2

3. DEFINITION OF ADOLESCENT
• period after childhood
and before adulthood
WHO
• period from puberty
stage to adulthood
Lewis J.
3

4. CRITICAL TRANSITION IN
LIFE SPAN
Rapid sexual and
physical development
Personality
4

5. 2015  ±1.3 MILLION ADOLESCENT DIED FROM
PREVENTABLE OR TREATABLE CAUSES
• Mental illness or disorder
• Early pregnancy and childbirth
• HIV or other infectious disease
• Substance and tobacco abuse
• Obesity and malnutrition
• Social media addicted
HEALTH ISSUE IN ADOLESCENT HEALTH
5

6. HIGH-RISK BEHAVIOR
Family
High risk behavior
Self Harm Suicide
Risky sexual
behavior
Alcohol, tobacco
or Substance use
Unhealthy diet
behavior
Family Family
6

7. MENTAL HEALTH
S A F I A H AT I Q A H A D A N A N
7

8. MENTAL HEALTH IN
ADOLESCENT
• Mental health as one of the important components of health
• Mental illness  the largest cause of the burden disease among
adolescent
• Research has shown that most of the mental illness has onset <24yo
• It is normal
– to feel anxious about new school or friend
– To have a sad feeling for a short period of time after a loss or death
• Individual with mental illness have a different way of feeling, thinking,
acts and handling things
– If left untreated may cause severe ongoing symptoms and lead to bad
impact on their life
• Common mental disorder that may develop during adolescent stage:
– Major depressive disorder
– Anxiety disorders 8

9. RISK FACTOR
Mental
Illness
Family type
Family
Functioning
Household
income
Hx of violence,
humiliation,
poverty
Bye-bye
Mental
Illness
Aware of
warning sign
Early detection Build soft skill
Good
psychosocial
support
PREVENTION
9

10. ADOLESCENT MENTAL
HEALTH SERVICE
European: (Global model)
- Well developed
- Focus on child and adolescent health (health
care)
- Implement interdisciplinary concept
- Focus more on outpatient service than
inpatient service
Not started:
- Still focusing on other major health problem
and survival issue especially communicable
disease
-Stigma on mental health
Just started:
- Mental health service still focusing on adult.
- Child psychiatry is newly emerged
subspecialty
Developedcountry
Developingcountry
10

11. MALNUTRITION
A B D U L R A H M A N R A M D Z A N
11

12. INTRODUCTION
Definition
undernourished or
overnourished
Factors
Socioeconomic
status
Sedentary
lifestyle
Eating habits
Level of
physical
activities
12

13. UNDERNUTRITION
Definition Side effects
Protein energy
malnutrition
Diseases related
to defiency of
vitamins &
mineral
Infections
13

14. DEVELOPED AND DEVELOPING COUNTRY
United states: 1%
chronic malnutrtion
Southeast asia : 50%
Sri Lanka :
underweight- 47.2%
Stunting- 28.5%
Developedcountry
Developingcountry
14

15. PROGRAMS
United States Malaysia
15

16. OVER NUTRITION
obesityoverweightovernutrition
16

17. 0
20
40
BOY GIRL RURAL URBAN
10.3
15.7 19.1
24.5
Turkey
Turkey
7
18
6
20
boy
rural
0 5 10 15 20 25
Egypt
Egypt
17

18. FACTORS THAT CONTRIBUTE TO INCREASING
NUMBER OF ADOLESCENT OBESITY
♦ Limited access to healthy and affordable
foods.
♦ Food insecurity.
♦ Poor eating habits.
♦ Food marketing targeting children and
adolescents.
♦ Decreased physical activity both inside and
outside of school.
18

19. STRATEGIES TO REDUCE PREVALENCE OF OBESITY
Nutritional
information
access exposure
Physical
activities
private
sector
19

20. INFECTIOUS
DISEASE
A B D U L R A H M A N R A M D Z A N
20

21. INTRODUCTION
Definition
common
others
Definition
common
prevalence
21

22. HIV
• More than 2 million
adolescents are living with
HIV in the world
• In sub-Saharan Africa 25%
adolescents are aware of their
HIV status.
• In Malaysia, male continue to
represent the majority (89%)
of all HIV cases.
• The United States: had a
syphilis rate among adolescent
females of about nine per
100,000
• Five countries have adolescent
rates higher than rates in the
general population
– Canada
– Denmark
– Romania,
– Russian
– United States
22

23. FACTORS ADOLESCENTS ARE AT
GREATER RISK OF GETTING AN
STD
biology Talk openly
access > partner
23

24. PROGRAMS FOR INFECTIOUS
DISEASE
United states:
Best Practices for
HIV Prevention
Program
Malaysia:
Program Sihat
Tanpa AIDS untuk
Remaja (PROSTAR)
Developedcountry
Developingcountry
24

25. EARLY
PREGNANCY
N A T R A H A B D U L R A N I
25

26. DEVELOPING COUNTRIES
• Almost 95% occur in developing countries (2% in China to
18% in Latin America and the Caribbean)
• An analysis of survey data from 51 developing countries
from mid-1990s to early 2000s showed that almost 10% of
girls were mothers by age 16, with the highest rates in sub-
Saharan Africa and South-Central and South-Eastern Asia.
• About 90% of births to adolescents occur within
marriage. (the proportion is close to 100%in Western
Asia/Northern Africa, Central Asia and South Central and
South-Eastern Asia, while between 70% to 80% in South
America and in sub-Saharan Africa.
EARLY PREGNANCY
26

27. Developed countries
• Less than 1% per year in places like Japan and
Republic of Korea, to over 20% per year in the
Democratic Republic of Congo, Liberia and
Niger.
27

28. • Girls they may be have limited educational
and employment prospects;
• May be unable to refuse unwanted sex or to
resist coerced sex;
• Some of them do not know how to avoid a
pregnancy or are unable to obtain
contraceptives.
Factors That Contribute
To This Phenomenon
28

29. • Studies have shown rates of newborn death to average about 50%
higher to adolescent mothers versus mothers in their 20s (Macro
International 2008).
• As with health risks to the mothers, a combination of physical and
socioeconomic factors place babies of youngest mothers at higher
risk of dying.
• Studies have shown an independent adverse effect of early
pregnancy on newborn health, even after controlling for a range of
other factors (Conde-Agudelo et al. 2005; WHO 2007).
• A large U.S. study found a 55% higher risk of neonatal death to
babies of mothers aged 10-15, a 19% higher risk in babies of 16-17
year-olds, and a 6% higher risk in babies of 18-19 year-olds.
• The adverse impact of poor newborn health due to adolescent
pregnancies can have inter-generational effects and also long term
effects leading to adulthood disease (Fetal Origins of Adulthood
Diseases).
Too-early Childbearing IMPACTS The Survival Of The
Newborns:
29

30. Healthcare services
provided
Mothers and babies need care in pregnancy, for
childbirth and after birth. It must be delivered as
a continuum of care that starts in the household
and community and extends into the healthcare
system, including care for complications.
1)Individual, Family And Community Care
2) Outpatient And Clinical Care
3)Health Systems Features
30

31. SOCIAL MEDIA
N A T R A H A B D U L R A N I
31

32. SOCIAL MEDIA
Most commonly used by teens:
Text Messaging
(example: cell phone feature)
Social Networking Sites
(example: Facebook, Instagram,
Twitter )
Online Video Sites (example:
YouTube)
Online Gaming
( example: SecondLife.com)
Blogging Within Social Networking
Sites
(example: Facebook)
32

33. Risks Of Social Media:
• Negative Effect On Mental Health;
• Cyber Bullying;
• Dangers Of Sexual Solicitation;
• Exposure To Problematic ;
• Illegal Content ;
• Privacy Violations.
33

34. HOW IT HAPPENDED???
• Adolescents are exposed to
information from all across the
world;
• This exposure is unsupervised;
• Increasing use of electronic gadgets.
34

35. TEACHING KIDS TO BE SMART ABOUT
SOCIAL MEDIA
• Be SafeS
• Don’t Meet upM
• Accepting emails can be dangerousA
• ReliableR
• Tell someone!T
35

36. Tobacco smoking among
teenagers
36

37. Prevalence of tobacco smoking among
male : world (WHO 2015)
0%
20%
40%
60%
80%
17% 22%
28%
43%
53%
60%
76.2%
prevalence
of male
smokers
37

38. Prevalence of smoking among
adolescent in Malaysia, Singapore,
Indonesia
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
Singapore Malaysia Indonesia
11.7%
33.2%
41%
5.9%
1.9%
3.5%
male
female
38

39. • The level of prevalence does reflect the effort
and progress of smoking prevention strategies
done by each country.
• Female in Asian country has maintained low
prevalence because it is not culturally
acceptable for Asian women to smokes
tobacco. But otherwise, males are acceptable
and it is even considered as norm or family
“tradition” among male in Indonesia.
39

40. Factors motivate teenager to smoke
• Triad of PERSONAL, PEERS, ENVIRONMENT
Personal
PeersEnvironment
40

41. Factors motivate teenager to smoke
Adult vs Adolescent
• Adult: personal factor > environment & peer
• Adolescent: peer > environment > personal
• In adolescent: peer > important than family
* extremely vulnerable to negative peer
pressure
41

42. • Peer influence : by far is the most common
cause of teenagers to start smoking
• Environment: having family members who are
also smoking ( father, brother). Environment
conducive for smoking : peers; +acceptability
attitude toward smoking in the family, no
strict enforcement of smoking ban.
• Personal: stress, curiosity, to gain confidence
42

43. TEENAGERS characteristics
teenagers
confused
curious
selfish
emotional
rebellious
adventurous
independant
reckless
43

44. New challenges
• Recently there is emergence of many alternative tobacco/
E-cigarette product which was ‘perceive’ less harmful and
starting to gain popularity among teenagers ( attract more
teenagers)
• Problem is there is not much study on the safety of
smokeless tobacco and not much evidence to prove yet
that shisha/ E -cigarette product are harmless to health
• In addition to that, a study noted that more teenagers have
initiated to smoke E-cigarette since its introduction. The risk
of teenager to change from E-cigarette to real cigarette is
real. If it happens, it may ultimately increase the prevalence
of tobacco smokers in future.
44

45. Programs for smoking adolescent
• Government are currently strengthening the effort
to de-normalize smoking culture in malaysia
through increasing smoking-banned places.
• Prohibition of selling cigarette to adolescent below
18 years old;
• Through School Health team, promotion on
smoking cessation clinic was done regularly. All
Young Smokers are welcomed to be registered and
be referred to Smoking cessation clinic nearby for
further treatment.
45

46. Substance/alcohol abuse
46

47. Drug abuse in Malaysia
47

48. Drug abuse in Malaysia
• According to National antiDrug Agencies, it is reported
that in 2015, 6.74% of new drug addict are teenagers <
19years old.
• It shows Increasing trend from previous year, same with
the trends in Indonesia. They also noted that Most of the
drug addicts has started abusing drug since their
adolescent age.
• Most used drugs are: Opioid (55%), meth (34%),
marijuana (6%)
• Causing euphoria/ excitement – more easily to get
addicted than tobacco and tends to craving for more.
48

49. Factor causing drug abuse in teenagers
Drug
abuse
Peers
(63%)
Curiosity
(15%)
Excitement
(9%)
Stress (6%)
49

50. Alcohol abuse
Malaysia: mainly involves majority
non-muslims teenagers compare to
muslims (religion banning)
• Prevalence of consuming alcohol (past 1 week) are
reported at 43% among teenagers (age15)
• Consistent with prevalence in UK
• Family and environment factors plays a big role in
leading to underage alcohol consumption
50

51. Program in Ministry of Health to
battling substance abuse & tobacco
smoking
• In contrast with tobacco smoking, the health effects from
substance abuse are more catastrophic. “Once affected,
difficult to treat”
• Thus our main program is mainly focus on primary
prevention to ensure that teenager avoid substance abuse
at all cost and tobacco smoking as well.
• Regularly, school health team will come to school & gives
talk on adolescent health combine with health exhibition.
• Despite that: we need “positive peers influence” to make
teenagers participate in healthy lifestyle.
51

52. Kelab Doktor Muda
• program collaboration between Ministry of Health &
Ministry of Education.
• Health team will train students on health modules to
become health representatives at school.(facilitator)
• These students then will be appointed as “young doctor”
and will lead and advice their peers on healthy behavior.
They will convey health education to their peers too. Aim
for: primary prevention of disease
• Gives health education and
awareness – avoid smoking
and substance abuse,
apart from promoting
healthy lifestyle.
52

53. CONCLUSION
• Teenagers are our future: our next generations’s
hope
• Teenagers are unique: unstable & vulnerable
• Teenagers need different approach than adult
• Peers/ environment are major factors influence
them for healthy/unhealthy behaviour
• Our programs in dealing issues above needs
changes of environment and peer involvements.
Parents play a vital role of being a role model to
guide them and provide supportive and healthy
environment for their child.
53