Overview of adolescent reproductive rights and health in nigeria
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OVERVIEW OF ADOLESCENT REPRODUCTIVE RIGHTS AND HEALTH IN NIGERIA. BY C.I. Alakija-Ladapo (Mrs.) MPH; BSc ( Ed) Health Education Deputy director/ Coordinator Adolescent/Youth Sexuality & Reproductive H ealth Ministry of Health, Lagos, Ikeja AT

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Overview of adolescent reproductive rights and health in nigeria

OVERVIEW OF ADOLESCENT REPRODUCTIVE RIGHTS AND HEALTH IN NIGERIA

BY

C.I. Alakija-Ladapo (Mrs.)

MPH; BSc (Ed) Health Education

Deputy director/Coordinator

Adolescent/Youth Sexuality & Reproductive Health

Ministry of Health, Lagos, Ikeja

AT

A TWO-DAY TRAINING OF TRANINERS’ WORKSHOP FOR SCHOOL DISTRICT COUNSELLORS AND SCHOOL GUIDANCE COUNSELLORS

Friday 21st June 2013

HDI Training room 2, Onike, Yaba.


Prelude

PRELUDE


What is health

What is Health?

  • A state of complete physical, mental and social wellbeing;

  • Not merely the absence of disease. (W.H.O.)

    Reproductive Health:

    …Not merely the absence of reproductive disease or infirmity.


Overview of adolescent reproductive rights and health in nigeria

Reproductive health implies that at all stages of life…

  • People are able to have a satisfying and safe sex life and

  • That they have the capability to reproduce and

  • The freedom to decide if, when and how often to do so.


What is a right

What is a Right?

  • Rights are fundamental normative rules about what is allowed of people or owed to people, according to some legal system, social convention or ethical theory.


Overview of adolescent reproductive rights and health in nigeria

REPRODUCTIVE HEALTH IS EVERYONE’S RIGHT!!!

Young or Old


Overview of adolescent rights and health in nigeria

OVERVIEW OF ADOLESCENT RIGHTS AND HEALTH IN NIGERIA

  • Introduction to Adolescent health

  • Adolescent developmental processes and behaviour

  • Factors associated with adolescent health status and key issues in programming for adolescent health and development


Introduction to adolescent health

Introduction to Adolescent Health


Objectives

Objectives

By the end of the session participants will be able to:

  • Explain the concept of adolescence;

  • Define adolescence, adolescent, youths, and young person;

  • Discuss rationale for focusing on adolescent health based on the demographic and health situation of adolescents and young people in Nigeria;

  • Discuss key legal and policy provisions regarding the definition of adolescents and young persons in Nigeria.


Session overview

Session Overview

  • The concept of adolescence

  • Age definition of adolescent, youth, and young persons

  • Rationale for focusing on adolescent health

  • Key legal and policy provisions regarding the definition of adolescents and young person in Nigeria


Overview of adolescent reproductive rights and health in nigeria

The Concept of Adolescence & Chronological Definitions


Adolescence a transition phase

Adolescence… A Transition Phase

Adolescence is a period of transition between childhood and adulthood: it is a period in which ‘although no longer considered a child, the young person is not considered an adult either’.


Adolescence

Adolescence…


Adolescence is a developmental stage where

Adolescence…is a developmental stage where:

  • Young people develop their adult identity.

  • Move toward physical and psychological maturity, and

  • Become (relatively) economically independent.

    - WHO


Defining adolescents other young people nigeria who

Young People

10

24

Youth

15

24

Adolescence

19

10

Defining Adolescents & Other Young People.. (Nigeria & WHO)


Adolescents

Adolescents

Adolescence can be subdivided into three periods:

  • Early: 10-14 years

  • Middle: 15-17 years

  • Late: 18-19 years


Adolescents are not homogeneous

Adolescents are not homogeneous….

Needs of adolescents can differ based on…

  • Demographic characteristics: e.g. age & sex,

  • Family characteristics: e.g. family status, structure

  • Socio-economic: e.g. poverty, literacy

  • Sexual behavior: e.g. sexual orientation, sexual risk

  • Health status: e.g. physically-challenged

  • Political context

  • Legal context

    e.t.c


Overview of adolescent reproductive rights and health in nigeria

Rationale for Focusing on Adolescent Health


Why focus on adolescent health development issues

Why Focus on Adolescent Health & Development Issues?

  • Demographic rationale

  • Health rationale

  • Human rights rationale

  • Economic rationale


Overview of adolescent reproductive rights and health in nigeria

  • Adolescents constitute about 20% of global pop.


Adolescent population by region 2003 and 2050

Adolescent Population by Region, 2003 and 2050

Reproduced from UNFPA, State of the World Population, 2003


Why focus on adolescent health development issues contd

Why Focus on Adolescent Health & Development Issues? (contd.)

  • Human rights rationale: rights to

    • Information & skills development

    • Safe and supportive environment

    • Health services

    • Development opportunities

  • Economic rationale

    • Averting future health costs

    • Cost-effective interventions

    • Potentials of healthy adolescents to contribute to national economy


Health rationale

Health rationale

  • ARH status has significant implications for human reproduction and health development

  • Feasibility of “simple” and cost-effective interventions

  • Prevention of later health problems

  • Leading adolescent health problems

  • Sexual and reproductive health problems

  • Intentional and unintentional injuries

  • Mental health problems

  • Substance use and abuse Nutritional problems

  • Endemic and chronic diseases


Comprehensive knowledge of hiv among people 15 24

Comprehensive Knowledge of HIV among People 15-24

Percent of women and men age 15-24 with comprehensive knowledge of HIV/AIDS*

*Comprehensive knowledge includes knowing that the risk of getting HIV can be reduced by using condoms and limiting sex to one uninfected partner, knowing that a healthy looking person can have HIV, and rejecting the two most common local misconceptions about HIV prevention and transmission.


Age at first sex condom use

Age at First Sex & Condom Use

  • 49% of women 18-24 had sex before age 18 and 16% of women 15-24 had sex before age 15

  • 26% of men 18-24 had sex before age 18

    • 11% of women 15-24 and 22% of men 15-24 used a condomat first sex


Premarital sex condom use

Premarital Sex & Condom Use

Among never-married people 15-24, percentage


Age at first sexual intercourse and first marriage nigeria 2008

Age at First Sexual Intercourse and First Marriage, Nigeria, 2008

Percent of women

age 25-49

Source: NDHS, 2008


Teenage pregnancy and motherhood

Teenage Pregnancy and Motherhood

18.0% of women between the ages of 15-19 are already mothers and another 4.8% are pregnant with their first child in 2008.


Teenage childbearing in nigeria 2008

Teenage Childbearing in Nigeria, 2008

Percent of women age 15-19 who are mothers or pregnant with their first child

Source: NDHS, 2008


Teenage childbearing by zone 2008

Teenage Childbearing by Zone, 2008

Nigeria

23%

North West

45%

North East

39%

North Central

22%

Percent of women age 15-19 who are mothers or pregnant with their first child

South West

9%

South

South

12%

South

East

8%

Source: NDHS, 2008


Recent hiv tests among people 15 24

Recent HIV Tests among People 15-24

Percent of women and men 15-24 who have had sex in the past year and who received an HIV test in the past year


Other health problems

Other Health problems


Overview of adolescent reproductive rights and health in nigeria

School-based violence


Overview of adolescent reproductive rights and health in nigeria

Prevalence of some forms of school related violence by urban-rural location of schools in Osun state, Nigeria.

[Source: Omisore et al 2010]


Nutrition

Nutrition


Substance use and abuse

Substance Use and abuse


Overview of adolescent reproductive rights and health in nigeria

Key Legal & Policy Provisions about adolescents in Nigeria


Legal provisions

Legal Provisions

  • The Child Rights Act: child: < 18 years.

  • Young People (YP)’s Law: 14-17= YP

  • Consent to sex (criminal code): 14 years for boys &16 years for girls unless she is married.

  • Rape and child prostitution are illegal.

  • Public display of obscene materials: punishable offence.

  • Minimum age for conviction by a court of law is 15 years. 15-17 years: remand homes

  • Work: not less than 15 years of age


Legal provisions key challenge

Legal Provisions.. Key Challenge

  • Law enforcement agents do not adequately enforce and combat violations of sexual rights such as sexual harassment or abuse, rape and domestic violence.


Policies

Policies

  • Several Policies relating to the health & development of adolescents exist

  • Knowledge of policy poor

  • Implementation rate very poor


Adolescent yp s health policy focal areas

Adolescent & YP’s Health Policy: Focal Areas

  • Sexual and reproductive health and rights;

  • Nutrition;

  • Accidents and violence;

  • Mental health;

  • Substance use and abuse;

  • Education;

  • Career and employment;

  • Spirituality;

  • Social adjustment and parental responsibilities.


Other relevant policies include

Other relevant policies include..

  • The National Education Policy (1998)

  • The Child Rights Act (2004)

  • The National Health Policy (2004)

  • The National Population Policy (2004)

  • The National Nutrition Policy (2005)

  • National Policy on HIV & AIDS for the Education Sector in Nigeria (2005)

  • The National School Health Policy (2006)

  • The National Youth Policy (2009)

  • The National Policy on HIV/AIDS (2009)


Conclusions

Conclusions

  • Adolescence is a transitional stage of life, and a period of both opportunities and challenges.

  • With their size and energy, adolescents have great potential to contribute to national development.

  • As a nation, we ned to pay greater attention to adolescent’s health and development.


Overview of adolescent reproductive rights and health in nigeria

Questions & Comments


Reflections evaluations

Reflections/Evaluations

  • What do we mean by Adolescence.

  • Describe some of the key health problems faced by adolescents in Nigeria.

  • List the focal areas of the National Policy on the Health and Development of Adolescents and Young People in Nigeria.


Adolescent development process and behavior

Adolescent Development, Process and Behavior

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Objectives1

Objectives

By the end of the session participants will be able to:

  • Describe the physical, cognitive and emotional changes during the period of adolescence.

  • Explain adolescent’s sexual and social behaviour in the light of the changes above.

  • Explain adolescents’ sexual lifestyles and the effect on their health and development.

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Session overview1

Session Overview

  • Physical, cognitive & emotional changes during the period of adolescence

  • Adolescent’s sexual and social behaviour

  • Adolescents’ lifestyles

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Overview of adolescent reproductive rights and health in nigeria

Adolescent Development Process

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Adolescent development stage progression

Adolescent Development Stage Progression

Socio-econ, cultural & env. factors

Biologic factors

Interaction with peers & adults

Preadolescence

Early adolescence

Middle adolescence

Late adolescence

Youth

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Adolescent development key tasks

Adolescent Development: Key Tasks

  • Moving from dependency to interdependency

  • Establishing a sense of identity

  • Acquiring a knowledge base and skills

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Adolescent development key processes

Adolescent Development: Key Processes

  • Ongoing

  • Uneven (within & between individuals)

  • Complex

  • Influenced by the environment

  • Mediated through relationships

  • Triggered & sustained through participation

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Tasks in adolescence

Tasks in adolescence

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Adolescent development physical physiological processes

Adolescent development: physical & physiological processes

  • Increase in physical size, stamina, strength

  • Development of reproductive capacity

  • Changes in sexual response system

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Overview of adolescent reproductive rights and health in nigeria

Female Pubertal Development

  • Begins 8-13 years

  • Duration: range of 2 to 5 years

  • Menarche 2-2.5 years after.

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Overview of adolescent reproductive rights and health in nigeria

Compared with Females, Male Development

  • Occurs 18-24 months later;

  • Progresses slowly through middle-late adolescence;

  • Early changes are not often as visible.

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Sequential events of puberty

Sequential Events of Puberty:

Male

  • Growth of testicles

  • Pubic hair appears

  • Growth of penis and scrotum

  • Axillary hair

  • Facial hair

  • Adult height

Female

  • Breast bud appears

  • Pubic hair appears

  • Breasts mature

  • Axillary hair

  • Menarche

  • Adult height

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Overview of adolescent reproductive rights and health in nigeria

Adolescent Brain Development

  • Brain development now extends into the adolescent years

  • Most of this development occurs in the frontal lobe

    • Executive functions

    • Planning

    • Reasoning

    • Impulse Control

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Emotional development

Emotional development

  • Experience a mix of emotions

  • Experience a change in moods

  • Desire to be accepted by peers

  • Sensitive to criticism

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Adolescent development social

Adolescent development: social

  • Transition from dependency to interdependency

  • Building social capital

  • Establishing identity

  • Exploring sexuality & relationship

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Overview of adolescent reproductive rights and health in nigeria

SEXUAL AND SOCIAL BEHAVIOUR OF ADOLESCENTS

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Sexual social behavior

Sexual & Social Behavior

Adolescent peculiar lifestyle (“youth culture”)

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Sexual social behavior1

Sexual & Social Behavior

  • Social Behaviour

  • Dating

  • Sexual Behaviour

  • Adolescent lifestyle (“youth culture”

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Conclusions1

Conclusions

  • adolescence is a period of physical, cognitive and emotional transformation.

  • Changes in adolescents are largely hormone-driven & have relationships with adolescents peculiar ways of thinking and doing things.

  • Adolescents’ social behavior and sexuality need to be understood within the context of these transformations.

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Overview of adolescent reproductive rights and health in nigeria

Questions & Comments

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Reflections evaluations1

Reflections/Evaluations

  • List the physical changes that occur in both male and female adolescents.

  • Describe the emotional characteristics of adolescents.

  • Explain the cognitive changes in adolescents and its possible influence on their behaviour.

Adolescent Sexuality Reproductive Health Unit "hellolagos"


Overview of adolescent reproductive rights and health in nigeria

Factors associated with adolescent health status and Key issues in programming for adolescent health and development


Objectives2

Objectives

By the end of the session, participants will be able to:

  • Explain some key factors that affect adolescent development.

  • Describe the comprehensive approach to adolescent health and development.

  • Identify possible interventions to reduce or eliminate the negative factors.


Factors affecting adolescent development

Factors affecting adolescent development

  • Prenatal/Genetic fators

  • Nutrition

  • Social Environment

  • School Environment

  • Traditional Practices and Gender

  • Policies


Risk and protective factors

Risk and Protective factors

  • Protective factors:

    they increase the likelihood of positive health behaviouror moderate and discourage behavioursthat might lead to negative health outcomes.

    Strong connectedness between an adolescent and his parents, for example, is a protective factor.

  • Risk Factors:

    Factors are regarded as “risk” if they increase the likelihood of negative behavioursand outcomes or discourage positive behaviours that might prevent them.


Overview of adolescent reproductive rights and health in nigeria

The green balls represents protective factors

The red triangle represents the risk factors Sources: WHO, 2001.


Key issues in addressing adolescent health challenges

KEY ISSUES IN ADDRESSING ADOLESCENT HEALTH CHALLENGES

GUIDING CONCEPTS

Efforts to address adolescent health challenges must recognise that:

  • Adolescence is a time of opportunity and risk.

  • Not all adolescents are equally vulnerable.

  • Adolescent development underlies the prevention of health problems.

  • Adolescent problems often have common roots and are often inter‐related.

  • Social environment influences adolescent behaviour.

  • Gender considerations are fundamental.


Major interventions

MAJOR INTERVENTIONS

The following categories define the major programmatic approaches that are important to address adolescent health issues:

  • Create safe and supportive environment

  • Provide information

  • Build Skills

  • Provide Counselling

  • Improve health services


Settings and key players

SETTINGS AND KEY PLAYERS

  • Adolescent health interventions can be implemented in virtually all settings where young people can be found.

  • Various stakeholders can bring their knowledge and skills to bear positively on adolescent health development.These include:


Summary

SUMMARY

SEPARATE YOUR ROLE FROM THAT OF THE TEACHER!!

IDENTIFY YOUR ROLE AS A COUNSELLOR and please play it!!


Evaluation

Evaluation

  • Explain the concept of protective and risk factors.

  • Discuss factors that can affect adolescent health and development.

  • Describe some of the issues that should be considered in programming for adolescent health and development


Thank you

THANK YOU!!!

  • ESE, MODUPE!

  • NAGODE!

  • DAALU!

    MERCI BEAUCOUP!!!

    Eko o nibaje o!


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