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Adolescents and Reproductive Health

Adolescents and Reproductive Health. Shiv Chandra Mathur Professor of Preventive and Social Medicine. Director, State Institute of Health and Family Welfare,Rajasthan, Jaipur 302004, India. What is Adolescence.

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Adolescents and Reproductive Health

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  1. Adolescents and Reproductive Health Shiv Chandra Mathur Professor of Preventive and Social Medicine. Director, State Institute of Health and Family Welfare,Rajasthan, Jaipur 302004, India Shiv Chandra

  2. What is Adolescence • It is the transitional period separating childhood and adulthood. • It is the phase of life when certain specific anatomical, physiological and psychological changes occur in the body. Shiv Chandra

  3. Defining the Young • Adolescents 10-19 years • Early adolescence 10-14 years • Late adolescence 15-19 years • Youth 15-24 years • Young People 10-24 years • Youth Policy of India includes people unto the age of 35 years. Shiv Chandra

  4. Changing World of Adolescents • Globalization of trade/economic relationships • Mass Communication and the development of a youth culture • Modes of Governance and exclusion of certain social group • Decentralization of decision making • Changing nature of work,requiring new skills and capacities • Urbanization and Migration • Emerging and resurgent diseases particularly HIV/AIDS • Changing Family structures and dispersal of family members • Trafficking in illicit drugs and human trafficking • Conflict and social disruption Shiv Chandra

  5. Psychological changes in Adolescence • Internalized sense of Identity. • Drawing apart from old members of family. • Intense relationship with Peers. • Strong Emotions.Gradual move from involvement with same sex to mixed group. • Greater creativity. Energy, new ideas and skills. Shiv Chandra

  6. Reproductive Health Problem of Adolescents • Too Early Pregnancy* • Unwanted Pregnancy • STD/RTI/HIV/AIDS • Failure to negotiate for contraceptive use Shiv Chandra

  7. Figure 3: Percentage of Women Giving Birth by Age 20, by Level of Education 100 Noeducation PrimaryGrade SecondaryGrade 50 Asia Africa Latin America and the Caribbean Shiv Chandra

  8. Rights (CRC) denied by Early Marriage • The right to education (Article 28) • The right to be protected from physical/mental violence(Article 19) • The right from all forms of sexual protection (Article 34) • The right to highest attainable standards of Health (Article24) • The right to education/vocational guidance (Article 28) • The right to rest/participate freely in cultural life (Article31) Shiv Chandra

  9. Contributing Factors Early Marriage Poverty Gender Discrimination Lack of IEC Inability to negotiate contraceptive use Social Consequences High IMR/MMR Higher Health Costs Higher Social Welfare Costs Reduced Prospects for eradicating Poverty Reduced Demographic Bonus Consequences of Limited Investments in ARHEarly Pregnancy and Childbearing Shiv Chandra

  10. Contributing Factors Lack of Reproductive Rights Low access to IEC/Contraceptives Gender Bias Sexual Violence Poverty Social Consequences Reduced Investments in Children’s needs and development Reinforcement of Gender Inequality Increased Population Momentum Consequences of Limited Investments in ARHUnwanted Pregnancy Shiv Chandra

  11. Basic Errors in Sex Education • To talk at wrong level • To place things in too favorable a light • To be too problem oriented • To be too abstract Shiv Chandra

  12. Shiv Chandra

  13. ABC approach - UNGASS, 2001 • Abstain from sexual relations (Delay!) • Be faithful to one uninfected partner • Condom - consistent and correct use • Drugs and Alcohol - avoid Shiv Chandra

  14. Improving Voluntary Counseling and Testing for Youth • Training of service providers on counseling • Availability of privacy • Free or reduced price of tests for youth • Outreach to schools/youth groups • Multimedia campaigns to inform youth • Referral system for young clients Shiv Chandra

  15. Service Providers Specially trained staff Respect for Young People Privacy/confidentiality honored Adequate time for client-provider interaction Peer-counselorsavailable Health Facilities Convenient hours/location Adequate space and sufficient privacy Comfortable surroundings What makes Health Services Youth-Friendly Shiv Chandra

  16. Program Design Involvement of youth No overcrowding Wide range of services Necessary referrals Affordable Fee Other measures IEC material for taking away GroupDiscussions available What makes Health Services Youth-Friendly - ll Shiv Chandra

  17. Service Providers to Youth • Teachers. • Peer Educators. • Nurses. • Community Workers. • Doctors. Shiv Chandra

  18. Shiv Chandra

  19. Millenium Development Goals • Eradicate extreme poverty and hunger • Achieve universal primary education • Promote Gender Equality and Empower women • Reduce Child Mortality • Improve Maternal Health • Combat Malaria,HIV/AIDS and other diseases • Ensure Environmental Sustainability • Develop a global partnership for development Shiv Chandra

  20. Lessons for the Future • Involvement of Policy-Makers, Government Leaders and Civil Society Leaders • Community Participation for Youth-friendly Policy • Gender Awareness and Equity • Social Mobilization for Higher Age at Marriage • Safer Sex practices to be promoted Shiv Chandra

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