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Adolescent Health-An Overview. DR.HARIVANSH CHOPRA MD.,D.C.H. ASSOCIATE PROFESSOR LLRMMC MEERUT. THREE STORIES WITH SIMILAR ENDING. NINA URBAN ADOLESCENT. CHETAN ADOLESCENT BOY. RESHMA RURAL ADOLESCENT. APPARENTLY HEALTHY SON OF A DOCTOR. EXPERIMENTING SEXUALLY.

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Adolescent Health-An Overview


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slide1

Adolescent Health-An Overview

DR.HARIVANSH CHOPRA

MD.,D.C.H.

ASSOCIATE PROFESSOR

LLRMMC MEERUT

slide2

THREE STORIES WITH SIMILAR ENDING

NINA

URBAN ADOLESCENT

CHETAN

ADOLESCENT BOY

RESHMA

RURAL ADOLESCENT

APPARENTLY HEALTHY

SON OF A DOCTOR

EXPERIMENTING

SEXUALLY

DEVELOPING RAPIDLY

TEENAGE PREGNANCY

NEVER SCREENED

EARLYMARRIAGE

ABORTION R.M.P.

+HISTROY OF CHD

TEENAGE PREGNANCY

DEATH

slide3

Adolescent Health-An Overview

ALL THESE EVENTS ARE THE EXAMPLES OF SYSTEM FAILURE

SYSTEM WHICH IS INSENSITIVE TO

THE NEEDS OF ADOLESCENT

slide4

DISADVANTAGE

  • DOUBLE DISADVANTAGE
  • CARRY THE BURDEN OF PRE EXISTING DISEASES OF CHILD HOOD
  • DEVELOPING RAPIDLY AND HAVING EXTREME DEGREE OF PRESSURE
  • FROM PEERS, PARENTS, SOCIETY AND SELF

LACK KNOWLEDGE AND SKILL TO COPE UP

WITH PRESSURE

Adolescent Health-An Overview

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Adolescent Health-An Overview

No longer Children, Not Yet Adults

Young people

10-24 Years

Adolescence

10-19 years

Youth

15-24 Years

adolescent health an overview
Adolescent Health-An Overview

Population Profile: Ages 10-24 Years in India

Population Reference Bureau. Inc.

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Adolescent Health-An Overview

India: Country of Diversity

  • 5,000 year old civilization
  • 325 languages spoken – 1,652 dialects
  • 18 official languages
  • 29 states, 5 union territories
  • 3.28 million sq. kilometers - Area
  • 7,516 kilometers - Coastline
  • 1,000,000,000 people in 2000
  • 207 Million Adolescents
slide8

Adolescent Health-An Overview

Adolescents: A Very diverse population segment

  • Different stages of development
  • Different circumstances
  • Different needs and
  • Diverse problems
slide9

Adolescent Health-An Overview

Adolescents have important subgroups with markedly different needs:

Urban

Rural

Slum

Street Children

Those in specially difficult circumstances

slide10

Adolescent Health-An Overview

Why Focus on Adolescents?

  • Large number >22% of the population (Approximately 207 Million of our population);
  • Adolescence is a period of rapid physical growth, sexual and psycho-social changes;
  • Habits and behavior picked up during adolescence (Risk taking behavior, substance abuse, eating habits, conflict resolution) have life long impact.
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Adolescent Health-An Overview

Why Focus on Adolescents?

  • Adolescence is the last chance to correct growth lag and malnutrition;
  • Many adolescent boys and girls are sexually active but lack information and skills for self protection (Low level of information on FP, low contraception use);
  • Have simple, but wide pervading and crucial RH needs – menstrual hygiene, contraception; (including Emergency Contraception), safety from STI/HIV;
  • Communication gap exists with parents and other adults (Lack of family “Connectedness”);
slide12

Public Health Implications

  • 70% of mortality in adulthood is linked to habits picked up during adolescence. (Risk taking behavior, substance abuse, eating habits, conflict resolution);
  • Prevailing malnutrition, anemia, stunting and lack of immunization has adverse impact on MMR, IMR, morbidity and have inter- generational effects;
  • Adolescent sexuality: leads to adolescent pregnancy, unsafe abortions, RTI, STI/HIV and social problems;
  • Adolescent pregnancy : Risk of ADVERSE outcome (IMR, MMR, LBW babies) is higher;
  • Lack of “connectedness” with parents and other adults prevents transmission of health messages and crucial skills, leading to adoption of risky behavior- substance abuse, early sexual debut, STI/HIV etc.
adolescent health an overview1
Adolescent Health-An Overview

Characteristics

  • A – Aggressive Anaemic Abortion
  • D – Dynamic,Developing,Depressed
  • O – Overconfident,Overindulging,Obese
  • L – Loud but lonely,& Lack information
  • E – Enthusiastic,Explorative,& Experimenting
  • S – Social,Sexual, & Spiritual
  • C – Courageous,cheerful, &concern
  • E – Emotional,Eager,& Emulating
  • N - Nervous,Never say no to peers
  • T – Temperamental,Teenage pregnancy
slide14

Ill Health Recipe: “Ye Dil Mange More” Lifestyle of Adolescents

Tobacco/Alcohol

Excess dietary FAT

Lack of vegetables

& fruits

Sedentary habits

Sexual behavior/ poor genital hygiene

Adolescent Health-An Overview

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Adolescent Health-An Overview

A Common Scenario

  • 14 Year old school girls in a big City X:
  • Out of 100 girls:
    • 60 have never had sex;
    • 15 have had sex, but are not currently sexually active;
    • 25 are sexually active more or less regularly
    • 8 have had health problems;
    • 2 have been coerced into having sex;

All these girls have different needs for health information, services and social support

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Adolescent Health-An Overview

Evidence of Common Roots*

Risk & Protective factors foradolescents

Early Sex

Substance Use

Depression

A positive relationship with parents

Conflict in the family

A positive school environment

Friends who are negative role models

A positive relationship with adults in the community

Having spiritual beliefs

Engaging in other risky behaviours

*”Broadening the Horizon” Evidence from 52 countries

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Adolescent Health-An Overview

Priority Health Problems

  • Sexual and reproductive health problems
  • Nutritional problems
  • Mental health problems
  • Substance abuse
  • Accidental and intentional violence

Clustering of problems

slide18

PREVALENCE OF ANAEMIA IN ADOLESCENT-MEERUT

42

36

34

Adolescent Health-An Overview

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Adolescent Health-An Overview

Health problems

  • Large number are malnourished, and anaemic – (56% Baroda study, 95% SWACH study), or stunted (59% boys, 37% girls- NNMB 2000);
  • Obesity is increasing,8-10% in public schools of Meerut and Delhi.
  • Adolescent pregnancy – common (50%of women in india had a child before reaching the age of 20-

IP-JAN 2004)

  • Large number of adolescents are – still un-immunized. (TT,RUBELLA );
slide20

Adolescent Health-An Overview

HEALTH PROBLEMS

  • One out of 10 children in India is sexually abused at any given point of time (WHO)
  • Sexual problems;25%of patients attending Government STI clinics are Younger than 18
  • Year old (Ramasubban-1995)
  • Increasing vulnerability to HIV/AIDS,Over 50%of all new HIV cases in india are among 10-
  • 24years (UNAIDS-2002)
  • Substance abuse is quite common
slide21

PROGRAMMES FOR ADOLESCENTS

KISHORI SHAKTI YOJANA –To improve the health and

nutritional status of girls

BALIKA SAMRIDHI YOJANA –To Delay the age of marriage

NEHRU YUVA KENDRA – ACT AS HEALTH AWARENESS

UNIT-Through active participation

of youth

MAHILA SAMAKHYA PROGRAMME- Equal access to education

facilities for adolescent girls

and young women

Adolescent Health-An Overview

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Adolescent Health-An Overview

PROGRAMMES FOR ADOLESCENTS

SCHOOL AIDS EDUCATION, UNIVERSITY TALKS AIDS

TRAINING OF RURAL YOUTH FOR SELF EMPLOYMENT

REPRODUCTIVE AND CHILD HEALTH PROGRAMME

? WHERE ARE THE BOYS

NO COMPREHENSIVE PROGRAMME ADDRESSING ALL NEEDS OF ADOLESCENT

adolescent health an overview2
To promote healthy development to meet needs and build competencies

To prevent and respond to health problem from:

Early, unprotected,

unwanted sex

Use of tobacco and misuse of alcohol and other substances

Accidents

Violence

Poor nutrition

Endemic disease

Adolescent Health-An Overview

Programming

slide24

STRATEGIES FOR PROMOTION OF ADOLESCENT HEALTH

A =ADOPTION OF HEALTHY LIFE STYLE

D=DEVELOP APPROPRIATE I.E.C. STRATEGY

DISCOURAGE EARLY MARRIAGE AND TEENAGE PREGNANCY

O=ORGANIZE ADOLECENT/ YOUTH FRIENDLY CLINIC

L=LIFE SKILL EDUCATION , LEGAL SUPPORT, LIASIAN WITH PEERS , PARENTS

E=EDUCATE ABOUT SEXUALITY,SAFE SEX,SPIRITUALITY,RESPONSIBLE

PARENTHOOD

S=SAFE, SECURE AND SUPPORTIVE ENVIRONMENT TO BE PROVIDED

C=COUNSELLING / CURRICULM IN SCHOOL INCUSIVE OF FAMILY

LIFE EDUCATION

E=ENABLE &EMPOWER FOR RESPONSIBLE CITIZENSHIP

N=NETWORKING FOR EXPERIENCE SHARING

T=TRAINING FOR INCOME GENERATION,TEEN CLUBS

slide25

Adolescent Health-An Overview

IAP HAS MADE AN ADOLESCENT

CHAPTER

EXISTING HEALTH FACILITIES

MUST BE MADE ADOLESCENT

FRIENDLY

IAPSM HAS GOT THE INSIGHT

LET US JOIN TOGETHER AND

TAKE APPROPRIATE ACTION

LET US WORK WITH YOUTH

NOT MERELY FOR YOUTH

AND MAKE THEM CHANGE

AGENTS

slide26

Adolescent Health-An Overview

THE CHALLENGES ARE THERE BUT

POTENTIAL IS FAR GREATER

Thank You!