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Situation of Adolescent Health

Media Seminar on preventing school girls pregnancies and keep girls in school in Tanzania Ubungo Plaza 29 th July, 2010 Isaac Njau – MoHSW/RCHS. Situation of Adolescent Health. About 65 per cent of Adolescents are below 25 years while those aged 10 – 24 years constitute 31 percent.

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Situation of Adolescent Health

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  1. Media Seminar on preventing school girls pregnancies and keep girls in schoolin Tanzania Ubungo Plaza 29th July, 2010Isaac Njau – MoHSW/RCHS

  2. Situationof Adolescent Health About 65 per cent of Adolescents are below 25 years while those aged 10 – 24 years constitute 31 percent. A high percentage of adolescents are sexually active and practice unsafe sex.

  3. Situation of Adolescent Health… • Consequently the majority are highly vulnerable to SRH problems that;include adolescent pregnancy and early child bearing,the complications arising from unsafe abortion,STIs including HIV/AIDS. • OVC girls are slightly more likely to initiate sex before age of 15, while OVC boys initiate sex later than non OVC boys (THMIS 2007/08)

  4. Situation of Adolescent Health… Sexual Behaviour • Adolescents develop an interest in sex as their bodies change and mature. The median age at first intercourse for women is 17.3 and 18.5 years for men. • Many girls are coerced into having sex as they lack the power, confidence and skills to refuse unwanted sex or to negotiate safer sex. Poverty often forces girls into commercial sex work.

  5. Adolescent Pregnancy and child bearing • In Tz a quarter of girls btwn 15-19 of young women are pregnant or already mothers • Perinatal mortality rate is significantly higher for young women under the age of 20 (56 per 1,000 pregnancies, than for aged 20-29(39/1000) - (TDHS 2004/05 ) • Teenage pregnancy and the subsequent dropout of girls from school has a negative implications in their health and development and for the country to achieve MDG , 4 and 5

  6. Adolescent pregnancy……….. • In developing countries Maternal mortality among adolescents girls under 18 yrs is 2-5 times higher than those aged 18-25yrs. • Pregnancy complications are the main cause of deaths for 15 -18 yrs old girls worldwide • Children born to adolescents aged 15-19 are at higher risks of death during the first 5 yrs of life (28%),compared to age 20-29

  7. Adolescent pregnancy……… Risks associated with Adolescent Pregnancy and Child Bearing • Adolescent pregnancy carry a greater risk to the health of both mother and baby,than adult women. • Adolescent pregnancies are currently a major sexual and reproductive health concern in Tanzania. • Young Maternal Age,Low social status, and Inadequate access to health care, contribute to high Maternal Mortality.

  8. Adolescent pregnancy………. Risks during antenatal Period • Pregnancy Induced hypertension ( hyperternsive disease of pregnancy ) • Anaemia:caused by nutritional deficiencies, malaria, and intestinal parsites.Vit A deficiency, and HIV Infection may also contribute. • STIs/HIV:Youth (15 – 24) accounts for 60 percent of the new HIV infections (THMIS 2007/8)Young women aged 15 - 19 years are 4 times more likely to contract HIV than their male counterparts.

  9. Antenatal Risks cont…….. • Higher severity of Malaria:Most important cause of anaemia during pregnancy.

  10. Labour and delivery • Pre –term births:Women under 19 yrs of age ,are at increased risk of pre term delivery (immaturity of genital ograns,social factors-poverty, lack optimal antenatal care. • Obstructed labour: Due to cephalopelvic disproportion in girls 15 yrs and below- immaturity of pelvic bones,small size of birth canal and fistula

  11. Risks during Post Partum period • Anaemia • Pre – enclampsia: first postpartum days • Too early repeated pregnancies:Due to limited access to contraceptive,unproted intercourse and repeated pregnancy have been found in as many as 50% of those young women within 24 months of delivery. • Post partum depression, or other mental depression.

  12. Problems affecting the baby • Low birth weight : Higher incidence of low birth weight ( less than 2500 gms) among infants of adolescents mothers. • Perinatal and neonatal mortality: Higher rates of Perinatal and Neonatal mortality rates in infants of adolescents mothers, compared to older women.

  13. Problems affecting baby……. • Inadequate child care and breastfeeding practices: Young mothers and single, in diff. socio economic situation, make it hard to provide proper care to their children.

  14. Why complications worse in adolescents than adults? 1.Biologically young adolescents are not mature enough for strain imposed on them by pregnancy. 2.Less empowered to make decisions about matters affecting their health. 3.Are likely to be enrolled later and to make fewer health facility visits for ANC. 4.In many places adolsecents delver at home. They visit h/f only as alast resort, often with serious complications.

  15. Why worse than…….. Factors to deliver at home: • Social and cultural norms. • Afraid of hospital. • Discouraging stories about mistreatment by hospt.staff. • May be unable to bear hospital charges. 5.In many places unmmaried adolescents are treated with scant respect by medical and nursing staff.

  16. UNSAFE ABORTION Magnitude of unsafe abortion. • In Tz, it is estimated that abortion contribute about a third of all maternal deaths and leaves a substantial number of women with debilitating consequences of abortion.( Kinoti et al 1994). • In a study of 300 respondents, 72 (24 %) of respondents were young girls less than 20 yrs/

  17. Unsafe abortion…….. • ¾ of them agreed that their pregnancies had not been planned and re –wanted. • 50% of them did induced abortion.

  18. Consequences of unsafe abortion. Medical consequences Major short term complications: • Cervical or vaginal lacerations. • Sepsis/infection • Haemorrhage /excessive blood loss • Perforation of the uterus or bowel • Tetanus • Pelvic infection or abscess

  19. Medical conseq…….. • Excessive blood loss leads to anaemia. • Both infection and anaemia are common cause of deaths.

  20. Long term medical complications: • Secondary infertility- a particularly heavy life long burden • Spontanous abortion in a subsequent pregnancy, • Increased likelihood of both ectopic pregnancy and pre term labour.

  21. Psychological consequences • A sense of loss and reactions of grief. • Guility that extends beyond the abortion itself, for being engaged in sexual relations

  22. Social and economic conseq…. • Leave school, and face disapproving attitudes. • Thrown out by their families • Marry early • Get poorly paid jobs • Tempted or forced into prostitution.

  23. CONCLUSION The need to invest in adolescent Sexual and Reproductive Health ( SRH ) Services including HIV/AIDs is paramount; given the fact that SRH needs are not only basic human rights, but adolescents form a significant section of the population and been a disproportionate burden of disease with regards to reproductive ill – health and HIV prevalence.

  24. THANK YOU FOR LISTENING TOGETHER WE CAN MAKE A DIFFERENCE. ‘’TOO OLD FOR TOYS, TOO YOUNGER FOR MOTHERHOOD’’

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