1、10/9/2018,1,Adolescent Health-An Overview,DR.HARIVANSH CHOPRA MD.,D.C.H. ASSOCIATE PROFESSORLLRMMC MEERUT,10/9/2018,2,THREE STORIES WITH SIMILAR ENDING,RESHMA RURAL ADOLESCENT,DEVELOPING RAPIDLY,EARLY MARRIAGE,TEENAGE PREGNANCY,NINA URBAN ADOLESCENT,EXPERIMENTINGSEXUALLY,TEENAGE PREGNANCY,ABORTION R
2、.M.P.,CHETAN ADOLESCENT BOY,APPARENTLY HEALTHY SON OF A DOCTOR,NEVER SCREENED,+HISTROY OF CHD,DEATH,10/9/2018,3,ALL THESE EVENTS ARE THE EXAMPLES OF SYSTEM FAILURE,SYSTEM WHICH IS INSENSITIVE TO THE NEEDS OF ADOLESCENT,Adolescent Health-An Overview,10/9/2018,4,DISADVANTAGE,DOUBLE DISADVANTAGECARRY T
3、HE BURDEN OF PRE EXISTING DISEASES OF CHILD HOODDEVELOPING RAPIDLY AND HAVING EXTREME DEGREE OF PRESSUREFROM PEERS, PARENTS, SOCIETY AND SELF,LACK KNOWLEDGE AND SKILL TO COPE UPWITH PRESSURE,Adolescent Health-An Overview,10/9/2018,5,No longer Children, Not Yet Adults,Adolescence 10-19 years,Youth 15
4、-24 Years,Young people 10-24 Years,Adolescent Health-An Overview,10/9/2018,6,Adolescent Health-An Overview,Population Profile: Ages 10-24 Years in India,Population Reference Bureau. Inc.,10/9/2018,7,India: Country of Diversity,5,000 year old civilization325 languages spoken 1,652 dialects18 official
5、 languages 29 states, 5 union territories3.28 million sq. kilometers - Area7,516 kilometers - Coastline 1,000,000,000 people in 2000207 Million Adolescents,Adolescent Health-An Overview,10/9/2018,8,Adolescents: A Very diverse population segment,Different stages of development Different circumstances
6、 Different needs and Diverse problems,Adolescent Health-An Overview,10/9/2018,9,Adolescents have important subgroups with markedly different needs: Urban Rural Slum Street Children Those in specially difficult circumstances,Adolescent Health-An Overview,10/9/2018,10,Why Focus on Adolescents?,Large n
7、umber 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 imp
8、act.,Adolescent Health-An Overview,10/9/2018,11,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 u
9、se); 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”);,Adolescent Health-An Overview,10/9/2018,12,Public Health Impl
10、ications,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- generatio
11、nal 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 cr
12、ucial skills, leading to adoption of risky behavior- substance abuse, early sexual debut, STI/HIV etc.,10/9/2018,13,Adolescent Health-An Overview,A Aggressive Anaemic Abortion D Dynamic,Developing,Depressed O Overconfident,Overindulging,Obese L Loud but lonely,& Lack information E Enthusiastic,Explo
13、rative,& Experimenting S Social,Sexual, & Spiritual C Courageous,cheerful, &concern E Emotional,Eager,& Emulating N - Nervous,Never say no to peers T Temperamental,Teenage pregnancy,Characteristics,10/9/2018,14,Ill Health Recipe: “Ye Dil Mange More” Lifestyle of Adolescents,Tobacco/Alcohol,Excess di
14、etary FAT,Lack of vegetables & fruits,Sedentary habits,Sexual behavior/ poor genital hygiene,Adolescent Health-An Overview,10/9/2018,15,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
15、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,Adolescent Health-An Overview,10/9/2018,16,Evidence of Common Roots*,Risk & Protective factors for adolescen
16、ts,Early Sex,Substance Use,Depression,A positive relationship with parents,A positive relationship with adults in the community,Engaging in other risky behaviours,Conflict in the family,A positive school environment,Friends who are negative role models,Having spiritual beliefs,*”Broadening the Horiz
17、on” Evidence from 52 countries,Adolescent Health-An Overview,10/9/2018,17,Priority Health Problems,Sexual and reproductive health problems Nutritional problems Mental health problems Substance abuse Accidental and intentional violenceClustering of problems,Adolescent Health-An Overview,10/9/2018,18,
18、PREVALENCE OF ANAEMIA IN ADOLESCENT-MEERUT,42,34,36,Adolescent Health-An Overview,10/9/2018,19,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 Delh
19、i. 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 );,Adolescent Health-An Overview,10/9/2018,20,One out of 10 children in India is sexually abused at any given point of time (WHO
20、)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,HEALTH PROBLEMS,Adolescent Health-An Overview,1
21、0/9/2018,21,PROGRAMMES FOR ADOLESCENTS,KISHORI SHAKTI YOJANA To improve the health andnutritional status of girlsBALIKA SAMRIDHI YOJANA To Delay the age of marriageNEHRU YUVA KENDRA ACT AS HEALTH AWARENESSUNIT-Through active participationof youthMAHILA SAMAKHYA PROGRAMME- Equal access to educationfa
22、cilities for adolescent girlsand young women,Adolescent Health-An Overview,10/9/2018,22,SCHOOL AIDS EDUCATION, UNIVERSITY TALKS AIDSTRAINING OF RURAL YOUTH FOR SELF EMPLOYMENTREPRODUCTIVE AND CHILD HEALTH PROGRAMME ? WHERE ARE THE BOYSNO COMPREHENSIVE PROGRAMME ADDRESSING ALL NEEDS OF ADOLESCENT,PRO
23、GRAMMES FOR ADOLESCENTS,Adolescent Health-An Overview,10/9/2018,23,Adolescent Health-An Overview,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 substanc
24、es Accidents Violence Poor nutrition Endemic disease,Programming,10/9/2018,24,STRATEGIES FOR PROMOTION OF ADOLESCENT HEALTH,A =ADOPTION OF HEALTHY LIFE STYLED=DEVELOP APPROPRIATE I.E.C. STRATEGYDISCOURAGE EARLY MARRIAGE AND TEENAGE PREGNANCYO=ORGANIZE ADOLECENT/ YOUTH FRIENDLY CLINICL=LIFE SKILL EDU
25、CATION , LEGAL SUPPORT, LIASIAN WITH PEERS , PARENTSE=EDUCATE ABOUT SEXUALITY,SAFE SEX,SPIRITUALITY,RESPONSIBLE PARENTHOODS=SAFE, SECURE AND SUPPORTIVE ENVIRONMENT TO BE PROVIDEDC=COUNSELLING / CURRICULM IN SCHOOL INCUSIVE OF FAMILYLIFE EDUCATIONE=ENABLE &EMPOWER FOR RESPONSIBLE CITIZENSHIPN=NETWORK
26、ING FOR EXPERIENCE SHARINGT=TRAINING FOR INCOME GENERATION,TEEN CLUBS,10/9/2018,25,IAP HAS MADE AN ADOLESCENT CHAPTEREXISTING HEALTH FACILITIES MUST BE MADE ADOLESCENT FRIENDLYIAPSM HAS GOT THE INSIGHT LET US JOIN TOGETHER AND TAKE APPROPRIATE ACTIONLET US WORK WITH YOUTH NOT MERELY FOR YOUTH AND MAKE THEM CHANGEAGENTS,Adolescent Health-An Overview,10/9/2018,26,Thank You!,Adolescent Health-An Overview,THE CHALLENGES ARE THERE BUT POTENTIAL IS FAR GREATER,
