Needs to Adolescent care
‫الدكتور عبد المهدي عبد الرضا حسن‬
‫ جامعة بابل‬/ ‫كلية التمريض‬
PhD, pediatric & Mental Health Nursing
Demographic and Socioeconomic Status
Why Adolescents are Important?
What are Adolescent Health Problems?
Estimate of Adolescent Health Burden
Risk Factors for Adolescent Health Burden
Why invest in Adolescent Health?
Guiding Principals for Adolescent Health Programming
Summary.
Who is Adolescent?
No longer a child but not yet an adult
Age Groups
WHO DefinesAdolescents- 10-19 years
Youth - 15 – 24 Years
Young People – 10 – 24 Years
What is Adolescence?
World Health Organization
A phase which involves Progression from appearance of secondary sexual characteristics (puberty) to
sexual and reproductive maturity
Development of adult mental process and identity
Transition from total social-economic dependence to relative independence
What is early, middle and late Adolescence?
Early (10 – 14))
Growth Spurt, Beginning of Sexual Maturity and Start to think abstractly.
Middle (14 – 15)
Main Physical Change Completed, Develop stronger sense of Identity, relates
strongly to peer group, Thinking becomes reflective.
Late (16 – 19)
Body takes adult form, has distinct identity and more settled ideas and
opinions.
Global Demographic and Socio-economic information on Adolescents
Population
Education
Employment
Poverty
Global Demographic and Socio-economic information on Adolescents
Population
1.1 billion are Adolescents.
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1 in every 5 human on this planet is Adolescent.
85% of them live in Developing Countries.
Global Demographic and Socio-economic information on Adolescents
Education
Formal education is very important
School Provide environment for acquiring knowledge,
building literacy and
thinking skills.
Offer a setting for health screening and services.
In least developed countries 13% girls and 22% boys enroll for secondary
education.
Global Demographic and Socio-economic information on Adolescents
Employment
Many do not complete secondary education.
Seek work in informal sector.
73 million work in conditions that are detrimental to their health.
Many millions live and work on street – are at greater risk for substance use
and sexual abuse.
Global Demographic and Socio-economic information on Adolescents
Poverty
Relative and absolute poverty continues to grow.
Pressure to earn a living at an earlier age –
Hinders education
Exposes them to exploitation by unscrupulous adults
Why Adolescents are Important?
They are a demographic force.
They are an economic force.
They are the future health.
They have a right to participate.
What are Adolescent Health Problems?
Young Adolescents
Malnutrition
General Health Problems
Menstrual Problems
Mental Health Problems
Early and Unprotected Sex
Addictive Behaviors
Accidents and violence
Sexual Abuse
Depression and Suicide
Eating Disorders.
What are Adolescent Health Problems?
Young Adolescents
Can not bear the responsibility of their own health
Lack knowledge about the physical changes happening in body
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Such concerns – low self esteem and depression
Need reassurance and Support
What are Adolescent Health Problems?
Malnutrition
Shortage of food – priority for babies – inadequate adolescent diet –
delayed/impaired development.
Girls – fed last and fed least – pubertal delay – small pelvis.
Baby mothers – less equipped to withstand complications (physically
immature body)
MMR higher in anemic adolescent mothers
Undernourished Adolescent Mother – LBW Babies
What are Adolescent Health Problems?
General Health Problems
Same illnesses but
Less likely to recognize symptoms
More likely to underestimate their importance
Least likely section to go for early treatment
afraid about outcome,
worried about stigma, and
do not have confidence on treatment.
Parents actively take care of health of young children
Parents feel adolescents responsible for their heath needs – as they become
more independent
Conditions like Asthma and Epilepsy become uncontrolled – as considered
responsible for self medication.
What are Adolescent Health Problems?
What are Adolescent Health Problems?
Menstrual Problems
Without proper knowledge – fail to understand normal and to recognize
menstrual problems
School Health Checkups usually fail to identify these
What are Adolescent Health Problems?
Mental Health Problems
May first become apparent in Adolescence
No frame of reference available with them
Thus fail to
Recognize and
Seek medical treatment
What are Adolescent Health Problems?
Early and Unprotected Sex
Sexual activity is more common than available official data – evidenced by
increased no. ofUnwanted Pregnancies
Unsafe Abortions
Steep Rise in HIV
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Early and unprotected sexual experience is not planned, and with no
knowledge of consequences
What are Adolescent Health Problems?
Predisposing Factors for Early and Unprotected Sex
Adolescents live in Increasingly sexualized societies
Impact of Media – Electronic and Print
Rapid Growth of cities and breakdown of traditional family structure – Erode
protective cultural layer
Conflict and forced migration – put them at risk
Pressured in to desperate situations – forced into sex for survival sp. during
economic hardships etc.
Trend – earlier sexual maturation while late marriage
What are Adolescent Health Problems?
Early and Unprotected Sex – Results In
STI 1 in 20 young people every year
7000 young people every day are infected with HIV
Early and Unprotected Sex – Remedy
Abstaining from Sex
Delaying the onset of first sexual experience
Increasing the level of protection through condoms
What are Adolescent Health Problems?
Addictive Behavior (Risk Taking)
Do not assess the long term consequences
Alcohol and drugs – further reduce caution and judgment
May appear to be a way out for one who sees no positive solution – but
actually is a way to more serious problems
Expensive and illegal habits – draws them to crime
What are Adolescent Health Problems?
Accident and Violence
Deaths and Injuries are more common in them
Unintentional Injuries is the leading cause of Death in many countries
Vulnerable both as victims and perpetrators
Violence with in home is usually not treated seriously.
What are Adolescent Health Problems?
Sexual Abuse
For millions – sex is linked with – cruelty, violence and abuse – family
members or adults with privileged access.
Women are conditioned to be submissive to men – thus early marriage, birth
spacing, unprotected sex or unfaithful partner.
Much sexual abuse takes place in home and is never reported
Homeless –street adolescents are more vulnerable
Young women may trade sex
Increase in world trade sexual exploitation of young people – “sex Tourism”
UNICEF estimates – 1 million adolescents are recruited in commercial sex
trade
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What are Adolescent Health Problems?
Depression and suicide
Common with Low self esteem
They feel they have no future and are useless
Reduces the quality of life
Likely to take risk with own health
Depression can lead to suicide
90,000 young people commit suicide every year.
What are Adolescent Health Problems?
Eating Disorder
Obesity and eating disorders exist along with malnutrition
From early age adolescents are under pressure to be ultra thin – impact of
media
Bulimia and anorexia can permanently damage physical and mental health.
Obesity – if failed to deal in time may lead to serious health problems.
Estimates of Disease Burden
DALY – (Disability Adjusted Life Year)
Time based measure to quantify burden.
Includes – Years of Premature Deaths & Years lived with disability.
1 DALY is 1 lost year of Health
Few Figures !!!
Young People represents 15% of total Burden
90% of DALYs lost in Developing Countries
Main contributory factors
Sexual and Reproductive Health Problems (STIs, HIV)
Mental Illness
Endemic and Chronic Diseases
Nutritional Problems
Drug use and Substance Abuse
Accidents and Injuries
Maternal Conditions
Risk Factors for Global Burden
Why pay attention to Adolescent Health?
To reduce death and disease in adolescents
To reduce the burden of disease in later life
To invest in health — today and tomorrow
To deliver on human rights
To protect human capital
Why Invest in Adolescent Health?
Health Benefits
Current & Future Health
Intergenerational Effects
Economic Benefits
Improved Productivity
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Return On Investments
Alleviate Future Health Cost
As a Human Right
Guiding Principals for
Adolescent Health Programming
(UNFPA, UNICEF & WHO)
Adolescence is a time for opportunity and risk
Not all adolescents are equally vulnerable
Adolescent Development underlies prevention of Health Problems
Problems have common roots and are interrelated
Social environment influences adolescent behavior
Gender considerations are fundamental
Summary
Adolescents represent a positive force in society, now and for the future.
They face dangers more complex than previous generations faced, and often with
less support.
The development needs of adolescents are a matter for the whole of civil society.
Health services play a specific role in preventing health problems and responding
to them.
Many changes are needed in order for health services to become adolescent
friendly.
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