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ADOLESCENT HEALTH

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					                   ADOLESCENT HEALTH


                     Dr.I.Selvaraj,I.R.M.S
B.SC.,M.B.B.S.,(M.D Community medicine).,D.P.H.,D.I.H.,P.G.C.H&FW(NIHFW,New Delhi)
               Sr.D.M.O (ON STUDY LEAVE)
           INDIAN RAILWAYS MEDICAL SERVICE
                ADOLESCENT HEALTH
•   The term adolescence is derived from the Latin word “adolescere”
    meaning to grow, to mature.
•   It is considered as a period of transition from childhood to
    adulthood.
•   They are no longer children yet not adults. It is characterized by
    rapid physical growth, significant physical ,emotional,
    psychological and spiritual changes.
•   Adolescents constitute 22.8% of population of India as on 1st
    march 2000.
•   They are not only in large numbers but are the citizens and
    workers of tomorrow.
•   The problems of adolescents are multi- dimensional in nature and
    require holistic approach.
•    A large number of adolescents in India are out of school,
    malnourished, get married early, working in vulnerable situations,
    and are sexually active.
•   They are exposed to tobacco or alcohol abuse.
•   Adolescence          : 10 – 19 years
•   Early Adolescence    : 10 – 13 years
•   Middle adolescence    : 14 – 16 years
•   Late adolescence     : 17 – 19 years
•   Youth                : 15 – 24 years
•   Young people           :10 - 24 years
Challenges in adolescent development
  and health in INDIA:
1. 45% of adolescent girls under nourished
2. 20% of adolescent boys under nourished
3. Early marriage 26% < 15yrs – girls, 54%
    < 18yrs
4. 20 – 30% adolescent boys sexually active
5. 10% adolescent girls sexually active
6. 59% adolescents know about condoms
7. 49% adolescents know about
    contraceptives
8. 4.5% drug abuse
9. 50% of all HIV positive new infections are
    in the age group of 10 – 25yrs
10. Adolescent abortion 1 – 4.4millions
INDIAN ACADEMY OF PAEDIATRICS
 PROPOSAL:
• 1999 = Family Education for
  adolescents
• 2000 = Teenage care clinic in the
  hospitals
• 2001 – 2003 = Teenage care wards
  for girls and boys in the hospitals
• 31st July Every year = Teenage day
• 25 – 31st July Every year = Teenage
  week
• Early adolescence(10 -13yrs):
  Spurt of growth of development
  of secondary sex.
 Middle adolescence(14-16yrs):
  Separate identity from parents,
  new relationship to peer groups,
  with opposite sex and desire for
  experimentation.
• Late adolescence(17-19yrs):
  Distinct identity, well formed
  opinion and ideas
The following changes are taking place during
   adolescent period:
a) Biological changes – onset of puberty
b) Cognitive changes – emergence of more
   advanced cognitive abilities
c) Emotional changes – self image, intimacy,
   relation with adults and peers group
d) Social changes – transition into new roles
   in the society
   SMR(Sexual Maturity Rating)


• Genitalia stage for boys(G1 to G5)
• Pubic hair stage(PH1 to PH5)
• Breast development for girls(B1 to
  B5)
             Impact of adolescence:
1) Lack of formal or informal education
2) School dropout and childhood labour
3) Malnutrition and anemia
4) Early marriage, teenage pregnancies
5) Habits and behaviours picked up during
  adolescence period have lifelong impact
6) Lot of unmet needs regarding nutrition ,
  reproductive health and mental health
7) They require safe and supportive
  environment
8) Desire for experimentation
9) Sexual maturity and onset of sexual activity
10) Transition from dependence to relative
  independence
• Ignorance about sex and sexuality
• Lack of understanding
• Sub optimal support at family level
• Social frustration
• Inadequate school syllabus about adolescent
  health
• Misdirected peer pressure in absence of adequate
  knowledge
• Lack of recreational, creative, and working
  opportunity
         ADOLESCENT HEALTH PROBLEMS
1.    Anorexia nervosa
2.    Obesity & overweight
3.    Adolescent pregnancy
4.    Micronutrient deficiency
5.    Emotional problems
6.    Behavioural problems
7.    Substance abuse & injuries
8.    Sexually transmitted infection
9.    Thinking and studying problems
10.   Identity problems
Reasons for adolescent reluctant to seek help

•   FEAR
•   UNCOMFORTABLE WITH OPPOSITE HEALTH WORKER
•   POOR QUALITY PERCEPTION
•   LACK OF PRIVACY
•   CONFIDENTIALITY
•   CUMBERSOME PROCEDURE
•   LONG WAITING TIME
•   PARENTAL CONSENT
•   OPERATIONAL BARRIER
•   LACK OF INFORMATION
•   FEELING OF DISCOMFORT
             PREVENTION


•   HEALTH EDUCATION
•   SKILL BASED HEALTH EDUCATION
•   LIFE SKILL EDUCATION
•   FAMILY LIFE DUCATION
•   COUNSELLING FOE EMOTIONAL STRESS
•   NUTRITIONAL COUNSELLING
•   EARLY DIAGNOSIS & MANAGEMENT OF
    MEDICAL AND BEHAVIOURAL PROBLEM
   Syllabus for adolescent health education
• Development of secondary sexual characters &
  menarche
• Problems associated with menstrual cycle &
  menstrual hygiene
• Body image
• Nutritional needs (micronutrients)
• Managing emotional stress
• Early marriage
• RTI/HIV/AIDS
• Safe sex
• Family life including pregnancy
• Child rearing & responsible parenthood
• Stress management
• Substance abuse
ADOLESCENT FRIENDLY HEALTH
         SERVICE
ADOLESCENT FRIENDLY HEALTH CENTER SERVICES

• Reproductive Health services
• Sexual & Reproductive health education
• Contraception
• Pregnancy testing and option
• MTP
• STD/HIV Screening counselling and treatment
• Prenatal & postpartum care
• Well baby care
• Nutritional services
• Growth & development monitoring
• Anticipatory guidance about substance abuse and
  other risk taking behaviour
• Counseling for life skill development
• Screening for various disorders
       CRITERIA FOR ADOLESCENT FRIENDLY
                HEALTH WORKER

•   Welcoming and friendly Nature
•   Knowledgeable
•   Presentable
•   Have good communication skill
•   Maintain confidentiality
•   Punctuality
•   Flexibility
•   Understanding
•   Good listener
•   Non-judgemental
Criteria for Adolescent Friendly Health Center


•   Good reception
•   All facilities
•   Accessibility
•   Quality care service
•   Well trained people
•   Security
•   Easy communication to the outside
•   Privacy
•   Conducive environment
Conclusion:
• This adolescent period is hazardous for adolescent
  health due to absence of proper guidance and
  counselling.
• Family has a crucial role in shaping the adolescents
  behaviour
• They have to ensure a safe, secure, and supportive
  environment for the adolescents.
• Family members in the community to be informed
  and educated about this problem.
• A positive and encouraging attitude has to be
  developed among the family members and parents.
• School teachers should be trained on adolescent
  health.
• Community leaders play a vital role on adolescent
  health care.
                THANK YOU


Reference:
1.ESSENTIAL PAEDIATRICS BY O.P.GHAI(6th edition Revised)
2.INDIAN PUBLIC HEALTH JOURNAL = SEP-2002, MARCH- 2001

				
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posted:4/2/2008
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