Adolescent- Definition and Stages

•
• Adolescents – young people between the ages of 10 and 19
years.(the period in human growth and development that occurs after
childhood and before adulthood)
• Early adolescence: 10-14 yrs, spurt of growth
physical, sexual and mental.
• Mid adolescence : 15-17yrs, strong sense of identity, relates
more to peer group. Thinking becomes more reflective.
• Late adolescence: 18-19yrs. Develops fully. Have more
settled ideas and opinion.
Youth: 15-24 years
Young people: 10-24 years
 Adolescence- characteristics

1. Rapid physical growth and Development

2. Social and psychological Maturation 3. Shyness, Blushing,Modesty

 Adolescence- characteristics

4. Worry about physical appearance

5.Makes friends, Close friends is more important than family

 Adolescence- characteristics

6. Risk taking behavior- drug use, alcohol use, smoking, unprotected Sexual activities

7. Aggressive, Rebellious
 Why Is Adolescent Health Important?

1.Young people face serious health challenges.

2. Adolescent Health and Development affect

Economic Prosperity and break the cycle of poverty
 1.Young people face serious health
challenges
• Around 1 in 6 persons in the world is an adolescent: that is 1.2
billion people aged 10 to 19.

• At first glance, youth appears to be a relatively healthy —

although not hazard-free — period of life

• An estimated 1.3 million adolescents died in 2012, mostly

from preventable or treatable causes.
1. Early pregnancy and childbirth
second cause of death for 15-19-year-old girls
globally.
Some 11% of all births worldwide are to girls
aged 15 to 19 years, and the vast majority are in
low- and middle-income countries.

2.Early marriage- 15 million under 18 are

married
3. HIV-More than 2 million adolescents are living with HIV

4. Other infectious diseases

Diarrhea, lower respiratory tract infections and meningitis are among the top
10 causes of death for 10 to 19 year olds
 1.Young people face serious health challenges, contd…………….

5. Mental health
Depression is the top cause of illness and
disability among adolescents and suicide is the
third cause of death.
Half of all mental health disorders in adulthood
appear to start by age 14, but most cases are
undetected and untreated.

6. Violence
Violence is a leading cause of death. An
estimated 180 adolescents die every day as a
result of interpersonal violence
Globally, some 30% of girls aged 15 to 19
experience violence by a partner.
7. Substance Use
Globally, at least 1 in 10 younger adolescents (aged 13 to 15)
uses tobacco. Alcohol and drug use- unsafe sex, road traffic
accident, violence, premature death

8. Road Traffic Accident- Approx 330 adolescents dying every

day.
9. Malnutrition and obesity

10. Gender inequalities- expose young girls to coerced sex, HIV infection,
unwanted pregnancy, and poor nutrition..
 2. Adolescent Health and Development affect Economic Prosperity
and break the cycle of poverty
Investing in the healthy development of adolescents

healthy, competent adolescents

enter the work force

can raise the economic productivity of a country

Example- promote the adoption of healthy behaviours that help prevent health
problems that occur later in life, such as cardiovascular diseases and lung cancer
resulting from physical inactivity and tobacco use initiated during adolescence.
 Health problems of Adolescents

1. Anaemia, malnutrition and obesity

2. HIV/AIDS
3. Early marriages
4. Teenage pregnancies
5. Unwanted pregnancies and abortions
6. School dropouts
7. Accidents and injuries/ Substance Use
8. Gender disparity
 What health services do Adolescents need?

 Monitor growth and development

 Supportive parenting; Psychosocial support
 Identify and assess problems and problem
behavior, managing these where possible or,
referring young people if they cannot;
– general health services for tuberculosis, malaria,
endemic diseases, injuries, accidents and dental
care
– reproductive health including contraceptives, STI
treatment, pregnancy care and post abortion
management
– management of sexual violence;
– mental health services
– substance abuse;
 Provide immunization. Adolescent girls need
protection from rubella before they become
pregnant. Vaccines are also available for
meningitis, hepatitis and tetanus.)
 Offer information and counseling on
developmental changes, personal care and
ways of seeking help;
 counselling and testing for HIV, which should
be voluntary and confidential; ,
 services to address the use of tobacco,
alcohol and drugs; information and
SITUATION OF ADOLESCENT
S IN NEPAL
• The adolescent population in Nepal is
approximately 6.0 million or 24 percent of the
total population.
• Education- School dropout – 19 %- higher in
female than male (National Adolescent and
Youth survey 2011
• Early Marriage- - 28.8% of women and 6.9% of
men aged 15-19 were married. 11.5 % of
population were married below 14. ( NDHS
2011)
– Due to early marriage, girls often bear children at a
young age, which has severe effects on their health
• Teenage Pregnancy and Motherhood-
– 17% of adolescent women age 15-19 are already
mothers or pregnant with their first child
• Abortion-
– Among total pregnacies adolescent girls, 3 %
pregnancies were aborted. ( reasons- wanted to delay
child bearing, wanted to space child, bad health of
mother.)
• Nutritional status- ( NDHS 2011)
– 10 % of Adolescent women ( age15-19) are below
145 cm ( stunted)
– 5% under nourished,
– 3 % overweight
- 24% Adolescent and young people faced
physical violence from any one of their family
members.
- Compared to girls (21%), a higher proportion of
boys (27%) reported that they were beaten by
their family members.
- Among those who faced violence, 8% reported
that they required treatment
• 10.0% of students currently uses any form of
tobacco; 9.0% currently use any smoked
tobacco products; 16.2% currently use any
 National Health Programme

• Before The international conference on Population and

Development (ICPD), adolescent specific health services
were virtually non existent in Nepal except few program s
focusing on HIV/AIDs and drug abuse.
– As signatory to ICPD program- Nepal is committed to
improve the reproductive health of adolescent .
• After ICPD 1994, Ministry of health and Population
developed the National Reproductive Health
Strategy in 1998
– . Adolescent reproductive health was adopted as a
critical component of the integrated reproductive
Emphasized on developing
Health package Reproductive Health Program
including Adolescent Health
• The Ninth five year Plan
The Second Long term Health Plan
(1997-2017)
• In 2000 Nepal Adopted National Adolescent
Health and Development Strategy
– to provide Health and development service for
Adolescents.
– Helped government and non government organization
to implement various program and project in the
country
• The National Adolescent Sexual Health
Program(ASRH)-
• Ministry of education and sports
The National Adolescent Sexual Health
Program(ASRH)
• The ASRH program is implemented by family Health
division/ Department of Health service/ Ministry of
health population
• Goal-To promote the sexual and Reproductive
Health status of Adolescents
• Objectives-
– To increase the availability of and access to
quality information on adolescent health and
development
– Increase accessibility and utilization of adolescent
health and counseling
– To create safe and supportive environment for adolescents
in order to improve that legal, social and economic status
• Target- to make 1000 health facilities
adolescent friendly service by 2015 in line
with National Health sector Programs
2(2010-2017).
• (More than 1000 health facilities in 59
districts are providing adolescent friendly
services (AFS) in support of different stake
holders (Save the Children, UNICEF,
UNFPA, WHO, ADRA)
• The Programme will improve existing clinical
services in the areas of safe abortion,
– Family planning,
– maternal and child health care,
– and HIV and Sexually Transmitted Infection (STI)
prevention and treatment with a view of making
these services more accessible to adolescents
• Nepal Adolescent and Youth Survey –
generate specific data that would be use ful
for government to formulate policies , Plan
and programmes that addresses problems
Adolescent Friendly services(WHO)
• Services are accessible, acceptable and
appropriate — in the right place at the right time,
and affordable.
• They are equitable, inclusive and do not
discriminate, avoid stigma
• They are delivered by competent and motivated
providers who know how to communicate.
• Equipment & supplies are in place.( education
Materials)
• A system of quality improvement supports and
motivates staff.
Millennium Development Goal (NEPAL)
Sustainable development Goals (2015-2030),
NEPAL 1- No Poverty
2. No hunger
3. Good health
4. Quality education
5. Gender equality
6. Clean water and sanitation
7. Sustainable energy
8. Good job and economic Growth
9. Innovation and infrastructure
10. Global prosperity
11. Sustainable cities
12. Responsible consumption
13. Protecting Planet
14. Life below water
15. Life above water
16. Peace and Justice
17. Partnership for the future.
 Do Existing services meet the
need of Adolescents?
• Adolescents lack knowledge about what
services are available and how to access
them.
• There may be legal restrictions on the use
of services or cultural reasons why young
people do not wish to be seen there(Services
may be a long way from where the young
person lives, studies or works, or available
only at inconvenient hour).
• Adolescents give high priority to
confidentiality. This may be more important
than seeking treatment.
• They will not use unfriendly services or