Unit 4.

Adolescent Health
Dharmesh Singh Thakuri
Bph/M.Psychology
2 Adolescence :
 Adolescence is a word that comes from Latin and means to
mature.
 It is a transitional phase of growth and development between
childhood and adulthood.
 The World Health Organization (WHO) defines an adolescent as any
person between ages 10 and 19.
 Adolescence is a time of rapid physical, cognitive and psychosocial
changes that affect how people feel, think, make decisions and
interact with the world around them.
 Adolescents are usually are very energetic and receptive to
information.

dharmesh- BPH/M.Psychology 6/15/2023

3 Adolescent Health:
 Adolescent health is a term that refers to the range of approaches to
preventing, detecting or treating young people's health and well-being.
 It is often complex and requires a comprehensive, biopsychosocial approach.
 Adolescent health encompasses changing transitions within multiple
domains, including the physical, social, emotional, cognitive, and intellectual.
 To improve adolescent health, it is important to provide them with
information, opportunities to develop life skills, health services that are
acceptable, equitable, appropriate and effective, and safe and supportive
environments.
 It is also important to involve them in the design and delivery of
interventions that address their specific needs and rights.

dharmesh- BPH/M.Psychology 6/15/2023

4 Health Issues affecting Adolescents

 Early pregnancy and childbirth.

 HIV and other infectious diseases.
 Mental health problems including depression and suicide.
 Gender based Violence.
 Alcohol and other drugs.
 Injuries both unintentional and self-injury.
 Sexual and reproductive health.
 Malnutrition and obesity.
 Exercise and nutrition.
 Tobacco use.
dharmesh- BPH/M.Psychology 6/15/2023
5 Situation of Adolescent in Nepal

 The situation of adolescents in Nepal is complex and challenging.

 Adolescents make up more than one fifth (22%) of the total
population of Nepal.
 They face many health risks and problems, such as early marriage
and pregnancy, HIV and other infections, mental health issues,
violence, substance abuse, malnutrition and obesity.
 Nepal has some policies and programs to address adolescent health
needs, such as a law banning child marriage before age 20, a
legalized abortion service, and a national adolescent sexual and
reproductive health program.
dharmesh- BPH/M.Psychology 6/15/2023
  However, these measures are not enough to reach all adolescents,
6 especially those who are poor, rural, marginalized or living in
remote areas.
 Adolescents also face barriers to access health services, such as
UNICEF= United distance, cost, lack of privacy and confidentiality, and adverse
Nations International gender norms.
Children's Emergency
Fund.  To improve the situation of adolescents in Nepal, the government is
working with partners such as WHO and UNICEF to redesign the
adolescent health program and make it more responsive to the
diverse needs and rights of different subpopulations of adolescents.
 Some of the strategies include expanding adolescent-friendly
services to hard-to-reach groups, increasing community
engagement and awareness, and involving adolescents in the
design and delivery of interventions.
dharmesh- BPH/M.Psychology 6/15/2023
7 NDHS report 2022

 The percentage of women age 15–19 who have ever been pregnant
rises with age, from 1% at age 15 to 32% by age 19.
 Teenage pregnancy is highest in Karnali Province (21%), followed by
Madhesh Province (20%), and lowest in Bagmati Province (8%).
 Women age 15–19 with no education (33%) are more likely to start
childbearing earlier than those with at least some secondary
education (8%).

dharmesh- BPH/M.Psychology 6/15/2023

8 Effects of Early Pregnancy in Adolescent health

 Early pregnancy in adolescent health has many negative effects for both
the mother and the child. Some of the effects are:
 Early pregnancy increases the risk of maternal death and disability,
especially among girls under 15 years old.
 Pregnancy and childbirth complications are the leading cause of death
among girls aged 15–19 years globally.
 Early pregnancy also increases the risk of poor health outcomes for the
child, such as low birth weight, preterm birth, stillbirth and neonatal
death.
 Babies of adolescent mothers are more likely to die in their first year of
life than those of older mothers.
dharmesh- BPH/M.Psychology 6/15/2023
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 Early pregnancy can disrupt the education and livelihood opportunities of

adolescent girls, as they may face pressure or discrimination to drop out of
school, marry early or abandon their aspirations. This can affect their future
income and empowerment.
 To prevent early pregnancy and its consequences, it is important to provide
adolescents with comprehensive sexuality education, access to contraception
and safe abortion services, support for pregnant and parenting adolescents, and
protection from child marriage and sexual violence.

dharmesh- BPH/M.Psychology 6/15/2023

10 Ways to Prevent Early Marriage

 Provide girls with access to quality education and life skills training.
 Report any child marriage happening around you to the proper authorities.
 Educate your friends, family and community about why child marriage is harmful.
 Promise to never be a part of any event that promotes child marriage.
 Addressing violence within the home is essential to preventing child marriage in
crisis.
 Peers continue to have a strong influence in marriage decisions for girls in
displacement settings.

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 Support girls’ economic empowerment and livelihood
opportunities.
 Raise awareness and change social norms that perpetuate child
marriage.
 Strengthen legal and policy frameworks to protect girls’ rights and
enforce the minimum age of marriage
 Engage men and boys as allies and advocates for gender equality
and girls’ rights.
 Ensure girls’ participation and leadership in decision-making
processes that affect their lives.

dharmesh- BPH/M.Psychology 6/15/2023

 Adolescent friendly health services and its
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characteristics.

Adolescent friendly health services (AFHS):-

 According to the WHO adolescent-friendly health services are health
services that are acceptable, appropriate, effective and equitable for
adolescents.
 They are based on national quality standards that define the characteristics
of health services and health providers that can meet the specific needs and
rights of adolescents.
 Adolescent-friendly health services can protect and improve the health and
well-being of adolescents, including their sexual and reproductive health.
 They can also help adolescents establish healthy patterns of behavior that
can benefit them throughout their lives.
dharmesh- BPH/M.Psychology 6/15/2023
13 Some of the characteristics of adolescent-friendly health services
are:
 They are accessible: Adolescents can obtain the health services that
are available.
 They are acceptable: Adolescents are willing to obtain the health
services that are available.
 They are equitable: All adolescents, not just some groups of
adolescents, can obtain the health services that are available.
 They are appropriate: The right health services (i.e. those that they
need and want) are provided to them.
 They are effective: The right health services are provided in the
right way, and make a positive contribution to their health.
dharmesh- BPH/M.Psychology 6/15/2023
14 Current Nepal’s law regarding contraception to
adolescents:
 Nepal has a high adolescent fertility rate of 71 births per 1000 women aged 15-
19 years, and a low modern contraceptive prevalence rate of 23% among
married adolescents aged 15-19 years.
 These indicate that many adolescents in Nepal face barriers to access and use
contraception, such as lack of information, social stigma, gender norms, provider
bias, and legal restrictions.
 The Constitution of Nepal (2015) guarantees the right to reproductive health as
a fundamental right of every citizen.
 The National Adolescent Sexual and Reproductive Health Program (2016) aims
to improve the availability, accessibility, acceptability and quality of adolescent-
friendly health services, including contraception.

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 Everybody has right to access of the FP services according to their
need and relevant situation.
 Every adolescent must have access to counselling if they need
regarding FP, marriage, STIs and HIV/AIDS.

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dharmesh- BPH/M.Psychology 6/15/2023