ADOLESCENT REPRODUCTIVE

HEALTH (ARH)

Lecture (14)
 GENERAL OBJECTIVES
2

To understand the importance of adolescent reproductive 

health, the stages of adolescent development, the desired
state of general and reproductive health, and the reproductive
rights of adolescents.

Wednesday, January 22, 2020

 SPECIFIC LEARNING OBJECTIVES:
3

By the end of the session, participants will be able 

to:
1. Explain the rationale for undergoing special 
training on adolescent reproductive health.
2. Identify biological and psychosocial changes that 
occur during adolescence.
3. Discuss desirable health status for adolescents. 
4. Identify the reproductive rights of adolescents. 

Wednesday, January 22, 2020

 The Context of Adolescents
4

 Adolescence is a period between 10-19

years where sexual maturity develops but
comes in with social demands (WHO,).
Adolescent is a time of:
 Experimentation and curiosity.

 Increasing confidence and self-esteem.

 Increased sexual feeling and impulse

Wednesday, January 22, 2020

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 Beginning to reproduce
 Transition from childhood to adulthood

 Enjoy life before responsibilities of adulthood

begins in a way which doesn’t affect their life.

Skills and knowledge are needed for positive
relationships with others (communication,
decision making, overcoming peer pressure,
assertiveness. etc). It is one of the most crucial
periods in an individual life.
Wednesday, January 22, 2020
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 A time when many key socioeconomic,

biological and demographic events occur
that set for adult life.
 A period rapid psychological changes
and vulnerability to physical,
psychological and environmental
influences.

Wednesday, January 22, 2020

 Age Definitions
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 The Department of Health (DOH) and the

Philippine Paediatric Society (PPS) divides
this period into:
 Early adolescence: 10-13 years old
 Middle adolescence: 14-16 years
 Late adolescence: 17-19 years

Wednesday, January 22, 2020

 What is Special about Adolescents?
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Adolescence is one of the most rapid and formative 

phases of human development, and the distinctive

physical, cognitive, social, emotional and sexual
development that takes place during adolescence
(Figure 3) demands special attention in national
development policies, programmes and plans.

Wednesday, January 22, 2020

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Rapid
Rapidphysical, cognitive,
physical, cognitive, Widening
Wideninggap gap between
between Balance between
Balance between
social, emotional
social, emotional and and biological maturity
biological andsocial
maturity and social protection and
protection and
sexual development
sexual development transition to adulthood
transition to adulthood autonomy
autonomy

• Hormonal changes and
puberty
• New and complex sensations
and emotions
• Sexual awareness and gender
identity
• Burst of emotional and
physiological brain
development
• Enhanced and evolving
cognitive ability
• Context-influenced emotional
impulse control
• More years in education and
training due to the expansion of
primary, secondary and further
education
• Later onset of employment and
family formation
• More independent involvement in
health services, which may be ill
prepared to serve adolescents with
special needs
• Emerging autonomy but
limited access to resources
(e.g. finances, transportation)
• Appropriate representation in
decision-making bodies
• Rights to consent to services,
commensurate with evolving
capacity
• Increased vulnerability to
some aspects of globalization
(e.g. increased vulnerability to
gaming, pornography. online
bullying)

Wednesday, January 22, 2020

 Activity nos.1
10

Body map….LumalaKi…tumutubo…nagkakaroon 

Wednesday, January 22, 2020

 Vulnerable and Marginalized Adolescents
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Vulnerability
Refers to factors that make a person more susceptible to poor health outcomes ⦁
In contrast, risk is defined as the likelihood that a person may acquire a disease

Abandoned and neglected adolescents and adolescents on the streets

Adolescents in commercial sexual exploitation
Adolescents (Children) in conflict with the law
Adolescents in geographically isolated and disadvantaged areas (GIDA
Adolescents in indigenous communities
Adolescents in hazardous work
Adolescent survivors of calamity and disasters
Adolescents in situations of armed conflict
Adolescent survivors of abuse and exploitation
Adolescents (Persons) with disability
lesbian, gay, bisexual, transgender and queer (LGBTQ) adolescent
Out-of-school adolescents
Substance dependent and addicted adolescents (including alcohol, drugs and
tobacco)
Adolescents or Young key affected populations
(YKAP) which includes males who have sex with males (MSM), sex workers, and people
who inject drugs (PWID)
Wednesday, January 22, 2020
 Adolescent Health Situation:Global and in
the Philippines
12

Comprise large proportion of the total

population (20% of the world’s
population is young (10-24 years)
An increasing adolescent sexuality,
surrounded by so much secrecy, has
become one of the major risk factor
implicated in the current pandemic of
HIV/AIDS and its socioeconomic and
health consequences. Wednesday, January 22, 2020
13

 . According to YAFSS 4, data shows that in the Philippines, an increasing

proportion of adolescents and young people have early sexual
encounters.
 - In 2013, 1 in 3 young people report having premarital sex.
 - Males are more likely to report having premarital sex than females. In
2013, 36% of males reported having early sexual encounters
compared to 29% of females. –
 -The highest levels of early sexual encounters are reported in NCR
(41%) & Central Luzon (31%) regions.
 -The high prevalence of drug abuse among adolescents leads to risk
behaviors i. e.-

Wednesday, January 22, 2020

 HIV and AIDS
14

In April 2017, there were 629 new HIV antibody sero-

positive individuals reported to the HIV/ AIDS & ART
Registry of the Philippines (HARP) [Table 1]. More than
half were from the 25-34 year age group while 30% were
youth aged 15-24 years. 33 adolescents aged 10-19
years were reported. All were infected through sexual
contact (8 male-female sex, 19 male-male sex, 6 sex
with both males & females)
• People who inject drugs
• Men who have sex with men
Transgender
Sex workers.

Wednesday, January 22, 2020

 Abortion risks
15

lack of information on contraception 

the cost of health services 
lack of confidentiality 
limited access to safe services 
delay in realising or admitting to the pregnancy 

Wednesday, January 22, 2020

 Components of ARH
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 Adolescents FP, IEC, service, counseling

 STIS/HIV

 Unwanted pregnancy and unsafe abortion

 Harmful traditional practices

 o Abduction and rape

 o Early marriage

 Sexual violence (Gender-violence)

Wednesday, January 22, 2020

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 The major causes of adolescent reproductive

health problems are early unprotected sexual
intercourse and unwanted pregnancy which
may occur due to:
 Lack of knowledge on physiology of the
reproductive system and human sexuality
 Declining age of menarche

 Early marriage

 Sexual violence and coercion

Wednesday, January 22, 2020
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 Peer influence
 Lack of knowledge of family planning

 Unavailability and inaccessibility of

service
 Attitude of the society towards use of
family planning services by adolescents

Wednesday, January 22, 2020

 The consequences of adolescent
sexuality and pregnancy:
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 Psychological impact
 Poor psychological development

 lack of confidence

 isolation

 stigmatization.

Wednesday, January 22, 2020

 Health impact
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 Early child bearing (CPD, LBW, MM),

each year about 15 million adolescents
aged 15-19 yrs give birth, as many as 4
million obtain abortion and
 - STIs / HIV, globally up to 100 million

adolescents become infected with STIs

and 40% of new HIV infections occur
among 15-24 years old.
Wednesday, January 22, 2020
 Socio-economic impact
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 School dropouts - Dwarfs futurity

- Curtails life options - Juvenile
deliquesces
 - Dangerous vanagrancy - commercial sex

workers

Wednesday, January 22, 2020

 Strategies of ARH
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 Making clinical service available,

 Meeting their Reproductive health needs
include;
 Confidentiality
 Convenient location and time
 Youth friendly environment

Wednesday, January 22, 2020

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Range of choices
Strong counseling component
Specially trained professionals
 Comprehensive clinical services

Wednesday, January 22, 2020

 Provision of information
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Appropriate and relevant information

about RH
Clinic based education and counseling
For practical skills use role plays,
community visits, exercises
Curriculum should address gender
inequalities, that affect health and
promotes shared female-male
responsibility for health.
Wednesday, January 22, 2020
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 Ensuring community support

 School based clinics

 Community based adolescent RH

centers
 Peer group education

 G.ARH clubs at schools

 H. Youth center

Wednesday, January 22, 2020

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Participants
 Involve youngsters in ARH program and design its
evaluation
 Parents should improve interaction with their
children, guide them in the right way.
 Support process of maturation of their children in
the area of sexual and RH
 Providers should not be judgmental not to make
things worse (trust, confidentiality, privacy,
helpful)
Wednesday, January 22, 2020
 Targets
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 Direct:
 in school adolescents

 out of school adolescent

 street adolescent

Wednesday, January 22, 2020

 Indirect:
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 Parents
 School teachers

 Policy makers

 Community leaders

 Religious leaders.

Wednesday, January 22, 2020

 International and National
initiatives on adolescent RH
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 The 1994 ICPD and 1995, Beijing conferences

highly acknowledged the ARH.
 International organizations (Marie – stops. IPPF,

pathfinders have been supporting ARH.

 Nationally, ARH sector under MOH

 FGAE is the 1st to launch FLE and establish ARH

center since 1989.

Wednesday, January 22, 2020

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 There are also other National partner

NGOs supporting ARH activities.
 FGAE is addressing multipurpose activities
for adolescents under
 The youth counseling & FP education
project
 IEC

 Counseling service
Wednesday, January 22, 2020
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 FP services, STIs management and other

RH services
 Recreational services

 Library services

 Mass Media

 School services

 Community based project centers.

Wednesday, January 22, 2020

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 The National workshop was held in 1994

by the MOH and the need for youth
projects to incorporate adolescent sexual
and reproductive Health was emphasized.

Wednesday, January 22, 2020

 Conclusions and
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Recommendations:
 For years, ARH has been neglected:
However, recently it is recognized as one
of the major concern and determinants of
development thus, Government policy
makers should concern for ARH and
allocate budget to:

Wednesday, January 22, 2020

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 Parents should improve interaction with

their children, guide them the right way,
and enable them to comply with
educational duties.
 support the process of maturation of their

children in the area of sexual behavior

and RH

Wednesday, January 22, 2020

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 Create supportive Environment for youths

efforts should be made to overcome
deep-seated adult discomfort with
adolescent sexuality in many developing
countries.
 Young people should be given information
on negotiating skills to resist peer
pressure that often leads them to be
sexually active. Wednesday, January 22, 2020
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 Studies show that sex education does not

increase sexual activity, in fact, it may
delay or lead to responsible sexual
behavior for those who are sexually
active, where as keeping teenagers in the
dark helps them to discover sex on their
won often with tragic consequences.

Wednesday, January 22, 2020

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 Efforts should be made to overcome

deep-seated adult discomfort with
adolescent sexuality.
 Involve youngsters in ARH program design
its evaluation.
 Health care providers should not be

judgmental, help Adolescents keep

privacy and build trust.
Wednesday, January 22, 2020
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 Educate young men to respect girl's self-

determination and share responsibility in
matters of sexuality and RH.
 Promote responsible sexual behavior
including country abstinence.
 Provide appropriate RH services
appropriate to age group.

Wednesday, January 22, 2020

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 Train adolescents on Gender equality,

equity, assertiveness and gender violence.

Wednesday, January 22, 2020

 Develop the following values in
adolescents
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 A respect of self and others Non

exploitation in sexual relationships
Mutuality, honesty, and maturity
 Non exploration of rights, duties,
responsibilities involved in sexual
relationships.

Wednesday, January 22, 2020

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 Compassion, forgiveness and compromise

when people do not agree on their way
of life.
 Acknowledge diversity (religion, culture
etc). Self-discipline in own sexuality.

Wednesday, January 22, 2020

 Thank you
42

Wednesday, January 22, 2020