ADOLESCENT HEALTH

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 Contents
• Introduction
• What is special about adolescence ?
• Stages of adolescence
• Why pay attention to health of adolescents?
• Health problems of adolescents
• Health programmes for adolescents
• Legislations
• Needs of adolescents and how to fulfill them
• Who framework on adolescent health and development

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 Introduction

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 The second decade:
No longer children, not
yet adults!

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 What is special about adolescence ?
(What makes it different from childhood & adulthood ?)
• A time of rapid physical
and psychological
(cognitive and
emotional) growth and
development.

• A time in which new

capacities are
developed.

• A time of changing
social relationships,
expectations, roles and
responsibilities.
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 What is adolescence ?
• The term adolescence is
derived from the Latin
word “adolescere”
meaning to grow, to
mature.

• WHO defines
'Adolescents' as
individuals in the 10-19
years age group and
'Youth' as the 15-24
year age group.
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7 08/02/2021
Formative years of life Physical and emotional
• Great human of an individual- major changes -body matures
physical, psychological
resource for & behavioral changes
the society takes place. • Mind -more
• Future of the society questioning and
depends on independent
adolescents
 Stages Of Adolescence

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 STAGES
• Adolescence : 10 – 19 years
– Early adolescence: 10 – 13 years
– Mid adolescence: 14 – 16 years
– Late adolescence: 17 – 19 years
• Youth: 15 – 24 years
• Young people: 10 - 24 years

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 CHARACTERSTICS

Early adolescence -Relates strongly to his Later adolescence

(10-13): or her peer group
(17-19):
-Thinking becomes
more reflective

-Body fills out and takes

-spurt of growth, -Main physical changes its adult form
-beginnings of sexual are completed -Individual now has a
maturation -Develops a stronger distinct identity
sense of identity
.

Has settled ideas and

-Abstract thinking Mid-adolescence (14- opinions
16):

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Why pay attention to health of
adolescents?

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 To reduce death and disease in adolescents:
• Estimated 1.7 million young people - 10 to 19 years

die each year

accidents, violence, pregnancy related problems or illnesses.

 To reduce the burden of disease in later life:

 Malnutrition
 young pregnant women
 sexually transmitted infections
 smoking habit.

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 To invest in health today and
tomorrow:
 Healthy and unhealthy practices
-may last a lifetime.

 Today’s adolescents - tomorrow’s

parents, teachers and community
leaders.

 Adolescence -period of curiosity

 receptive to information about

themselves and their bodies

 Begin to take an active part in

decision making.
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 To protect human capital:
In some societies two
out of three
adolescents are
involved in productive
work.
Injury, illness or
psychological damage
costs primarily a
human one, but there
is also a cost to
society.
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 Health problems of
adolescents

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 General health problems

Cannot recognize their symptoms

Underestimate their problems
Do not know where to go

Least likely section of the population to

go for early treatment.

Leave diseases untreated

Afraid of the outcome
Worried about the stigma
Do not believe that they will be treated well at
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Reproductive and sexual health
problems:
Risks to mother
 risks to baby
Health problems during pregnancy & child
birth (including unsafe abortion)
Sexually Transmitted Infections including
HIV
Harmful traditional practices e.g. Female
genital mutilation
- Sexual coercion
- Unmet need of contraception in married
adolescents.
• Low condom use characterizes a vast
majority of sexual encounters among
adolescents in India.
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Physiological problems:
• irregular menstrual cycles
• Acne vulgaris
Early & unprotected sex:
• Many young people become
sexually active without planning
the sexual relationship or thinking
about the consequences.

• This results into the high number

of unwanted pregnancies and
unsafe abortions and the steep rise
in HIV infection.
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Malnutrition:
• Inadequate diet can delay or impair
healthy development.

• Stunting during adolescence.

• Anemia - most important problem

among adolescents due to
malnutrition.
• For adolescents 15-19yrs
anemia(mild-39.1), (Mod-14.9)&
(Severe-1.7)—(NFHS-3)
• Obesity and eating disorders exist
along side malnutrition.
• Extreme cases eating disorders such
as bulimia and anorexia permanently
damage physical and mental health
poor health and early death.
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Mental health problems:
• Depression is common,
especially for young
people who have low
self-esteem.
• Depression can also lead
to the ultimate tragedy
— almost 90,000 young
people commit suicide
each year across the
world.

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 Other issues

• Injuries from accidents &

intentional violence
• Substance use problems
• Internet addiction/smart
phone addiction
• Endemic diseases:
• Malaria
• Schistosomiasis
• Tuberculosis
• Diarrhoeal diseases

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 Health programmes for
adolescents

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 Kishori Shakti Yojana
• Key component under ICDS programme
• Aims at empowerment of adolescent girls.
• Adolescent girls who are unmarried and belong to families below
the poverty line and school drop-outs are attached to the local
Anganwadi Centres for six-month of learning and training activities

Scheme- I (Girl to Girl

Approach)
•Age group of 11-15 years
•Belonging to families whose
income level is below Rs.
6400/- per annum
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Scheme-II (Balika Mandal)
• Age group 11-18 years
irrespective of income levels of
the family
•Younger girls 11-15 years and
belonging to poor families
24
 Balika mandal

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 Balika Samridhi Yojana
• Launched by Government of India in1997 .
• Balika Samridhi Yojna is being implemented in both
rural and urban areas.
• Target group:
• Girl children belonging to families below the
poverty line are given benefit, who are born on or
after 15th August, 1997. The benefits are
restricted to two girl children in a household
irrespective of number of children in the
household.
• Benefits: A post birth grant amount of Rs. 500/-
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 Balika Samridhi Yojana
Objectives:
• To change negative family and community
attitudes towards the girl child at birth and
towards her mother.
• To improve enrollment and retention of girl
children in schools ,to increase the age of
marriage of girls and to assist the girl to
undertake income generation activities.

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 Reproductive and Child Health-II
Adolescent Reproductive and Sexual Health(ARSH):
Services provided to all adolescent married and
unmarried girls and boys
Package of services

 Promotive services
 Preventive services
 Curative services:
 Referral services
 Outreach services
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 Rashtriya Kishor Swasthya Karyakram
(RKSK)
• Launched on 7thJanuary 2014 by MOHFW.
• addressing adolescent health needs would obviate
several reproductive, maternal and child health
challenges.
• expands the scope of adolescent health programming
in India - from being limited to sexual and
reproductive health, it now includes
– nutrition
– injuries and violence (including gender based violence)
– non-communicable diseases
– mental health and
– substance misuse.
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 Rashtriya Kishor Swasthya Karyakram
(RKSK)
• The strength of the program is its health
promotion approach. It is a paradigm shift
from the existing clinic-based services to
promotion and prevention and reaching
adolescents in their own environment, such as
in schools and communities.

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 7 C’s of RKSK

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 WIFS(weekly iron folic acid
supplementation)
• Launched by MOHFW.
• Objective :
To reduce the prevalence and severity of
anaemia in adolescent population (10-19
years).
• supervised weekly ingestion of IFA
supplementation and biannual helminthic
control.

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• Target groups:
 School going adolescent girls and boys in 6th to
12th class enrolled in government/government
aided/municipal schools.

 Out of school adolescent girls.

• Weekly 100mg elemental iron,500mcg folic

acid.
• Biannual de-worming (Albendazole 400mg), six
months apart.
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 Menstrual hygiene scheme(MHS)
• Launched by MOHFW.
• Objectives of the scheme are:
– To increase awareness among adolescent girls on
Menstrual Hygiene.
– To increase access to and use of high quality
sanitary napkins to adolescent girls in rural areas.
– To ensure safe disposal of Sanitary Napkins in an
environmentally friendly manner.

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•  Under the scheme a pack of 6 sanitary
napkins is provided under the NRHM’s brand
‘Freedays’.
• Rupees 6 for a pack of 6 napkins in the
village by the Accredited Social Health Activist
(ASHA).

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 Adolescent friendly health
services(AFHS)
• Broad range of preventive, promotive & curative
services under one roof & which helps to ensure
improved availability, accessibility & utilization of
health services.
• AFHS in India is first taken by Safdarjang Hospital in
New Delhi.
• The National Institute of Research in Reproductive
Health, Mumbai in collaboration with Municipal
cooperation of Mumbai started AHFS under the name
“Jagruti” for providing specialized sexual &
reproductive services for adolescent boys & girls.
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 Package of health services at AFHS:

• Monitoring of growth & development.

• Monitoring of behavior problems.

• Offer information & counseling on

developmental changes, personal care
& ways of seeking help.

• Reproductive health including

contraceptives, STI treatment,
pregnancy care & post abortion
management.

• Voluntary counseling & testing for HIV.

• Management of sexual violence.
• Mental health services including
management of substance abuse.
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• To make the clinics
adolescent friendly,
states have branded the
clinics in the name of
‘Maitri’ in Maharashtra,
‘Udaan’ in Uttrakhand,
‘Sneha’ in Karnataka and
so on.

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 National AIDS control programme
• Under NACO Adolescent Education Programme
developed which focuses primarily on prevention
through awareness building.
• One of the key policy initiatives of NACP II.
The Adolescence Education Programme (AEP):
• Co-curricular adolescence education in classes IX-XI.
• Curricular adolescence education in classes IX-XI and
life skills education in classes I- VIII .
• Inclusion of HIV prevention education.
• measures to prevent stigma.
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10 core life skills laid down by WHO
• Self awareness
• Empathy
• Critical thinking
• Creative thinking
• Decision making
• Problem solving
• Effective communication
• Interpersonal
communication
• Coping with stress
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Coping with emotion 42
 Other programs
 YUVA - Youth Unite for Victory on AIDS

• Yuva comprising seven youth organisations, Nehru Yuva Kendra

Sangathan, National Service Scheme, Indian Red Cross Society, National
Cadet Corps, Bharat Scouts and Guides, Youth Hostels Association of India
and the Association of Indian Universities.
• Goal is to have an “AIDS prepared Campus, AIDS prepared Community
and AIDS prepared Country”.
• Prevention, education and life skills.

 Red Ribbon Club (RRC)

• The club is established in every school and college to provide youth with
access to information on HIV/AIDS and voluntary blood donation.

• The club also works towards promotion of life skills to bring about
behavioural change among the youth.
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 Family life education
• Self awareness, understanding of others,
sexuality, marriage and parenthood.
• The knowledge gained and skills developed
will contribute to the individual’s ability to
cope both with social change and with
relationships in society as a citizen, spouse or
parent.”

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 Family life education
• Understand the importance of the institution of family, its
changing composition and structure, functions
• To appreciate physical, physiological, psychological and
social changes and developments during the process of
growing up, conception and consequences of adolescent
pregnancy, and to be aware of the HIV/AIDS pandemic and
implications of drug abuse.
• To understand the significance of marriage, responsible
parenthood, changing gender roles’and male responsibilities
in the family life.
• To develop positive attitude and responsible behaviour
towards various issues of family life and to appreciate
traditional family values
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 Legislations

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 Child marriage restraint act,1978
• Minimum age at marriage
• 21 years –males
• 18 years females

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 Juvenile justice(care and protection)
act,2000
• Special treatment, care, protection of juvenile
and neglected children.
• Males< 16 years, females <18 years- juveniles
• “Special juvenile police unit" to be
incorporated in police stations.

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 Child labour (prohibition & regulation)
act,1986
• Regulates minimum age limit of 14 years for
employment of children and prohibits
engagement of children in certain
employments.

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 Immoral traffic (prevention)
act,1986(ITPA)
• Prohibits trafficking in human beings.
• An Act to provide in pursuance of the
International Convention signed at New York
on the 9th day of May, 1950, for the
prevention of immoral traffic including
children.

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 Narcotic drug and psychotropic
substances act,1985(NDPS)
• Prohibits a person to
produce/manufacture/cultivate, possess, sell,
purchase, transport, store, and/or consume
any narcotic drug or psychotropic substance.
• Supply reduction activities
• Rigorous imprisonment and fine is there for
any of these illegal activities.

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 Protection of children from sexual
offences act,2012
• The Protection of Children from Sexual Offences Act,
2012 defines a child as any person below the age of
18 years and provides protection to all children
under the age of 18 years from the offences of sexual
assault, sexual harassment and pornography.

• These offences have been clearly defined for the first

time in law. The Act provides for stringent
punishments, which have been graded as per the
gravity of the offence.

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 Right to education,2009
• The Right of Children to Free and Compulsory
Education (RTE) Act, 2009, which represents the
consequential legislation envisaged under Article
21-A, means that every child has a right to full
time elementary education of satisfactory and
equitable quality in a formal school which
satisfies certain essential norms and standards.
• Aged 6 -14 years.
• came into effect from 1 April 2010.
• Includes words ‘free and compulsory.’
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 Needs of adolescents and how
to fulfil them

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• Information & skills
(they are still
developing)
• Safe & supportive
environment
(they live in an
adult world)
• Health &
counselling services
(they need a safety
net)

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 Contribution in meeting these needs
& fulfilling these rights

• Politicians
• Journalists
• Bureaucrats
• Relatives
• Parents • Friends
• Brothers/Sisters • Family friends
• Teachers
Adolescents • Sports coaches
• Healthcare providers
• Religious leaders
• Traditional leaders
• Musicians
• Film stars
• Sports figures
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 WHO, World bank, UNFPA
framework on adolescent
health and development

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 World Bank framework: Youth transitions
seen through three lenses
– First lens: Broadening
opportunities for young people to
develop skills and use them
productively.

– Second lens: Helping them

acquire the capabilities to make
good decisions in pursuing those
opportunities

– Third lens: Offering them second

chances to recover from bad
decisions, either by them or by
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others.
 4 ‘S strategy for adolescent
development(WHO)

S
Supportiv
S Supportive
e
Strategic evidence-
evidence-
information informed
informed
policies
policies

S
S
S Strengthening
&
Services
Services&&
commodities
commodities supporting
other sectors

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 UNFPA framework for action
on adolescents & youth
1. Supportive policy making
that applies the lens of
population structure &
poverty dynamics analyses
2. Gender & life-skills based
sexual & reproductive health
education
3. Sexual & reproductive health
services
4. Young people's leadership
and participation
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 ASSIGNMENT
Q. Define adolescent. Write in brief about the
health programmes for adolescents.

Note- complete the assignment in your

notebooks and then send the pic @
priyankassachdeva2014@gmail.com

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 Thank you

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