Adolescent health PH.pdf ppt wryyuujjijj

Poisson distribution ppt

1. Adolescent Reproductive Health
ARH
Markos D(MPH. Asst prof)
WU, IHS, 2025
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2. Adolescent and Adolescence
How do you define adolescence and
adolescent?
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3. Adolescent and Adolescence
•Terms used
•Adolescents
•Teenagers
•Youth
•Young
•Adult
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4. Defining Adolescent and Adolescence
•Definitions of adolescence can vary by place and time
•The terms “adolescents”, “youth” and “young people” are
used differently in various societies.
•These categories are associated with different roles,
responsibilitiesand agesthat depend on the local
context.
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UNFPA, State of the World Population 2003, Overview of Adolescent Life

5. Introduction…
•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.
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6. Defining Adolescent and Adolescence
•Ethiopia
•Gurmisna/Goremsa(notformal)
•AflaWotatnet/AflaWotat(formal)
•Equivalenttoadolescenceandadolescent
•Tadagi(Earlyadolescent)
•Wotat(Youth)
•Findata(notformal)
•Dargaggoo/Dargaggeessa,Qeerroo..(AfaanOromo)
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7. Defining Adolescent and Adolescence
Nolongerchildren,notyetadults.
Adolescenceisaperiodofrapiddevelopmentwhenyoungpeople
◦Rapidlychangephysicallyandmentally
◦Acquirenewcapacitiesandarefacedwithmanynewsituations–
opportunitiesforprogressandriskstohealthandwell-being.
◦Isaphaseinanindividual’slifenotfixedtimeperiod
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8. The second decade:
No longer children, not yetadults !
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Adolescence :10–19yrs
EarlyAdolescence:10–13yrs
Middleadolescence:14–16yrs
Lateadolescence:17–19yrs
Youth :15–24yrs
Youngpeople :10–24yrs
Source: A picture of health? A review and annotated bibliography of the
health of young people in developing countries (WHO, UNICEF, 1995).

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10. Defining Adolescent and Adolescence
•Periodofdynamicchangerepresentingthetransition
fromchildhoodtoadulthoodmarkedbyprofound
•Physical,Emotional,MentalandSocialchanges
•Changeisthehallmarkofadolescence.
•Occurbetweentheagesof10and19years.
•Notallgothroughthechangessametime.
Nutritional,biological,genetics,environmentalfactors…
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12. Adolescence……
•Theprocessofautonomisationbywhichthechildbecomesmore
andmorereliantonhis/herowncompetencesandlessdependent
ontheopinionandsupportofhis/herparents
•Theacquisitionofastableidentity,thepermanentfeelingthatan
individualhasthathe/sheknowswhohe/sheis,whathis/herlife
shouldlooklikeandtosomeextenthowothersseehim/her
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13. The Adolescence Process
Early adolescence (10-13y.)
•Intellectualdevelopment:concrete,egocentric
Autonomisation:
•Selfimage:centeredonpubertalchanges
•Independence:lessinterestinparents’activities
•Intimacy:relationshipswithsame-sexfriends
•Identity
•Sexual:increasedneedsforprivacy
•Moral:idealisticgoals
•Vocational:lackofimpulsecontrol
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14. The Adolescent Process
Middle Adolescence (13-16yrs)
•Intellectual development: concrete, but more complex
tasks
Autonomisation:
•Self image: making the body attractive
•Independence: peak of conflicts with parents
•Intimacy: peak peer group activities
•Identity:
•Sexual: exploratory behaviour
•Moral: testing of rules
•Vocational: first job experiences
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15. The Adolescent Process
Late adolescence (17-19 yrs)
•Intellectual development: abstract tasks, logic reasoning
•Autonomisation:
•Selfimage:acceptanceofone’sbody
•Independence:reacceptanceofparentalsupport
•Intimacy:moreintimaterelationships
•Identity:
•Sexual: consolidation of sexual identity
•Moral: can set limit, ability to compromise
•Vocational: choice of profession
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16. Key Developmental Tasks of Adolescence
•Biological and sexual maturation
•Am I normal?
•Personal identity
•Who am I?
•Intimate relationships with an appropriate peer
•Am I loveable and loving?
•Independence/autonomy
•Am I competent?
Note:Features and domains of adolescent development
are universal
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17. At what age is the brain physically adult?
15-17 yrs
18-19 yrs
22-24 yrs
Thebrainplasticity:Thehumancreativityisboomingduring
adolescence,butthiscapacityfadesaftertheageof25
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18. Problem Behavior
•Whatarethedifferencesbetweenbetweenrisktaking
orexploratorybehaviorandproblembehavior?
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19. Exploring and risk taking are healthy and important
•Adolescents find their assets and what they like
•They demonstrate to themselves and others (parents?) that they
are growing up, and can do rebellious things
•They test different life styles
•They learn how to trust and nurture others outside family
•It helps them identify their personality
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20. Markers of Adolescence
What marks the beginning?
Puberty
What marks the end?
Marriage??
Childbearing??
Unclear marker of end
Age at puberty falling and age at marriage rising
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21. Adolescents Need Adult Guidance
•Untilthemid-twentiesyoungpeopledonothave
thephysicalbraincapacitytomakefullymature
decisions
•ElementsofDecisionMaking:
•CognitiveDevelopment–maynotberefinedenough
toallowforrealisticcost-benefitanalysis
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22. Adolescents need guidance…
•EmotionalDevelopment:HotEmotions(strong
undercurrentsdependantonthesituation)VSCold
Emotions(relyonbasicvaluesandcognitiveskills)
•Example:
–Situationsconcerningsexualdecisions(consentingto
havesexorusingcontraceptives)arefloodedwith
passionateemotions;
–Importantdecisionsoftenmadeintheheatof
themoment
•YoungPeopleareCryingOutforHelp!!
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23. Warning Signs
•Decreased school/vocational achievement
•Isolation, lack of relationship
•Violence, deviant behaviour
•Physical/functional symptoms
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24. The “Normal” Adolescent
•Aflexiblebehaviourwhichevolvesovertime,andkeeps
creativityinatleastsomeareas.
•Usuallyhasagoodrelationshipwithatleast1-2peers.
•Onedoesnotjudgenormalityonlyintermsofbehaviourbut
mustreflectonthemeaningofanybehaviourandthecontextin
whichittakesplace.
•Somebehavioursareacceptableforolderadolescentsbutmay
be less acceptable at younger ages.
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25. •Adolescenceisatimeofopportunity,butalsooneofrisk.
•Itpresentsawindowofopportunitytosetthestageforhealthyand
productiveadulthoodandtoreducethelikelihoodofproblemsintheyears
thatlieahead.
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26. •Atthesametime,itisaperiodofrisk:aperiodwhenhealthproblems
thathaveseriousimmediateconsequencescanoccurorwhenproblem
behaviorsthatcouldhaveseriousadverseeffectsonhealthinthefuture
areinitiated.
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27. 2. Why should we invest in the health and
development of adolescents ?
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28. Demographicrationale
Publichealthrationale
Economicrationale
Humanrightsrationale
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29. Demographic rationale –1/2
•Oneinfiveindividualsintheworld
todayisanadolescent(around1.2
billion).
•Thelargestnumberofadolescentsin
thehistoryofmankind.
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30. Demographic rationale –2/2
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31. Demographic rationale –2/2

32. Public health rationale: mortality –1/5
•Therearearound2.6million
deathsamongthe10-24year
agegroupworldwideevery
year.
•97%occurinlowandmiddle
incomecountries.
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33. Source: UNAIDS/UNICEF, 2002
Public health rationale: morbidity –3/5
38%
62%
South Asia
1.1 million
Industrialized
Countries
240,000
67%
33%
Middle East
& North
Africa
160,000
31%
69%
Central and
Eastern Europe
430,000
35%
65%
49%
51%
East Asia & Pacific
740,000
31%
69%
Latin America & Caribbean
560,000
38%
62%
Sub-Saharan Africa
8.6 million
There are over 10 million young people (15-24) living with HIV/AIDS
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34. Public health rationale: HIV/AIDS
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35. Girlsinsub-SaharanAfricaaged15-19are5timesmorelikelytohave
HIVthanboystheirownage.Why??
Between40%and58%ofsexualassaultsarecommittedagainstgirls
aged15andyounger.
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39. Public health rationale: teen pregnancy
•Everyyear,anestimated21milliongirlsaged15to19yearsand2million
girlsagedunder15yearsbecomepregnantindevelopingregions
•Approximately16milliongirlsaged15to19yearsand2.5milliongirls
underage16yearsgivebirthindevelopingregions
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40. •Theglobalpopulationofadolescentscontinuestogrow,projections
indicatethenumberofadolescentpregnancieswillincreasegloballyby
2030,withthegreatestproportionalincreasesinWestandCentral
AfricaandEasternandSouthernAfrica
•Eachyear,about15milliongirlsaremarriedbeforetheageof18
years,and90%ofbirthstogirlsaged15to19yearsoccurwithin
marriage???
•Thisdatarevealedthat……..?
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41. Why teen pregnancy?
•Barrierstoaccessingcontraceptionincludingrestrictivelawsand
policies
•Healthworkerbiasand/orlackofwillingnesstoacknowledge
adolescents’sexualhealthneeds
•Adolescents’owninabilitytoaccesscontraceptivesbecauseof
knowledge,transportation,andfinancialconstraints
•Pressuretohavechildren;stigmasurroundingnon-maritalsexual
activityand/orcontraceptiveuse;fearofsideeffects;lackof
knowledgeoncorrectuse
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42. Why teen pregnancy cont…
•Sexualviolenceiswidespreadandparticularlyaffectsadolescent
girls:about20%ofgirlsaroundtheworldexperiencesexualabuse
aschildrenandadolescents
•Whataboutyourlocalityorworedas???
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43. Public health rationale: teen pregnancy
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44. Public health rationale: teen pregnancy
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45. •Adolescentmothers(ages10to19years)facehigherrisksofeclampsia,
puerperalendometritis,andsystemicinfectionsthanwomenaged20to24
years
•Additionally,some3.9millionunsafeabortionsamonggirlsaged15to19
yearsoccureachyear,contributingtomaternalmortalityandlastinghealth
problems
•Newbornsborntoadolescentmothersarealsoatgreaterriskofhaving
lowbirthweight,withlong-termpotentialeffects
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46. •TeenpregnancycanbepredictorsofHIV
transmission.How???Discuss
•__________________________________
__________________________________
__________________________________
_________________??
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47. Public health rationale: behaviours –4/5
•Nearlytwothirdsof
prematuredeathsandone
thirdofthetotaldisease
burdeninadultsare
associated with
conditionsorbehaviours
thatbeganinyouth.
WorldDevelopmentReport
20070
0.02
0.04
0.06
0.08
0.1
0.12
0 10 20 30 40 50 60 70
Age
female
male
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Age of smoking initiation

48. Public health rationale: behaviours –4/5
•Alcohol,thesubstancemostcommonlyusedbyteens,is
involvedinmorethanone-thirdofthedeathsfrom
unintentionalinjury,homicide,andsuicide,whichtogether
accountforthree-fourthsofmortalityinthe15-to19-yearage
group
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49. Economic rationale –1/4
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1. The benefits of investing
in adolescents
2. The cost of not
investing
in adolescents

50. Economic rationale
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Theneedtomakefulluseofthe
demographicdividendwhenonecan
Givenevenreasonablygood
governance,ahealthyand
productiveworkforcecanhelp
moveacountryfrom
lowtomiddleincome

51. Economic rationale –3/4
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The need to act
before
the demographic
transition
closes doors.

52. Economic rationale -4/4
Socio-economic deprivation: a cause & consequence of adolescent pregnancy
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Too early
pregnancy
Loss of
educational
&
employment
opportunities
Poverty
" We young women are not prepared to become
mothers. I would like to continue my studies. But since
I have had my daughter, my options have changed
because I have many more obligations now."
Eylin 19, Honduras January 2006.
Source: World Development Report 2006 (World Bank, 2006.)
Too early
pregnancy
Loss of
educational
&
employment
opportunities
Poverty

53. Conventionontherightsofthe
child
•Article24:Therighttothehighest
levelofhealth&toaccessthe
requiredhealthservices
•Article17:Therighttoaccess
appropriateinformationfromthe
media&tobeprotectedfromharmful
information
•Article13:Therighttoseek,receive
andimpartinformationandideasofall
kinds
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Choices: A guide for young people
Gill Gordon, 1999.
Human rights rationale -1/2

54. Human rights rationale –2/2
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For many adolescents the world
is in fact 'flat':
•Greater access to education
•Greater access to information
about the world
•Greater ability to make personal
& professional choices
For many other adolescents, the
reality is very different

55. ELEMENTS ADOLESCENT SEXUAL AND
REPRODUCTIVE HEALTH SERVICES
ReproductiveHealthservices
Sexual&Reproductivehealtheducation
Contraception
Pregnancytestingandoption
STD/HIVScreeningcounsellingandtreatment
Prenatal&postpartumcare
Wellbabycare
Nutritionalservices
Growth&developmentmonitoring
Anticipatoryguidanceaboutsubstanceabuseandotherrisk
takingbehaviour
Counselingforlifeskilldevelopment
Screeningforvariousdisorders
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57. •Thanks a lot!!!!
•Galatoomaa!!!
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