Adolescent sexual and reproductive health
Dostogir Harun
Email: [email protected] Cell: 01556 636 545
What is adolescent reproductive health
• Health is a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity."
• Adolescent health:
• Reproductive health:
Reproductive health is defined as a state of physical, mental, and social
well-being in all matters relating to the reproductive system, at all
stages of life. Good reproductive health implies that people are able to
have a satisfying and safe sex life, the capability to reproduce and the
freedom to decide if, when, and how often to do so. Men and women
should be informed about and have access to safe, effective, affordable,
and acceptable methods of family planning of their choice, and the
right to appropriate healthcare services that enable women to safely go
through pregnancy and childbirth
What is adolescent reproductive health
– Reproductive Health has a particular interest on the
impact changes in reproductive health have globally,
and therefore encourages submissions from
researchers based in low- and middle-income
countries
Adolescent reproductive health
• Adolescents – young people between the ages of 10 and 19 years – are often thought of as a healthy group. Nevertheless, many adolescents do die prematurely due to accidents, suicide, violence, pregnancy related complications and other illnesses that are either preventable or treatable.
• Many more suffer chronic ill-health and disability. In addition, many serious diseases in adulthood have their roots in adolescence. For example, tobacco use, sexually transmitted infections including HIV, poor eating and exercise habits, lead to illness or premature death later in life (WHO)
• So we can tell simple, any health challenges that specially young people suffer considering their age factor is adolescent health.
• Mortality
– There are around 2.6 million deaths among the 10-24 year age group worldwide every year
– 97% occur in low and middle income countries
• Morbidity
– There are over 10 million young people (15-24) living with HIV/AIDS
Why public health concern?
Why public health concern?
• Behaviours
– Nearly two thirds of premature deaths and one third of the total disease burden in adults are associated with conditions or behaviours that began in youth.
Age of smoking initiation (World Development Report 2007 (
0 0.02 0.04 0.06 0.08 0.1 0.12
0 10 20 30 40 50 60 70
Age
female male
The Health and Development of Adolescents has an Impact throughout the Life Course…for example…
Health problems
during adolescence Age when health problem has its Major Impact
Adolescence Adulthood Childhood
(next generation)
Accidents and
Violence
+++ +
Adolescent
Pregnancy
++ + ++
Human Papilloma
virus
+ +++
Tobacco use
+ +++ +
HIV
+ +++ ++
Adolescent
Reproductive health -Girls
• When a girl grow older her breast start to grow
• There might be a minor discomfort or pain as the breast grow
• Usually breast is round, conical, upright soft or firm depend on age and health condition
• Two breast may not be equal in size
• Nipple erection may happen (
both sex) it its touched and stimulated
• The breast begin to produce milks while she is pregnant and end when the baby does not need the milk
• The size may be different depending on health condition
• Breast milk also very person to person depending on health condition
Reproductive health –Girls (Menstruation)
•Menstruation(natural and necessary) i.e. regular cycles of bleeding par vagina
•Normally menstruation of a girl start between 10-15 year of age
•This is the process in order to develop reproductive capabilities
•At this time the ovaries begin to release ova, thus a girl becomes capable of bearing a child
•Every month the ovaries release an egg. The uterus prepares itself with a thick lining of blood for the protection, safety and the nutrition of the fetus (baby)
•It occur to all girls while growing up and its happen each month
•Many girls get frightened by watching the blood first ( if not oriented)
•Girls notice some whitish sticky fluid come out at certain times of the month
•The flushing out continues for three to seven days and it is menstruation or
Personal hygiene during menstruation
• Personal hygiene is necessary to prevent RTI, local itching , bad odour
• Regular bath, wear neat, sun dried cotton clothes and undergarments
• Wash the genital area after each use of the toilet, also after urination
• Use of cloth or sanitary napkin depends on personal choice, but make
sure to change them frequently depending on the quantity of flow
• Do not wash insides of vagina with soap or any other product
• Before onset of flow it is comfortable to trim the hairs around genitalia;
shaving is not recommended.
Reproductive health-Boys
• As boys grow up their bodies become more muscular,
• Their voice change and hair seen to body
• The body become producing semen
(whitish sticky substance , comes out of the penis)• Its formed in the testes continuously and contains sperms
(male egg)• Some time semen comes out at night and boy may be frightened
(if not oriented)• Sometime, boy may notice some drop of whitish fluid during urinating
• Erection may also occur more frequently while boys are excited
• Producing semen is the sign that the boy got reproductive egg
Key reproductive health concern for young people
•
Sexual & reproductive health, including gender-based violence
•
Malnutrition and anaemia
•
Mental health and substance misuse
Disease Control Priorities in Developing Countries:
Elizabeth Lule, James E. Rosen, Susheela Singh, etc
Adolescent Health Programs
International Perspectives on Sexual and Reproductive Health ,Michelle J. Hindin and Adesegun O.Fatusi , Volume 35,Number 2, June 2009 A
Review
• Health Risk Behaviors among Adolescents and Young People
– Injuries
– Mental Health
– Smoking, Alcohol, and Drug Use – Nutrition and Exercise
– Sexual and Reproductive Behaviors – Poverty and Adolescent Health
Injuries
• Violence and war account for more than ¼ of injury-related deaths among young
• Adolescent people in their 20s are an important part of the military forces in all countries and are at high risk, in areas where armed conflict is occurring
• About 300,000 soldiers under the age of 18 are involved in armed conflicts (UNICEF)
• Homicide a cause of death for young men, leading cause of death for young men in some Latin American countries (WHO 2001)
• In addition, road accidents, Self-inflicted injuries, suicide, are also a major health problem for young people
• Accounting for 4% of DALYs in men and 3% of DALYs in women age 15- 29
Mental Health
• Depression, schizophrenia, and other mental illnesses are important causes of illness and death among young and account for a significant proportion of DALYs for both men (18%) and women (23%) age 15 to 29;
for 5- to 14-year-olds, it is about 9 percent for boys and 8 percent for girls
• The relative importance of mental illnesses is much greater in the high- income countries
Smoking, Alcohol, and Drug Use
• Most adult smokers worldwide begin smoking in adolescence or earlier (WB 1999a)
• An estimated 15% of young men and 7% of women age 13 to 15 are currently smoking cigarettes (WHO and CDC)
• Every day, worldwide, almost 100,000 young people start smoking, more than two-thirds of them in LMICs (World Bank)
• At preset around 300 million young people smoking, half will eventually die from tobacco use(WHO 2001b)
• By 2030, tobacco is expected to be the single biggest cause of death worldwide (10 million deaths per year (World Bank).
• Alcohol and drug use account for 8 percent of all DALYs for young men age 15 to 29 but for only 2 percent for young women
• Evidence indicates that young people are starting to drink at earlier ages
• Longitudinal studies have found that the earlier young people start drinking, the more likely they are to experience alcohol-related injuries and alcohol dependence later in life
(WHO 2001a)
Nutrition and Exercise.
• Nutritional deficiencies such as anemia are widespread in both young men &
women
• Chronic undernutrition that causes pregnancy and childbirth, stunting among young people delays growth and physical maturation
• Undernutrition increases the risks to pregnant mothers and their newborns
• Diet and lifestyle-related chronic diseases are the most important health problems in LMICs.
• Cardiovascular diseases that are responsible for 10% of DALYs lost in LMICs, typically occur in middle age or later; risk factors are determined to a great extent by behaviors learned during childhood and adolescence and continued into adulthood, such as dietary habits and smoking
• Physical activity can decreased markedly in adolescence, particularly in girls, and obesity has increased substantially (MacKay andMensah 2004).
Sexual and reproductive behaviors.
• Worldwide, the majority of young people initiate sexual activity during adolescence and face sexual complication
• The age at first marriage has also increased in most parts of the world over recent decades, except in Latin America (Mensch, Singh, and Casterline 2003).
• All these key transitions to adulthood bring with them the potential for risks to health that may have both immediate and longer-term effects
• Among young women age 15 to 29, illnesses related to pregnancy and childbearing account for 16 percent of their DALYs
• Young mother and their child are more risky than adult mother
• Adolescents are at most risk of acquiring sexually transmitted infections (STIs)
• About half of all HIV infections occur in peopleunder age 25
