ADOLESCENT HEALTH

Dr.I.Selvaraj,I.R.M.S

B.SC.,M.B.B.S.,(M.D Community medicine).,D.P.H.,D.I.H.,P.G.C.H&FW(NIHFW,New Delhi)

Sr.D.M.O (ON STUDY LEAVE)

INDIAN RAILWAYS MEDICAL SERVICE

ADOLESCENT HEALTH

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.
They are no longer children yet not adults. It is characterized by
rapid physical growth, significant physical ,emotional,
psychological and spiritual changes.
Adolescents constitute 22.8% of population of India as on 1st
march 2000.
They are not only in large numbers but are the citizens and
workers of tomorrow.
The problems of adolescents are multi- dimensional in nature and
require holistic approach.
A large number of adolescents in India are out of school,
malnourished, get married early, working in vulnerable situations,
and are sexually active.
They are exposed to tobacco or alcohol abuse.

Adolescence
Early Adolescence
Middle adolescence
Late adolescence
Youth
Young people

: 10 19 years
: 10 13 years
: 14 16 years
: 17 19 years
: 15 24 years
:10 - 24 years

Challenges in adolescent development

and health in INDIA:

1. 45% of adolescent girls under nourished

2. 20% of adolescent boys under nourished
3. Early marriage 26% < 15yrs girls, 54%
< 18yrs
4. 20 30% adolescent boys sexually active
5. 10% adolescent girls sexually active
6. 59% adolescents know about condoms
7. 49% adolescents know about
contraceptives
8. 4.5% drug abuse
9. 50% of all HIV positive new infections are
in the age group of 10 25yrs
10. Adolescent abortion 1 4.4millions

INDIAN ACADEMY OF PAEDIATRICS

PROPOSAL:
1999 = Family Education for
adolescents
2000 = Teenage care clinic in the
hospitals
2001 2003 = Teenage care wards
for girls and boys in the hospitals
31st July Every year = Teenage day
25 31st July Every year = Teenage
week

 Early adolescence(10 -13yrs):

Spurt of growth of development
of secondary sex.
Middle adolescence(14-16yrs):
Separate identity from parents,
new relationship to peer groups,
with opposite sex and desire for
experimentation.
Late adolescence(17-19yrs):
Distinct identity, well formed
opinion and ideas

The following changes are taking place during

adolescent period:
a) Biological changes onset of puberty
b) Cognitive changes emergence of more
advanced cognitive abilities
c) Emotional changes self image, intimacy,
relation with adults and peers group
d) Social changes transition into new roles
in the society

SMR(Sexual Maturity Rating)

Genitalia stage for boys(G1 to G5)
Pubic hair stage(PH1 to PH5)
Breast development for girls(B1 to
B5)

Impact of adolescence:
1) Lack of formal or informal education
2) School dropout and childhood labour
3) Malnutrition and anemia
4) Early marriage, teenage pregnancies
5) Habits and behaviours picked up during
adolescence period have lifelong impact
6) Lot of unmet needs regarding nutrition ,
reproductive health and mental health
7) They require safe and supportive
environment
8) Desire for experimentation
9) Sexual maturity and onset of sexual activity
10) Transition from dependence to relative
independence

Ignorance about sex and sexuality

Lack of understanding
Sub optimal support at family level
Social frustration
Inadequate school syllabus about adolescent
health
Misdirected peer pressure in absence of adequate
knowledge
Lack of recreational, creative, and working
opportunity

ADOLESCENT HEALTH PROBLEMS

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Anorexia nervosa
Obesity & overweight
Adolescent pregnancy
Micronutrient deficiency
Emotional problems
Behavioural problems
Substance abuse & injuries
Sexually transmitted infection
Thinking and studying problems
Identity problems

Reasons for adolescent reluctant to seek help

FEAR
UNCOMFORTABLE WITH OPPOSITE HEALTH WORKER
POOR QUALITY PERCEPTION
LACK OF PRIVACY
CONFIDENTIALITY
CUMBERSOME PROCEDURE
LONG WAITING TIME
PARENTAL CONSENT
OPERATIONAL BARRIER
LACK OF INFORMATION
FEELING OF DISCOMFORT

PREVENTION

HEALTH EDUCATION
SKILL BASED HEALTH EDUCATION
LIFE SKILL EDUCATION
FAMILY LIFE DUCATION
COUNSELLING FOE EMOTIONAL STRESS
NUTRITIONAL COUNSELLING
EARLY DIAGNOSIS & MANAGEMENT OF
MEDICAL AND BEHAVIOURAL PROBLEM

Syllabus for adolescent health education

Development of secondary sexual characters &
menarche
Problems associated with menstrual cycle &
menstrual hygiene
Body image
Nutritional needs (micronutrients)
Managing emotional stress
Early marriage
RTI/HIV/AIDS
Safe sex
Family life including pregnancy
Child rearing & responsible parenthood
Stress management
Substance abuse

ADOLESCENT FRIENDLY HEALTH

SERVICE

ADOLESCENT FRIENDLY HEALTH CENTER SERVICES

Reproductive Health services

Sexual & Reproductive health education
Contraception
Pregnancy testing and option
MTP
STD/HIV Screening counselling and treatment
Prenatal & postpartum care
Well baby care
Nutritional services
Growth & development monitoring
Anticipatory guidance about substance abuse and
other risk taking behaviour
Counseling for life skill development
Screening for various disorders

CRITERIA FOR ADOLESCENT FRIENDLY

HEALTH WORKER

Welcoming and friendly Nature

Knowledgeable
Presentable
Have good communication skill
Maintain confidentiality
Punctuality
Flexibility
Understanding
Good listener
Non-judgemental

Criteria for Adolescent Friendly Health Center

Good reception
All facilities
Accessibility
Quality care service
Well trained people
Security
Easy communication to the outside
Privacy
Conducive environment

Conclusion:
This adolescent period is hazardous for adolescent
health due to absence of proper guidance and
counselling.
Family has a crucial role in shaping the adolescents
behaviour
They have to ensure a safe, secure, and supportive
environment for the adolescents.
Family members in the community to be informed
and educated about this problem.
A positive and encouraging attitude has to be
developed among the family members and parents.
School teachers should be trained on adolescent
health.
Community leaders play a vital role on adolescent
health care.

THANK YOU

Reference:
1.ESSENTIAL PAEDIATRICS BY O.P.GHAI(6th edition Revised)
2.INDIAN PUBLIC HEALTH JOURNAL = SEP-2002, MARCH- 2001