Adolescent health burden

Adolescent health burden

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  Adolescent health burden Prof. Dr.Amany R.Aboel-Seoud Community Medicine Zagazig University
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  Objectives: • Identify majorhealth problems of adolescents & risk factors • Assess needs of adolescents • Explain the components of preventive health program for adolescents
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  Definition: • Adolescence isthe period of life between puberty and maturity. Roughly between 10 to 19 years. It is characterized by: • Rapid physical growth (called adolescent spurt).There is increase in height, weight, sexual development due to hormonal changes. • Mental (cognitive) change: from concrete operational thinking to abstract, deductive, reasoning thinking. Understand risk and benefit and appreciate future consequences of choices. • Psychological change: developing peer relationship, sexual intimate relation, determination of educational goals, establishing identity and self responsibility. Sensation of independency.
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  Adolescent burden Why ?????
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  Health burden Population number Health problems magnitude Availability of solutions Health needs
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  Demographic data • Population inEgypt: 94,666,993 (July 2016 est.) Age structure • 0-14 years: 33.21% (male 16,268,862/female 15,169,039) 15-24 years: 19.24% (male 9,371,819/female 8,839,999) around 18 millions 25-54 years: 37.47% (male 18,020,332/female 17,448,871) 55-64 years: 5.91% (male 2,771,399/female 2,826,094) 65 years and over: 4.17% (male 1,937,119/female 2,013,459)
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  Population pyramid ofEgypt
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  Global burden of adolescent health • Around1.2 billion people, or 1 in 6 of the world’s population, are adolescents aged 10 to 19.WHO reports • Estimated 1.2 million adolescents died in 2015, over 3000 every day, mostly from preventable or treatable causes. • Road traffic injuries were the leading cause of death in 2015. Other major causes of adolescent deaths include lower respiratory infections, suicide, diarrheal diseases, and drowning. • About 15% of global maternal death occurs among adolescent girls.There are 44 births per 1000 to girls aged 15 to 19 per year. • Nearly 35% of the global burden of disease has roots in adolescence. Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated. • There is an increasing global trend in adolescent obesity due to great shift in diet and activity pattern
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  Adolescent health problems
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  Main health problemsof adolescents A) Morbidity: • Infections : pharyngitis, lower respiratory tract infections, measles, mumps, meningitis, AIDS, typhoid, viral hepatitis, food poisoning, ascaris, schistosoma and enterobius. • Reproductive system problems: hydrocele, varicocele, breast and menstrual disorders. • Complication of early maternity and sexual abuse
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  • Accidents andinjuries. • Behavioral problems: cigarette smoking, addiction • Dermatological problems: acne, tenia, scabies, conjunctivitis. • Eating disorders: over eating or severe anorexia, for body shape, malnutrition: anemia, vitamin deficiency and obesity. • Psychological problems: depression, adolescent abuse. • Musculo skeletal problems: scoliosis, kyphosis • Dental problems
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  B) Mortality Adolescent mortalityin general is minimal except after: • Accidents (mainly motor vehicle), injuries, homicide, suicide, drowning, substance abuse • Complications of severe infections as pneumonia, tuberculosis, sexually transmitted diseases (HIV), diarrhea, meningitis • Cancer, chronic disease complications
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  Risk factors
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  Risky lifestyle thatlead to adolescent problems • Behaviors that contribute to unintentional injury and violence. • Tobacco ,alcohol and other drug use. • Unhealthy eating, sleeping • Inadequate physical activity. • Sexual behaviors that can result in HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancy. • Internet addiction
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  Addiction is majorproblem
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  Objectives: • Identify majorhealth problems of adolescents & risk factors • Assess needs of adolescents • Explain the components of preventive health program for adolescents
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  Adolescent needs
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  Needs of adolescents • Needsto accept autonomy, to find way to develop a life style • Needs for trust , confidentiality and love • Education needs: special teachers understanding adolescent psychology. Adjusted curricula to meet their needs. Sex and family education. • Needs for good family relationship. • Need for healthy sufficient diet. • Support safe motherhood for married adolescents by frequent antenatal care visits, safe attended labor and use of suitable family planning method. • Prevention of child labor by law, supportive working environment, ensure nutritional and health care for working adolescents. Prevention of employing adolescents in hazardous occupations. ‫المراهقون‬ ‫يحتاج‬ ‫لالحترام‬.‫واإلنصات‬..‫والحب‬‫والتفهم‬.‫االحتواءوالحنان‬ ..‫الثقة‬ ‫و‬‫الوقت‬ ‫نفس‬ ‫فى‬‫والتوجيه‬ ‫الحزم‬‫والرقابةالمسئولة‬ ‫والصدق‬‫الحسنة‬ ‫والقدوة‬ •
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  Objectives: • Identify majorhealth problems of adolescents & risk factors • Assess needs of adolescents • Explain the components of preventive health program for adolescents
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  Prevention and controlof adolescent’s health problems • What to do?Who is responsible? where? When? indicators of success?
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  What to do? I)Prevention Screening : by physical, psycho-social and laboratory examinations to assess normal development, early detection of problems. .  Weight, height measurements, screening for vision, hearing and speech defects. Screening tests for smokers and drug abuse, vulnerability for suicide, screen for tuberculosis, hypertension and diabetes and nutritional deficiency and parasitic infections.  These examinations are done at school entry, at beginning of prep. and secondary schools
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  • Immunization: MMR atentry of preparatory school.Tetanus and diphtheria vaccine booster dose, BCG for tuberculin negative adolescents. Meningococcal meningitis andTAB vaccine for typhoid in outbreaks and booster dose of hepatitis B.
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  Health education for generalhygiene, use seat belts and helmets in driving cars or motor cycles. e.g. Do not use drugs and drive. Do not smoke cigarettes or shisha. Nutritional health education, eat low fat diet, avoid junk foods. Physical exercise regularly. Appropriate sex education with abuse prevention skills at schools, colleges and also in the community to bridge the knowledge gap in adolescent.With this approach, sexual abuse and unsafe sexual practice can be reduced. This in turn prevents unwanted pregnancy, AIDS/STIs and its complications. Health education can be part of school curriculum or by teacher, doctor or conference with community leader in school.
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  • Safe (school,home) environment: Away from pollutants, safety measures against accidents, proper lightening, safe water supply, safe waste disposal, proper size desks, sufficient space for playground
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  Protection by law: •Delay age of marriage through advocacy, counseling and strict enforcement of law. • Strict enforcement of laws related to traffic rules, prohibiting sale of tobacco, alcohol and other substance of abuse to minors. • Restricting advertisement related to junk food products.
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  II)Control of healthproblems • First aid and emergency services at school or near hospitals. • Control of diseased adolescents: rheumatic heart, infections, drug abuse, skin infections , parasitic infection, anemia, obesity and psychological troubles.
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  III) Rehabilitation • Rehabilitationof handicapped adolescents: special aids, • psychological support, • special educational programs • special schools, training skills.
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  Who is responsible • Parents,family, friends, relatives • Community as a whole including: school, health care giver, scientific research, law & policies, religion, media, clubs, recreational activities, job vacancies, social workers, education, environment
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  Family role • Supplyinggood nutrition, safe home, education and health care • Good communication and strong bonds with adolescents, love, acceptance • Supervision and sharing with their adolescents' activities, supply opportunities, patience • Give trust , confidence and respect
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  Health care providerrole (WHO) 1. Understand normal adolescents development and its impact on health 2. Effectively interact with an adolescent client 3. Deliver quality health care services for adolescents 4. Apply in clinical practice the laws and policies that affect adolescents 5. Provide clinical care to adolescents with developmental delay and puberty conditions
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  6. Provide immunization 7.Manage common conditions during adolescence, proper counseling 8. Manage chronic conditions and disability 9. Provide sexual and reproductive health care 10.Provide HIV prevention, management and care 11. Detect and manage mental health problems
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  12. Assess andmanage substance use and its disorders 13. Assess nutrition status and manage nutrition related disorders 14. Detect violence and provide first-line support to the victim 15. Prevent and manage unintended injuries 16. Promote physical activity 17. Detect and manage endemic diseases
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  Media role  Increasedfocus on the use of positive youth development interventions. providing all youth support, relationships, experiences, resources, and opportunities needed to become successful and competent adults. Adolescents who are exposed to media portrayals of violence, sexual content, smoking, and drinking are at risk for adopting these behaviors  Online consultation and counseling can be considered. It will be accessible and gives a feel of security and confidentiality for adolescent population
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  Religion • Positive instructionsfor religious commitment , preying, fasting, avoid smoking, addiction, illegal sexual relationship. • Build good personality, adopt honesty, manhood, tender, responsibility, how to make decision etc..
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  Thank you