Adolescents and

Youth reproductive 1

health
Lecture 1
by :
Sadat M. (BSc., MPH/Rh)

Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024

 Learning objectives
2

At the • Defining Adolescence

end of • Understand adolescent Developmental changes
this
• Discuss the rational of adolescents reproductive health
lecture,
the • Identify RH risks and consequences in adolescents
students • Explain the basic concepts of Youth Friendly Services (YFS)
are
expected • Identify common strategies to address ASRH problems.
to:

Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024

 Brainstorming questions 3

Who are adolescents, youth, young people?

What makes adolescence special ?

Why do we need to give special emphasis on

youth and adolescents Reproductive Health?

Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024

 Introduction
4
 While the adolescent classification is mostly universal, different continents or

nations adopt different age ranges for youth.

The definition of youth is also influenced by the constant changes in demographic,

economic, and socio cultural circumstances.

Adolescence
 A person of 10-19 years (UNFPA, WHO, UNICEF)
 Early adolescence : 10-13 years
 Middle adolescence: 14-16 years
 Late adolescence : 17 -19 years
 5
Intro….
 Teen age

o A person of age 13-19 years (American  Young people

expression) o A person of 10-24 years (UNFPA ,WHO,

A Youth
UNICEF)
o person of 15-24 years (UNFPA, WHO,
UNICEF)
o A person 10-35 years (African youth

o A person 15-35 years (African youth charter)

charter) o A person 10-29 years (Ethiopia youth
o A person 15-29 years (Ethiopia youth
policy)
policy)
 Defining Adolescent
 Age Related definitions: WHO
Young people
10_______________________________24
Youth
15________________________24

Adolescent
10________________________19
Adulthood
Childhood

6
 Intro….
7

Adolescence is the transition

period between childhood It is a period when their
and adulthood.

• They are no longer children • Decisions, behaviors and

and not yet adults
relationships determine
• Major physical, psychological
their health and
and social changes occur
development
during this period that can
shape their entire life.
Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024
 Intro….
8

• SRH issues are added to the health concerns of the

Adolescen individual
ce is the • Adolescents are not knowledgeable about sexuality
and reproduction
period • Abstinence not encouraged by peers
• Gender equality not promoted
during • Healthy and responsible sexual and reproductive
which behaviour not discussed within family

Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024

 9

Why Focus on Young People?

Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024

 Rationale for ASRH
10

1. Demographic Rationale
2. Transition from Childhood to Adulthood

3. Youth Are Assets

4. Huge RH Risks and Consequences
5. It is issue of human right

Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024

 Adolescent Developmental Stages
• Early Adolescents
• Physical changes: growth of breast, hair,
genital organs
• Middle Adolescents
Three • Psychological changes (cognitive and
devel emotive): desire to love or being loved,
sexual attraction
opme • Young Adult
ntal • Social changes: more independence,
opinions of friends are more important
stage
s

11
 Adolescent Developmental Stages
• Opinions of friends may become
more important,
• seek more independence from
• Is the shift in intellectual family
Cognitive problem- solving skills Social • Considering sexual relations,
developme • It is a shift from concrete marriage, parenthood - signs of
nt:
changes maturity.
to abstract thinking • Social development brings with it a
broader set of influences than just
family: peers

• Desire to be loved or feel

close to someone
• Sexual feelings/ attraction Moral
Emotional • Brings with it idealism, social
to opposite sex developme engagement, and volunteerism
changes
• Beginning to question nt
parents and authority

12
 13

Adolescent Health
problems

Reproductive lecture notes by Sadat M (MPH/Rh) 11/07/2024

 Key facts
Over 1.5 million adolescents and young adults aged 10–
24 years died, nearly 5000 every day.

Injuries (including road traffic injuries and drowning),

violence, self-harm and maternal conditions are the
leading causes of death among adolescents and young
adults.

Half of all mental health disorders in adulthood start by

age 14, but most cases are undetected and untreated.
14 11/07/2024
 Key facts
Early onset of substance use is
associated with higher risks of
developing dependence and other
problems during adult life.
Globally, there are 43 births per
1000 to girls aged 15–19 years per
15
year. 11/07/2024
 Global major health problems of
adolescents include:
Mental
disorders
Homelessne Substance
ss use

Unintended
Violence
regnancies
Sexually
transmitted
infections,
including
Malnutrition
human
immunodefic
16 iency virus 11/07/2024
 In Ethiopia, the major health problems of
adolescents include:
• About 4.4% of Ethiopian adolescents
and youth smoke cigarettes or other
Mental • 12-25% childhood mental illnesses
tobacco make the
products.
disorders highest burden of mental illnesses in the health
sector.
Substance • The practice is more common among
Violence
use urban adolescents and youth and
among those in Harari, Somali and
Dire Dawa regions.

Harmful • Khat consumption among adolescents

Traditional and youth is 51%; higher among
males (56.5%) than females (36.6%).
Practices
Sexually
transmitted
Adolescent
infections,
Nutrition
including
(Malnutritio
human
n)
immunodefic
17 iency virus 11/07/2024
 Why do young
people engage
in

Health risking
behaviors?

18 Lecture by Sadat Mohammed 11/07/2024

 There are two basic assumptions about why
young people engage in health risking behaviors

Two basic assumptions are

• Adolescents take risks because they lack knowledge
• Adolescents engage in health risking behaviors
because they think they are not vulnerable
 Factors contributing to AYRH Problems

1. Immediate factors
2. Underling factors
• A significant number of youth are
in poor economic conditions due
to unemployment.
• The increasing migration of
adolescents and youth from rural
to urban areas further aggravates
the situation.

21 Lecture by Sadat Mohammed 11/07/2024

 (1)Early Sexual debut
When
entering • Do not use any form of contraception

into sexual • Encounter difficulties in negotiating safer

relations sex
for the • Unplanned parenthood
first time, • More susceptible than adult women to
adolescent STIs/HIV
s:
22
(1)Early Sexual debut
 (1)Early Sexual debut

24 Lecture by Sadat Mohammed 11/07/2024

 (1)Early Sexual debut

25 Lecture by Sadat Mohammed 11/07/2024

 (2)Adolescent/Teenage
Pregnancy

Many For young

adolescents in More young men, most
sub-Saharan women marry sexual activity
Africa are than young takes place
sexually men outside of
experienced marriage

26
 Adolescent pregnancy
 Every year, an estimated 21 million girls aged 15–19 years in developing regions
become pregnant and approximately 12 million of them give birth.
 While the estimated global ABR has declined, the actual number of childbirths to
adolescents continues to be high.

27
Adolescent pregnancy
• Adolescents are not prepared biologically,
psychologically, economically or socially to bear
Social and economic consequences
rear a child
•Abortion
Girls who in Adolescents
become Pregnancy
pregnant before the and
age child
of 18birth
More related
years
girls aged are complications
15 more likely to
MMR
are19theinLeading
yearsthis
dieage cause
from of death among
pregnancy-related girls
causes aged
than
experience violence within a marriage or partnership.
• Each year at least group2 ismillion
twice thatyoung
women inwomen
15–19from
years globallyworldwide
any
• Associated with higher
Adolescent pregnancy morbidity
their twenties.
and childbearing andleads
often mortality
other causes.
girls (mothers
to drop and
out of school,
have unsafe Babies bornmainly
abortions to mothersdue underto20 inaccessibility
years of age face higher or
• children.)
although efforts are underway is some place to enable them to return to school
risks of low birth weight, preterm delivery and severe
costschild
after of safe
birth,services.
this may well jeopardize neonatal conditions
girls’ future education and
employment opportunities

• Affect educational attainment

 (3) Abortion in Adolescents
 Adolescents aged 15–19 years in low- and middle-income
countries (LMICs) had an estimated 21 million pregnancies
each year, of which approximately 50% were unintended and
which resulted in an estimated 12 million births.

 55% of unintended pregnancies among adolescent girls

aged 15–19 years end in abortions, which are often unsafe
in LMICs.
29
 (3) Abortion in Adolescents
 About 13% of maternal deaths worldwide are due to
complications related to unsafe abortion (as high as
1/3 in some countries).

 Most of the deaths occur in countries where abortion is

legally restricted, leading to procedures performed under
unsafe conditions.

30
 Youth friendly services (YFS)

11/07/2024 Sadat Mohammed 31

 Brain storming

What is YFS?

When do we say the service is YF?

11/07/2024 Sadat Mohammed 32
 Youth-friendly services

Definition:
YFS represent an approach which brings together the qualities that young people demand,

with the high standards that have to be achieved in the best public services.

AYFS Are services that are accessible to, acceptable by and appropriate for adolescents

and youth.

11/07/2024 Sadat Mohammed 33

 YFS....
What do adolescents need in RH serve use?
Confidentiality
Short waiting time
Low cost/free service
One-stop shop (all-in-one-centre)
Clinic is close to home, school or work
Friendly staff
Convenient opening hours
Provider is not rushed
11/07/2024 Sadat Mohammed 34
 Characteristics of YFS

According to WHO 2002,

• Accessible
• Acceptable
• Appropriate
• Comprehensive
• Equitable
• Effective
• Efficient
11/07/2024 Sadat Mohammed 35
 Characteristics....
Accessible, acceptable and appropriate
 In the right place, at the right time and at the right price

Comprehensive
 Deliver an essential package of services

Equitable
Do not discriminate against any sector of youth on grounds of gender,
ethnicity, religion, disability, social status or any other reason
Reach out to those who are most vulnerable and those who lack services
11/07/2024 Sadat Mohammed 36
 Characteristics....
Effective
 Delivered by trained and motivated health care providers

Efficient
 Can be given successfully without wasting time and energy

11/07/2024 Sadat Mohammed 37

38 Lecture by Sadat Mohammed 11/07/2024
 Priority Areas, Strategies, Performance
Targets and Interventions
• Ethiopia set a strategic framework proposes six priority areas for action:
1. Increasing access to AYH information and age appropriate CSE (Comprehensive Sexuality Education)
and life-skills education;
2. Enhancing equitable access to high quality, efficient and effective adolescent and youth-friendly health
services;
3. Strengthening strategic information and research on adolescents and youth;
4. Promoting a supportive and enabling policy environment;
5. Supporting and facilitating youth engagement and ownership of health programs; and
6. Strengthening inter-sectoral coordination, networking and partnership.11/07/2024
Lecture by Sadat Mohammed 39
 Effective policies and programs areas to
address AYA health issues
• Access to health care
• School-based health care services
• Violence prevention
• Mental health and substance use interventions
• Teen pregnancy prevention
• HIV prevention
• Nutrition
11/07/2024
Lecture by Sadat Mohammed 40
 Reading assignment

Epidemiology of MTCT of HIV

Modes of Transmission of HIV

Ethiopian adolescent- and youth-friendly service standards

11/07/2024 Sadat Mohammed 41

 THANK YOU

11/07/2024 Reproductive lecture notes by Sadat M (MPH/Rh) 42