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
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 : 10 19 years
Early Adolescence : 10 13 years
Middle adolescence : 14 16 years
Late adolescence : 17 19 years
Youth : 15 24 years
Young people :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
31
st
July Every year = Teenage day
25 31
st
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. Anorexia nervosa
2. Obesity & overweight
3. Adolescent pregnancy
4. Micronutrient deficiency
5. Emotional problems
6. Behavioural problems
7. Substance abuse & injuries
8. Sexually transmitted infection
9. Thinking and studying problems
10. 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

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
PREVENTION
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