Essays

Adolescence is a vital stage in human development, a time of rapid, often uneven development of physical, emotional, intellectual, social, moral, spiritual and aesthetic aspects. Adolescents are susceptible and vulnerable to external influences and the socio- culture environment has an impact on their health, development, security and dignity. Habits and behaviours picked up during adolescence, including risk- taking behaviours, substance abuse, eating habits, conflict resolution, etc have often lifelong impact.

Of course, adolescents are not a homogenous entity and they have diverse needs relating to their development, social and economic security and health. Unfortunately, many adolescents in the Member Countries of WHO South- East Asia Region are at a disadvantage as they have had insufficient formal and vocational education. Also, there are inadequate opportunities for sports and exercise, which help to develop physical, mental and social capabilities.

While many girls drop out of school, a large number of adolescents are further disadvantaged and vulnerable as they live on streets, face poverty and deprivation, are victims of violence and exploitation or live in situations of conflict.

Adolescent behaviour and health have public health implications. Prevailing malnutrition, anaemia, stunting and lack of immunization have an adverse impact not only directly on the young people, through general morbidity and premature death, as in high maternal mortality rates (MMR), but there are also inter-generational effects including higher infant mortality rate (IMR).

In countries of WHO South-East Asia Region, adolescents face dual health problems - those associated with early marriage and childbearing among the conservative segments of the population, as well as the changing lifestyle related health problems among the more progressive segments of the population. Throughout WHO South-East Asia Region, the majority of people married and unmarried, become sexually active during adolescence. Decreasing family influence, earlier puberty and later marriage extend the risks of unprotected sex among unmarried adolescents in these parts of the world. Most lack experience and skills in self- protection and access to services and supplies  such as counseling services and contraceptives, like condoms.

Adolescent sexuality may lead to adolescent pregnancy, unsafe abortions, RTI, STI/HIV and social problems. Adolescent pregnancy has 3-5 times higher risk of adverse outcome, as the IMR, MMR and Low Birth Weight babies are much higher. Another important fact is that up to 70% of mortality in adulthood have its roots in the adolescent period, There is a need for developing adolescent friendly health services, as the traditional health services generally do not recognize- adolescents as a special constituency that has specific, special needs. Adolescents require Information and Skills, Counseling, Friendly Health Services and a safe and supportive environment that encourages them to express themselves, have meaningful relationships and provide viable options for educational, economic and social upliftment. Programming for adolescents can be accomplished only with supportive policies, translated into effective strategies. WHO Regional Office for South-East Asia and WHO Country Offices in the Region have been supporting efforts of the Ministries of Health and other stakeholder ministries in these efforts by providing technical support and capacity building. WHO has assisted countries, including Bangladesh, Maldives, Myanmar, Nepal, India and Indonesia in formulating effective strategies to address the health needs of adolescents. In India, adolescents (aged 10-19 years) constitute 21.8% of the population i.e. 207 million in number. The first Adolescent Friendly Health Services (AFHS) Centre in India was operationalised in August 2001 at Safdarjung Hospital, New Delhi. It has partnerships with NGOs, schools and colleges and is a good example of inter-sectoral partnership and supporting governments on their pro- adolescent policy making. Six more AFHS centres in different parts of the country were opened in India. Nepal has recently begun providing services to adolescents in Bir Hospital, Kathmandu.

An Inter Agency Working Group on Population and Development (IAWG-P&D), comprising 14 UN Agencies has been working on Adolescent Health and Development WHO Regional Office for South-East Asia and the India. Country Office are actively involved in the ADH activities of IAWG. One of the important initiatives taken up jointly was the development of Life skills modules for health promotion of out of school adolescents- The Draft modules were formally launched just a few days ago.