World Health Organization
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Transcript of World Health Organization
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Programming for Adolescent Health and Development
WHO's 4 S Framework
World Health Organization
Paul Bloem
London 6 February 2008
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Overview
Why focus on adolescents ? What contribution can different sectors - in
particular the health sector - make to improve adolescents' health?
Reflections on contribution a Professional Association can make to move the public health agenda - in the UK and abroad
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Adolescents are a large and very diverse population group.
Different needs.
Changing needs.
One in five individuals in the world today is an adolescent (around 1.2 billion).
The largest number of adolescents in the history of mankind.
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Defining the adolescent ….
"Child" according to CRC: < 18 years
According to the World Health Organization (WHO) “Adolescence” covers ages 10 to 19 years “Youth” covers ages 15 to 24 years “Young people” covers ages 10 to 24 years
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What kind of world do today's adolescents live in ?
For some adolescents…
• Greater access to education• Greater access to information about the world• Greater ability to make personal & professional choices
While others…
• Limited or no parental support• Limited job opportunities• Social unrest and war
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Why focus on young people?
Public health Economic development Global goals and targets Human rights
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Adolescent sexuality and fertility
UNICEF region
Annual number of
births to girls aged 15-19(millions)2000-2005
Age-specific fertility rate
(15-19 years)(Annual births per
1000 girls aged 15-19)2000-2005
Sub-Saharan Africa 4.3 127
(Eastern/Southern Africa) (1.9) (111)
(Western/Central Africa) (2.4) (143)
Middle East/North Africa 0.7 39
South Asia 3.7 56
East Asia/Pacific 1.4 18
Latin America/Caribbean 1.8 71
CEE/CIS and Baltic States
0.7 35
Developing countries 12.8 xx
Least developed countries
4.4 127
Industrialized countries 0.7 24
World 13.4 50Source: UN Population Division, Population Estimates and Projections, 2000 Revision.
"England and Wales now have the highest birth rates for under-16s in western Europe. In some areas, nearly one schoolgirl in every 50 is falling pregnant."
Telegraph , 7 January 2008
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Top ten causes of death in adolescents (10-19) World, 1999
12345678910
Road traffic accidentsMalariaRespiratory Tract InfectionsOther unintentional injuryDrowningHomicideSuicideHIVDiarrhoea Tuberculosis
MaleHIVMaternal conditionsMalariaRespiratory Tract InfectionsTuberculosisSuicideDiarrhoeaRoad traffic accidentsFiresOther unintentional injury
Female
Accidents are leading cause of death among adolescents in European Region
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<= 25<= 20<= 15<= 10<= 5No data
Min = 0
Overweight (%), 15 years olds
LastAvailable
EUROPENo data
Source HBSC
The global Obesity pandemic
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Youth suicide in CEE/CIS1989-1998
0
10
20
30
40
50
Tajikistan
FR Yugoslavia
Bulgaria
Czech Republic
PolandKyrgyzstan
Turkmenistan
UkraineLatviaEstoniaBelarusSloveniaLithuaniaKazakhstan
RussiaAzerbaijan
ArmeniaGeorgia
FYR Macedonia
RomaniaMoldovaSlovakiaUzbekistan
Hungary
1989 1998
Rises Falls
rates per 100,000 15-24 year olds
Male/female ratio = between 2 and 5
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8 July 2002 – XIV 3
Source: UNAIDS/UNICEF, 2002
38%
62%
South Asia1.1 million
IndustrializedCountries240,000
67%33%
Middle East & North Africa
160,000 31%
69%
Central and Eastern Europe
430,00035%65%
49%
51%
East Asia & Pacific740,000
31%
69%
Latin America & Caribbean560,000
38%
62%
Sub-Saharan Africa8.6 million
Why we are concerned about young people and HIV Over 10 million young people (15-24)
living with HIV/AIDS
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Key adolescents health concerns Intentional and unintentional injuries Sexual and reproductive health (including HIV/AIDS) Substance use and abuse (tobacco, alcohol and
other substances) Mental health problems Nutritional problems Endemic and chronic diseases
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Why focus on young people?
Public health Economic development Global goals and targets Human rights
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Adolescent health figures on the global development public health agenda
Investing in young people makes economic sense Return on investments.. Using the "demographic bonus" Economic development requires a health educated
workforce
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Why focus on young people?
Public health Economic development Global goals and targets Human rights
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Global goals and targets
The UN General Assembly Special Session on Children provides the broader context
develop and implement national health policies and programmes for adolescents, including goals and indicators, to promote their physical and mental health
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Global goals and targets
The MDGs of particular relevance to Adolescents
Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Reduce by three quarters the maternal mortality ratio
Entry points: HIV & Maternal Mortality
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Global goals and targets
The UN General Assembly Special Session on HIV/AIDS
provides focus to move from the aspirational to the operational
By 2010, ensure that at least 95% of young people have access to the information, skills and services they need…to reduce their vulnerability to HIV
By 2010 , HIV prevalence among young people (15-24 years) reduced prevalence by 25% globally
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Why focus on young people? Public health Economic development Global goals and targets Human rights
Convention of the Rights of the Child - General Comment # 4 on Adolescent health and Development
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Overview
Why focus on adolescents ? What contribution can different sectors - in
particular the health sector - make to improve adolescents' health?
Reflections on contribution a Professional Association can make to move the public health agenda - in the UK and abroad
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What do young people need to improve their health and development?
Information and Life Skills Services and Counselling Safe and Supportive
environment Opportunities to
contribute and participate
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A framework for programming for young people's health and development
Health Sector
Education Sector
Media And many others: labour, criminal-justice, social services, parents, peers, etc.)
Information and Life Skills + +++ ++ ++Services and Counselling +++ + + +Safe and Supportive Environment
+ ++ ++ +++Opportunities to participate + + + ++
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What are the priorities for the health sector?
Collect, analyse and disseminate the data that are required for advocacy, policies and programmes
Provide services that include a focus on prevention, treatment and rehabilitation
Support the development of evidence-informed policies and strategies that provide vision and guidance
Mobilise, support and coordinate with other sectors
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The health sector contribution
Strategic Information Services and commodities Supportive evidence-informed
policies Strengthening other sectors
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Strategic Information
Collect, analyse and disseminate data needed for policies, programmes and advocacy
Monitor and evaluate the quality, coverage, (and cost) of interventions
At a minimum disaggregate existing data (epi and HMIS) by age and sex!
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Services Increasing the coverage and utilization of services for
young people Delivering a package of evidence based interventions in effective and sustainable ways Standards of Care for adolescents to increase the
coverage of services for adolescents India Tanzania Moldova
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Supportive evidence-base policies Support countries to develop policies
and strategies that are based on evidence
Strengthen Evidence-base: facts for policy makers HIV interventions for young people Prevention of Tobacco Use in YP Intervention for Mental health in resource poor settings
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Overview
Why focus on adolescents ? What contribution can different sectors - in
particular the health sector - make to improve adolescents' health?
Reflections on contribution a Professional Association can make to move the public health agenda - in the UK and abroad
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Contribution Professional Associations can make … in England and beyond
Build critical mass & capacity for adolescent health Health Workers Orientation Modules – Commonwealth Medical
Association EUTEACH – European collaboration Liverpool School of Tropical Medicine - district managers training
Evidence base: need for quality interventions research Mwanza trial – LSHTM
Advocate for effective Policies – eg. National youth health policy - Every Child Matters Sexuality education / substance education
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Contribution Professional Associations can make … in England and beyond
Ensure access to services Ensure NHS provides quality services to adolescents
Your Welcome! GP standards QAF
Influencing the international youth health agenda DFID …ensuring the MDGs are reached IAAH
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The health of adolescents in the world.
Think globally, act locally
Act locally, think globally