International Handbook on Adolescent Health and Development: The Public Health Response
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BMC Medical Education Eke, H. Sayal K. Transition between child and adult services for young people with attention-deficit hyperactivity disorder ADHD : Findings from a British national surveillance study. The British Journal of Psychiatry, Blood, Heart and Circulation ; volume Das S et al. Infectious Disorders - Drug Targets in press. Case Rep Health Med ; Conference Reports. Springer International Publishing.
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Of the 1. Further, adolescents not in school are more vulnerable to trafficking, recruitment into armed conflict, and child labor.
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Many adolescent girls marry and begin bearing children at a young age, contributing to the perpetuation of poverty and health problems. Adolescents also represent a resource to be cultivated through education and training, to move them toward economic independence. This can be accomplished through initiatives to improve their reproductive health, and through positive interpersonal relationships to help them avoid risky behaviors and make positive decisions about their futures. The new handbook will be invaluable for a wide range of stakeholders working with adolescents in low- and middle-income countries.
The volume tackles both the challenges and the promise of adolescence by presenting recent research on social, emotional, behavioral, cognitive, and physical development. The volume looks at adolescent development with a distinctive focus on issues that affect adolescents in low- and middle-income countries.
It adopts a positive framing, representing young people as opportunities, to accelerate a positive shift in discourses around young people. It combines up-to-date reviews of research on adolescent development by the world's leading authorities with thoughtful discussions of some of the most pressing concerns that societies face in both developed and developing countries in their efforts to minimize problematic outcomes and maximize positive development during this critical stage of development. In most contexts, policy and programme responses to adolescents are fragmented and inconsistent.
Disconnects between national level policies and local services, as well as lack of continuity with early childhood responses, present a significant challenge to ensuring a coherent approach for this age group.
All the participants aged over 18 signed an informed consent document. Of all the participants invited for the study, five adolescents were excluded because of the lack of parental consent. Key informants and health professionals were recruited by being invited directly within the study settings.
The health professionals included in the sample were those working with adolescents in the YFHS selected for fieldwork.
Global Challenges in Adolescent Health (POPH) — The University of Melbourne Handbook
They were mainly midwives, followed by social workers, and in smaller numbers psychologists, nutritionists, health technicians and one nurse. Adolescents were recruited through three mechanisms: a being contacted through health professionals and teachers; b directly by the research team in waiting rooms of health centres c and through snowball sampling, in which the first participants recruited adolescents they knew.
Field notes from observations and audio recordings from interviews and discussion groups were transcribed verbatim, and analysed using thematic analysis, a qualitative method that enables thematic patterns to be identified and analysed from the collected data 31 with the support of NVivo software. The interviews were conducted in Spanish. A low turnout was expected; nonetheless, 18 health professionals and 41 adolescents attended the meetings, where the main findings of the research were presented.
Participants were invited to give their opinions, which were useful for providing missing information and deepening certain topics. The main need reported by adolescents and confirmed by the health professionals is access to quality information and counselling, on topics ranging from physiological processes, such as their reproductive cycles, preventing pregnancy and sexually transmitted diseases, to the affective dimensions of sexuality and parenthood.
And… knowing how to discriminate what's true from what's false, that's the problem. Regarding the family, most of the adolescents felt that their parents consider sexuality as a taboo topic, not to be discussed. Young interviewees declared that schools teach basic sexual education that does not satisfy their needs. The adolescents acknowledged that this lack of quality information leads to unwanted pregnancies, which could be avoided with adequate sexual and reproductive health education.
Knowing how to effectively prevent pregnancy appears to be an urgent need. If you don't have the basic knowledge of what it is to get pregnant and you cannot prevent a pregnancy, you're going to have sex anyway… and that is the concern of us as teenagers. The adolescents also recognized a growing acceptance of different sexual identities; for example, some of them spoke about themselves as heterocurious.
Now we have to give space to the needs of the trans, the lesbian. I feel they don't have an adequate space in the health system. The need for quality information on sexual and reproductive health is common to all adolescents, although the users of YFHS reported a higher understanding of physiological processes than those who had not accessed them. In most adolescents who were sexually active, the desire to start or continue using contraceptive methods was fundamental.
Confidentiality was also mentioned as an important need for all adolescents, and, while the current health regulations guarantee confidentiality in health care for adolescents over 14, some said that they could only access health care if a parent were present. Key informants and health professionals agreed that the topic of adolescent health has been on Chile's national agenda in recent years.
Despite this perceived progress, they consider that the health sector still lacks effective strategies for approaching adolescents. The development of intersectoral strategies, especially with education, therefore becomes crucial to reaching adolescents wherever they are, rather than waiting for them to approach the health centres.
Although the YFHS Programme explicitly stipulates that health professionals in charge of adolescent care must do extramural activities in schools, the type of activities and the number of hours allocated are not specified, and they differ widely between contexts. While this model brings sexual and reproductive health information and counselling closer to adolescents, it perpetuates the idea that health is a topic situated mainly in its own territory, which is the health centre.
According to the key informants, health professionals and adolescents who participated in the programme, this strategy has the following strengths:. Significant emphasis is placed on activities and workshops focussed on adolescent girls developing a life project, in order to reverse the idea of motherhood as a goal and an end in itself.
But now that we're here, what we've done is to help change the mentality of these young people who didn't have a clear life project. That's really important. They have therefore not been exposed to some of the public health sector's culture habits regarding working with adolescents, such as working in isolation from other sectors and reproducing prejudices towards adolescents as a difficult age group that is not interested in health issues and constantly involved in risky behaviours. Taking them from the centres to go to work to schools would have been a disaster, because they have a particular culture, their own way of doing things.
And it's very difficult to make them leave their working culture. Observation showed that when they are not in the welfare rooms with adolescents, they are walking around the school and using the public spaces, such as hallways, yards and the dining room, to establish informal conversations with adolescents.
The interactions are caring and affectionate, with hugs, laughter, jokes and an informal tone of conversation. Here they give you confidence, they help you a lot, which I didn't expect. Then, it's like a real change, seriously it's a change, because the staff is kind and very loving.enter
The bond that is established in this space is crucial. This tackles one of the health sector's biggest historical problems regarding adolescents: the invisibility and exclusion of young men's sexual and reproductive rights. In fact, now that we're in the school, young men go to the midwife and have that incentive.
Men do go to the midwife in school, and we have the possibility, the opportunity to be there, but they don't go to the midwife in the health centre. Girls only need to go to the welfare room, and there they are given a card, and with that card they go after school to the primary health centre, without having to wait in line, or having to make an appointment with the midwife.