Adolescent Health

Adolescents – young people between the ages of 10 and 19 years – are often thought of as a healthy group. Nevertheless, many adolescents do die prematurely due to accidents, suicide, violence, pregnancy related complications and other illnesses that are either preventable or treatable. Many more suffer chronic ill-health and disability. In addition, many serious diseases in adulthood have their roots in adolescence. For example, tobacco use, sexually transmitted infections including HIV, poor eating and exercise habits, lead to illness or premature death later in life.

Key facts

• More than 1.8 million young people aged 15 to 24 die each year, mostly due to preventable causes.
• About 16 million girls aged 15 to 19 give birth every year.
• Young people, 15 to 24 years old, accounted for 40% of all new HIV infections among adults in 2008.
• In any given year, about 20% of adolescents will experience a mental health problem, most commonly depression or anxiety.
• An estimated 150 million young people use tobacco.
• Approximately 565 young people aged 10 to 29 die every day through interpersonal violence.
• Road traffic injuries cause an estimated 1 000 young people to die every day.

OVERVIEW
Most young people are healthy. However, more that 1.8 million young people aged 15 to 24 die each year. A much greater number of young people suffer from illnesses which hinder their ability to grow and develop to their full potential. A greater number still engage in behaviours that jeopardize not only their current state of health, but often their health for years to come. Nearly two-thirds of premature deaths and one-third of the total disease burden in adults are associated with conditions or behaviours that began in their youth, including: tobacco use, a lack of physical activity, unprotected sex or exposure to violence.
Promoting healthy practices during adolescence, and taking steps to better protect young people from health risks is critical to the future of countries’ health and social infrastructure and to the prevention of health problems in adulthood.
In 2002, the UN General Assembly Special Session on Children recognized the need for the "development and implementation of national health policies and programmes for adolescents, including goals and indicators, to promote their physical and mental health".
An important framework for young people's health are the Millennium Development Goals (MDGs). Two of the MDGs are particularly relevant to young people's health.

• MDG 5 aims to achieve universal access to reproductive health, for which one of the indicators is the pregnancy rate among 15 to 19 year old girls.
• MDG 6 to halt the spread of HIV/AIDS has indicators like a 25% reduction among young people, and also measures the proportion of 15 to 24 year olds with comprehensive and correct knowledge of HIV/AIDS.

The right of all young people to health is also enshrined in international legal instruments. In 2003, the Committee of the Convention on the Rights of the Child (CRC) issued a General Comment in which the special health and development needs and rights of adolescents and young people were recognized. These are further supported by the Convention on the Elimination of Discrimination Against Women (CEDAW) and the Right to Health.

Health Issues affecting young people: 


Some of the main health issues affecting young people are described below.

Early pregnancy and childbirth

About 16 million girls aged 15 to 19 years give birth every year - roughly 11% of all births worldwide. The vast majority of adolescents’ births occur in developing countries. The risk of dying from pregnancy-related causes is much higher for adolescents than for older women. The younger the adolescent, the greater the risk. The formulation and enforcement of laws that specify a minimum age of marriage, community mobilization to support these laws, and better access to contraceptive information and services can decrease too-early pregnancies. Those adolescents who do become pregnant should be provided with quality antenatal care and skilled birth attendance. Where permitted by law, those adolescents who opt to terminate their pregnancies should have access to safe abortion.

HIV

Fifteen to 24 year olds accounted for an estimated 40% of all new HIV infections among adults worldwide in 2008. Every day, 2 500 more young people get infected and globally there are more than 5.7 million young people living with HIV/AIDS. Young people need to know how to protect themselves and have the means to do so. This includes condoms to prevent sexual transmission of the virus and clean needles and syringes for those who inject drugs. Currently, only 30% of young men and 19% of young women have the comprehensive and correct knowledge they need to protect themselves from acquiring the virus. Better access to HIV testing and counselling will inform young people about their status, help them to get the care they need, and avoid further spread of the virus. Where social, cultural and economic conditions increase the vulnerability of young people to HIV infection, an effective HIV prevention strategy should aim to address these factors as well.

Malnutrition

Many boys and girls in developing countries enter adolescence undernourished, making them more vulnerable to disease and early death. Conversely, overweight and obesity (another form of malnutrition with serious health consequences and important longer term financial implications for health systems) are increasing among young people in both low- and high-income countries. Adequate nutrition and healthy eating and physical exercise habits at this age are foundations for good health in adulthood. In addition, it is important to prevent nutritional problems by providing advice, food and micronutrient supplementation (e.g. to pregnant adolescents), as well as detecting and managing problems (such as anaemia) promptly and effectively when they occur.

Mental health

In any given year, about 20% of adolescents will experience a mental health problem, most commonly depression or anxiety. The risk is increased by experiences of violence, humiliation, devaluation and poverty, and suicide is one of the leading causes of death in young people. Building life skills in children and adolescents, and providing them with psychosocial support in schools and other community settings can help promote mental health. If problems arise, they should be detected and managed by competent and caring health workers.

Tobacco use

The vast majority of tobacco users worldwide began when they were adolescents. Today an estimated 150 million young people use tobacco. This number is increasing globally, particularly among young women. Half of those users will die prematurely as a result of tobacco use. Banning tobacco advertising, raising the prices of tobacco products and laws prohibiting smoking in public places reduce the number of people who start using tobacco products. They also lower the amount of tobacco consumed by smokers and increase the numbers of young people who quit smoking.

Harmful use of alcohol

Harmful drinking among young people is an increasing concern in many countries. It reduces self-control and increases risky behaviours. It is a primary cause of injuries (including those due to road traffic accidents), violence (especially domestic violence) and premature deaths. Banning alcohol advertising and regulating access to it are effective strategies to reduce alcohol use by young people. Brief interventions of advice and counselling when alcohol use is detected can contribute to reducing harmful use.

Violence

Violence is one of the leading causes of death among young people, particularly males: an estimated 565 young people aged 10 to 29 years die every day through interpersonal violence. For each death, an estimated 20 to 40 youths require hospital treatment for a violence-related injury.
Promoting nurturing relationships between parents and children early in life, providing training in life skills, and reducing access to alcohol and lethal means such as firearms help prevent violence. Effective and empathetic care for adolescent victims of violence and ongoing support can help deal with both the physical and the psychological consequences of violence.

Injuries

Unintentional injuries are a leading cause of death and disability among young people. Road traffic injuries take the lives of a staggering 1 000 young people every day. Advising young people on driving safely, strictly enforcing laws that prohibit driving under the influence of alcohol and drugs and increasing access to reliable and safe public transportation can reduce road traffic accidents in young people. If road traffic crashes occur, prompt access to effective trauma care can be life saving.

Traditional medicine

Traditional medicine (TM) refers to the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or treatment of physical and mental illness. Traditional medicine covers a wide variety of therapies and practices which vary from country to country and region to region. In some countries, it is referred to as "alternative" or "complementary" medicine (CAM).

Traditional medicine has been used for thousands of years with great contributions made by practitioners to human health, particularly as primary health care providers at the community level. TM/CAM has maintained its popularity worldwide. Since the 1990s its use has surged in many developed and developing countries.

Key facts

• In some Asian and African countries, 80% of the population depend on traditional medicine for primary health care.
• Herbal medicines are the most lucrative form of traditional medicine, generating billions of dollars in revenue.
• Traditional medicine can treat various infectious and chronic conditions: new antimalarial drugs were developed from the discovery and isolation of artemisinin from Artemisia annua L., a plant used in China for almost 2000 years.
• Counterfeit, poor quality, or adulterated herbal products in international markets are serious patient safety threats.
• More than 100 countries have regulations for herbal medicines.

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Traditional medicine is the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses.
Traditional medicine that has been adopted by other populations (outside its indigenous culture) is often termed alternative or complementary medicine.
Herbal medicines include herbs, herbal materials, herbal preparations, and finished herbal products that contain parts of plants or other plant materials as active ingredients.

Who uses traditional medicine?

In some Asian and African countries, 80% of the population depend on traditional medicine for primary health care.
In many developed countries, 70% to 80% of the population has used some form of alternative or complementary medicine (e.g. acupuncture).
Herbal treatments are the most popular form of traditional medicine, and are highly lucrative in the international marketplace. Annual revenues in Western Europe reached US$ 5 billion in 2003-2004. In China sales of products totaled US$ 14 billion in 2005. Herbal medicine revenue in Brazil was US$ 160 million in 2007.

Challenges

Traditional medicine has been used in some communities for thousands of years. As traditional medicine practices are adopted by new populations there are challenges.
International diversity: Traditional medicine practices have been adopted in different cultures and regions without the parallel advance of international standards and methods for evaluation.

National policy and regulation: Not many countries have national policies for traditional medicine. Regulating traditional medicine products, practices and practitioners is difficult due to variations in definitions and categorizations of traditional medicine therapies. A single herbal product could be defined as either a food, a dietary supplement or an herbal medicine, depending on the country. This disparity in regulations at the national level has implications for international access and distribution of products.
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Nutrition

Nutrition is the intake of food, considered in relation to the body’s dietary needs. Good nutrition an adequate, well balanced diet combined with regular physical activity is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.


recommended food for children in their very early years

Breast milk is the best food for the healthy growth and development of infants. Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. After six months, they should be fed adequate and safe complementary foods while continuing breastfeeding for up to two years or beyond.
Complementary food is the additional nutrient-rich food and drink that is recommended for children from six months of life. The transition from exclusive breastfeeding to complementary feeding (which includes continued breastfeeding) typically covers the period from 6 to 18–24 months of age. This is a very vulnerable period as it is the time when malnutrition starts in many children. Thus it is essential that infants receive appropriate, adequate and safe complementary foods to ensure the right transition from breastfeeding to the full use of family foods.
These recommendations are made in the Global Strategy for Infant and Young Child Feeding, which was jointly developed by WHO and UNICEF in 2003.
The strategy is a guide for countries to develop policies and implement activities addressing feeding practices and the nutritional status, growth and health of infants and children. It is based both on the evidence that nutrition plays a crucial role in the early months and years of life, and on the importance of appropriate feeding practices in achieving optimal health.
Lack of appropriate feeding can set up risk factors for ill-health. The life-long impact may include poor school performance, reduced productivity, impaired intellectual and social development, or chronic diseases.