Adolescent Issues

Raga Manduaru
1061050135

WHO Age Group

Classifications

Age classifications
Adolescent
age 10-19
Youth
age 15-24
Young people
age 10-24
Young Adolescents
age 10-14

Child
Defined Child' as individuals in the < 10
years age group

Child
Children are particularly vulnerable to
malnutrition and infectious diseases,
many of which can be effectively
prevented or treated

Child Healths Facts

Preterm birth, birth asphyxia and infections

cause most newborn deaths

Pneumonia killed an estimated 1.2 million

children under the age of five years worldwide

An estimated two million children under 15

years of age are living with HIV, and every day
more than 1000 are newly infected (motherchild-transmission)

Adolescents
WHO defines Adolescents as individuals in the 1019 years age group
One in every five people in the world is an adolescent, and 85% of them live
in developing countries

NOTE: The term young people is used to denote those between 10 and 24
years

Adolescents
(the second decade of life)

Undergoes major physical and

psychological changes

Enormous changes in the persons social

interactions and relationships

An opportunity to set the stage for healthy

and productive adulthood

Adolescents
it is a period of risk: a period when health
problems that have serious immediate
consequences can occur or when problem
behaviours that could have serious
adverse effects on health in the future
are initiated.
Department of Child and Adolescent Health and Development
(CAH) World Health Organization

Adolescents Healths Facts

About 16 million girls aged 15 to 19 give birth

(early pregnancy) every year - roughly 11% of
all births worldwide.
Young people aged 15-24 accounted for an
estimated 45% of new HIV infections worldwide
in 2007
Today more than 150 million adolescents use
tobacco, and this number is increasing globally
Harmful drinking (alcohol drink) among
young people is an increasing concern in many
countries

World Health Organization (WHO)

4-S framework
To strengthen the adolescent health and
development

The 4-S framework currently uses two

programmatic:
HIV prevention, care and support of
those with HIV
2. Preventing early pregnancy and
pregnancy-related mortality and morbidity.
1.

Adolescent
Health
Epidemiology

Adolescent Mortality
1.

2.

3.

4.
5.

15% of female deaths were caused by

maternal conditions
11% of deaths were due to HIV/AIDS and
tuberculosis
14% of male and 5% of female deaths resulted from
traffic accidents
12% of male deaths resulted from violence
6% of all deaths resulted from suicide

Data from:
http://www.who.int/maternal_child_adolescent/epidemiology/adolesce
nce/en/index.html

Thats why, many national sexual and

reproductive health (SRH) and HIV
programmes highlight adolescents as
requiring specific attention.

Sexual Activity in
Adolescent
The reasons for first sexual intercourse cited
werelove, curiosity and influence of peers.
The majority (60%) of adolescents who have
had sex did it without using condoms.1

World Health Organization. Healthrelated Millenium Development Goals 2005. Geneva.

(http://www.who.int/m e d i a c e n t r e / f a c t s h e e t s / f s 2 9 0 /en/index.html,
accessed 30 October 2006).

The number of sexually active male

students in high school had increased
from 8.8% in 1997 to 22.9% in 1999

Based on data from Riskesda 2010 about

sexual activity in age 10-24 years old
It showed that there is a 0.5 percent women
have had first sexual intercourse at the
age of 8 years, and 0.1 percent in men

Pregnancy and
Childbearing
Pre-marital/unmarried pregnancies are not
approved of by society

Pregnancy and
Childbearing
Another survey2 in Jakarta reported
that 23% of students aged 15-19 and
68.2% aged 20-24 knew of at least one
friend who had experienced one premarital pregnancy.

Jakarta marriage values and sexuality survey of high school and university students, 1994-95, cited
in Adolescent and Youth Reproductive Health in Indonesia: Status, Issues and Policy Programmes,
Policy Project 2003. http://www.auick.org/database/apc/apc033/apc03306.html

16% of women begin childbearing by the

age of 18
25% of women have had a baby by the age
19

Risk and Complications

Young mothers are more likely to suffer from

severe complications during delivery which
results in higher morbidity and mortality for both
themselves and their children.

Adolescents tend to have a higher maternal

mortality ratio (MMR) than older women.

Pregnancy and Childbearing

The risk of death from pregnancy related

causes is twice as high for women aged 1519 years than for women in their early
twenties. (see figure 7)

Pregnancy and Childbearing

Mothers age at birth can affect a childs

chances of survival.

High neonatal and infant mortality rates for

births to mothers aged under 20 as
compared with births to older women.(see
figure 8)

Abortion

Abortion is prohibited in Indonesia, except when it

is necessary to save a womans life.
High amount of Premarital/unmarried pregnancy
can lead the possibility of abortion

World Health Organization

(WHO)
Estimated 4.2 million abortions performed
each year in Southeast Asia:

1.3 million in Vietnam and Singapore

between 750,000 to 1.5 million in Indonesia
between 155,000 to 750,000 in the Philippines
between 300,000 and 900,000 in Thailand

From the previous table, it shows that,

incidences of miscarriage or abortion
occur higher in the reproductive age
group younger, and live in urban areas.

SMOKING,
DRINKING, AND
USE OF DRUGS

Smoking
Tobacco smoking is associated with major
health problems

Prevalence of diseases such as

cardiovascular diseases, diabetes, chronic
obstruction pulmonary diseases, and
cancer (Truelsen and Bonita, 2002).

Smoking
2007 IYARHS, a daily smoker is defined as
someone who is a current smoker and
smoked at least one cigarette in the 24
hours preceding the survey.

Table 7.2 shows that smoking starts early:

a) 26 percent of women and 21 percent of
men started to smoke before 13 years
b) a slight INCREASE especially for women
compared with the 2002-2003 IYARHS findings
(17 and 19 percent, respectively).

ALCOHOL DRINKING

Data from the 2001 National Household Health

Survey (NHHS) found that the prevalence of
current drinkers among people age 10 and
older is 3 percent, former drinkers is 7
percent, and lifetime abstainers is 90
percent.

Figure 7.3 Compares Alcohol Drinking in The

2002-2003 IYARHS with the 2007 IYARHS

Percentage of young women who have never

consumed alcohol decreased from 98 percent
in 2002-2003 to 94 percent in 2007.
For women, the percentage increased from 2
percent to 4 percent,
For men from 18 percent to 20 percent

Drug Use
Drug user is someone who takes drugs,
such as ganja, putau, or shabu-shabu, that
people can use for fun or to get high.

Based on,
PERATURAN PEMERINTAH REPUBLIK
INDONESIA NOMOR 40 TAHUN 2013
TENTANG
PELAKSANAAN UNDANG-UNDANG NOMOR 35
TAHUN 2009 TENTANG NARKOTIKA

Narkotika
zat atau obat yang berasal dari tanaman atau
bukan tanaman, baik sintetis maupun
semisintetis, yang dapat menyebabkan
penurunan atau perubahan kesadaran, hilangnya
rasa, mengurangi sampai menghilangkan rasa
nyeri, dan dapat menimbulkan ketergantungan.

Types of Narcotic

Based on,
Undang-Undang Nomor 5 tahun 1997 tentang
psikotropika Pasal 1

Psikotropik
zat atau obat, baik alamiah maupun sintetis
bukan narkotika, yang berkhasiat psikoaktif
melalui pengaruh selektif pada susunan
saraf pusat yang menyebabkan perubahan
khas pada aktivitas mental dan perilaku

Types of Psychotropic

Tabel 7.7 shows that six percent of men age

15-24 reported having used drugs, and
almost all of them smoked the drug.

Epidemiology
and Prevention
Concepts

1.
2.
3.

Concepts of disease and health

Natural History of Disease
Levels of Prevention

Concepts of disease and health

Example

Natural history of disease

Natural history of disease refers to the

progress of a disease proces in an individual
over tie, without intervention.

Natural history of disease

The process begins with exposure to or
accumulation of factors capable of causing
disease

Without medical intervention, the

process ends with recovery, disability, or
death

four common stages that most disease

manifests:
Stage of susceptility
Stage of presymptomatic disease
Stage of clinical disease
Stage of diminished capacity

Stage of susceptility
The disease has not yet developed, but
the host is susceptible due to the presence
of risk factors.
Examples: high serum cholesterol,
hypertension, a sedentary lifestyle, and
diabetes increased risk of developing
coronary heart disease

Stage of presymptomatic
disease
Disease process has begun, but no overt
signs or symptoms are evident to the
host.
Incubation period, time between the
invasion of an infectious agent
the development of the first signs or
symptoms of the disease

Stage of clinical disease

stage in the history of a pathologic

condition that begins with anatomic or
physiologic changes that are sufficient to
produce recognizable signs and
symptoms of a disease.

Stage of diminished
capacity
Characterized by convalescent period or a
residual disability (prolonged complications)
Recovery, disability, or death

Levels of prevention
The four levels of prevention are:
1. primordial prevention
2. primary prevention
3. secondary prevention and
4. tertiary prevention

Primordial prevention
Consists of actions to minimize future
hazards to health and hence inhibit the
establishment factors (environmental,
economic, social, behavioural, cultural)
known to increase the risk of disease

Primordial prevention

Primordial prevention of chronic disease

should include national policies and
programmes on nutrition.

Example

There is good evidence that tobacco

consumption can be reduced by
taxation and increased prices (see
Figure 6.5)

Primary Prevention

The purpose of primary prevention is to

limit the incidence of disease by controlling
specific causes and risk factors.

Primary prevention strategies emphasize:

1.
2.
3.
4.

risk factor reduction

other health protective measures
health education
health promotion programs

Examples
1.

2.

3.

immunization against communicable

diseases
chlorination and filtration of public water
supplies
Table 6.3 compares both approaches to the
prevention of diabetes and obesity

Secondary Prevention

aims to reduce the more serious

consequences of disease through early
diagnosis and treatment.

Secondary prevention

Can be applied only to diseases in which the

natural history includes an early period
when it is easily identified and treated, so
that progression to a more serious stage
can be stopped

Secondary prevention
two main requirements for a useful secondary
prevention programme are
1. Safe, and
2. Accurate method of detecting the disease

Examples
mammography for breast cancer detection
eye tests for glaucoma
the Pap test for cervical
concrete breath test for Helicobacter
pylori,
the Prostate-Specific Antigen(PSA) test for
prostate cancer

Example
Figure 6.8 shows an association between
screening rates and reductions in the
death rate from cervical cancer in
selected Canadian provinces in the 1970s.

Tertiary prevention
is aimed at reducing the progress or
complications of established disease
and is an important aspect of therapeutic
and rehabilitation medicine

Tertiary prevention
reduce impairments
reduce disabilities
minimize suffering

Examples
1.

2.

3.

treatment of diabetics to prevent

complication of the disease
the management of chronic heart disease
patients with medication, diet, exercise,
and periodic examination
improving functioning of stroke patients
through rehabilitation by occupational
and physical therapy, nursing care,
speech therapy, etc

Infidelity

Infidelity

Having sex with another individualout of

the relationship. (Having affair)

Infidelitys Fact

A new study co-authored by UC Berkeley

researchers has found that the rate of HIV
transmission due to infidelity is higher than
previously thought. (sexual transmitted
diseases STD)

The study found that out-of-couple sex accounted

for 27 to 61 percent of all HIV transmissions in
men and 21 to 51 percent in women.

Researchers found that young men are most

likely to be infected from infidelity while
young women are more likely to be
infected before entering a stable
partnership (extramarital )

Young people adopt risky behaviours and

are often poorly informed about their
bodies, sexuality and the
consequences of unprotected sex.

Overall, IYARHS 2007, 84 percent of women and 77

percent of men say that they have heard of AIDS

Result

The percentage is lower than that from

IYARHS 2002-2003 (87 percent for women
and 81 percent for men, respectively).

Conclusions :
- Decreasing adolescents knowledge about
AIDS
- Young people need more health
promotions about sexual transmitted
disease and HIV-AIDS

Preventions
Primary preventions
Secondary preventions

Primary preventions
In primary prevention the aim is to prevent
the acquisition of infection and disease.
This can be done by promoting:
safer sexual behaviour;
the use of condoms for penetrative sexual
acts

Secondary intervention
The activities should include:
1. promotion of health care
2. support and counselling services for both
STD and HIV patients

Interventions: aims and

outcomes
Number of strategies for reducing exposure
to STD, including:
increased condom use
Primary
prevention
reduction in partners
Secondary
Screening
prevention
treatment
tertiary
prevention

Sexual behaviour may be influenced by a number

of personal and structural determinants of risk
including:
1. Self-esteem
2. Skills in using condoms
3. Skills to negotiate safer sex
4. Knowledge about the risks of different sexual
behaviours
5. Avaibility of sexual services (condom, etc)

How to deliver
Interventions ?
Delivered at different levels:
1. Individual (partner notification, risk
counselling)
2. Group (group work, school sex education)
3. Community (community development,
campaigns)
4. Socio-political (legislation, resource
allocation,professional development)

Daftar Pustaka

Page RM, Cole GE, Timmreck TC. Basic

Epidemiological Methods, and Biostatistics. A
Practical Guidebook. Jones and Barlett Publisher:
Boston, London, 1995.

Green, L. CL Andersen. 1982. Community Health.

4thEd. St. Louis: C.V. Mosby

Beaglehole. Basic Epidemiology.1992

Riskesdas 2007 dan Riskesdas 2010

http://www.who.int/maternal_child_adolescent/ep
idemiology/adolescence/en/index.html

UNDANG-UNDANG NOMOR 35 TAHUN 2009

TENTANG NARKOTIKA

Undang-Undang Nomor 5 tahun 1997 tentang

psikotropika Pasal 1

Department of Child and Adolescent Health and

Development (CAH) World Health Organization.
Strengthening the health sector response to
adolescent health and development. World Health
Organization 2009
WHO/UNAIDS. Sexually transmitted diseases:policies
and principles for prevention and care
Indonesia Young Adult Reproductive Health Survey.
2007. Ministry of Health. Jakarta, Indonesia
Adolescent Health at a Glance in South-East Asia
Region 2007. WHO: Regional Office for South-East
Asia