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Healthy Development Of Adolescents And Young People

 text 'Healthy Development Of Adolescents'
Adolescents as defined by the World Health Organization (WHO) refer to people between the ages of 10 and 19 years, while youths refer to persons between the age range of 15 and 24 years, and the term 'young people' is used to cover both group (10-24 years).
Young people form a significant population group in terms of demographic parameter as they constitute about a fifth of the human population globally and are rapidly increasing in terms of absolute number. Young people are also a unique population in terms of characteristics and needs they face unique challenges as a result of their level of development and the societal situation.


One of the most important commitments a country can make for future economic, social and political progress and stability is to address the health and development needs of its young people. In Nigeria, there has been a growing recognition of the challenge of young people's health issues and need to address this challenge. As evidence from various local and national surveys have shown, young people in Nigeria face the challenges of early sexual initiation, early marriage, and unsafe sexual practices, among others, with the consequences of increasing rate of unwanted pregnancies, unsafe abortions, and sexually transmitted infections (STIs), including HIV and AIDS.


The Federal government I must say have been trying to respond to the challenges of young people's health and development. The government heightened interest in adolescent health issues and strong collaboration between development partners which led to the organization of National Adolescent Reproduction Health Conference in 1999. One of the outputs of the conference was a National Adolescent Reproductive Health Strategic Framework, which complements the policy and aimed at translating the policy into actionable plans. This new strategic framework aims to capture all the domains of the adolescent health (including adolescent mental health, spirituality and rights for purpose of completeness) that the national policy focuses on.



MAJOR AREAS OF ADOLESCENT HEALTH CARE NEEDS

  • NUTRITION
To be healthy, young people must have the right kinds and amounts of food. Health and nutrition is closely linked: disease contributes to the malnutrition, and malnutrition makes an individual more susceptible to disease. During adolescence, average weight doubles and height may increase more than 15%. The demands of physical growth can only be met by a balanced intake of nutrients, and a lack of excess or any nutrient may lead to health problems later.



Many young people are becoming economically active, due to poverty and family circumstances, and may be required to perform heavy manual or domestic labour, which may further compound their problem of inadequate diet. Young people may not have adequate nutrition as a result of poverty due to specific food habits, which have to do with preference for snacking and food fad. Available evidence also indicate that even where intake of calories and protein is sufficient, shortages of other nutrients such as iron, calcium and some vitamins may be relatively common because of peculiar feeding habits.



Over-nutrition and obesity among young people, resulting from excessive consumption of certain food and lack of physical exercises, are also increasing in incidence. Young people are often attracted by processed and refined foods. Such foods are often high in fats and sugars, and excessive consumption of these foods results in malnutrition. The establishment of a preference for food containing these substances may lead to early bio-physiological changes and ultimately pathological change and disease.



Adolescent females may sometime face more challenges than their male counterparts due to biological and social circumstances. As a result of gender discrimination, for example, young people may receive less food in general compared to their male siblings, or less of certain foods such as meat. Teenage pregnancy, when such occurs, further compounds the precarious nutritional state of many young girls, and they are particularly at high risk of anemia.




  • ACCIDENTS AND VIOLENCE

Accidents constitute one of the major causes of death and disability among young people throughout the world and account for as many as half of all deaths of people aged 10-24 years in many countries. Four settings constitute the major site for accidents among young people: home settings, work or school setting, road, and recreational settings. Increase in community upheavals, including political clashes and intercommunal violence, as well as natural disasters also increase the exposure of young people to accidents and trauma.



Sexual assault, physical harassment and psycho-social abuse of young female occur commonly in cult-linked campus-based violence. Adolescent girls and other young females may also be victims of intimate partner abuse in dating relationships and domestic as well as sexual violence in family settings. Exposure to violence through the mass media, peer pressure and lack of conflict resolution skills are some of the other factors known to be associated with violence among young people. The various types of accidents and violent activities contribute to high injury-related morbidity and mortality among young people.



Young people may also be at a higher risk of accidents than other population groups as a result of factors such as alcohol intake, exuberance, lack of experience, a feeling of invulnerability, and risk-taking behavior that comes with the need to demonstrate independence and courage.



Environmental conditions can also contribute greatly to risk, and it is often a combination of risk-taking and unsafe environment that leads to injury. Many young people especially in developing countries start work too young and are especially at risk since they often work in conditions more appropriate for adults, may not have fully developed psychomotor skills, are not as aware of potential hazards, and may be careless because of tiredness. Leisure and sports-related accidents, burns, poisoning and falls also represent major risks to young people.



While population-based and national data are scarce and disaggregated in Nigeria about the involvement of young people in road-traffic accidents (RTA), practical experiences showed that RTA impact significantly on the health and well-being of young people and may result in life-long and severe disabilities such as spinal cord injuries. With the steady rise in the number of commercial motorcycles on the Nigeria roads, the careless attitudes of the riders and the high proportion of young people involved in the use of motorcycles, either as the commercial rider or passenger, the mortality and morbidity rates relating to motorcycle accidents are increasing among young people in Nigeria. The non enforcement of the relevant laws compelling riders and passengers of motorcycles to wear safety helmet has also contributed to the increased rate of head injury and case fatality among victims of motorcycle accidents.



  • DRUG AND SUBSTANCE ABUSE

Drug and substance abuse poses a significant hazard to the health and development of young people and cuts across age and social class. The quest for new experiences and the rebellious nature of the young predisposes them to drug abuse. The average age of drug users/abusers has declined in recent years, and multiple drug use has become more common.



Alcohol and tobacco constitute a major threat to the health of young people. They are referred to as "gate way drugs" as most young people who abuse drug and other dangerous substances started with alcohol and cigarettes. The illicit drug most commonly used all over the world is cannabis. It is illegally cultivated and are relatively cheap. Making it readily available. There is also high incidence of non-medical or self-medicated use of benzodiazepines and psychotropic substances, which are easy to obtain as a result of the ineffective enforcement of laws on their sale and distribution.



Drug taking has a close inter-relationship with crime. This is most evident with respect to the consumption of hard drugs such as cocaine and heroine, which, because of their cost and highly addictive nature, drive their users to robbery or prostitution as a means of maintaining their habit. The ready availability and use of drugs in tertiary educational institutions has been linked to the upsurge of violent cult activities. It is believed that armed robbers, vigilant militants, as well as cult members use drugs as a means of stimulating boldness.



  • EDUCATION

Formal education is of great importance for the development of all young people. It is in school that literacy, numeracy and thinking skills are fostered and exercised and knowledge acquired. School also often introduce young people to sports and provides the conditions for healthy, supervised exercise. Schools and teachers may be able to provide some stability to young people who have been uprooted from their culture or whose family are unstable.


Studies have shown attending school is often not enough: boys have been documented as getting more attention from teachers than girls in mixed classes.

Other challenges in the education sector include:

  • Improving access and equity. Efforts to improve access should appropriately address the issues of regional and gender disparities. Underlying issues such as socio-cultural and religious concerns in Northern Nigeria that encourage parents to send their children to just koranic schools must be addressed. The role of poverty also deserves attention.

  • Improving the quality and relevance of education. Ineffective implementation of educational curriculum, rather than the content of the curriculum, plays a major role in the low quality of education. Low quality and poor motivation of teaching staff, as well as insufficient teaching time arising from disruption of school calendar as a result of frequent strike actions are associated with ineffective delivery of curriculum. Inadequate school infrastructure and lack of requisite tools such as textbooks, teaching aids and laboratory equipments and materials also play a role in this respect.

There is therefore a strong need to encourage private sector participation in educational development e.g finance institutions, communication outfits etc. These bodies would contribute by awarding scholarships, sponsor in service teachers training programs, repairing and building classrooms and other infrastructures.



  • CAREER AND EMPLOYMENT

One of the hallmarks of adolescence is the individual's preparation to become economically self-sufficient in adulthood. Career development is, thus, a highly important responsibility of all who are concerned with the preparation of young people for future assumption of work role in the society.



In general, educational exposure and skills development are important to position young people to be comfortably placed on the socio-economic ladder. As more young people attend school, expectations are raised which the other sectors may be unable to satisfy. While it is clear that the young people have potentials to make significant contribution to the economy, they are all too frequently subject to a disproportionate burden of unemployment, which sometimes leads to psychological stress, juvenile delinquencies which manifest as increased participation in crime.



Child trafficking and prostitution have come under increased attention in recent times. Also street trading, working in drinking parlors are some of the risky jobs compromising the health and well-being of young people. These areas have a preponderance of young people. A lower proportion of females are employed in the upper echelon, and gaining promotion may also be slower for females as a result, among others, of gender-related factors including gender-based discrimination, sexual harassment and family pressure and duties.



  • SOCIAL ADJUSTMENT AND PARENTAL RESPONSIBILITY
Parents also are vital to any configuration of social factors by shaping their health and development. Parents usually remain close to young people and can exercise some degree of authority over their actions. From time to time, peers and the community may be more or less influential, but parents and family are constant elements in most young people's lives despite fluctuations in their relative importance.



Caring relationships with families and friends play a vital role in fostering healthy development. Studies have shown that young people who feel close to their parents constantly show more positive psychological development, behavioral competence and psychological well-being.



A safe and supportive environment is part of what motivates young people to make healthy choices. "Safe" in this context refers to absence of trauma, excessive stress, violence (or fear of violence) or abuse. "Supportive" means an environment that provides a positive close relationship with family, other adults (including teachers and religious leaders) and peers. Such relationships can nurture and guide young people, set limit when needed, and challenge certain assumptions and beliefs. Supportive and caring relationships with adults and friends, and positive school experiences are particularly significant aspects of supportive environment for young people. Such relationships provide specific support in making individual behavior choices, such as when to become sexually active, how to handle anger, what and what not to eat, when and if to use substances.



Serious delinquent and crime acts begin as disobedience and stubbornness. Results from studies confirm that family circumstances (eg. parental handling, instability in homes) are some of the most frequent cited causes of deviance. Similarly, parental control and regulation was also cited as the most relevant control mechanism for young people in our society. The implication of this is that parents must be urged to provide more effective control and more supportive family environment.



  • MENTAL HEALTH

Mental health itself is not the absence of frank mental illness but is a state of well being in which the individual realizes his/her abilities, can cope with the normal stress of life, can work productively and fruitfully and is able to make contributions to his/her community. It entails the optimal development and use of mental abilities (such as cognitive, effective and relational); the achievement of individual and collective goals consistent with justice; and the attainment and preservation of conditions of fundamental human rights. A disruption which affects the interrelation of the individual, the group and the environment in the above context could manifest as mental health problem.



Mental health problems in young people among others include antisocial disorders, anxiety disorders, depression, psychosis, eating disorders, substance abuse e.t.c and are often characterized by patterns of behavior, feeling or thinking which interfere significantly with the individuals ability to work, to fulfill adequately his/her expected role, to get along with other people or to enjoy life resulting in risky behavior such as engaging in unprotected sex and dangerous driving, disruptive behavior, physical inactivity, poor academic performance including school dropout and even suicide.



The strategies towards prevention and management of mental health problem in young people include:

  • Mental health education through media both formal and informal, rallies in markets, schools etc.

  • Integration of mental health into primary health care, including capacity building and early referral system.

  • Early management including detection treatment, counseling and rehabilitation of established cases.


IN CONCLUSION

Mental health of young people needs to be approached in a holistic manner with multisectoral collaboration from all parties and stakeholders. Protection of mental health of young people is an individual investment into our future and will promote attaining a state of sustainable development. Young people should also be developed spiritually as it has been identified as an important element in young people's lives alongside intellectual and emotional development and other desirable traits.



Young people also have a limited access to relevant reproductive health services. Where health services are available, the non-friendly nature of these facilities to young people limits their utilization. The response of the healthcare system to the needs of young people has been tepid and ineffective. Any initiative in response to the mental and reproductive health needs of young people must give due consideration to the following:

  • Involvement of young people and gatekeepers/stakeholders in planning, implementation, monitoring and evaluation of activities.

  • Establishment of acceptable channels of communication between young people and adults.

  • Establishment of functional youth-friendly services.

  • Research to update knowledge and information on adolescent issues and services.




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