Beruflich Dokumente
Kultur Dokumente
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SESSION OBJECTIVES
At the end of the session, participants
should be able to:
Define Adolescence and related terms;
Describe the current status of adolescent
sexual health in Nigeria;
Discuss the factors influencing sexual
activities among adolescents;
Mention the challenges of adolescent
pregnancy and parenthood.
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DEFINITIONS
ADOLESCENCE
Adolescence is the period of physical,
YOUTHS
Youths are aged between 15 and 24 years.
YOUNG PEOPLE
These are aged between 10 and 24 years.
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ADOLESCENT SEXUAL AND
REPRODUCTIVE HEALTH
The adolescent years are a tumultuous
period for many individuals.
It is the period when an individual makes a
gradual transition from childhood to
adulthood.
During this period:
The individual progresses from the point
of initial appearance of the secondary
sexual characteristics to that of sexual
maturity; 4
ADOLESCENT SEXUAL AND
REPRODUCTIVE HEALTH
The individual’s psychological process
and patterns of identification develop
from those of a child to those of an adult;
A transition is made from a state of total
socio-economic dependence to one of
relative independence (WHO, 1975).
This transition period is threatened b
many health and social problems and
thus has become a topical issue in recent
times.
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ADOLESCENT SEXUALITY
As physical maturation takes place,
adolescents must acknowledge their
sexuality;
Today, young people reach reproductive
maturity at an earlier age than did their
counterparts at the turn of the century.
On the other hand, there has been an
upsurge of interest in pursuing higher
education in many parts of the country
which has led to a delay in marriage.
The decline in menarcheal age coupled with
the delay in marriage has created a bio-
social gap. 6
ADOLESCENT SEXUALITY (Contd.)
Adolescents became sexually active during
this period.
Therefore, adolescents in Nigeria today, are
biologically mature much before they are
socially mature and independent.
The high rate of sexual activity coupled with
the ambivalent attitude towards
contraception has been responsible for an
increased rate of pregnancies with their
attendant life threatening complications.
Thus, the period is fraught with a number of
medical and social consequences.
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FACTORS INFLUENCING SEXUAL
ACTIVITY AMONG ADOLESCENTS
Decline in the age of menarche
Peer-group pressure
Psychological factors
Disruption in cultural bonds and traditional
restraints
Cultural interaction
Lack of parental care/guidance
Economic gains
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SEXUALLY TRANSMITTED
INFECTIONS (STIs) & HIV/AIDS
There are indications of increasing prevalence
of gonorrhea, Chlamydia, syphilis and
trichomoniasis among adolescents.
Similarly, there is an increasing trend of HIV
prevalence in this age bracket.
The prevalence of HIV among young people
between the ages of 20 and 24 years is 8.1%.
Among adolescents, girls are about twice more
vulnerable than boys.
About 80% of HIV infections in Nigeria are
contracted through sexual intercourse.
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EARLY MARRIAGE
Marriage and motherhood begin early in
Nigeria.
The two are closely related in the sense that
culturally, Nigerians believe that the major
purpose of marriage is procreation.
The median age for marriage for Nigeria is
17 years.
Adolescent nuptuality and fertility pose
enormous challenges to the society and
government.
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PATTERNS OF ADOLESCENT
MARRIAGE IN NIGERIA
There are considerable variations in the median
age for marriage among cultural and socio-
economic groups:
17 years in urban areas and,
15 years in rural areas
Marriage is very early in the North, often taking
place before menarche;
While Christianity has for a long time
discouraged early marriage, the Muslim religion
shows more acquiescence with the culture of
early and child marriage.
Education also influences the age at marriage.
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ADOLESCENT PREGNANCY
Early childbearing poses significant risks for
both the mother and the infant.
Its adverse effects also affect the society.
In addition to bearing the costs for maternal
and child health care, it may also loose the
added potential of an educated person.
The reasons for adolescent pregnancy are
diverse and complex.
They vary among different cultural and ethnic
sub-groups and the society’s attitude toward
adolescent contraception.
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ADOLESCENT ABORTION
Abortion in the discontinuation of pregnancy
when the fetus weighs less 500g. (WHO). i. e.
gestational age of 24 weeks.
The cut off age of 24 weeks was chosen to
indicate the period when the fetus has some
reasonable chance of extra uterine life.
Spontaneous abortion (miscarriage):
occurs naturally, without willful intervention;
rarely associated with death.
Induced abortion (termination):
occurs with intervention; can be associated
____________________________________
Type of Complication Percentage
____________________________________
Sepsis/Infection 86.2
Haemorrhage 35.2
Uterine Perforation and
Bowel injury 16.2
Lower genital tract injury 9.5
Renal Failure 0.4
Death 7.0
____________________________________
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FACTORS AFFECTING THE
POSSIBILITY OF COMPLICATIONS
Skill of the abortionist
The environment
Age of pregnancy
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FACTORS AFFECTING INCREASED
PREGNANCY/ABORTION AMONG
ADOLESCENTS
Adolescents are biologically more mature
before they are socially mature and
dependent.
Lack of factual knowledge on reproductive
health.
Increased sexual activity:
timing, lack of planning and frequency,
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Medical Complications of
Adolescent Pregnancy
During Pregnancy
Nutritional deficiency
Anaemia
Threatened abortion
Pre-eclampsia and eclampsia
High incidence of abortion and its
complications
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Medical Complications of
Adolescent Pregnancy (Contd.)
During Labour
Premature labour
Prolonged labour
Obstructed labour
High incidence of operative delivery
Obstetric neuropathies
Obstetric fistulae – vesico-vaginal and
recto-vaginal
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SOCIAL AND DEMOGRAPHIC
CONSEQUENCES OF EARLY MARRIAGE
AND CHILDBEARING
economic dependence.
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ADOLESCENT MOTHERS (Contd.)
Repeated Pregnancy:
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ADOLESCENT FATHERS
Most adolescent males are ill-prepared
for the responsibilities of fatherhood.
Recent studies have shown that
academic, drug, and conduct problems
were significantly more common among
adolescent fathers than among
adolescent males in general.
Young men also suffer educational and
economic disadvantages from early
fatherhood.
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ADOLESCENT FATHERS (Contd.)
A male student, responsible for a girl's
pregnancy, may be expelled from school
through pressure from the girl's parents, or
forced to abandon school or enter a
premature marriage.
Such men are less likely to graduate from
school, less likely to have a skill, and more
likely to enter into low-paying occupations
or jobs.
In general, men suffer less ill-effects of
parenthood than young mothers.
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CONCLUSIONS
Adolescent sexuality and reproductive health
issues pose enormous challenges to the
society and government.
Therefore, there is need to consider policies
and programmes that could help adolescent
women achieve their full potential, including:
Policies that discourage early marriage and
childbearing by providing educational and
employment alternatives;
Programmes to help young people stay in
school, even if they have children; 26
CONCLUSIONS (Contd.)
Programmes to establish or expand family-life
education, for teenagers in school;
IEC programmes aimed at partners, parents,
and other relatives of adolescent women;
Policies that increase access to high quality,
appropriate family planning services and
counseling for sexually active adolescents;
MCH programmes that seek out teenagers who
may not know what health care they and their
babies need or where to obtain services.
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CONCLUSIONS (Contd.): Policies
addressing ARH Issues in Nigeria
Adolescent Health Policy (1995)
Strategic Framework for Adolescent
Reproductive Health Work (arising from the
National conference on ARH in 1999);
Reproductive Health Policy (2001);
HIV/AIDS Emergency Action Plan (HEAP) –
2001 – 2004;
National Reproductive Health Strategic
Framework and Plan (2002 – 2006)
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CONCLUSIONS (contd.): ADOLESCENT
REPRODUCTIVE HEALTH POLICY
Has a number of foci:
Sexual behaviour
Reproductive health
Nutrition
Accidents
Drug abuse
Education
Career and employment
Parental responsibilities and adjustment
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THANK
YOU
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