Introducing 

Prezi AI.

Your new presentation assistant.

Refine, enhance, and tailor your content, source relevant images, and edit visuals quicker than ever before.

Loading…
Transcript

Dr. ASM Sayem

Health Specialist (Maternal and Adoelscent Health)

UNICEF Bangladesh

CONTEXT

The strategy focused overall health needs of adolescents by linking broad and holistic understanding of the concept of health

CONTEXT

WHAT DRIVES US

36 million adolescents

More than 1/5 of the total population

Adolescent Birth Rate is 113 per 1,000 women

Highest in south asia

600,000 pregnant adolescents/year

Equity

Almost half of adolescent pregnant have no education

What drives us

41% adolescent pregnant mothers are from lowest wealth quintile

Communication

Nutrition

lower than the national average (11%)

High prevalence of under-nutrition (stunting–29%, underweight–31%)

Contraceptives : only for married adolescents (CPR 51%)

Policy

54 % adolescents use mobile phone

The Vision

Strategic framework

By 2030, all adolescent boys and girls of Bangladesh, especially those who are most vulnerable, will be able to enjoy a healthy life

By 2030 all adolescents will lead a healthy and productive life in a socially secure and supportive environment where they have easy access to quality and comprehensive information, education and services.

Impact

The Goal

14 years (2017 to 2030) in line with the SDG

Time Frame

Human rights principles

Guiding Principles

Highest standard of health

Right of all adolescents

Comprehensive ?

Thematic Areas

Priority thematic areas

4 Thematic areas

  • Adolescent sexual and reproductive health
  • Violence against adolescents
  • Adolescent nutrition
  • Mental health of adolescents

2 Cross Cutting

  • Social and Behavior Change Communication
  • Health Systems Strengthening

Special Focus

  • Vulnerable Adolescents and Adolescents in Challenging Circumstances

TOP 5 CAUSES OF DEATH

Females, 10-14 years

Drowning

Road injury

Diarrhoeal diseases

Self-harm

Lower respiratory infections

Females, 15-19 years

Self-harm

Maternal conditions

Drowning

Road injury

Diarrhoeal diseases

Males, 10-14 years

  • Road injury
  • Drowning
  • Epilepsy
  • Rabies
  • Falls

Males, 15-19 years

  • Road injury
  • Drowning
  • Epilepsy
  • Interpersonal violence
  • Self-harm

Adolescent mental health in pregnancy

Adolescent mental health in pregnancy

Mothers’ expectation of AH services from health facilities

BSMMU 2017

  • Women aged 20-24 years who were married before 18 years, think domestic violence is normal
  • Symptoms of depression are common among adolescents
  • More than 80% depressed adolescents sought no help
  • Women who had experienced adolescent pregnancies are more likely to report signs of moderate to severe depression

‘Because of early marriage, many adolescents are not aware about their health’.

- H&FP service manager, Khulna

‘We are not aware about adolescent health. Parents are not concerned. Boys or girls, usually in case of girls’ parents’ lack of awareness was observed’. - Gatekeeper, Khulna

Perception of service provider and gatekeepers

Source: BDHS 2011

Nasreen et al., 2013

BRAC & population council (Amin 2015)

Qualitative finding of survey

Adolescents sexual and reproductive health enabling environment issues in Bangladesh

Strategic Direction-1 & 2

SD2 Violence against Adolescents

Key Strategies

1. Enable evidence based advocacy and communication at national and local level to raise awareness on the issue of age and gender based discrimination, child marriage and its

consequences ;

2. Build the capacity of the health and social protection sector to respond to age and gender based violence and child marriage prevention by providing effective and efficient services;

3. Develop and implement evidence based programmes to prevent and mitigate the consequences of age and gender based violence, including child marriage;

SD1 Adolescent Sexual and Reproductive Health

Key Strategies

1. Enable evidence based advocacy for comprehensive policy and programme development, investments and implementation;

2. Promote age appropriate comprehensive sexuality education, which are on par with

international standards, through all academic and training institutions;

3. Build capacity for the delivery of age and gender sensitive sexual and reproductive health

services which includes HIV/STI prevention, treatment and care;

Key strategies

Strategic Direction-3

Adolescent Nutrition

Strategic Objectives

1.Mainstream nutrition education and promotion and hygiene education including hand washing into the health care system, education system as well as other systems which reach out-of-school adolescents;

2. Establish programmes that promote dietary diversification, dietary adequacy, fortified foods and nutrition security through community and school based interventions;

3. Strengthen the capacity of service providers to deliver effective nutrition counselling and services to all adolescents, with a special focus on raising awareness on the consequences of child marriage and meeting the nutritional needs of pregnant adolescent girls;

4. Provide and promote micronutrient supplementation (i.e. IFA and MMS), consumption of fortified foods and de-worming at health facilities, schools, and workplace;

5. Conduct community based awareness campaigns on the importance of good nutrition, healthy foods and the consequences of malnutrition, anaemia and obesity on the overall development and growth of adolescents;

6. Promote and improve access to sports and physical activity in the community, schools and at workplace

1.To reduce under nutrition and anaemia among adolescent girls (pregnant and non-pregnant) and boys;

2. To reduce the risk of low birth weight babies, pregnancy related complications and nutritional risks among adolescent girls;

3. To reduce micro-nutrient deficiencies such as Calcium, Vitamin D and Iodine deficiency among pregnant adolescent girls

Key strategies

Strategic Direction-4

Mental Health of Adolescents

Strategic Objectives

1. Enable evidence based advocacy for comprehensive programme development to promote mental health among adolescents and reduce stigma against mental ill health

2. Develop skills among adolescents to deal with stress, manage conflict and develop healthy relationships

3. Develop the capacity of the health sector to address mental health issues as per the provisions of primary mental healthcare and to screen for anxiety, stress, depression and suicidal tendencies;

4. Promote school and facility level interventions which include counselling and management of mental health disorders through linkage with the national mental health programme;

5. Create a robust system for data collection/analysis on mental health issues including substance use, to inform policy and programming.

1. To integrate the mental health agenda within primary health care services and other relevant health and education services

2. To promote mental health and prevent mental ill health by implementing a range of evidence based interventions and screening for common mental illnesses and suicidal behaviour as per the provisions of primary mental health care

3. To create an enabling environment for mental health services including counselling and to develop the capacity to provide effective services at all levels of facilities.

ADOLESCENT INTERVENTIONS

Adolescent health programming and strategy

APPROACH

National Plan of Action-Adolecent Health

National Plan of Action-Adolecent Health

IEC materials

Focusing psychosocial issues

IEC materials

Awareness program for Parents & gatekeepers (Teacher, elite person, Religious leader)

IEC

IEC

materials focusing mental healths

Poster, Festoon, Billboard, Class Routine, Booklet, Brochure, Flash Card

Adolescent Friendly Health Services (AFHS)

Facility based services

Adolescent Clubs

Designated Human Resources for counseling

Training on Psychosocial issue

Infrastructure: Separate Room/Space, Furniture, Computer, Drinking Water, Toilet Facilities

BCC Materials: Adolescent Mental Heath Focused Materials

Enabling Environment: Maintenance of privacy and confidentiality (at ticket counter, at waiting place, at provider’s office)

The Demand

MULTI-SECTORAL

OUTREACH

SCHOOL BASED PROGRAM

ADOLESCENT'S CLUB

Adolescent health program in School or Madrasha

Out of School

Adolescent Club/Outreach centers

Strengthening School Health Program

Satellite or roaming health team in School & Club for counselling and treatment

Referral linkage among School, adolescent Club, SHC & Health facilities

Strengthen Comprehensive Sexuality Education in Secondary School & Teachers Training Institute

Peer education

Corporate Social Responsibility

Life Skills Based approaches/education in School

Life Skills Based approaches/education in Adolescent Club

GEMS-Gender Equity Movement in School

Bringing key lessons from all partners to scale best practices

Strategic Partnership with Rutgers on SRHR Capacity Building

ADOHEARTS

HPNSP (Health Population, Nutrition Sector programme) : 4th health SWAp, 8 DLI

ASTHA : Strengthening Access to Multi-sectoral Public Services for gender based violence (GBV) Survivors in Bangladesh

A program for better SRHR for young people vulnerable to HIV in Bangladesh

IMAGE-Plus: Initiatives for married adolescent girls’ empowerment

Unite for Body Rights

Working with Women: Phase II

Generation Breakthrough

NIRAPOD 2: Empowering women on Sexual and Reproductive Health & Rights and Choice of Safe MR and FP

Ritu: Promoting Menstrual Hygiene Management in Bangladesh

SHOKHI:

Shastho, Odhikar o Narir Icchapuron

supported by the Netherlands embassy

THANKS

THANKS

"

Investments in adolescent health can bring a triple dividends**:

Immediate benefits,

Benefits into future adult life and

Benefits for the next generation of children

"

Learn more about creating dynamic, engaging presentations with Prezi