Introducing
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Dr. ASM Sayem
Health Specialist (Maternal and Adoelscent Health)
UNICEF Bangladesh
The strategy focused overall health needs of adolescents by linking broad and holistic understanding of the concept of health
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
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
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.
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
4 Thematic areas
2 Cross Cutting
Special Focus
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
Males, 15-19 years
Mothers’ expectation of AH services from health facilities
BSMMU 2017
‘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
Source: BDHS 2011
Nasreen et al., 2013
BRAC & population council (Amin 2015)
Qualitative finding of survey
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
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
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.
Focusing psychosocial issues
Awareness program for Parents & gatekeepers (Teacher, elite person, Religious leader)
materials focusing mental healths
Poster, Festoon, Billboard, Class Routine, Booklet, Brochure, Flash Card
Adolescent Friendly Health Services (AFHS)
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)
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
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
Investments in adolescent health can bring a triple dividends**:
Immediate benefits,
Benefits into future adult life and
Benefits for the next generation of children