Appreciate the need for specialized health services for

adolescents
Sate the objectives of the programmes for adolescents in
Malaysia.
Describe the organizational set up and the services for these
programmes.
Critically evaluate the outcomes of the programes at the level
of health centre, district or state using reports and relevant
indicators

Triggers:
Define Adolescent according to WHO.
Describe the Facts on Adolescent Health according to WHO.
Discuss causes of adolescent mortality in worldwide.
Explain major problems regarding adolescent health in Malaysia.
List and explain 5 adolescent health programmes implemented
in Malaysia.
 Adolescence, transitional phase of growth and development
between childhood and adulthood.
The World Health Organization (WHO) defines an
adolescent as any person between ages 10 and 19.
This age range falls within WHO's definition of young
people, which refers to individuals between ages 10 and
24.Mar 2, 2017
 Around 1.2 billion people, or 1 in 6 of the worlds population, are
adolescents aged 10 to 19.
Most are healthy, but there is still substantial premature death,
illness, and injury among adolescents. Illnesses can hinder their
ability to grow and develop to their full potential. Alcohol or tobacco
use, lack of physical activity, unprotected sex and/or exposure to
violence can jeopardize not only their current health, but also their
health as adults, and even the health of their future children.
Estimated 1.2 million adolescents died in 2015, over 3000 every day,
mostly from preventable or treatable causes.
Road traffic injuries were the leading cause of death in 2015. Other
major causes of adolescent deaths include lower respiratory
infections, suicide, diarrhoeal diseases, and drowning.
Globally, there are 44 births per 1000 to girls aged 15 to 19 per year.
Half of all mental health disorders in adulthood start by age 14, but
most cases are undetected and untreated.
 Early pregnancy and childbirth : The leading cause of death for 15 19-
year-old girls globally is complications from pregnancy and childbirth.
The vast majority of these births are in low- and middle-income
countries.
How to Prevent:

--Girls who do become pregnant need access to quality antenatal care.

--Where permitted by law, adolescents who opt to terminate their
pregnancies should have access to safe abortion.
HIV : More than 2 million adolescents are living with HIV. Although the
overall number of HIV-related deaths is down 30%. One of the specific
targets of the health Sustainable Development Goal (SDG 3) is that by
2030 there should be an end to the epidemics of AIDS, tuberculosis,
malaria and neglected tropical diseases, hepatitis, water-borne diseases
and other communicable diseases. Given the high prevalence of HIV in
many countries, to achieve this, adolescents will need to be central to
control efforts.
 Other infectious diseases :
Adolescent deaths and
disability from measles
have fallen markedly.
Diarrhoea and lower
respiratory tract
infections are estimated to
be among the top 5 causes
of death for 1019 year
olds. These two diseases,
together with meningitis,
are the top three causes of
adolescent death in African
low and middle-income
countries (LMICs).
o Mental health
Depression is the third leading cause of
illness and disability among adolescents, and
Suicide is the third leading cause of death in
older adolescents (1519 years).
Violence, poverty, humiliation and feeling
devalued can increase the risk of developing
mental health problems.
How to Prevent :
Building life skills in children and adolescents
and providing them with psychosocial support
in schools and other community settings can
help promote good mental health.
Programmes to help strengthen the ties
between adolescents and their families are
also important.
If problems arise, they should be detected and
managed by competent and caring health
workers.
 Violence : Violence is a
leading cause of death in
older adolescent males.
How to Control :
--Promoting nurturing
relationships between parents
and children early in life, ---
--providing training in life
skills, and reducing access to
alcohol and firearms can help
to prevent injuries and deaths
due to violence. Effective and
empathetic care for adolescent
survivors of violence and
ongoing support can help deal
with the physical and
psychological consequences.
Alcohol and drugs : Harmful drinking
among adolescents is a major concern in many
countries. It reduces self-control and increases
risky behaviours, such as unsafe sex or
dangerous driving. It is a primary cause of
injuries (including those due to road traffic
accidents), violence (especially by a partner)
and premature deaths. It can also lead to health
problems in later life and affect life expectancy.
How to Control :
--Setting a minimum age for buying and consuming
alcohol and regulating how alcoholic drinks are
targeted at the younger market are among the
strategies for reducing harmful drinking.
--Drug use among 1519 year olds is also an
important global concern. Drug control may focus
on reducing drug demand, drug supply,
or both, and successful programmes usually include
structural, community, and individual-level
interventions
 Injuries: Unintentional injuries
are the leading cause of death
and disability among o Drowning: is also a major
adolescents. In 2015, over 115
000 adolescents died as a result cause of death among
of road traffic accidents. adolescents 57 000
How to Prevent : adolescents, two-thirds of
Young drivers need advice on them boys, are estimated
driving safely,
while laws that prohibit driving
to have drowned in 2015
under the influence of alcohol o How to prevent:
and drugs need to be strictly
enforced. Teaching children and
Blood alcohol levels need to be adolescents to swim is an
set lower for teenage drivers. essential intervention to
Graduated licences for novice
drivers with zero-tolerance for prevent these deaths
drink-driving are recommended.
 Malnutrition and Exercise and nutrition :
obesity: Iron deficiency anaemia is the leading
Many boys and girls in cause of years lost to death and disability in
2015.
developing countries
enter adolescence --Iron and folic acid supplements are a solution that
also helps to promote health before adolescents
undernourished, making become parents.
them more vulnerable to --Regular deworming in areas where intestinal
disease and early death. helminths such as hookworm are common is
At the other end of the recommended to prevent micronutrient (including
iron) deficiencies.
spectrum, the number of
--Developing healthy eating and exercise habits in
adolescents who are adolescence are foundations for good health in
overweight or obese is adulthood.
increasing in low, middle --Reducing the marketing of foods high in saturated
and high-income fats, trans-fatty acids, free sugars, or salt and
countries. providing access to healthy foods and opportunities
to engage in physical activity are important for all
but especially children and adolescents.
 Tobacco use :
The vast majority of people using tobacco today began doing so when
they were adolescents.
Globally, at least 1 in 10 adolescents aged 13 to 15 years uses tobacco

How to Quit:
Prohibiting the sale of tobacco products to minors and
Increasing the price of tobacco products through higher taxes,
Banning tobacco advertising and
Ensuring smoke-free environments are crucial.
 What are DALYs?
Disability-adjusted life years (DALYs) are a measure
of the years of healthy life lost due to ill health,
disability or premature death. They estimate the gap
between current health status and an ideal health
status, with the entire population living to an
advanced age free of disease and disability.
For a specific health condition, DALYs are calculated
as the sum of the years of life lost (YLL) due to
premature death plus disability (YLD) for people
living with the health condition.
Leading causes of death Leading causes of disability
(YLL) (YLD)

Road injury Unipolar depressive

HIV disorders
Suicide Iron deficiency anaemia
lower respiratory Asthma
infections, and Back and neck pain,
Interpersonal and
violence. Anxiety disorders.
 Health of Adolescents in The Activities:
Malaysia(WHO):
Common Health (a) EDUCATION:
Morbidity/Mortality:
Legislation: child is to be
i. Accidents
enrolled as a pupil in a primary school the
ii. Violence age of six years on the first day of January.
iii. Diseases of the
circulatory system Student enrollment: To increase net
enrollment ratio (NER) for primary &
iv. Infectious and parasitic Secondary education level.
diseases
v. Malignant neoplasms Primary school retention rate: To
Improve.
vi. Obstetric causes and
conditions in the Gender parity index: Reduce disparity.
perinatal period
(b) SEXUAL AND REPRODUCTIVE
HEALTH
Legislation:
Under the Malaysian Syariah
Law (for Muslims), the minimum
age for marriage for women is 16
years and for men 18. Under the
Civil Marriages Law (for non-
Muslims), the minimum age for
marriage for both women and
men is 18.
The Penal Code permits
termination of pregnancy when
the life or health of the
woman is threatened.
( c) Contraceptive knowledge and
use: by increasing awareness.
(d) Child-bearing: reducing child-
bearing age
under 19 years old .
(e) Adolescent birth rate: to decline.
(f) Sexually Transmitted Infections
(STIs): Increasing awareness for HIV .
(g) NUTRITIONAL STATUS : To
Decrease obesity.
(h) MENTAL HEALTH: Creating
Awareness.
(i) SUBSTANCE USE
:Legislation on
Tobacco & Alcohol ADOLESCENT-FRIENDLY HEALTH SERVICES
use. By Federation of Family Planning Associations
of Malaysia (FFPAM), a nongovernmental
(j) CRIMES AND organization (NGO) in collaboration with Govt.
VIOLENCE: by
legislation to reduce Rakan Muda (Young Friends or Partners),
domestic & Child Ministry of Youth and Sports: on intellectual
violence. development, spiritual and religious
activities, and social and physical activities
such as sports.

Programme Sihat Tanpa AIDS untuk Remaja

PROSTAR (Healthy Adolescents Without AIDS
Programme), Ministry of Health
 References
(1) SDG Indicators, Global Database
https://unstats.un.org/sdgs/indicators/database/?indicator=3.7.2
(2) WHO Fact Sheet; Adolescents: health risks and solutions ;(Updated May 2017 )
(3) WHO Report ; Maternal, newborn, child and adolescent health ; Adolescent health
epidemiology ;
http://www.who.int/maternal_child_adolescent/epidemiology/adolescence/en/