WHO Definition Adolescents: 10-20 y/o Youth: 15-24 y/o Young people: 10-24 y/o Young people: account for little over 30% of total population

of the Philippines or around 26M Health Indices • Mortality from all causes is 0.87/100,000 population By the age of 19: 12% sexually active By the age of 24: 45% of women are already mothers Women 15-24 y/o: group with the highest unmet need for family planning services at 26% Smoking prevalence among adolescent is 25% and admits social drinking 41% Random drug testing of public and private high school students yield screening positivity rates of 3-10% Drug use rate is estimated to be higher among college students •

• • • • •

5) Poor access to a health facility or unable to afford services Teenage pregnancy and abortion ◦ Consequence of teenage pregnancy 1) Low birth weight babies 2) Mothers – not finishing school leads to reduced employment options later in life ◦ Young pregnancies account for 16.5% of abortion cases ◦ Factor contributing to high rates of abortion is their restricted access to family planning information and services

Values Formation • In a study in 2002, the ff morals were asked from young people: ◦ 19% believed that cheating neither right nor wrong ◦ 5.6% think that taking something without permission is right ◦ 12% feel that gambling is right ◦ 16% okay public display of affection ◦ 18% approve of living-in arrangement ◦ 15% approve of pregnancy without marriage ◦ 38% approve of separation ◦ 36.5% approve of divorce

Causes of Mortality (Age 10-24) 1. Accidents/Injuries 2. CVD, all forms 3. Malignant neoplasm 4. TB, all forms 5. Pneumonia 6. Nephritis, Nephrotic syndrome and Nephrosis 7. Other diseases of nervous system 8. Meningitis 9. Septicemia 10. Epilepsy Areas of Concern Among Young People Sexual Activity • Unprotected sexual activity brings it with the dangers of early or unwanted pregnancy, induced abortion, STDs, HIV infection, AIDS ◦ HIV/AIDS registry as of 2001  Total of 766 HIV seropositive children and youth  90%: age 20-29  5%: age 10-19 Factors that may increase the risk of STDs 1) Lack of information on unprotected sex 2) Poor access to contraceptive and counselling services 3) Poor health seeking behavior 4) Ignorance of the presence of disease

Poisoning and Substance Abuse • Tobacco ◦ Average age of initiation of tobacco use: 12.5 yrs ◦ Average start of regular tobacco use: 14 yrs ◦ Adolescents who smoke are more likely to use other substances:  3x more likely to use alcohol  8x more likely to use marijuana  22x more likely to use coccaine Alcohol ◦ Filipino youth starts drinking alcohol at the age of 16 or 17 ◦ They were influenced by family, friends and mass media ◦ Male 68.5%; Female 21% Drugs ◦ Average age when illegal drugs were first used is 17.3; With males outnumbering females ◦ Drugs commonly used are:  Sedatives- barbiturates, tranquilizers  Stimulants – amphetamines (shabu), cocaine  Hallucinogens – LSD, marijuana  Narcotics – opium, morphine

Suicide • Methods used include: ◦ 54% slashed wrist 21% ingestion 12% hanging 3% stabbing, jumped from a building or river Violence and Abuse

Indicator: Mortality rate/100,000 young people Target: 0.7 deaths/100,000 young people Baseline data: 0.9 deaths/100,000 young people Indicator: Mortality rate from accidents and injuries Target: 25 deaths/100,000 young people Baseline data: 29.2 deaths/100,000 young people 2. Maternal mortality among young women is reduced Indicator: Maternal Mortality ratio among young women/100,000 live births Target: 0.5 deaths among young women/100,000 live births Baseline data: 0.6 deaths among young women/100,000 live births Indicator: Pregnancy rate among young women Target: 5 percent Baseline data: 7 percent 3. Malnutrition among adolescents is reduced Indicator: Percentage of obese adolescents Target: 3 percent Baseline data: 3.5 percent 4. The health-seeking behavior of young people is increased Indicator: Percentage of young people seeking preventive and promotive health services Target: 90% Baseline data: 80%sought consultation at least once for a particular illness Strategic Thrusts for 2005-2010 1. Develop models for adolescent friendly health services and environment • A comprehensive young people’s health care package needs to be designed and implemented in coordination with other government agencies • Essential Health Care Package for Adolescents and Youth ◦ Management of illness ◦ Injury and violence prevention ◦ Counselling on substance abuse ◦ Nutrition and diet counselling ◦ Mental health ◦ Fertility awareness, family planning, responsible sexual behavior and

• •

Majority of child abuse involve those between 11 and 17 years old 2% (4 M) nationwide have experienced sexual abuse while 3% (0.6 M) have suffered physical abuse from a family member

Most of the problems cited have bearing in the health outcome late in the lives of young people • Several factors hinder their access to and utilization of health services 1) They do not recognize their illnesses and are not aware of its serious consequences 2) They do not know that they can get help to treat and prevent their illnesses 3) Lack of skills of service providers to deal with the concerns of young people ∴ There is a need to remove the barriers to the delivery of health services AYHDP of the DOH • • • Created to address the global policy changes on adolescents and youth Expanded version of the Adolescent Reproductive Health (ARH) Aims to integrate adolescent and youth health services into the health delivery systems

FOCUS of the Program • Growth and development concerns • Reproductive health • Communicable diseases • Mental health • Intentional and non-intentional injuries • Other issues: education, social and employment needs shall be coordinated with other concerned agencies and NGOs VISION: Well-informed, empowered and healthy adolescents and youth MISSION: Ensure that all adolescents and youth have access to quality health care services in an adolescent and youth friendly environment National Objectives for Health for 2005-2010

GOAL: The total health and well-being of young people are promoted

1. Mortality among young people is reduced

◦ ◦

management of reproductive tract infections Oral care Healthy lifestyle advocate

huhuhu!!! Hanggang dulo, except ung last part, na ung Malabo, bale semi-imbento q na 2 dhl linya lng ytlga nkkta q..)

2. Organize and build the capability of young

people to promote healthy lifestyles • Includes sound reproductive health practices, injury prevention and promotion of sound policies on work to improve their health and quality of life

3. Strengthen fertility awareness activities among high school teachers and students to reduce the proportion of unplanned pregnancies and unmet need for family planning among young people Guiding Principles 1. Involvement of the youth • AYHDP shall involve the young people in the design, planning, implementation, monitoring and evaluation of activities and program • Favors the acquisition of valuable skills including interpersonal skills • Gives young people self-confidence • Promotes individual self-esteem and confidence • Contributes to a sense of belonging 2. Rights Based Approach • Promotion of young people’s rights shall be applied to ensure protection against neglect, abuse and exploitation 3. Diversity of adolescents needs and problems • Addressed most effectively by a combination of interventions that promote healthy development 4. Gender and health perspective • Adopted in all processes of policy implementation and delivery of services especially sexual and reproductive health Program Strategies The DOH shall adopt a 2 pronged noticeable liked and overarching strategies

A. Service Provision • Ensure access and provision of quality gender responsive biomedical and psychosocial services. ◦ Eventually, these will contribute to the reduction of maternal, infant, child and young peoples’ morbidity and mortality, ensure the quality of life of the families and communities; and promote total health and well being of Filipino adolescents and youth. B. Education and Information • Early education and information sharing for adolescents and services information providers (parents, teachers, communities, church, health staff, media and NGOs) on adolescent services geared towards adolescent health shall be done • This aims to increase knowledge and understanding of a particular health issue, and with the explicit intention of motivating the young people to adopt healthy behavior and to prevent health hazards such as unwanted pregnancies, STDs, substance use / abuse, violent behavior and nutritional deficiencies. C. Building Skills • Life skills training to enable them to deal effectively with the demands and challenges of everyday life ◦ It refers to skills that enhance psychosocial development, decision making and problem solving; creative and critical thinking; communication and interpersonal relations , self awareness, coping with emotions and causes of stress. Examples of these skills are:  * Self care skills eg. how to plan and prepare healthy meals or ensure good personal hygiene and appearance. * Livelihood skills eg. how to obtain and keep work.  * Skills for dealing with specific risky situations eg. how to say no when under peer pressure to use drug. • Life skills shall be integrated in the training module for health workers and of the school curiculA • Service providers, parents and teachers shall be equipped with competencies to influence behavior of adolescents and promote healthy development and prevent health problems.

1. To promote healthy development among young

adults • Promote healthy lifestyle • Adopt life skills approach • Create a safe and supportive environment • Promote positive values and caring relationships

2. To prevent and respond to adolescent health problems • Prevent, control and manage health risks MAJOR STRATEGIES
(super labo po ng pic, yan lng kinaya ng powers ko! Sbrang bilis din yan nilecture kya ung A-F lng nkuha q.. :’(

D. Promoting Safe and Supportive Environment • Refers to as environmental that: (1) Nurtures and guides young people towards healthy development (2) Provides a positive close relationship with family, other adults and peers (3) Provides the least trauma, excessive stress, violence and abuse (4) Provides specific support in making individual responsible behavior choices.
(Dahil Malabo, alangan nmn na wla tau trans? Eto galing sa DOH: kay doc kc nka-hiwalay ung monitoring & evaln, at resource mobilization) While intervention

See above (super dq na tlga mabasa..)

Implementing Guidelines
(eto sa net na lhat galing..  d kc mbsa ung pic e! )

A. Service Delivery (15 nga lng ung kay Doc e!! :-P)

(5) 1. Relationship with families, service providers and significant others.  Adults contribute to a supportive climate for behavioral choices through positive relationship. They can substantially enrich the lives of young people through their fundamental role as parents and caregivers 2. Social norms and cultural practices  This involve what people typically do in all areas of life and peoples expectation of others. These forces usually shape the lives of young people thus it is important to take note of the attitudes and practices that are harmful to them. Attitudes and norms concerning (a)early marriage, (b)sexual behavior among young people, (c)access to information about sexuality may need to be addressed. 3. Mass Media and entertainment  The media is a very important component in influencing social norms that encourage adolescent to make responsible health behavior choices. It also provides great potential to communicate and mobilize community support on adolescent health issues. 4. Policies and legislation  Promoting policies and legislation for adolescent health can ensure young people have the opportunities and services they need to promote and protect their own health.
5. Monitoring and Evaluation  This is to ensure the smooth implementation of the program. Regular monitoring and evaluation will be conducted to identify the status, issues, gaps and recommendations. A scheme shall be developed which will include indicators, monitoring tools and checklist. Monitoring will be through conduct of field visits, consultative meeting and program implementation review. 6. Resource mobilization  The Department of Health have prepared a 10 year work plan for AYHDP. The budgetary requirements will be sourced out from national and international donor agencies. Advocacy with LGUs, other GOs and NGOs shall be conducted on sharing of existing resources where AYHDP will be integrated.

should now focus on the action that will facilitate growth and development and encourage adolescents and youth to practice healthy behavior, the following major aspects of social environment have to be considered:

E. Monitoring and Evaluation • Regular monitoring and evaluation will be conducted to identify the status, issues, gaps, and recommendations • Monitoring will be through field visits, consultative meetings, and program implementation reviews F. Resource Mobilization

1. The priority target group of the program are adolescents and youth belonging to the following category: o Out of School Youth (OSY) o In-School Youth (ISY) o Working youth o Prostituted youth o Marginalized (to include survivors of violence, indigenous group) 2. Health care services shall be available and accessible at all public health facilities with respect to ethnic, cultural, religious and gender differences by a trained health care provider. 3. DOH retained and private hospitals to include NGO clinics shall also provide health services. If feasible, they are encouraged to establish an adolescent & youth friendly designated area. 4. Stress reduction shall be an important activity. Various adolescent and youth stresses such as peer, economic and family pressure are major factors that increases their vulnerability to risky behaviors. 5. Privacy and confidentiality shall be preserved at all times when dealing with adolescent health problems except on suicide, homicide, cases of physical and sexual abuse. Confidentiality will build trust of the adolescents and will also protect them from the unnecessary peer pressure and embarrassment 6. A constellation of referral networks for special health problems and conditions such as substance use / abuse, disability, and survivors of abused victims shall also be made available. This shall include medical, legal, & rehabilitative services to include occupational therapy, etc. → Bantay Bata 7. Health workers need to be technically competent and have a positive attitude (interested, concerned, understanding, considerate, easy to relate to and trustworthy) towards adolescents and youth. 8. The family shall remain to be the most important source of basic knowledge, behavior, attitude and skills of adolescents & youth on health.

9. Adolescents and youth shall be tapped to promote the health of their peers, the young children and even of the adults. 10. A stable peer support system shall be established within the school or community. Activities such as community / school awareness sessions, young people group meetings and round table discussions often build a common desire for adolescent health and development. 11. Parents and adults shall be motivated to exert all efforts to create a safe environment and ascertain their need for protection from exploitation such as cigarette advertising, unhealthy food advertising ( empty-calorie food), abuse by people with authority over them — relatives, school personnel, irresponsible media particularly on sex and violence. 12. Parents and teachers through the ParentTeachers Association shall have regular interaction to facilitate early identification of behavioral problems. 13. The concerned sectors such as teachers, counselors, health providers, social workers, religious leaders, employers, the community and others shall support the family in caring for adolescents & youth to prepare them in making good health decisions. 14. Religious leaders shall be encouraged to continue their value clarification initiatives. 15. (eto wla) Health Care Financing scheme shall be encouraged to support the institutionalization of adolescent & youth health care and services. 16. A 2 way referral system shall be established at all levels of health facilities and with other concerned agencies. 17. (eto rin wla) The standards and concepts set by the Sentrong Sigla (SS) shall be applied in all aspect of implementation to ensure quality health service. It shall work in partnership with the SS steering committee to ensure that quality standards are developed and updated to conform with project structures and directions. B. Information / Advocacy (6 lng sa slides ni doc) 1. The DOH-National Office shall o set standards in the development of AYHDP IEC messages and materials o provide technical assistance to the regional office in the development of prototype IEC materials and in the conduct of other innovative IEC strategies / activities.

2. AYHDP IEC materials shall be culture friendly and be made available / accessible and utilized by adolescents and youth. 3. Service providers should learn the information needs of adolescents and misinformation that needs clarification and be able to respond appropriately. (eto kasunod ala sa slides ni doc) The following are some of the types of information needed by young people : o Basic information about growth and development and the changes experienced physically, psychologically and socially during maturation. o Information about specific areas of health, such as nutritional requirements, dental care, physical activity, sexual and reproductive health, and ways to express feelings without resorting to aggression towards others. o Information about potential risks to their health from behavior such as early sex, use of tobacco, abuse of alcohol and other drugs, and on how to avert these risks. o Information about opportunities and available services, related to health, education, vocational and recreational o Information on how, what and where to get health services. 4. Parents and those in parenting roles shall be given appropriate information on adolescent concerns especially sexuality and communication skills training to strengthen their capability to share information with adolescents. 5. (eto wla rn) Media personnel shall be provided information regarding strategies as to how to provide information that can help modify social norms; promote healthy behavior; increase sensitivity to issues; and influence their attitudes and opinions. 6. Mass media shall be tapped to popularize healthy behavior. 7. (eto pa wla rn) Folk media can be used in conveying messages on adolescent & youth health & development 8. The DOH shall work closely with other agencies who are also focusing on other aspects of adolescent development 1. Department of Education (DepEd),Commission on Higher Education (CHED), Department of

Labor and Employment (DOLE), Technical Education and Skills Development Authority (TESDA), National Youth Commission (NYC), Commission on Population (POPCOM), Department of Social Welfare Development (DSWD), etc. as well as with NGOs and international agencies. C. Capability Building (haha! 4 lng sa slides ni doc.. bkt
kya kulang2 un nilec nya stn?)


(Eto mrn din!!!) LGUs shall be encouraged to

1. DOH-National Office shall developed AYHDP training module with inputs from other concerned group. 2. Service providers such as doctors, nurses, midwives in the public sector shall undergo training on AYHDP courses in order to maintain the provision of quality of care. 3. Trained service providers shall undergo periodic refresher courses / training at least every 5 years to update on recent development and trends. 4. (ahhh.. eto pla nkaincorporate sa #1 sa slides nya..)The DOH shall assist and or provide technical assistance to other national government agencies when necessary in reviewing and updating their health services standards / curriculum and guidelines for implementation. 5. Adolescents and youth shall have life skills training. D. Research and Information base (grabe na a! 3 lng
ung sa knya!)

conduct local survey on adolescent KAP. E. Monitoring and Evaluation 1. Monitoring and evaluation of the availability and effectivity of services shall be conducted regularly with the participation of adolescents & youth to further enhance the quality of programs and services. 2. AYHDP program review shall be conducted o At least semi-annually at CHD. o Annually at the national level. 3. Annual accomplishment report shall be forwarded to DOH-National Office by the CHD. 4. Annual evaluation and planning workshops shall be conducted in coordination with the national and CHD office. Challenges in Health Care Provision among Young People
(eto sa lecture na, malaki na ung letra, kaya kita na..  ala rn sa net.. magtype na daw ako ulit )

1. Measures to prevent disease and reduce

mortality entail lifestyle changes 2. How to capture young people for health promotion and disease prevention at a stage when they generally do not feel sick at all 3. How to influence the development of national and local policies that favor promotion and protection of the health of young people
References: http://www.doh.gov.ph/programs/adolescent_health/ayhdp http://doh.gov.ph/ayhd/htm/guidelines.htm


(eto ata wala.. dq mabasa un sa pic!) Multi and





interdisciplinary approaches in research shall be encouraged between researcher and implementers to optimize the efficiency and benefits derived from these researches. AYHDP researches of the DOH shall initially be referred to CFEH for review / comments and for recommendation to Health Policy Development & Planning Bureau (HPDPB). (eto kita q..) All research finding shall be translated into user-friendly information for full appreciation, dissemination and utilization by all stakeholders and program workers. In coordination with National Epidemiology Center (NEC), AYHDP researches should be part of the RH Data Management System to ensure availability and accessibility of information. (eto din meron) DOH-CHD shall provide technical assistance on research capability building at the LGU level.

Dami pa space! So? Lessons learned fr this trans: 1. Habang may mata, may pag-asa 2. Pag pumalya ung (1), may internet, may panibagong pag-asa 3. Dapat pala, ung (2) muna, para d na mahirapan ang mata! -malta  Ala nq masabi..

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