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![Status of Adolescents in Nepal
;fIf/tfsf] cj:yf
Source: NDHS 1996, 2001, 2006 & 2011
17.3
51.5
13.3
37.6
4.5
21.3
3.6
12.5
0
10
20
30
40
50
60
M F M F M F M F
1996 2001 2006 2011
Percentages of adolescents (15-19) having 'No
education' by sex
Includes those
who have
never attended
school and
those in Early
Childhood
Development
(ECD) centers](https://image.slidesharecdn.com/presentationasrhadra-170314114053/75/Adolescent-Sexual-and-Reproduction-Health-Presentation-5-2048.jpg)
![lszf]/Lx?sf] kf]if0f cj:yf
Source: NDHS 1996, 2001 and 2006 and NFHP survey 2009
30.6
23.2
26.3 25.8
0
5
10
15
20
25
30
35
1996 2001 2006 2011
BMI status of women aged 15-19 years (BMI <18.5 kg/m2)
Status of Adolescents in Nepal](https://image.slidesharecdn.com/presentationasrhadra-170314114053/75/Adolescent-Sexual-and-Reproduction-Health-Presentation-6-2048.jpg)
![Source: NDHS 1996, 2001 and 2006 and 2011
lszf]/lszf]/Lx¿df x'g] k|hgg b/
qmdz M == == =
127
110
98
81
0
20
40
60
80
100
120
140
1996 2001 2006 2011
Adolescent (15-19 years) Fertility Rate
15-19
NDHS
2011:
Urban (42),
Rural (87)
Status of Adolescents in Nepal](https://image.slidesharecdn.com/presentationasrhadra-170314114053/75/Adolescent-Sexual-and-Reproduction-Health-Presentation-7-2048.jpg)
![ue{jtL x'+bfsf] pd]/
Source: NDHS 1996, 2001, 2006 and 2011
23.9
21.4
18.5
16.7
19.8 19.9 19.9 20.2
0
5
10
15
20
25
30
1996 2001 2006 2011
Median Age at Child birth and Percentage of women who have begun
childbearing by 19 years
% begun child bearing by 19 yrs among 15-19 yrs women
Median age at first birth among 25-49 cohorts
Status of Adolescents in Nepal](https://image.slidesharecdn.com/presentationasrhadra-170314114053/75/Adolescent-Sexual-and-Reproduction-Health-Presentation-9-2048.jpg)
![ue{ lg/f]w tyf kl/jf/ lgof]hg
Source: NDHS 1996, 2001, 2006 and 2011
98.3 99.9 99.6 99.9
4.4
9.3
13.8 14.4
40.5
35.6 37.9
41.5
0
20
40
60
80
100
120
1996 2001 2006 2011
Situation of contraception use among currently married
women aged 15-19 years
Knowledge Current use Unmet need
G
a
p
G
a
p
NDHS 2011
• Currently using
14.4 using any modern
method (82.4 Not using)
Status of Adolescents in Nepal](https://image.slidesharecdn.com/presentationasrhadra-170314114053/75/Adolescent-Sexual-and-Reproduction-Health-Presentation-11-2048.jpg)
![10.40
9.80
19.70
13.30
3.03
11.11
7.87 7.42
0.00
5.00
10.00
15.00
20.00
25.00
Early adolescents (N= 636) Adolescents (N=644 ) Youths (N= 644) All total (1924)
Govt HF visited by A & Y and their perception towards it
Visited Satisfied among visited
;/sf/L :jf:Yo ;+:yfsf] k|of]u
Status of Adolescents in Nepal](https://image.slidesharecdn.com/presentationasrhadra-170314114053/75/Adolescent-Sexual-and-Reproduction-Health-Presentation-14-2048.jpg)
![Guiding Documents for Adolesecent
Sexual and Reproductive Health
• National Adolescent Health and
Development Strategy prepared &
endorsed, 2000
Goal : To improve the health and
development status of
adolescents
:jf:Yo ;]jf
tyf k/fdz
;"rgf /
;Lkx?
;'/lIft tyf
;xof]uL
jftfj/0f](https://image.slidesharecdn.com/presentationasrhadra-170314114053/75/Adolescent-Sexual-and-Reproduction-Health-Presentation-17-2048.jpg)
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Adolescent Sexual and Reproduction Health Presentation
- 1. Adolescent Sexual andReproductive Health Services in Nepal Deepak Timsina Training Officer ADRA Nepal 2012
- 2. Why Adolescent ? •One in every 10 births world-wide and 1 in 6 births in least developed countries is to teenage mothers. • Pregnancy before age 18 has many health risks. – Girls 10 to 14 are five times more likely to die in pregnancy or childbirth than women aged 20 to 24.
- 3. Why Adolescent ? •At least 1 in 10 abortions world-wide occurs to women aged 15 to 19 years. – More than 4.4 million young women in this age group have an abortion every year, 40 per cent of which are performed under unsafe conditions. • Nearly two thirds of premature deaths and one third of the total disease burden in adults are rooted in conditions or behaviours that began in youth • Young people aged 15-24 accounted for an estimated 45% of new HIV infections worldwide in 2007.
- 4. Why Adolescent ? •At least 20% of young people will experience some form of mental illness - such as depression, mood disturbances, substance abuse, suicidal behaviours or eating disorders. • Today more than 150 million adolescents use tobacco, and this number is increasing globally. • Among 15-19 year olds, suicide is the second leading cause of death, followed by violence in the community and family.
- 5. Status of Adolescentsin Nepal ;fIf/tfsf] cj:yf Source: NDHS 1996, 2001, 2006 & 2011 17.3 51.5 13.3 37.6 4.5 21.3 3.6 12.5 0 10 20 30 40 50 60 M F M F M F M F 1996 2001 2006 2011 Percentages of adolescents (15-19) having 'No education' by sex Includes those who have never attended school and those in Early Childhood Development (ECD) centers
- 6. lszf]/Lx?sf] kf]if0f cj:yf Source:NDHS 1996, 2001 and 2006 and NFHP survey 2009 30.6 23.2 26.3 25.8 0 5 10 15 20 25 30 35 1996 2001 2006 2011 BMI status of women aged 15-19 years (BMI <18.5 kg/m2) Status of Adolescents in Nepal
- 7. Source: NDHS 1996,2001 and 2006 and 2011 lszf]/lszf]/Lx¿df x'g] k|hgg b/ qmdz M == == = 127 110 98 81 0 20 40 60 80 100 120 140 1996 2001 2006 2011 Adolescent (15-19 years) Fertility Rate 15-19 NDHS 2011: Urban (42), Rural (87) Status of Adolescents in Nepal
- 8. j}Jfflxs cj:yf Source: NDHS1996, 2001, 2006 and 2011 NA- Not Available a= Among total (15 above) b= Among 20-49 yrs NA 19.7 20.6 21.6 16.4 16.6 17.2 17.8 0 5 10 15 20 25 1996 2001a 2006b 2011b Median age at marraige by sex Male Female Status of Adolescents in Nepal
- 9. ue{jtL x'+bfsf] pd]/ Source:NDHS 1996, 2001, 2006 and 2011 23.9 21.4 18.5 16.7 19.8 19.9 19.9 20.2 0 5 10 15 20 25 30 1996 2001 2006 2011 Median Age at Child birth and Percentage of women who have begun childbearing by 19 years % begun child bearing by 19 yrs among 15-19 yrs women Median age at first birth among 25-49 cohorts Status of Adolescents in Nepal
- 10. ;'/lIft dft[Tj ;DaGwL;"rsx? 31.2 34.9 50.8 63.5 58.3 40.7 55.7 69.8 73.2 69.7 8.8 12.1 20.7 41.2 35.3 12.3 15.2 22.1 42.1 36.0 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 1996 2001 2006 2011 Total (15-49), 2011 Safe motherhood indicators for women aged < 20 years ANC from SBA Received TT 2+ Institutional delivery SBA during delivery Source: NDHS 1996, 2001, 2006 and 2011 Status of Adolescents in Nepal
- 11. ue{ lg/f]w tyfkl/jf/ lgof]hg Source: NDHS 1996, 2001, 2006 and 2011 98.3 99.9 99.6 99.9 4.4 9.3 13.8 14.4 40.5 35.6 37.9 41.5 0 20 40 60 80 100 120 1996 2001 2006 2011 Situation of contraception use among currently married women aged 15-19 years Knowledge Current use Unmet need G a p G a p NDHS 2011 • Currently using 14.4 using any modern method (82.4 Not using) Status of Adolescents in Nepal
- 12. Source: NDHS 1996,2001, 2006 and 2011 Status of Adolescents in Nepal
- 13. Comprehensive Knowledge: *: Only condomuse **: Programmatically important ways : abstaining from sex, using condoms, and limiting the number of sexual partners. ***: Consistent use of condoms, having just one faithful partner and healthy looking person can have HIV AIDS 34.7 40.8 29.1 25.0 56.8 45.3 32.7 0 10 20 30 40 50 60 1996* 2001** 2006*** 2011 Comprehensiveknowledgeaboutpreventivemeasures ofHIV AIDS among adolescents (15-19) years Female Male NA- Not Available NA Source: NDHS 1996, 2001, 2006 and 2011 Status of Adolescents in Nepal
- 14. 10.40 9.80 19.70 13.30 3.03 11.11 7.87 7.42 0.00 5.00 10.00 15.00 20.00 25.00 Early adolescents(N= 636) Adolescents (N=644 ) Youths (N= 644) All total (1924) Govt HF visited by A & Y and their perception towards it Visited Satisfied among visited ;/sf/L :jf:Yo ;+:yfsf] k|of]u Status of Adolescents in Nepal
- 15. Programs that addressthe issues of adolescents • Family Planning • Safe motherhood (ANC, Delivery and PNC + emergency obstetric care network) • Safe Abortion Services • Social mobilization through a network of 48000 FCHVs • BCC • Sex education/counseling • HIV/AIDS and STI • Skill based training
- 16. • RH Strategy(1998) - ASRH component Status of Adolescents in Nepal
- 17. Guiding Documents forAdolesecent Sexual and Reproductive Health • National Adolescent Health and Development Strategy prepared & endorsed, 2000 Goal : To improve the health and development status of adolescents :jf:Yo ;]jf tyf k/fdz ;"rgf / ;Lkx? ;'/lIft tyf ;xof]uL jftfj/0f
- 18. Development of ASRH Program Implementation Guidein 2007 Guiding Documents for Adolesecent Sexual and Reproductive Health
- 19. • NHSP-IP II(2010 – 2015) – Specific programme on ASRH – targeting 1000 HFs with AFS by 2015 – Adolescent fertilty rate from 98 to 70 by 2015 • National Medical Standard-VoI I and II- ARSH • RH Clinical protocol – ARSH • National AIDS Strategy (2011-2015)-Youth target • National Adolescent Communication Strategy 2011 Guiding Documents for Adolesecent Sexual and Reproductive Health
- 20. Major Activities forimplementation of ASRH Services 1. Selection of health facility for ASRH program implementation 2. 2 days orientation of District Health Managers 3. 1 day RHCC and district stakeholders orientation 4. 2 days health service providers training 5. 1 day HFOMC and local stake holders
- 21. Major Achievements • AFSscaled up in 455 HFs of 35 districts • Basic logistic support in all AFS health facilities • Technical tools developed for scale up of ASRH program : orientation guidelines, monitoring tools etc • Mapping of organization working in ASRH 2010 • DoHS Annual Report 2067/68 has separate chapter on ASRH
- 22. Adolescent Friendly HealthFacility Adolescents Friendly Logo developed and endorsed by Reproductive Health coordination Committee (2011)
- 23. IEC/BCC • Series of8 Information Education and Communication (IEC) Booklets on Sexual and Reproductive Health of Adolescents Development that answers queries of adolescents collected by participatory research process from different districts.
- 24. Technical tools onASRH • National ASRH program Package finalized in Sept 2011 that includes i. National ASRH Program Implementation guide 2011 ii. ASRH District Health Mangers Orientation guideline 2011 iii. ASRH District Stakeholders Orientation guideline iv. ASRH guideline on orientation to service providers 2011 v. ASRH orientation guideline to Health Facility Operation and Management Committee (HFOMC) 2011
- 25. • National ASRHProgram Implementation Guide- 2011 Tools
- 26. Tools …. ASRH Flip-chartrevised
- 27. Tools- contd.. Job Aidfor health workers on ASRH (translation and contextualization of Adolescent Job Aid- WHO)
- 28. Dolpa Humla Mugu Dang Kailali Doti Gorkha Jumla Bajhang Mustang Rukum Ilam Kaski Taplejung Bajura Rolpa Surkhet Myagdi Sindhuli Banke Jajarkot Manang Salyan Solukhumbu Bara Bardiya Dolakha Darchula Jhapa Palpa Kalikot Chitawan Morang Parsa Dhading Baglung Baitadi Tanahu Udayapur Sankhuwasabha Achham Makwanpur Dailekh Bhojpur Lamjung Saptari Khotang Gulmi Siraha Rasuwa Sarlahi Nawalparasi Sindhupalchok Kapilbastu Sunsari Pyuthan Kanchanpur Nuwakot Dhanusa Syangja Rupandehi Panchthar Ramechhap Dhankuta Kavre Okhaldhunga Arghakhanchi Terhathum Lalitpur Mahottari Parbat Kathmandu Bhaktapur Status ofNational ASRH Program Status: Number of districts reached so far (December 2011): 35 Number of HFs upgraded to AFSs by this FY(June 2012) : 455 HFs 2068/2069: Udayapur, Rautahat, Rolpa, Baglung, Dadeldhura, Kathmandu, Lalitpur, Bhaktapur (WHO) Accham, Doti, Kailali, Banke, Dang including pilot districts Dailekh, Surkhet, Bardiya, Baitadi, Jumla (GIZ/GFA) Humla, Jajarkot, Rukum, Bajura and Darchula (UNICEF) 2067/2068: Jhapa, Kavre, Nawalparasi, Dolakha, Kaski (FHD) 2066/2067: Morang, Bara, Dhading, Gulmi, Parbat (FHD) Index GoN GIZ/GFA WHO* UNICEF SCI (Status: December 2011) * TOT from WHO and remaining activities from GoN source
- 29. Program implemetation status YEARGON GIZ SCF WHO UNICEF 2065/066 PILOTED BARDIYA DAILEKH JUMLA SURKHET BAITADI 2066/067 TRAINING MORANG BARA DHADING PARBAT GULMI 2067/068 TRAINING JHAPA KASKI NAWALPARASI DOLAKHA KAVREPALANCHOWK TRAINING KAPILVASTU PYUTHAN 2068/069 MAINTAINENCE JHAPA MORANG BARA DOLAKHA DHADING KAVRE GULMI KASKI NAWALPARASI PARBAT TRAINING BAITADI ACCHAM DOTI KAILALI SURKHET DAILEKH JUMLA BARDIYA BANKE DANG TRAINING UDAIPUR RAUTAHAT BAGLUNG ROLPA DADELDHURA KATHMANDU BHAKTAPUR LALITPUR TRAINING HUMLA JAJARKOT RUKUM BAJURA DARCHULA PMTCT SURKHET MORANG BARDIYA
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