Redefining the Narrative for Better Futures: Understanding Reproductive Health Needs for Adolescent & Young Adults

 

Health knowledge is a fundamental concept that is necessary for an individual from a very young age. Adolescence is the transition period between childhood and maturity, the time during which teenagers experience both biological and psychological changes and gain freedom. They are vulnerable to a variety of social and health concerns. Nearly fifty percent of the world's population is under the age of 25. Most are living in countries with the highest poverty rates, where many die prematurely and unnecessarily because of health-related conditions and studies have shown that these have their origins in adolescent behaviors.

Young individuals are frequently offered less access to information, services, and resources in comparison to older individuals. In most cases, the first responders for children for basic health education on issues such as personal hygiene, puberty, and reproductive health are parents /guardians or immediate family members. However, not all parents are comfortable addressing reproductive and sexual health with their children. Furthermore, health services are rarely tailored specifically to address the needs of adolescents, and health personnel receive occasional expert training in topics concerning adolescent sexual and reproductive health. It is not surprising that they have distinctively low levels of health-seeking behavior.

Risks and challenges for Adolescents:

Adolescent sexual and reproductive health (ASRH) contributes to a significant portion of the global burden of sexual ill health. It has a significant connection to their social, cultural, and economic environment. In addition to regional differences, experiences vary by age, gender, marital status, education, geographical location, migration status, gender identity, and socioeconomic level, among other factors. Access to health care, as well as information, guidance, and support, varies greatly.

Adolescents, particularly girls, encounter a variety of challenges including early pregnancy and parenting, difficulty getting contraception and safe abortion, and high prevalence of HIV and sexually transmitted illnesses, as well as sexual abuse, exploitation, and violence. They are also at greatest risk of maternal death: the probability of death caused by pregnancy is twice as high for girls aged 15-19 and five times greater for girls aged 10-14 when compared to women in their twenties. These issues have long-term consequences and impact an individual's bodily and mental health, as well as their families and communities.

 

The Global Challenges for Adolescent Sexual and Reproductive Health (ASRH)

1.     Pregnancy, Birth Control, and Abortion:

Pregnancy concerns and death are more prevalent in adolescents than in older women. According to Pakistan Demographic and Health Survey, data extracted from the 2019 survey, an estimated 617,000 pregnancies occur among adolescent women aged 15-19 in Pakistan each year. Amongst them, approximately 36% were unplanned. More than 58% of these unplanned pregnancies resulted in abortion. Furthermore, 30% result in birth, and 12% result in miscarriage or stillbirth.

In terms of morbidity, adolescent pregnancy has been associated with anemia, malaria, postpartum hemorrhage, and mental health issues such as depression. The pregnancy, labor, and delivery process for girls who have not completed their physiological growth predispose them to difficulties that are less prevalent in adult women; 9% 86% of women with obstetric fistula develop it as adolescents, with devastating, often lifelong repercussions.

2.     Sexually Transmitted Infections, HIV/AIDS:

Nowadays, the young adult population is the most seriously affected by HIV/AIDS. Furthermore, the rate of sexually transmitted infections is highest among 20-24 years, followed by 15-19-year-olds, with adolescent girls bearing the greatest burden. It is due to the underdeveloped reproductive and immunological systems of females that translate into higher susceptibility to STIs and HIV transmission. Cultural and socioeconomic variables, particularly social inequity, and exclusion, as well as having older spouses, increase their risk in addition to biological vulnerability.

Treating STIs is very crucial because it can facilitate HIV transmission while also causing other long-term damage. Only just a few percent of teenagers have access to appropriate and inexpensive STI/HIV services. In most countries, accurate and reliable HIV knowledge is lacking, and HIV testing in this age group is uncommon therefore most of the deaths in boys because of HIV/AIDS are reported.

    Barriers and Challenges: 

    Adolescent sexual and reproductive health is today challenged by an extensive number of complex hurdles. Their accessibility to services, based upon availability, is limited due to socioeconomic and physical constraints. On a personal level, fear, humiliation, a lack of awareness, misconceptions, myths, stereotypes, and shame may limit young people's care-seeking behavior. Peers, parents, family members, teachers, and healthcare providers all have an impact on teenagers' access to information and services. Some think that provider attitude is the single most critical barrier to care. Many healthcare providers discourage teens from using services due to a lack of confidentiality, judgmental attitudes, contempt, or a failure to take their patients' needs seriously. Other factors that impede are.

•       ASRH is given minimal priority in politics, and restricting laws and policies are frequently in existence.
  

•      As a lot of societies hold a deeply embedded sense of disapproval of adolescent sexual activity, various societal, cultural, and religious factors create an inhibiting environment for the discussion of ASRH; this is often demonstrated through the stigmatization of sexual health concerns, particularly STI’s/HIV.

•      The discriminating attitudes towards sexual activity, especially among people who are not married and sexually active.

•     Accepted practices of early marriage and children, age disparities between partners, and societal pressure limiting the use of contraceptive devices may prevail in some regions.

•      Conflict, migration, urbanization, and a lack of education can all complicate poor ASRH.

•      In terms of service-associated barriers, poor healthcare systems for sexual health, family planning, and maternal health are frequent.
  

•      Services that may cover counseling and family planning fail to include HIV/STI.

Strategies for Promoting Adolescent Sexual & Reproductive Health

Adolescents and young adults are our future generation. Giving them reproductive and sexual health care that is free of prejudice or discrimination empowers individuals to make healthy choices about their bodies and futures, which contributes to a better and healthier world.

• Universal Access to Sexual and Reproductive Health Care: Universal accessibility of sexual reproductive health care and women's control over their own reproductive decisions is essential not only for achieving sustainable development but also for ensuring women's empowerment.
  

•  Expanding Healthcare Providers Capacity: Increase the capacity of different levels of health professionals to provide quality sexual reproductive health information and services. To ensure sustainability, establish and incorporate sexual reproductive health into existing healthcare training curricula, improve training plans, secure long-term funding, strengthen healthcare provider capacity, and improve accountability. 

• Policy Making: Young people move ahead and bring about change. Connecting youth advocates and legislators is critical to establishing supportive policies that enhance the health and rights of young individuals.
  

• Inclusion of Reproductive Health Education: Comprehensive reproductive health and sexual education can be an inexpensive approach to promote recourse to contraception and equip teens and adults of all ages with the information they need to make healthy decisions for the rest of their lives.

• Professional Collaboration: Young individuals typically have an instinctive sense of what will help them achieve. Working with young people to develop novel and creative ways for adolescents and youth sexual and reproductive health and behavior modification techniques can help them build healthy habits and behaviors.   

 

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