WHO Definition 5) Poor access to a health facility or unable to

afford services
Adolescents: 10-20 y/o • Teenage pregnancy and abortion
Youth: 15-24 y/o ◦ Consequence of teenage pregnancy
1) Low birth weight babies
Young people: 10-24 y/o
2) Mothers – not finishing school leads to
Young people: account for little over 30% of total reduced employment options later in
population of the Philippines or around 26M life
◦ Young pregnancies account for 16.5% of
Health Indices abortion cases
◦ Factor contributing to high rates of
• Mortality from all causes is 0.87/100,000 abortion is their restricted access to family
population planning information and services
• By the age of 19: 12% sexually active
• By the age of 24: 45% of women are already Values Formation
mothers
• In a study in 2002, the ff morals were asked
• Women 15-24 y/o: group with the highest from young people:
unmet need for family planning services at ◦ 19% believed that cheating neither right
26%
nor wrong
• Smoking prevalence among adolescent is 25% ◦ 5.6% think that taking something without
and admits social drinking 41% permission is right
• Random drug testing of public and private high ◦ 12% feel that gambling is right
school students yield screening positivity rates ◦ 16% okay public display of affection
of 3-10% ◦ 18% approve of living-in arrangement
• Drug use rate is estimated to be higher among
◦ 15% approve of pregnancy without
college students marriage
Causes of Mortality (Age 10-24)
◦ 38% approve of separation
◦ 36.5% approve of divorce
1.
Accidents/Injuries Poisoning and Substance Abuse
2. CVD, all forms
3. Malignant • Tobacco
neoplasm ◦ Average age of initiation of tobacco
4. TB, all forms use: 12.5 yrs
5. Pneumonia ◦ Average start of regular tobacco use:
6. Nephritis, 14 yrs
Nephrotic ◦ Adolescents who smoke are more likely to
syndrome and use other substances:
Nephrosis
 3x more likely to use alcohol
7. Other diseases
of nervous system  8x more likely to use marijuana
8. Meningitis  22x more likely to use coccaine
9. Septicemia • Alcohol
10. Epilepsy ◦ Filipino youth starts drinking alcohol at the
age of 16 or 17
Areas of Concern Among Young People ◦ They were influenced by
family, friends and mass
Sexual Activity media
◦ Male 68.5%; Female
• Unprotected sexual activity brings it with the
21%
dangers of early or unwanted pregnancy,
induced abortion, STDs, HIV infection, AIDS
◦ HIV/AIDS registry as of 2001 • Drugs
 Total of 766 HIV seropositive children ◦ Average age when illegal drugs were first
and youth used is 17.3; With males outnumbering
 90%: age 20-29 females
◦ Drugs commonly used are:
 5%: age 10-19  Sedatives- barbiturates, tranquilizers
• Factors that may increase the risk of STDs
1) Lack of information on unprotected sex  Stimulants – amphetamines (shabu),
cocaine
2) Poor access to contraceptive and
 Hallucinogens – LSD, marijuana
counselling services
3) Poor health seeking behavior  Narcotics – opium, morphine
4) Ignorance of the presence of disease
Suicide
• Methods used include:
◦ 54% slashed wrist
21% ingestion
12% hanging
3% stabbing, jumped from a building or river
Violence and Abuse
• 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
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
 management of reproductive tract huhuhu!!! Hanggang dulo, except ung last part, na ung Malabo, bale
semi-imbento q na 2 dhl linya lng ytlga nkkta q..)
infections
◦ Oral care
◦ Healthy lifestyle advocate A. Service Provision
• Ensure access and provision of quality
2. Organize and build the capability of young gender responsive biomedical and
people to promote healthy lifestyles psychosocial services.
• Includes sound reproductive health ◦ Eventually, these will contribute to
practices, injury prevention and promotion the reduction of maternal, infant,
of sound policies on work to improve their child and young peoples’ morbidity
health and quality of life and mortality, ensure the quality of
life of the families and communities;
3. Strengthen fertility awareness activities among and promote total health and well
high school teachers and students to reduce the being of Filipino adolescents and
proportion of unplanned pregnancies and unmet youth.
need for family planning among young people
B. Education and Information
Guiding Principles • Early education and information sharing
1. Involvement of the youth for adolescents and services information
• AYHDP shall involve the young people in providers (parents, teachers, communities,
the design, planning, implementation, church, health staff, media and NGOs) on
monitoring and evaluation of activities and adolescent services geared towards
program adolescent health shall be done
• Favors the acquisition of valuable skills • This aims to increase knowledge and
understanding of a particular health issue,
including interpersonal skills
and with the explicit intention of
• Gives young people self-confidence
motivating the young people to adopt
• Promotes individual self-esteem and
healthy behavior and to prevent health
confidence
hazards such as unwanted pregnancies,
• Contributes to a sense of belonging
STDs, substance use / abuse, violent
behavior and nutritional deficiencies.
2. Rights Based Approach
• Promotion of young people’s rights shall be
C. Building Skills
applied to ensure protection against
• Life skills training to enable them to deal
neglect, abuse and exploitation
effectively with the demands and
challenges of everyday life
3. Diversity of adolescents needs and problems
◦ It refers to skills that enhance
• Addressed most effectively by a
psychosocial development, decision
combination of interventions that promote
making and problem solving; creative
healthy development
and critical thinking; communication
and interpersonal relations , self
4. Gender and health perspective
awareness, coping with emotions and
• Adopted in all processes of policy
causes of stress. Examples of these
implementation and delivery of services
skills are:
especially sexual and reproductive health
 * Self care skills eg. how to
Program Strategies plan and prepare healthy
meals or ensure good
The DOH shall adopt a 2 pronged noticeable liked personal hygiene and
and overarching strategies appearance. * Livelihood
skills eg. how to obtain and
1. To promote healthy development among young keep work.
adults  * Skills for dealing with
• Promote healthy lifestyle specific risky situations eg.
• Adopt life skills approach how to say no when under
• Create a safe and supportive environment peer pressure to use drug.
• Promote positive values and caring • Life skills shall be integrated in the training
relationships module for health workers and of the
school curiculA
2. To prevent and respond to adolescent health • Service providers, parents and teachers
problems shall be equipped with competencies to
• Prevent, control and manage health risks influence behavior of adolescents and
promote healthy development and prevent
MAJOR STRATEGIES (super labo po ng pic, yan lng kinaya ng health problems.
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
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:
(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 care-
givers
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.
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
• 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)
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 Parent-
Teachers 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), 6. (Eto mrn din!!!) LGUs shall be encouraged to
Technical Education and Skills conduct local survey on adolescent KAP.
Development Authority (TESDA), E. Monitoring and Evaluation
National Youth Commission (NYC), 1. Monitoring and evaluation of the availability
Commission on Population and effectivity of services shall be conducted
(POPCOM), Department of Social regularly with the participation of
Welfare Development (DSWD), etc. adolescents & youth to further enhance the
as well as with NGOs and quality of programs and services.
international agencies. 2. AYHDP program review shall be conducted
C. Capability Building (haha! 4 lng sa slides ni doc.. bkt o At least semi-annually at CHD.
kya kulang2 un nilec nya stn?) o Annually at the national level.
1. DOH-National Office shall developed AYHDP
3. Annual accomplishment report shall be
training module with inputs from other
forwarded to DOH-National Office by the
concerned group.
CHD.
2. Service providers such as doctors, nurses,
4. Annual evaluation and planning workshops
midwives in the public sector shall undergo
shall be conducted in coordination with the
training on AYHDP courses in order to
national and CHD office.
maintain the provision of quality of care.
3. Trained service providers shall undergo
Challenges in Health Care Provision
periodic refresher courses / training at least among Young People
every 5 years to update on recent
development and trends. (eto sa lecture na, malaki na ung letra, kaya kita na..  ala rn sa net..
magtype na daw ako ulit )
4. (ahhh.. eto pla nkaincorporate sa #1 sa slides nya..)The
DOH shall assist and or provide technical 1. Measures to prevent disease and reduce
assistance to other national government mortality entail lifestyle changes
agencies when necessary in reviewing and 2. How to capture young people for health
updating their health services standards / promotion and disease prevention at a stage
curriculum and guidelines for when they generally do not feel sick at all
implementation. 3. How to influence the development of national
and local policies that favor promotion and
5. Adolescents and youth shall have life skills
protection of the health of young people
training.
D. Research and Information base (grabe na a! 3 lng References:
ung sa knya!) http://www.doh.gov.ph/programs/adolescent_health/ayhdp
http://doh.gov.ph/ayhd/htm/guidelines.htm
1. (eto ata wala.. dq mabasa un sa pic!) Multi and
interdisciplinary approaches in research shall
be encouraged between researcher and Dami pa space! So?
implementers to optimize the efficiency and
Lessons learned fr this trans:
benefits derived from these researches. 1. Habang may mata, may pag-asa
2. AYHDP researches of the DOH shall initially 2. Pag pumalya ung (1), may internet, may panibagong pag-asa
be referred to CFEH for review / comments 3. Dapat pala, ung (2) muna, para d na mahirapan ang mata!
and for recommendation to Health Policy
Development & Planning Bureau (HPDPB). -malta 
3. (eto kita q..) All research finding shall be Ala nq masabi..
translated into user-friendly information for
full appreciation, dissemination and
utilization by all stakeholders and program
workers.
4. 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.
5. (eto din meron) DOH-CHD shall provide
technical assistance on research capability
building at the LGU level.