quality of life in youth

7/28/2019 Quality of Life in Youth

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The web of our life is of a mingled yarngood and ill together.

Shakespeare, Alls Well That Ends Well.


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The 1.2 billion people aged 10 to 19 make up about 20% of the global population, (85% ofwhom live in developing countries).

One in every five people in the world is an adolescentAdolescents constitute 25% of the population of Egypt (UNICEF 2007).Youth Ages (10-24), 2006-------- 23,300,000.Reference: population reference bureau (PRB).


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Adolescent is defined by WHO as aperson between 10-19 years of age.

Youth is defined , as those persons between the ages of 15 and 24 years,Within the category of "youth", it is also important to distinguish between

teenagers (13-19) and young adults (20-24).


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A cycle of positive outcomes can result from having a larger,better-

educated workforce with fewer children to supportchildren who will inturn be more educatedandemployable, provided thatinstitutions are

strengthenedandviable economic policies are in place.


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Most countries in Africa are projected to have more working-age adults perchild in 2030 than they did in 2006.A large workforce with fewer children to support creates a window of opportunity to save money on health care;

improve the quality of education;increase economic output because of more people working;invest more in technology and skills to strengthen the economy; and create the wealth needed to cope with thefuture aging of the population.This window of opportunity is the demographic dividend (or bonus).


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1. Investing in the health of adolescents helpsprevent the estimated 1.4 million deathsthat occur globally every year due to road traffic injuries, violence, suicide, HIV and

pregnancy related causes.2. It promotes the adoption of healthy behaviours that help prevent health problems that

occur later in life, such as cardiovascular diseases and lung cancer resulting fromphysical inactivity and tobacco use initiated during adolescence.


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Youth capacity for learning is greater than for older ages.

Thus, youth poverty represents missed opportunities to acquire skills

in school or on the job, or good health habits, and these problems

can be extremely difficult to remedy.


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Life-course events (e.g. leaving school, starting work, getting married,

having children) play a significant role in shaping vulnerability to poverty.These life events are more likely to occur during the 18-29 age interval.


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Youth living in poverty face deprivations of many of their

rights: to survive, to learn, to work, to participate, and to be

protected.

Income Poverty is known as the material incapability of

securing a decent living standard(providing basic needs)based on which individuals status is defined as poor or not.


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At the national level, 23% of children under age 15 years were in poverty

in 2008-09.Poverty rates peak dramatically for teenagers between 15 to 17 years at27

% rising to almost29% for young adults between 18 and 20 years.


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Net enrollment rate reached

13.9% for poor youth aged 18-24

years.

At the age of 20 years, 11.7% ofpoor females and 13.6% of poor

males were enrolled in education.


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Unpaid workers are more common among the poor than the non

poor.

The share of unpaid workers in total employment is at24.7 and

19% for the poor and non poor.

youth make up as much as 36 % of the total working-age population

and three in five of Africa's unemployed are youth.


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Source: International Labour Office, Global Employment Trends for Youth 2008
http://www.ilo.org/public/english/employment/strat/download/gety08.pdfhttp://www.ilo.org/public/english/employment/strat/download/gety08.pdf


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Some youth with few job prospects and little hope of future advancementmay see little alternative tocriminal activities or joining armed conflicts.

"Unemployed and underemployed [youth] are more exposed to conflictsand illegal activitiesmany of them fall prey to rebel groups.

(Office of the Chief Economist, Africa Region at the World Bank).


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Source: United Nations Population Division, World Population Prospects, The 2008 Revision.

World Population (in Billions): 1950-2050


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Source: Carl Haub and Mary Mederios Kent, 2009 World Population Data Sheet.

Population Ages 15-24 by World Region: 1950 and 2050

1950 2050


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Source: United Nations Population Division, World Population Prospects, The 2008 Revision.

Population by Age and Sex, Less Developed Countries: 2009


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With almost half of the world's population under age 25, investments in young people are vital toimprove economic and social outcomes and achieve the Millennium Development Goals (MDGs).

The United Nations proclaimedAug. 12, 2010, the start of an International Year of Youth


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1. More than 1.8 million young people aged 15 to 24 die each year, mostly due to p reventable causes.2. About 16 million girls aged 15 to 19 give birth every year.3. Young people, 15 to 24 years old, accounted for40% of all new HIV infections among adults in 2008.

4. In any given year, about 20% of adolescents will experience a mental health problem, most commonly depression or anxiety.5. An estimated 150 million young people use tobacco.6. Approximately 565 young people aged 10 to 29 dieevery day throughinterpersonal violence.7. Road traffic injuries cause an estimated 1000 young people to die every day.


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About 16 million girls aged 15 to 19 years give birthevery year - roughly11% of all births worldwide. The

vast majority of adolescents births occur in

developing countries.

The formulation and enforcement of laws that specify a

minimum age of marriage, andbetter access to

contraceptive information and services can decrease too-

early pregnancies


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To highlight the urgency of reproductive health needs of youth, an international conference was convened in 2008 in Abuja, Nigeria.Among the recommendations in the Call to Action is the expansion of three types of programs:Age-appropriate sexual and reproductive health educational interventions.

Youth-friendly health services with community outreach.Comprehensive information campaigns.


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In any given year, about 20% of adolescents will experience amental health problem, most commonly depression or anxiety.

The risk is increased by experiences ofviolence, humiliation,devaluation and poverty, and suicide is one of the leading causes of

death in young people.Building life skills in children and adolescents, and providing themwithpsychosocial support in schools can help promote mentalhealth.

If problems arise, they should be detected and managed by

competent and caring health workers.


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The majority of tobacco users began when they

were adolescents, an estimated 150 million

young people use tobacco.

Half of those users will die prematurelyas a resultof tobacco use.

Banning tobacco advertising, raising the prices of

tobacco products and laws prohibiting smoking in

public places reduce the number of smokers.


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Violence is one of the leading causes of death among youngpeople, particularly males: an estimated 565 young peopleaged 10 to 29 years die every day through interpersonalviolence.

For each death, an estimated 20 to 40 youths require hospitaltreatment for a violence-related injury.

Promoting nurturing relationships between parents andchildren early in life.

Providing training in life skills.

Reducing access to alcohol and lethal means help prevent

violence.Effective and empathetic care for adolescent victims ofviolence and ongoing support can help deal with both the

physical and the psychological consequences of violence.


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Unintentional injuries are a leading cause of death and disability

among young people.

Road traffic injuries take the lives of a staggering 1000 young people

every day.

Advising young people on driving safely, strictly enforcing laws that

prohibit driving under the influence of alcohol and drugs.

Increasing access to reliable and safe public transportation can reduce

road traffic accidents in young people.

If road traffic crashes occur, prompt access to effective trauma care

can be life saving.


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Egyptian figuresNutritionalStatus of Youth and YoungAdults.

5 % of never-married males age 10-19 and6 % of never-married females age 10-19 inEgypt were classifiedas overweight.

At the other end of the scale, 5 %of malesand 3 %of femaleswere considered to be underweight. (EDHS 2008)


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Stunted growth represent 18 % of adolescent.47 % of adolescents are anemic.

46 % are infested with parasites.Only 50 % use the school health insurance system.In 50% of marriages the girl was married before age 20.


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The stillbirth and infant death rate for adolescents was 45 and 75/1000.20% of boys and 30 % of girls were well informed regarding STDs, while in regard AIDS, 75 % of boys and 65 % ofgirls were well informed.

68% of adolescent express their opinions to their parents.30 % of adolescent state they dont have role model.


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20 % of adolescent observed violence between their parents.15 % report being hit on the mouth.

Overall prevalence of FGM of girls 13-19 is 86%.{National Adolescent Strategy, Ministry of Health and Population, (RH-IEC) United NationPopulation Fund. (2004)}


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To be healthy and free of disease

To pursue their goals and dreams.

To be protected from all forms of abuse.

The right to be educated.They should be treated equally without discrimination due to gender .

The right to have access to appropriate medical care.


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EQUITABLE: All adolescents, not just certain groups, are able to obtain the health services they need. ACCESSIBLE: Adolescents are able to obtain the services that are provided. ACCEPTABLE: Health services are provided in ways that meet the expectations of adolescent clients. APPROPRIATE: The health services that adolescents need are provided.

EFFECTIVE: The right health services are provided in the right way and make a positive contribution to the health of adolescents .(World Health Organization, Department of Child and Adolescent Health and Development. Global consultation on adolescent friendly health

services: a consensus statement, Geneva, 79 March 2001 (WHO/FCH/CAH/02.18). Geneva, World Health Organization, 2002. ).


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In terms of barriers to seeking help, the following were cited:how they were received/treated when accessing servicespoor information or misinformation about existing servicesinstitutional bureaucracy

belief/perception that seeking help is a sign of weaknessbelief that can resolve problem without helpcost issues, including transportation costsrestriction of mobility by family or community.(Costello J, Pickens L & Fenton J (2001). Social supports for children and families: A matter of connections. Chicago, Chapin Hall Centre for Children at the University of

Chicago (Draft manuscript).)


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What is quality of life? an individuals perception of their position in life in

the context of the culture and value systems in which

they live and in relation to their goals, expectations,standards and concerns.

(World Health Organization, Quality of Life (QoL)Group, 1993)


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Quality of Life is Determined by The extent to which hopes and ambitions are matched by

experience.

Appraisal of ones current state against some ideal.

The things people regard as important in their lives.

(Alison J. 2001).


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Quality of life measuresare increasingly used tosupplement objective

clinical or biologicalmeasures of disease toassess the quality ofservice, the need forhealth care, the

effectiveness ofinterventions, and incost utility analyses.


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Concepts related to quality-of-life

Quality-of-life; All personal and environmental factors

related to subjects life; may or may not include health

issues.

Health-related quality-of-life: Physical, psychological

and social aspects related to health.

Health status: Physical and symptomatic factors


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Functional status: Ability to perform desired activities,

including level of symptoms while doing activities;

external, observable.

Well-being: Psychological factors and sense of life

satisfaction; internal, self-reported.

Satisfaction; Patient attitudes toward health and degree of

approval of status.

Wh i QOL i t t t ?


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Why is QOL important to measure?

Person centered means of assessing distress/function Called for following improvement in health careintervention.

Accountability of social and educational services. Facilitates multi-dimensional assessment

(Skevington & Gillison, 2006)


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Health Related Quality of Life can be

then defined

as an integrative measure of physical andemotional well-being, level of independence, socialrelationships and their relationship to salientfeatures of their environment

(HRQOL Group (1995). World Health Organisation

quality of life assessment: position paper from theWorld Health Organisation. Social Science andMedicine, 41, 1403.).


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Adolescent quality

of life

It can include structural factors such as educational and

employment opportunities, personal factors such as

attitude and beliefs, and community factors.

It can encompass other aspects of life such as the

importance of peers , and family.

socia environment


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socia environment

Three basic psychological needs:

Autonomy

Feeling that one is the origin of ones actions

CompetenceFeeling effective, and having the opportunity to

demonstrate efficacy

Relatedness

Feeling valued by and connected to others around you


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Items in the Quality of Life Profile:Adolescent Version


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Being:1. Physical Being My appearance - how I look ,

Making healthy choices - alcohol, drugs,

smoking.2. Psychological Being

Being independent

Knowing where I am going3. Spiritual Being

Having hope for the future

Feeling that life has meaning


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belonging

1. Physical Belonging The earth and its environment Feeling safe at school, in the neighbourhood and

when I go out.2. Social Belonging Being appreciated by others The friends I have

3. Community Belonging Being able to access social services on my own Having things to do in community in spare time


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becoming1. Practical Becoming Looking after myself and my appearance

The work I do at a job while still a student.

2. Leisure Becoming

Participating sports and recreation activities

Visiting and spending time with others

3. Growth Becoming Planning for a job or career

Solving my problems


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Health-Related Quality of Life (HRQOL) scale items, South Carolina {Youth Risk

Behaviour Survey (YRBS)}

1. Self-perceived health:Would you say that in general your health is:

a. Excellent

b. Very good

c. Good

d. Fair

e. Poor?2. Recent physical health:

Now thinking about your physical health, which includes physical illness and injury, for how many days during the past

30 days was your physical health not good?

3. Recent mental health:

Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how

many days during the past 30 days was your mental health not good?

4. Recent activity limitation:

During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usualactivities, such as self-care, work, or recreation?


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Core Healthy Days Measures

1.Would you say that in generalyour health is excellent, very good, good,fair, or poor?

2. Now thinking about your physical health, which includes physical illnessand injury, for how many days during the past 30 days was your physical

health not good?3. Now thinking about your mental health, which includes stress,depression, and problems with emotions, for how many days during thepast 30 days was your mental health not good?

4. During the past 30 days, for about how many days did poor physical ormental health keep you from doing your usual activities, such as self-care,

work, or recreation?

Centre for Disease Control and Prevention.

Measuring Healthy Days. Atlanta, Georgia:

CDC, November 2000.


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Conclusion

It has become accepted that increasing one's quality of life

(QOL) via health promotion efforts and medical care

interventions is a desirable outcome for adolescents.

Monitoring adolescent QOL appear to be primarily

related to mental and physical health.

Although mental and physical health both contribute

significantly to adolescent quality of life, mental health

appears to make greater contributions.


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However, adolescents may also be considering other

health-related constructs in addition to their physical and

mental functioning such as Coping styles, social support,

and social bonding.


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quality of life in youth

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