Supporting the second decade of life by pursuing relevant sustainable development goals: a wake-up call to public health physicians to provide adolescent and youth-friendly health services in Bayelsa State, South-South Nigeria
Davids KI1,2*, Oguche O1, Ekeria OO1,2, Ndokinta OF1
1Department of Community Medicine and Public Health, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
2Association of Public Health Physicians of Nigeria, Bayelsa State chapter, Nigeria.
*Correspondence: Dr. Davids, Kellybest Ibasimama; +234 806 326 3545; email@example.com
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Cite this article: Davids KI, Oguche O, Ekeria OO, Ndokinta OF. Supporting the second decade of life by pursuing relevant sustainable development goals: a wake-up call to public health physicians to provide adolescent and youth-friendly health services in Bayelsa State, South-South Nigeria. Yen Med J. 2021;3(4):201–204.
As the world endeavours to address childhood survival, not much is being said about health services to the adolescents.1 According to World Health Organization, the period of adolescence is within the second decade of life, (10-19 years).1 In the past two decades, there has been a reduction in under five mortality and improved access to basic preventive health services across several nations.2 These achievements have resulted in increased number of children reaching adolescence,3 increased secondary school enrolment with its attending decline in early marriage and better opportunities for the adolescent especially the girl child.4
However, it would be unwise to invest so much to save children in their first decade of life only to lose them in the second decade, a critical period during which their potentials are to be nurtured and prepared to be admitted into adulthood.5 If nothing is done, the gains from the global efforts into child survival will be lost in adolescence.
Frankly currently, adolescents receive far less attention in terms of preventive health services on the world’s stage than their numbers merit.6
Today world-wide, about 1.2 billion adolescents stand at the challenging crossroads between childhood and the adult world.1 The average global probability of a 10-year-old dying before age 24 was 6 times higher in sub-Saharan Africa than in Northern America and Europe.1 In sub-Saharan Africa, at the individual level, young persons are still prone to preventable issues as teenage pregnancy, unsafe abortion, exploitation, internal displacement, sexually transmitted infections, drug misuse, violent conflict, kidnapping and suicides which are issues germane to community and public health and peace.7 Furthermore, the danger posed by emerging trends like armed conflicts in northern Nigeria and perennial flooding, militancy amidst profound lack of employment for young people leave them highly vulnerable, complicating the picture in Nigeria and the South-south region in particular.8
At the level of provision of health services in Bayelsa state, a south-south state for instance, there seem to be the challenge of non-availability of targeted health services to young people and poor utilization even where available due to concerns of confidentiality, privacy and friendliness. These concerns are not new to public health practitioners who interface with the community in the course of their field work.6,7,13
Well, adolescence is not only a time of challenges, it is also a period that presents an often-neglected opportunity to intervene. Educating an adolescent girl and providing user-friendly health services could ultimately improve the health indices in a community.9 However, at the soul of the adolescent’s utilization of health services is the desire for freedom to exercise his or her rights to be heard, to enjoy confidentiality, privacy and friendly services.10 When public health personnel offer youth friendly services that guarantee confidentiality, privacy, freedom of expression to vulnerable young persons, their interest in healthy life choices improves.11 These services should not only be formal and accessible but also comprehensive to address adolescent sexuality and other issues, preferably domiciled within existing educational institutions and tertiary health facilities.12 A study conducted in a family planning clinic of a tertiary health institution in Yenagoa, reported the low contraceptive uptake among adolescents despite the significant reporting of unsafe abortion among adolescent clients in the same tertiary institution.13 This observation was attributable to the fact that since the family planning clinic is adult based, adolescents who would require such contraceptive services may not be willing to voluntarily patronize adult clinics.
The Sustainable developmental goals 1 to 6, 8 and 16 and their noble targets have set the stage to build momentum towards investment in adolescent health. Essentially, the sustainable development goal 3 is to ensure healthy lives and promote well-being for all at all ages including those within the 2nd decade of life. Goal 4 which bothers on ensuring quality education and promoting lifelong learning opportunities for all also speaks about those in post primary institutions. Most specifically, goal 6 addresses gender equality and empowering the girl child and adolescent. All these goals call for steady public health action by health care providers, families, schools and communities.14
Figure 1: Adolescent health related sustainable development goals and targets. Source: UNICEF
Obviously, these goals can be achieved by collaborative efforts of all personnel and stakeholders in primary health care. The public health physicians and healthcare workers who are in practice of the well-known five levels of prevention must step in as they wield their training to galvanize stakeholders in the spirit of community participation and inter-sectoral collaboration.15 An urgent revival of the school health program by a robust and active collaboration between educational and health institutions under supervision by the relevant ministries is also apt.16 The World Health Organization has reiterated the necessity of schools being health promoting.17 However, most schools in Nigeria are far from these standards. Bayelsa state for instance has no very functional school health program at present.18 The time has come for establishing this as adolescents particularly boarding students, spend more time in school than with their parents. Similarly, the non-boarding students spent about one-third of their active hours daily within the four walls of their schools.
Finally, if these goals will be achieved, we must also invite young people to be part of the solution and ensure their voices are heard.19 According to the convention on the rights of the child, children are free to express their ideas and opinions, through any channel of their choice.20 Care providers must create the channel for this. Remarkably, August 12 every year, the world marks the International Youth Day. This day can be utilized to hear the well-articulated and sometimes heartrending stories of these special group of persons and to emphasize to all stakeholders that much can be done to better the lot of persons in their 2nd decade of life.
- World Health Organization. Adolescent & young adult health. Fact sheet 2021 Available from: https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions. Accessed July 23, 2021.
- United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME). Levels and Trends in Child Mortality: Report 2020. Available from: https://www.unicef.org/reports/levels-and-trends-child-mortality-report-2020. Accessed July 23, 2021.
- United Nations Children Fund. Available from: https://www.unicef.org/education. Accessed July 28, 2021.
- Santhya KG, Jejeebhoy SJ. Sexual and reproductive health and rights of adolescent girls: Evidence from low- and middle-income countries. Glob Public Health. 2015;10(2):189-221. doi: 10.1080/17441692.2014.986169.
- United Nations Children Fund. Programme guidance for the second decade: programming with and for adolescents. Program division 2018. Available from: https://www.preventionweb.net/publications. Accessed July 23, 2021.
- Patel V, Chisholm D, Dua T, et al, eds. Disease Control Priorities, Third edition (Volume 4): Mental, Neurological, and Substance Use Disorders. Washington, DC: World Bank; 2015. doi:10.1596/978-1-4648-0426-7.
- World Youth Report: Youth and the 2030 Agenda for Sustainable Development. New York 2018. Available from: https://www.un.org/development/desa/youth/wp-content/uploads/sites/21/2018/12/WorldYouthReport-2030Agenda.pdf. Accessed July 23, 2021.
- United Nations Children Fund. Missing childhoods: The impact of armed conflict on children in Nigeria and beyond. Available from: https://reliefweb.int/report/nigeria/missing-childhoods-impact-armed-conflict-children-nigeria-and-beyond. Published April 2015. Accessed July 23, 2021.
- Austrian K, Soler-Hampejsek E, Behrman J, et al. The impact of the Adolescent Girls Empowerment Program (AGEP) on short and long term social, economic, education and fertility outcomes: a cluster randomized controlled trial in Zambia. BMC Public Health. 2020;20:349. doi:10.1186/s12889-020-08468-0.
- Ford C, English A, Sigman G. Confidential health care for adolescents: Position paper of the Society for Adolescent Medicine. J Adolesc Health. 2004;35:160-167.
- Adams SH, Park MJ, Tweitmeyer L et al. Increasing delivery of preventive services in adolescents and young adults: Does the preventive visit help? J Adolesc Health. 2018;63:166-171.
- WHO recommendations on adolescent sexual and reproductive health and rights. Geneva: World Health Organization; 2018.
- Makinde OI, Osegi N, Ozori ES. Persistently poor contraceptive uptake by adolescents: finding from reviews of contraceptive uptake in a family planning unit in Yenagoa, Nigeria. Int J Res Rep Gynaecol. 2021;4(2):47-51.
- Bhutta ZA, Yount KM, Bassat Q, Arikainen AA (2020) Revisiting child and adolescent health in the context of the Sustainable Development Goals. PLoS Med. 2020;17(10):e1003449. doi:10.1371/journal.pmed.1003449.
- Schraeder K, Dimitropoulos G, McBrien K. et al. Perspectives from primary health care providers on their roles for supporting adolescents and young adults transitioning from pediatric services. BMC Fam Pract. 2020;21:140. doi:10.1186/s12875-020-01189-8.
- Making every school a health-promoting school: global standards and indicators for health-promoting schools and systems. Geneva: World Health Organization and the United Nations Educational, Scientific and Cultural Organization; 2021.
- WHO guidelines on school health services. Geneva: World Health Organization; 2021.
- McFubara KG. Health Promoting Schools: A way forward for Bayelsa State, Nigeria. AME. 2015;7(1).
- Jinhee Kim. Voices of youth in reconceptualising and repositioning the role of mobile learning for sustainable development. Inf Technol Dev. 2020;26(4):711-727. doi: 10.1080/02681102.2020.1749537
- United Nations General Assembly. Convention on the rights of the child, Treaty Series, 1577:3. New York, NY: United Nations; 1989.