groups » Adolescent Health and Preconception Care - Discussion for the month » Adolescent Health and Preconception Care - Discussion for the month
Worldwide in 2010, 287000 women died, with many more suffering long-term disability, from causes related to pregnancy and childbirth. In the same year, globally 3.1 million newborn babies died in their first month of life, while 14.9 million were born prematurely and 2.7 million were stillborn. There is widespread agreement that a continuum of care approach is necessary to further reduce maternal, newborn and child deaths. At present, this continuum extends from pregnancy and childbirth, to the postnatal period (for both mothers and neonates), through early childhood. A gap remains in this continuum, particularly for adolescent girls and young women, who often receive little or no healthcare from age five until their first pregnancy.
Recently adolesdcent health and preconception care has been widely advocated. It is suggested that preconception care completes the continuum, ensuring ongoing health surveillance and early intervention, so that women begin pregnancy in the best health possible. Interventions that optimize women’s health before pregnancy with the intent to improve maternal and newborn health outcomes are collectively termed preconception care.
A recent series on Preconception Care (http://www.reproductive-health-journal.com/supplements/11/S3) highlights the possible impact of preconception care for adolescents, women and couples of reproductive age on MNCH outcomes.
This month, we are also fortunate to have one of the key persons from this Series, Zohra S Lassi, available with us for questions and comments. We welcome all the members to join this discussion and put forward their comments and questions on the idea of "Preconception Care". Feel free to add comments or refer to your work in this area.
Adolescence is considered an important age group as they have the potential to raise the economic productivity of a country. Nevertheless, it is a period for the onset of symptoms and behaviors that lead to adulthood disorders including smoking and substance abuse, unsafe sexual practices, poor eating and lack of exercise. Many of the risk factors that impact maternal and newborn health, such as nutritional deficiencies, also exist right from adolescence.
It is increasingly being advocated that adolescence is an optimal time to target health interventions as the interventions will have more time to take effect and thus will maximize the impact on enhancing an individual’s health in the years ahead.
I would like to highlight the importance of the delivery platforms utilized to target this vulnerable age group. Delivery platforms are crucial as they can augment the coverage of these interventions and provide an opportunity to reach hard-to-reach and disadvantaged population groups. Furthermore, these platforms have the potential to ensure equitable delivery of proven interventions. Such delivery platforms include school based delivery, adolescent friendly clinics, utilizing social media and empowering youth to participate in the development and implementation of such programs.
Hi all, the topic of discussion is very interesting. I would like to take forward the discussion regarding delivery platforms. I would like to highlight the fact that much of the evidence has been evaluated for for school based delivery however many other platforms still need to be rigorously evaluated for effectiveness.
Thanks for your interest and comments on the topic.
In recent years, information communication technology has rapidly evolved with the advances in media, including online content via internet, use of short message service via mobile phones and also offline media. Since social media platform is widely used by adolescents, it could be a potentially effective platform to target this high-risk group.
In relation to the comment posted by John, I agree, so far school based delivery platform has been the most successful strategy specially for targeting adolescents. However, community based platforms such as support groups have been rigorously evaluated as well. If you refer to Paper 7 (Preconception care: delivery strategies and packages for care) of our recent Preconception series, we have talked about these and other delivery platforms as well.
I totally agree to Jai, information technology in recent past has evolved dramatically. Although many at-risk young adults in developing countries have poor exposure to educational programs – mass media through IT can be a very useful tool for effectively transmitting basic health messages to them. It can also be an instrument for changing behavioral stereotypes, attitudes, myths and misconceptions regarding reproductive health.
This discussion is relevant and timely. I would like to draw the attention of the public health personnel towards this important gap in research. There is very limited evidence existing on various adolescent health specific interventions including preconception genetic screening and counseling, adolescent mental health and interventions for disadvantaged adolescents and youth. The existing evidence vary in age groups, interventions and outcomes and there is paucity of studies directly comparing different interventions for relative effectiveness. Assessment of effects by gender and socioeconomic status is also an existing gap in research pertaining to adolescent age group. Furthermore, very limited data comes from low- middle- income countries where 90% of young people in the world live.
I would like to congratulate Dr Zohra Lassi for such an impressive work in compiling the evidence on preconception care. Considering the existing evidence on preconception care, what are the most effective means of targeting adolescent girls in the developing region?
That's very true Peter. But this is what the true research is, isn't it? It doesn't only look for the answers to our questions/hypothesis, but also the gaps - clinical and research gaps.
Thanks AlecStewart. Re the most effective means: If you refer to our Paper 7: "Preconception care: delivery strategies and packages for care." In that Paper we have suggested many different strategies for delivering the interventions, including how best to approach adolescent in developing countries. Amongst the many identified and reported in that paper, few are school based programs and community/outreach programs. I feel means have been identified; now the actions are required which need SUPPORT - both monetary and non-monetary and that too from the community and as well as government.