The determinants of health behaviours among adolescents

Early sexual debut is associated with increased risk of HIV and other negative sexual health outcomes. This indicates a need for early use of health services among this group. This study investigated whether early sexual debut was associated with lower usage of health services during adolescence in urban South Africa. Health-seeking behaviour data was collected from the Birth-to-Twenty cohort at 13, 15 and 17 years of age. Early sexual debut, defined as <15 years of age, was based on annual, self-completed questionnaires. Multivariate random effects regression models were used to test the association between healthcare use and frequency of healthcare use during adolescence with early sexual debut. Data was available on 1783 adolescents, 19% of whom had early sexual debut. Adolescents’ healthcare usage was low, declined through adolescence (23% at 13 years, 18% at 15 years and 17% at 17 years) and was significantly lower among adolescents with early sexual debut (adjusted OR 0.77, 95% CI 0.59-0.99, p 0.041). There was no evidence of an association between early sexual debut and frequency of adolescents’ healthcare usage (adjusted IRR 0.86, 95% CI 0.70-1.04, p 0.116). Better linkages between health services and youth programs may help reach vulnerable adolescents with health services.

The role of women’s decision-making in reproductive health cannot be ignored. Current research and policies on maternal and child health-care in India focus primarily on female education and employment, little attention is placed on women’s decision-making autonomy. In this paper women autonomy index has been constructed and women’s autonomy and their relationship to maternal and child health care utilization are investigated using data from the National Family Health Survey-3. The results of the study show that most of socio-economic factors including women's autonomy have significant influence on maternal and child health care services. Women's autonomy has strong positive association with health-care utilization. The impact of women's autonomy is not much on antenatal visit but very much on institutional delivery and child immunization. Finally, it may be concluded that women with higher autonomy are more likely to use maternal and child health care services as compared to women with low autonomy.

Utilization of maternal health services has a potentially important role in the improvement of reproductive health status of adolescent women. Understanding the challenges of different aspects of adolescent’s reproductive health is very important. In order to get better understandings of adolescent mothers' needs, health seeking practices of first time adolescent and adult mothers during pregnancy and early motherhood are compared. The National Family Health Survey-3 data is used for analysis purpose which provides a comprehensive picture of population and health conditions in India. Findings suggest that first adolescent mothers are more disadvantaged in terms of health care seeking for reproductive health services during pregnancy and delivery compared to first time adult mothers. First time adolescent mothers were less likely to use all three services (any antenatal care, full antenatal care and institutional delivery) compared to first time adult mothers. These results are compelling and call for urgent adolescent focused interventions.

Risk taking and experimentation is the order of the day for youngsters, which include experimenting not only with drugs, tobacco and alcohol, but also with sex. Heightened sexual urges in young people make them vulnerable to a whole host of problems, associated with sexuality- molestation, rape, teenage pregnancies, abortion and sexually transmitted diseases.
There is growing evidence to suggest that problem behaviours cluster together. They include alcohol and drug abuse, cigarette smoking and sexual precocity. Those who smoke cigarettes are more likely to use illicit drugs; drink heavily, and use some other drugs. These result in anti-social behaviour and traffic accidents, which are a major cause of death and disability in young persons. The use of tobacco, alcohol and other drugs is associated with poor performance in college, at work and in sports. The use of one drug is more likely to lead to multiple drug use. Substance use is primarily a social, rather than a solitary activity among youth. Peer pressures play a significant role in problem behaviour and may be particularly significant for the young person, who comes from a divided family, lives in unrewarding environment and is less successful at college, at sports, or in making friends.

The social consequances of psychic troubles are unfamiliar and some few studies have been made in France. Nevertheless, it is proofed that these troubles may have an important impact, as in personal life (in a decreasing quality of life) as on the economy of a country. The main aim of our study was to assess the global outcome ( physical, psychological and social) of a cohort of anorexia nervosa inpatients since 1996 to 2002. The secondary aim was focused on the study of interrelationships between this outcome and the care utilization fitted into some life biographies.
On the one hand, the biographic approach has highlighted three factors mostly influencing on the underused care utilization while the psychic and/ or somatic statement are required : the age of the patient at the first hospitalisation, the distance between the home and the hospital and the difficult relationships with the father.
On the second hand, we have focused our attention on the relations between the feeling of psychological chronical disease and the quality of life impairment -especially on mental health. The damage on the mental health (quality of life) is increasing the feeling of chronicity and is reducing the sense of recovery. Indeed,

Every society develops social norms that serve to channel and direct sexual activities in youth. These norms are dispelled by the socio-economic transformation over the past decades. The study examines relationship between social expectations, choices and sexual health risks among youth in the study area. Both qualitative and quantitative techniques were used to collect data from the study area. A multistage cluster sampling technique was used to select respondents for the quantitative data from three informal settlements in Metropolitan Lagos. Social expectation regarding pre-marital sex still in place, but 76% of the youth interviewed have had pre-marital sex. The neighbourhood characteristics was a significant factor associated with the sexual risks identified in the study areas. Some of the sexual health risks identified include forced sexual coercion, gang rape, “sexual tournament” by male adolescents, use of sex toys for stimulations, concurrent partners and multiple partnerships. Economic deprivation, living conditions, partners’ age, parents communication about sexual health, parents educational status, and family size are predisposing factors for likelihood of making choices about pre-marital sex and use of contraceptives. The study recommends that peer education programmes must be linked with youth health services.

Adolescents, as a component of the main stream population, affect the socio-economic and demographic features of society. The transitional period between childhood and adulthood is known as adolescence wherein individuals move toward physical and psychological maturity and economic independence, and acquire their adult identity. The North-Eastern states, which comprise of Arunachal Pradesh, Assam, Manipur, Mizoram, Nagaland, Tripura, Meghalaya is characterized by sharp differences in terms of geographical terrains, dispersed pattern of settlements and social identity. Health is strongly influenced by social variables. To see whether the condition of women is vulnerable in these states, a study is being done to see the factors that affect the adolescent mothers. The main aim of the study is to analyze the differences in adolescent fertility with respect to socio-economic variables and also to study the programmes initiated for the better condition of adolescent mother in India. The analysis of the study deals with married women in order to investigate determinants of teenage motherhood among them.

In India pre-marital sex although is taboo, interplay of multitude of factors exposes adolescent girls to pre-marital sex leading to unwanted pregnancy and further intricacies. Hence, this paper assesses the sexual exposure and awareness of ECP among the never married adolescent girls in India by taking National Family Health Survey 2005-06 (NFHS-3) data. Out of the total sample, 15,320 never married adolescent girls of the age group 15-19 years de jure residents are retained for this study. Levels are found out through percentage distribution; associations are assessed through cross tabulation and logistic regression is applied to find out the determinants. It is found that in India, about 0.6 percent of never married adolescent girls have already experienced sex, out of whom 22.4 percent were active during four weeks prior to the survey. Multi-variate result shows that with the increase in age, probability of having pre-marital sex also increases, whereas with the improvement in household wealth index, probability goes down. Further, pre-marital sexual exposure depends mainly on knowledge of ECP. Overall merely 4.9 percent of adolescent girls are aware of ECP. Age, education, religion and exposure to sexual intercourse exert significant effect on the knowledge of ECP.

Adolescent sexuality constitutes one of the most unattended aspects of young people’s development in Nigeria. Consequently, reproductive health mishaps such as sexually transmitted infections, unplanned pregnancies, abortion, maternal morbidity and mortality are common features among different categories of young women. This study which anchored on Social Action and Rational Choice Theories investigated sexuality education among out-school female adolescent house-helps in Ibadan as a way of understanding the culture of silence that characterises young people’s sexual orientation. Data were collected through 1020 questionnaires, 27 in-depth interviews and 2 case-studies. Findings reveal that although a large majority of adolescents do not receive sex education from parents and guardians, house-helps are disproportionately more disadvantaged. Some house-helps are given sexuality education not primarily for their personal benefit but as a means to indirectly educate guardians’ biological children since these employers’ comfort levels are low to personally undertake the activity. Prioritising sexuality education among adolescents and house-helps in particular will go a long way in demystifying unnecessary insensitivity that pervades sexuality discourses among Nigerian youths.

Despite adolescents (10- 19 year olds) having the lowest mortality compared to older and younger age groups in the country, the mortality rate of this age-group is increasing. Prominent broad- underlying and immediate causes of death have varied very little over the period. What remains unclear is the determinants of these causes of death among South African adolescents. This paper is a study of the determinants of adolescent mortality in South Africa. Data from the South African Death Registry is used (2006- 2009). Cause-specific mortality rates and proportional mortality ratios are used. Logistic regression is then used to infer the odds of adolescent mortality by specific demographic and socioeconomic characteristics. Results paper include that occurrences of mortality due to ‘Tuberculosis’ and ‘ill- defined and unknown causes’ are high among adolescents. Further this paper has found that female adolescents are at greater odds of natural or disease mortality than males. However, females are at lower odds of unnatural and violence related causes of death. Also, marriage decreases the odds of mortality.