Introduction
Young people form precious
human resources in every country. However, there is considerable ambiguity in
the definition of young people and terms like young, adolescents, adults, young
adults are often used interchangeably. World Health Organization (WHO) defines
‘adolescence’ as age spanning 10 to 19 yr, “youth” as those in 15-24 yr age
group and these two overlapping age groups as “young people” covering the age
group of 10-24 yr. The National Youth Policy of India (2003) defines the youth
population as those in the age group of 15-35 yr. Population aged 10-24 years
accounts for 373 million (30.9%) of the 1,210 million of India's population
with every third person belonging to this age group. Among them, 110 and 273
million live in urban and rural India, respectively. Males account for 195
million and females 178 million, respectively. As per the National Sample
Survey (NSS), (2007-08) 32.8 per cent of this group attend educational
institutions and 46 per cent (2004-05) are employed.
Youth - the critical phase of life, is a
period of major physical, physiological, psychological, and behavioural changes
with changing patterns of social interactions and relationships. Youth is the
window of opportunity that sets the stage for a healthy and productive
adulthood and to reduce the likelihood of health problems in later years. A
myriad of biological changes occur during puberty including increase in height
and weight, completion of skeletal growth accompanied by an increase in
skeletal mass, sexual maturation and changes in body composition. The
succession of these events during puberty is generally consistent among the
adolescents often influenced by age of onset, gender, duration, along with the
individual variations. These changes are also accompanied by significant stress
on young people and those around them, while influencing and affecting their
relationships with their peers and adults. It is also an age of impulsivity accompanied
by vulnerability, influenced by peer groups and media that result in changes in
perception and practice, and characterized by decision making skills/abilities
along with acquisition of new emotional, cognitive and social skills.
Most young people are presumed to be
healthy but, as per WHO, an estimated 2.6 million young people aged 10 to 24 yr
die each year and a much greater number of young people suffer from illnesses
‘behaviours’ which hinder their ability to grow and develop to their full potential.
Nearly two-thirds of premature deaths and one-third of the total disease burden
in adults are associated with conditions or behaviours initiated in their youth
(e.g. tobacco use, physical inactivity, high risk sexual behaviours, injury and
violence and others). The behavioural patterns established during this
developmental phase determine their current health status and the risk for
developing some chronic diseases in later years. A significant reduction in the
mortality and morbidity of communicable, maternal and neonatal disorders since
1990 due to concerted and integrated efforts led to a shift in focus
towards the health, safety and survival of the young people. It is crucial to
understand health problems of this population, processes and mechanisms that
affect their health, identify interventions and strategic approaches that
protect their health and develop and implement policies and programmes.
Problems
of Adolescents with special reference to Indian context
Any period of development
is likely to be accompanied by many potential difficulties. Adolescence is a
period of transition from childhood to adulthood that implies many development
changes and associated problems. Some of the outstanding problems of Indian
adolescence are the following:
Perplexity
with regard to somatic variation: Every adolescent has
more or less difficult task of adjusting to somatic variation which may occur
in connection with puberty. The follow of blood during menstruation in girls
and nocturnal emission in boys creates worries and give birth to so many fears
and anxieties. Since ours is a conservative society, youngsters are less
informed about the physical changes that are occurring during puberty.
Lack of scientific information about sex hygiene and philosophy make them to
satisfied with crude and perverted knowledge about sex related matters.
It creates guilt feeling and so many complexes in the minds of the children
which makes them introverted and secretive.
Problems
related with intensification of sex-consciousness: The
sudden awakening of sex instinct during adolescence results in intensification
of sex consciousness. Adolescents are curious to know about sex related topics
and are seeking answers to their innumerable doubts in sexual matters. In our
country most of the parents are illiterate and they do not have scientific
knowledge of sex problems. Moreover, our social values are different from
that of western countries, and hence parents hesitate to discuss sex problems
with their children. So the adolescents resort socially unacceptable ways to
quench their curiosity and to satisfy their sexual needs. There is also the
misguiding of print and electronic media that finally results in sexual
maladjustment in adolescents.
Adjustment
difficulties with parents: Adolescents
have a strong for freedom and independence. But often it is obstructed by
parental oppositions. In Indian context, parental opposition may extend to such
areas as choices of friends, choice of education, recreational interests,
dress, life-style, our of going from and coming to the home, mode of behaviour
etc. The conflict between parental norms of behaviour and peer group
relationships often lead to friction in the relationship and adolescents find
it difficult to adjust to the needs and demands of parents. Failure to adjust
with the parents may result in revolting against parents and authority.
Childhood-Adulthood
Conflict: In our society, the
adolescent is considered as neither as a child nor as an adult. He has to
depend his parents and elders for his physical and emotional needs. But at the
same time he wants to hold independent views and opinions like an adult. He can
very well manage his own affairs and resist any unnecessary interference from
the part of elders. He begins to feel ashamed and embarrassed for the
protection and care shown by the parents. He is often treated in an ambiguous
manner by parents and teachers. Sometimes they expect him to behave as an adult
and at other times, they treat him as a child. The poor adolescent is caught
between the role of the child and the adult, which push him into confusion and
tension.
Adjustment
difficulties with school discipline : Most
of the adolescents face a great problem in adjusting with school discipline.
Some times schools expects too much from students who must submit to
teachers who may be tyrannical sometimes. Schools should not implant habits of
unquestioning obedience that inhibits the growth of young people towards true
independence.
Adjustment
difficulties with community: The
adolescent is expected to find his place in a society marked by increasing
social isolation and rapid technological changes. This changing world make it
difficult to anticipate and plan for adolescent life. They have
difficulty in adjusting their capacity to the demands of the community. At this
critical phase most adolescents react by withdrawing into a non-demanding and
non-working world of pleasure and satisfaction.
The
Ideal and Reality conflicts: It is during
adolescence an adolescent move from being children to adults - perhaps the
single most important and grandest set of changes - others may not know how
they feel about themselves, but we should. The disparity between ideal
and actual can produce confusion and maladaptation, or this disparity can be a
source of motivation and aspiration for adolescents who are searching for
identity. As the adolescence represents a fascinating transitional period,
marked by the emergence of new found cognitive capacities and changing societal
expectations. Parental Influences has much important in this regard, which
includes deliberate expression of affection, concern about the
adolescent's problems, harmony in the home, participation in family activities,
availability to give organized help when needed or asked for, setting
clear and fair rules, understanding peer influences on self-esteem, etc. can
helps the adolescents to a great extent.
Adolescent
– Parent Attachment: Conflict between adolescents and
parents itself is not a sign of poor relationship quality, but it is the result
of the rapid neurological, cognitive and social changes of adolescence create a
socio-cognitive dilemma for youth: that is, maintaining connection with parents
while exploring new social roles away from the family and developing attachment
relationships with peers and romantic partners. It is a fact that the
successful transition of adolescence is not achieved through detachment from
parents but a healthy transition to autonomy and adulthood is facilitated
by secure attachment and emotional connectedness with parents. It is better
understood by parents that, adolescents who feel understood by their parents
and trust their commitment to the relationship, even in the face of conflict,
confidently move forward toward early adulthood. The ability of parents,
teachers, the elders, etc. to sustain a ‘goal-directed partnership’ with
adolescents in their daily hood by all means will remain them confident and
secure and protect them from all modes of newly emerged social evils like
improper and immature usage of social medias.
Alcohol
and other drug use in adolescence
Consumption of licit and
illicit substances has increased all over the world and the age of initiation
of abuse is progressively falling. The common drugs of abuse amongst children
and adolescents in India are tobacco and alcohol. Use of illicit drugs like
cannabis and heroin have also been reported. A high prevalence of drug use and
even intravenous use among street children and working children is a matter of
concern. Although initiation to drug use usually occurs during adolescence, the
adolescent drug users are seldom seen in various treatment centres. Thus
community based programmes are beneficial for prevention and treatment of
substance abuse among children and adolescents.
Role
of parents and teachers towards the adolescents
For a proper and
all round development of the adolescent boys and girls, parents and teachers
have a great role to play. Some suggestions have been discussed below
For Proper Physical Development
·
Provision
should be made for compulsory physical exercise at morning and evening
·
Monthly
health check-up by the school doctor must be done.
·
Scope
for some manual work for every adolescent must be provided at home and at
school.
·
Provision
of various types of indoor as well as outdoor games and sports for all students
in school.
·
Provision
for dance classes for girls at school.
For
Proper Mental Development
·
Home
and school atmosphere must be loving and secured.
·
The
school must have a good library, a school debating society and in every class,
a discussion group.
·
Various
types of clubs, like - music club, art and craft club, may be organised to
enable adolescents to develop their creative abilities.
·
The
guidance services available at school should provide both educational and
vocational guidance to their students.
·
The
teacher should keep an eye on every adolescent and try to fulfill his
individual needs. The tutorial system must be adopted when necessary.
·
Excursions
to places of historical and geographical importance may be organised.
·
Activity
for the adolescent should be planned in such a way that the imaginations of the
young adolescents are directed in the right channels and towards creative
efforts.
·
The
adolescents are generally interested in experimentation and self-examinations
of objects. Hence, it is suggested that importance should be given on using new
dynamic methods of teaching.
·
Different
assignments should be given to the students on the basis of their intelligence
and the abilities.
·
Yoga
and meditation must be included in the school curriculum.
For Proper Social Development
·
Many
informal functions may be organised in the school. These would enable the
adolescents to come closer to each other and understand the interests and
aspirations of each-other. These functions must cater to the needs of all types
of adolescents.
·
Excursions
and field trips may be organized. These lead to informal conversations and
close contact between the members of the group.
·
Group
games, debates, seminars, conference may be organized. These will help the
adolescents to participate in social activities.
·
The
teacher should try to find out the socio - economic conditions, social
interests of every adolescent and organize various activities accordingly.
·
In
the social field, every adolescent has to enter particular vocation in his
later life. As such the school authorities should impart him knowledge about
various vocations prevalent in society. He should also provided knowledge about
some new vocations.
·
The
adolescents should be initiated into the standards of adult behaviour. Thus he
will be trained for better future living.
·
They
should be entrusted with jobs of responsibility at home and at school as they
grow-up. Self-government may be introduced in school to develop a feeling of
responsibility among the adolescents.
For Proper Emotional Development
·
Parents
and teachers must be able to redirect the emotions of the adolescents in a
proper manner. The adolescent must be able to control his emotions and also to
repress those emotions which are not socially acceptable.
·
Most
of the adolescents accept problems of life in a negative way. They are afraid
of facing difficult situations in life. Parents and teachers should encourage
the adolescents and point out some of their plus points. They may also suggest
means and methods of achieving success. This will restore the self-confidence
of the adolescents.
·
It
should be brought into the notice of the adolescent that life is a mixture of
failure and success and he must build a power of resistance to face failure in
life.
·
The
adolescent has to face a large number of problems at this, stage, As such,
proper guidance and counseling should be provided by parents, teachers and
school Guidance Counselor.
·
Parents
and teachers should treat the adolescent well. They should give him freedom of
action within limit. The adolescent should be kept busy with various
activities.
·
The
teacher should try to develop maturity of thinking within the child. The
adolescent boys and girls must be allowed to discuss their emotional problems
with their parents and teachers. And they must be provided enough scope to take
part in different activities in school.
·
The
teacher should try to find out those students who are emotionally disturbed.
They should try to solve their problems personally.
·
The
parents as well as the teachers should not discriminate among the adolescent
boys and girls. The teacher must be known for his impartiality. Then only will
he be able to enjoy the confidence of his students.
For Proper Sexual Development
·
More
social contracts between boys and girls. Freedom with proper guidance must be
provided to the young adolescents to make friends with the opposite sex.
·
Proper
sex education on a scientific basis should be provided by the teachers.
·
Parents
and teachers should impart the right information about sex to the adolescent
boys and girls.
·
Information
about HIV and other sex related diseases should be provided on a scientific
manner by the parents and teachers to the young adolescents. If necessary,
teachers and parents must take help of counselors.
Conclusion
Adolescents in India are
facing problems of sexually transmitted infections, dysmenorrhoea, tobacco and
alcohol use, depressive problems, physical fights, worry, loneliness and oral health
problems. Health education and counselling to adolescents are necessary in
India to improve adolescence health. Primary care practitioners may act as a
bridge between the family and adolescents to solve the problems. Simultaneously
awareness to the programmes related to adolescent health should be generated
among family members so that they can also advise and guide the adolescents.
This type of health education programme can be held by primary care
practitioner doctors in their locality with involving family members and
adolescents.
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