KUALA MUDA, 7.8.08, (FINAL DAY)

Adolescent health (Kesihatan remaja)

According to the definition of WHO (1993), adolescents are categorized under the age group of 10 to 19 years of age.


Objectives

To create awareness among adolescents about the importance of leading a healthy life style.
Prevent bad habits which cause ill health by organizing health promoting activities.
Encourage adolescents for their active involvement in health promoting activities for prevention of bad habit and health promotion purpose.

Guidelines for implementation of adolescent health.

Four categories:
1) Adolescent clinic
2) Standard operating procedure (SOP)
3) Adolescents health screening
4) Guidelines to manage adolescent health

Part I

Adolescent clinic
1.1 Objectives: guidelines for health officers.
1.2 Implemented on year 1998.Revised back on year 2000.
1.3 Definition :
1.3.1 adolescent:10-19 years
1.3.2 adolescent health is under the National adolescent health policy
1.4 clinic concept used in all the clinics
1.4.1 services provided by a health clinic:
1.4.1.1 screening
1.4.1.2 management
1.4.1.3 counseling
1.4.1.4 referrals
1.4.2 optional services
1.4.2.1 physical activity in group
1.4.2.2 family counseling
1.4.2.3 health promotion
1.4.2.4 activity clubs
1.5 -services scope in adolescent clinics
-covers health promotion,prevention,management and referral


The service scopes covers
1.5.1 developmental assessments
1.5.2 diet
1.5.3 mental
1.5.4 sexual and reproductive
1.5.5 high risk attitudes
1.5.6 physical

Part II: SOP (Standard operating procedure)
-Management of adolescent health clinic
Introduction: i) Entry point through JPL
ii)’one stop’ service centers
iii) Daily clinic with centralized counters
Facilities in clinic
Medical registration card 96-pin 1/78
Registration book KKR/Fail KKR
Screening form SKR1 & SKR2
Height and weight scaling machines
BMI charts
Guidelines books
Adolescent health services
SOP book fir medical assistance (part 1 & part 2)
Standard laboratory tools
Checkup rooms and counseling
Human models
Flip charts

Part III
Screening Programmes
3.1-Introduction-To identify attitude or health problems
3.2 SKR forms (screening forms) SKR 1-males, SKR 2 –Females
3.3 implementation of SKR –regular check ups-#times (12, 13 and 17 years)
3.4 methods of health screening-guidelines for male adolescent (m/s 37), female perempuan(m/s 42)

Guidelines for sexual and reproductive system
4.1.1 Amenorrhea
4.1.2 Abdominal pain during menstruation
4.1.3 Abdominal Mass
4.1.4 Menstrual irregularity
4.1.5 Vaginal discharge
Dietary
4.2.1 Underweight problem
4.2.2. Overweight problem
4.2.3 Anemia



Psychological aspect:
4.3.1 Adjustment disorders
4.3.2 Anxiety disorders
4.3.3. Depressive disorders

Attitude problems
4.4.1 Smoking
4.4.2 Gum sniffing
4.4.3 Alcohol
4.4.4 Vandalism
4.4.5 Amphetamine
4.4.6 Acne
4.4.7 Headache
4.4.8 Intentional injury
4.4.9 Non intentional injury
4.4.10 abdominal pain

Part IV
Management of adolescent and flow chart (last page)

Reported by Shanky

DAY 3 :JITRA

Adolescent Health

Adolescent health specifically targets those between the age of 11 and 19 years old, with focus on sexual and reproductive health, growth and development, nutrition, mental and physical health.

Objective

1. Plan and provide health services to all adolescents which include the physical, mental and spiritual aspects to guide them towards a healthy life.
2. Prevent health problems due to risky behavior by promoting a healthy lifestyle.
3. Encourage adolescent involvement in healthy activities.

Standard Operating Procedure

1. Registration by Administrative Assistant.
2. New patients are given a screening form to fill up by Medical Assistant.
3. Antropometry(weight, height and BMI) measurements are done by Medical Assistant.
4. Screening form is assessed by Medical Assistant.
5. Further medical examination done by medical officer, if necessary.
6. Lab Test (hemoglobin and any specified test) done by Medical lab technician.
7. Referred to Family Medicine Specialist or other government agencies.
8. Given treatment, counseling and health education.
9. Next appointment given and asked to return home.

Activities

1. Identify, educate and treat adolescents with sexual and reproductive health problems( abnormal menstrual cycle, abdominal pain, mass, urogenital discharge, abnormal genitalia, sexual abuse, high risk behavior, and abnormal sexual orientation.)
2. Identify, educate and treat adolescents about nutrition.
3. Identify, educate and treat adolescents with mental health disorders( anxiety, stress, adjustment, behavioral, depressive and deviance)
4. Identify, educate and treat adolescents with high risk behavior( smoking, substance abuse, alcohol, vandalism, truancy, illegal racing)
5. Identify, educate and treat adolescent with physical health problems(acne, headache, non –intentional injury, and abdominal pain)

Records

Individual records are updated during visit along with screening form. Monthly records are prepared by MAs and biannual reports are sent to State Health Department on:
1. Number of new cases.
2. Number of old cases.
3. Types of morbidity.
4. Number of adolescents on treatment and counseling.
5. Number of referrals.
6. Number of screenings.

The team in front of the District Health Office in Jitra