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Usando un marco conceptual de derechosUsando un marco conceptual de derechos
humanos para la prevencion del VIH enhumanos para la prevencion del VIH en
jovenes en America Central y el Caribejovenes en America Central y el Caribe
Avances, lecciones aprendidas y desafios del 2012Avances, lecciones aprendidas y desafios del 2012
Belize
Indicadores de salud del adolescente
Avances
Lecciones aprendidas
Desafios
Contenido
Belice
Maternal, under five and neonatal mortality rate
Belize 1964-2012
Hypertensive disorders during pregnancyHypertensive disorders during pregnancy
Eclampsia/Thyroid Storm, Violence, Sepsis IUFD
o
1 13 19 21 34
44
75 81
60 72
93 99
184
241
226
330
431
447
457
434
443 450
425
365
244
226
251
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Female group is getting twice as many tests done as is the male group
(ratio of 1.93:1 F:M);
There was a marked increase in the total number of new infections
(approximately 10%) when compared to 2010 data
Casos de VIH. Belize. 1986 - 2012
Belice
Belice
Belice
GSHS 2011
Total Boys
Girls
• Adolescents need more access to preventive SRH services
• More participation from non traditional providers, schools and NGO,s, CBO’s
• FHS females, more than 90% approved SRH should be thought in schools
Education C. Quintiles Ethnicity
Males
Young adolescent (10-14) 0.0 1.1 0.0 0.0 0.0 0.0 298
Adolescent (15-19) 3.8 2.9 12.1 2.6 0.0 4.2 362
Older adolescent (20-24) 35.1 34.1 16.7 26.9 42.1 28.6 249
Development stage Creole Garifuna Hispanic Maya Mestizo Other N
Females
Young adolescent (10-14) 0.7 1.4 0.0 0.0 2.4 4.0 476
Adolescent (15-19) 19.1 16.0 32.1 20.2 14.3 11.1 1,035
Older adolescent (20-24) 61.1 61.7 80.2 68.6 75.0 59.7 1,026
Percent of respondents of the 2011 Belize Coverage Exercise who have at least one child, by
sex, development stage and ethnicity
Intergenerational??? Unintended pregnancies???
Belice
Fertility Rate 2006 2007 2008 2009 2010 2011 Reduction
Total fertility rate 3 2.9 2.7 2.8 2.6 2.6 0.4
<20 fertility rate 0.084 0.081 0.077 0.078 0.08 0.08 0.004
6.5
2.8
Number of children per woman
Adolescent birth rate 15-19
Lowest Belize district 51/1,000
Highest Stann Creek and Toledo 84 and 81 / 1000
Urban 39/1000
Rural 85/1000
Total Fertility Rate
Mother’s education
None 6.0
Primary 3.3
Secondary +2.0
Poorest 4.2
Richest 1.7
Ethnicity
Maya 3.8
Garifuna 3.1
Mestizo 2.8
Creole 1.4
It is estimated that approximately 15% of total pregnancies are loss spontaneously (miscarriage). In
Belize 2011, the percentage of abortions from total pregnancies is below the estimated standard [9.2%].
Morale and values?
Correct information?
Timely information?
Gender based
violence?
No girl or woman should undergo abortion
Indicadores de salud del adolescente
Avances
Lecciones aprendidas
Desafios
Contenido
- Politica de SSR aprobada en 2002
- ONG atencion a madres adolescentes – 1/6
distritos
- Pasantias hospitalarias adolescentes
embarazadas – 1/6 distritos
- Desarrollo de normativas AIA – FNUAP –
- MICS y otros estudios
- Encuesta de nutricion MER 15-49 y nino[as] 6-
59 meses – CDC y UNICEF
Avances
- Estudio costo efectividad – Vacuna HPV
- MINSA promueve cobertura universal
- Seguro nacional de salud en 3/6 distritos
- Brigadas medicas moviles a todas las
comunidades
- EU-PAHO 1 strengthening critical maternal and
neonatal care
- VIH tamizaje en ferias y otros eventos publicos
- ARV gratuito, Option B+, PTMI actualizada
Avances
Insumos anticoncepcion incremento de 50,000 a 160,000 USD con fondo de gobierno
Unintended
pregnancies among
adolescents reduced
Estrategias
-Help line – scaling up
-Informacion y acceso a
anticonceptivos
-Sensibilizar e identificar
adolescentes en riesgo de
embarazo no planificado
-Prevencion del segundo
embarazo en adolescentes
-Anticoncepcion Emergencia
-Fortalecer el sistema de
referencia y contrarreferencia
2. Censo, tamizaje, referencia, intervencion, seguimiento
con consentimiento firmado por padres y adolescentes
A Guide for Youth-Friendly Health Workers and
Community Health Workers
First Edition
September, 2013
Indicadores de salud del adolescente
Avances
Lecciones aprendidas
Desafios
Contenido
 Determinantes sociales de salud
 Determinates sociales - salud
sexual y reproductiva
 Determinantes sociales - salud
del adolescente
Enfoque multisectorial
Indicadores de salud del adolescente
Avances
Lecciones aprendidas
Desafios
Contenido
Comision nacional de SSR vs.
Comision nacional VIH
Desarrollo de habilidades en
atencion integral al adolescente en
atencion primaria y secundaria
Notificacion obligatoria de
adolescentes sexualmente activa y
embarazo en < 16 anos
Desafio
s
Desafios
Compromisos, leyes y politicas no
alineados
FNUAP-MINSA barreras legales para el
accesso a informacion y servicios de SR
para el adolescente
FNUAP-MINSA Modelo de ley de
accesso a SR del adolescente
Exceptos al acesso a servicios de salud sin
aprobacion de padres:
Abuso sexual
Embarazada o infectada con STI
Casada a los 16
Emancipated child
Common law exception: Gillick v Gillick.
•Lord Fraser: Doctor could provide contraceptives if:
the young person will understand the professional's advice;
the young person cannot be persuaded to inform their parents;
the young person is likely to begin, or to continue having,
sexual intercourse with or without contraceptive treatment;
unless the young person receives contraceptive treatment, their
physical or mental health, or both, are likely to suffer ;
the young person's best interests require them to receive
contraceptive advice or treatment with or without parental
consent
Where the young person refuses treatment, parents can
override the young person’s consent.
Desafios
 Ministerio de la Familia:
 Cambios en Codigo Penal- incluir abuso
sexual en ninos
 Actualizacion de la politica de Genero –
orientacion sexual
 Organizacion LGBT demandando al
Gobierno para la no penalizacion de HSH
 Ministerio Educacion: Retiro curricula
educ SR
APS
0.3 / 1,000
Enfermeras / poblacion

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Belice

  • 1. Usando un marco conceptual de derechosUsando un marco conceptual de derechos humanos para la prevencion del VIH enhumanos para la prevencion del VIH en jovenes en America Central y el Caribejovenes en America Central y el Caribe Avances, lecciones aprendidas y desafios del 2012Avances, lecciones aprendidas y desafios del 2012 Belize
  • 2. Indicadores de salud del adolescente Avances Lecciones aprendidas Desafios Contenido
  • 4. Maternal, under five and neonatal mortality rate Belize 1964-2012 Hypertensive disorders during pregnancyHypertensive disorders during pregnancy Eclampsia/Thyroid Storm, Violence, Sepsis IUFD
  • 5. o 1 13 19 21 34 44 75 81 60 72 93 99 184 241 226 330 431 447 457 434 443 450 425 365 244 226 251 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Female group is getting twice as many tests done as is the male group (ratio of 1.93:1 F:M); There was a marked increase in the total number of new infections (approximately 10%) when compared to 2010 data Casos de VIH. Belize. 1986 - 2012
  • 10. • Adolescents need more access to preventive SRH services • More participation from non traditional providers, schools and NGO,s, CBO’s • FHS females, more than 90% approved SRH should be thought in schools
  • 12. Males Young adolescent (10-14) 0.0 1.1 0.0 0.0 0.0 0.0 298 Adolescent (15-19) 3.8 2.9 12.1 2.6 0.0 4.2 362 Older adolescent (20-24) 35.1 34.1 16.7 26.9 42.1 28.6 249 Development stage Creole Garifuna Hispanic Maya Mestizo Other N Females Young adolescent (10-14) 0.7 1.4 0.0 0.0 2.4 4.0 476 Adolescent (15-19) 19.1 16.0 32.1 20.2 14.3 11.1 1,035 Older adolescent (20-24) 61.1 61.7 80.2 68.6 75.0 59.7 1,026 Percent of respondents of the 2011 Belize Coverage Exercise who have at least one child, by sex, development stage and ethnicity Intergenerational??? Unintended pregnancies???
  • 14. Fertility Rate 2006 2007 2008 2009 2010 2011 Reduction Total fertility rate 3 2.9 2.7 2.8 2.6 2.6 0.4 <20 fertility rate 0.084 0.081 0.077 0.078 0.08 0.08 0.004 6.5 2.8 Number of children per woman
  • 15. Adolescent birth rate 15-19 Lowest Belize district 51/1,000 Highest Stann Creek and Toledo 84 and 81 / 1000 Urban 39/1000 Rural 85/1000 Total Fertility Rate Mother’s education None 6.0 Primary 3.3 Secondary +2.0 Poorest 4.2 Richest 1.7 Ethnicity Maya 3.8 Garifuna 3.1 Mestizo 2.8 Creole 1.4
  • 16. It is estimated that approximately 15% of total pregnancies are loss spontaneously (miscarriage). In Belize 2011, the percentage of abortions from total pregnancies is below the estimated standard [9.2%]. Morale and values? Correct information? Timely information? Gender based violence? No girl or woman should undergo abortion
  • 17. Indicadores de salud del adolescente Avances Lecciones aprendidas Desafios Contenido
  • 18. - Politica de SSR aprobada en 2002 - ONG atencion a madres adolescentes – 1/6 distritos - Pasantias hospitalarias adolescentes embarazadas – 1/6 distritos - Desarrollo de normativas AIA – FNUAP – - MICS y otros estudios - Encuesta de nutricion MER 15-49 y nino[as] 6- 59 meses – CDC y UNICEF Avances
  • 19. - Estudio costo efectividad – Vacuna HPV - MINSA promueve cobertura universal - Seguro nacional de salud en 3/6 distritos - Brigadas medicas moviles a todas las comunidades - EU-PAHO 1 strengthening critical maternal and neonatal care - VIH tamizaje en ferias y otros eventos publicos - ARV gratuito, Option B+, PTMI actualizada Avances
  • 20. Insumos anticoncepcion incremento de 50,000 a 160,000 USD con fondo de gobierno
  • 22. Estrategias -Help line – scaling up -Informacion y acceso a anticonceptivos -Sensibilizar e identificar adolescentes en riesgo de embarazo no planificado -Prevencion del segundo embarazo en adolescentes -Anticoncepcion Emergencia -Fortalecer el sistema de referencia y contrarreferencia
  • 23. 2. Censo, tamizaje, referencia, intervencion, seguimiento con consentimiento firmado por padres y adolescentes
  • 24. A Guide for Youth-Friendly Health Workers and Community Health Workers First Edition September, 2013
  • 25. Indicadores de salud del adolescente Avances Lecciones aprendidas Desafios Contenido
  • 26.  Determinantes sociales de salud  Determinates sociales - salud sexual y reproductiva  Determinantes sociales - salud del adolescente Enfoque multisectorial
  • 27. Indicadores de salud del adolescente Avances Lecciones aprendidas Desafios Contenido
  • 28. Comision nacional de SSR vs. Comision nacional VIH Desarrollo de habilidades en atencion integral al adolescente en atencion primaria y secundaria Notificacion obligatoria de adolescentes sexualmente activa y embarazo en < 16 anos Desafio s
  • 29. Desafios Compromisos, leyes y politicas no alineados FNUAP-MINSA barreras legales para el accesso a informacion y servicios de SR para el adolescente FNUAP-MINSA Modelo de ley de accesso a SR del adolescente
  • 30. Exceptos al acesso a servicios de salud sin aprobacion de padres: Abuso sexual Embarazada o infectada con STI Casada a los 16 Emancipated child Common law exception: Gillick v Gillick.
  • 31. •Lord Fraser: Doctor could provide contraceptives if: the young person will understand the professional's advice; the young person cannot be persuaded to inform their parents; the young person is likely to begin, or to continue having, sexual intercourse with or without contraceptive treatment; unless the young person receives contraceptive treatment, their physical or mental health, or both, are likely to suffer ; the young person's best interests require them to receive contraceptive advice or treatment with or without parental consent Where the young person refuses treatment, parents can override the young person’s consent.
  • 32. Desafios  Ministerio de la Familia:  Cambios en Codigo Penal- incluir abuso sexual en ninos  Actualizacion de la politica de Genero – orientacion sexual  Organizacion LGBT demandando al Gobierno para la no penalizacion de HSH  Ministerio Educacion: Retiro curricula educ SR

Hinweis der Redaktion

  1. These are the new cases of HIV by age group and sex. Among adolescents, girls are more affected than boys. Although there is no research to back it up, through the grapevine, young girls are engaging in anal sex to preserve their virginity. This behavior is unacceptable. Biologically, there is an extremely high risk of contracting HIV, especially without the use of condoms. There is no such proof of love. Sexuality is not a game.
  2. This is from the MICS survey (Multiple Indicator Cluster Survey done in 2011 by UNICEF). It shows that among female adolescents 10-14, mestizos have the highest rate of early pregnancy Among females 15-19, are the hispanics Among females 20-24, hispanics Looking at males 10-14 year old, garifuna had the highest rate 15-19, hispanics 20-24, mestizos
  3. Number of teenage pregnancy by community ----- Meeting Notes (10/10/13 10:52) ----- peer education work for adolescents parents or an adult? learning is a game, all learning has an activity accesible to reach the ones in need those in need may not be able to read and text, limitation to use the help line movies, videos music, rapping, competition, adolescents reach bfla already with problems life skills are needed together we can program in schools are having informal sessions on life skills and srh schools are referring problem cases to bfla parents are not attending schools for their kids adolescents need an adult to consent