This document discusses adolescent health indicators in Belize, including progress made, lessons learned, and challenges. Some key advances are increased access to contraception and youth-friendly health services, as well as a national sexual and reproductive health policy approved in 2002. However, challenges remain in aligning laws and policies, ensuring access to sexual and reproductive health information and services for adolescents, and developing skills for integrated adolescent care. A multisectoral approach is needed to address the social determinants of adolescent health.
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
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
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.
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
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