Introduction: Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants. Methods: This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically. Results: Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent–adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation. Conclusion A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised.
Adolescent ; Reproductive Health Services ; Sexual Health ; Qualitative Research ; Rural Population

As a global public health problem, adverse childhood experiences (ACEs) is an important factor leading to serious psychological and behavioral problems in children and adolescents. Mental health service plan based on mental health service needs is the key to effectively improve the psychological problems of children and adolescents with ACEs. Emotional support, life skills training, mental health education, and individualized psychological intervention can effectively improve the mental health of children and adolescents with ACEs. Among them, emotional support is an important way to help individual reduce psychological and behavioral problems; secondly, life skills training can significantly improve the individual's psychosocial ability; and mental health education is a necessary way to promote the development of individual mental health. Individualized psychological intervention can promote individual to obtain more professional mental health service and improve their psychological symptoms, which is crucial for preventing the occurrence of mental health problems. Future research can develop targeted mental health interventions based on the specific mental health service needs.
Adolescent ; Adverse Childhood Experiences ; Child ; Humans ; Mental Health ; Mental Health Services

INTRODUCTION: We evaluated the impact of public health measures on paediatric emergency department attendances during the COVID-19 and severe acute respiratory syndrome (SARS) outbreaks in Singapore. METHODS: Between 1 January 2020 and 31 July 2020, we retrospectively reviewed paediatric emergency department attendances and admissions in a tertiary paediatric hospital in Singapore before and after a national lockdown to combat the spread of COVID-19 in Singapore. Hospital attendances and admissions were compared with data from a corresponding period in 2019 (1 January 2019 to 31 July 2019), as well as during and after the SARS outbreak (1 January 2003 to 31 December 2004). RESULTS: Compared with a corresponding non-outbreak period, emergency department attendances decreased in line with nationwide public health measures during the COVID-19 and SARS outbreaks (2020 and 2003 respectively), before increasing gradually following lifting of restrictions, albeit not to recorded levels before these outbreaks. During the COVID-19 outbreak, mean daily attendances decreased by 40%, from 458 per day in January-July 2019, to 274 per day in January-July 2020. The absolute number of hospital inpatient admissions decreased by 37% from January-July 2019 (19,629) to January-July 2020 (12,304). The proportion of emergency department attendances requiring admission remained similar: 20% in January-July 2019 and 21% in January-July 2020. CONCLUSION Nationwide public health measures in Singapore have had an impact on paediatric emergency department attendances and hospital inpatient admissions. Data from this study could inform planning and resource allocation for emergency departments in Singapore and internationally.
Adolescent ; COVID-19/prevention & control* ; Child ; Child, Preschool ; Disease Outbreaks ; Emergency Service, Hospital/trends* ; Facilities and Services Utilization/trends* ; Female ; Health Policy ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Acceptance of Health Care/statistics & numerical data* ; Patient Admission/trends* ; Pediatrics ; Retrospective Studies ; Severe Acute Respiratory Syndrome/epidemiology* ; Singapore/epidemiology*

Adolescent ; COVID-19/prevention & control* ; Child ; Child, Preschool ; Emergency Service, Hospital/trends* ; Facilities and Services Utilization/trends* ; Female ; Health Policy ; Humans ; Infant ; Infant, Newborn ; Male ; Pandemics ; Patient Acceptance of Health Care/statistics & numerical data* ; Retrospective Studies ; Singapore/epidemiology*

BACKGROUND: Adolescent pregnancy remains a significant public health problem in the Philippines wherein teenage pregnancy has been declared as a National Social Emergency. OBJECTIVES: This study aims to identify the received services and interventions during prenatal and postnatal visits and investigate the relationships between the received services and interventions during visits and the completeness of received services to neonatal death among adolescent pregnancies in the Cordillera Administrative Region. METHODS: This study used a descriptive correlational study design. A survey questionnaire was distributed to target participants among selected municipalities in the Cordillera Administrative Region and asked about the received services/interventions during and after pregnancy. Responses were analyzed using frequency and percentage, Chi-square and Phi Correlation Coefficient. RESULTS: The study showed that a high incidence of neonatal deaths occurs during the first delivery while decreasing prenatal and post-natal visits have been noted. It was also observed that neonatal mortality is high particularly among the category of middle adolescents. The study also demonstrated a significant correlation between Blood Testing and Measurement of the Abdomen or fundal height measurement provided to the respondents and neonatal mortality in the third trimester. However, no significant correlation coefficients have been noted between neonatal mortality and completeness of prenatal and postnatal services. CONCLUSION: Policies and programs on adolescent health development should be enhanced, first, to focus on preventing adolescent pregnancy and repeat pregnancies during the adolescent period, while strengthening the access to health services for all pregnant women, especially adolescent mothers.
Pregnancy ; Adolescent ; Female ; Humans ; Pregnancy in Adolescence ; Infant Mortality ; Adolescent Health Services ; Primary Health Care

BACKGROUND: Health and education are closely linked. However, few studies have explored the correlates of children's academic performance in Japan. We aimed to investigate comprehensively the associations of low academic performance among school children with lifestyles, parental smoke, and socioeconomic status. METHODS: In 2016, children aged 6 to 13 years from the Super Diet Education School Project were surveyed using questionnaires. The survey explored the lifestyles and subjective academic performance of 1663 children and asked their parents about parental smoke and subjective socioeconomic status. Academic performance and socioeconomic status were divided into three levels. Then, we defined subjective academic performance in the lower two levels as low academic performance. The odds ratios (OR) were analyzed by logistic regression analysis. RESULTS: Among all participants, 299 (18.0%) children reported low academic performance. In general, low academic performance was significantly associated with late wakeup time (OR = 1.36 for 6:30 to < 7 a.m. and OR = 2.48 for ≥ 7 a.m.), screen time ≥ 2 h (OR = 1.35), studying at home < 1 h (OR = 1.82), paternal smoke (OR = 1.47), maternal smoke (OR = 1.87), and low socioeconomic status (OR = 1.48). Analyses stratified by grade showed stronger associations between academic performance and socioeconomic status in senior (OR = 1.62 for middle, OR = 1.52 for low in grades 4 to 6) than in junior children (OR = 1.15 for middle, OR = 1.38 for low in grades 1 to 3). CONCLUSIONS Children's lifestyles, parental smoke, and socioeconomic status were significantly associated with low academic performance among Japanese children. Parents and health care providers should take these findings into consideration to prevent children from having low academic performance.
Academic Performance ; statistics & numerical data ; Adolescent ; Child ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; Japan ; Life Style ; Male ; Parents ; Risk Factors ; School Health Services ; statistics & numerical data ; Smoke ; adverse effects ; Social Class

PURPOSE: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. METHODS: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. RESULTS: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. CONCLUSION: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.
Adolescent ; Child ; Delivery of Health Care ; Disabled Children ; Financial Management ; Great Britain ; Health Services Needs and Demand ; Home Care Services ; Hospice Care ; Hospices ; Humans ; Japan ; Korea ; Methods ; Palliative Care ; Pediatrics ; Primary Health Care ; Quality of Life ; Referral and Consultation ; Singapore ; Specialization ; Tertiary Care Centers ; United States

OBJECTIVES: Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents.METHODS: PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included.RESULTS: The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0).CONCLUSIONS: The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.
Adolescent ; Africa ; Americas ; Asia, Southeastern ; Delivery of Health Care ; Dental Health Services ; Europe ; Humans ; Malocclusion ; Methods ; Prevalence ; World Health Organization

OBJECTIVE: We aimed to investigate the influence of area-level factors on adolescent suicide and to determine which variables differ according to age and sex.METHODS: We selected variables that were available for collection through an online database from 2005 to 2015 in the Korean Statistical Information Service and the Korea Labor Institute. We used administrative districts of Korea in 2017 for geographical classification. We examined the relationships between regional suicide rates and area-level variables in male and female subjects aged 10–14 years and 15–19 years. In addition, we analyzed area-level variables in adolescents aged 15–19 years according to sex.RESULTS: Our findings indicated that several area-level variables affected adolescent suicide rates, varying according to age and sex. Economic problems were shown to be more associated with suicide in male adolescents than in female adolescents. On the other hand, social fragmentation and health services were shown to be more associated with suicide in females.CONCLUSION: Suicide in adolescents was attributable to area-level factors such as economic status, social fragmentation, and community health services. By identifying area-level variables affecting adolescent suicide rates, we will be able to contribute to implement mental health policies related to adolescent suicide.
Adolescent ; Classification ; Community Health Services ; Female ; Hand ; Health Services ; Humans ; Information Services ; Korea ; Male ; Mental Health ; Suicide

PURPOSE: The purpose of this study was to explore psychological distress and examine the relationship between this distress and individual, family, and school factors among adolescents in four low- and middle-income countries (LAMICs) in Asia (i.e., Laos, Mongolia, Nepal, and Sri Lanka). METHODS: A total of 4,098 adolescents attending public schools in the four LAMICs were surveyed as part of the Healthy School Development Project, which aimed to develop school capacity for improving (1) health among all school members and (2) the school environment through tailored school health programs. Psychological distress, family factors (i.e., parental understanding and monitoring, and parental tobacco and alcohol use), and school factors (i.e., having close friends, not bullied, school attendance, and health education) were assessed using self-report questionnaires. Data were collected from September to November in 2012 and 2013. Data analysis comprised descriptive statistics, Chi-squared testing, and logistic regression. RESULTS: Over half of the participants were women (53.2%–64.1%), and 33.7% (in Sri Lanka) to 53.8% (in Laos) were aged older than 15 years. Approximately 32.9% reported the presence of psychological distress; moreover, 7.9%–13.2% reported suicidal ideation. Parental monitoring and being bullied were associated with psychological distress in all four countries. CONCLUSION: One-third of adolescents experience psychological distress across these four LAMICs, which poses a substantial public health issue. Adolescents can benefit from family and school-based approaches for screening, ameliorating, and preventing psychological distress.
Adolescent ; Asia ; Developing Countries ; Female ; Friends ; Humans ; Laos ; Logistic Models ; Mass Screening ; Mongolia ; Nepal ; Parents ; Public Health ; School Health Services ; Sri Lanka ; Statistics as Topic ; Stress, Psychological ; Suicidal Ideation ; Tobacco