Adolescent health and development
Adolescence brings a period of tremendous growth and development, but also considerable risks.
Adolescents and young people between 10 and 24 years of age represent almost a quarter of the total population of Moldova. Today, they are exposed to a variety of risk factors that negatively impact their health. Lack of education programmes on life skills, lack of parental supervision, migrant parents, and limited opportunities for education and employment, combined with easy access to alcohol, tobacco and illicit drugs, pose many challenges for adolescents. These include sexually-transmitted infections, unwanted pregnancies, substance use, mental health issues, and suicide.
Recent data show that 45 per cent of adolescent boys and 22 per cent of adolescent girls start drinking alcohol before the age of 15. Only 36 per cent of girls and 28 per cent of boys aged 15–24 know how HIV is transmitted and how to protect themselves from getting infected. This puts teenagers and young people at high risk of injuries, addiction, unwanted pregnancies, and sexually transmitted infections, including HIV.
Young people are the least likely to have access to the services they need and often underestimate the risks or know how to avoid them. More than 35 thousand Moldovan children and adolescents are having both parents living abroad, due to emigration. Children left behind are usually cared by their grandparents, or, in some cases, by themselves.
Lack of parental supervision due to labour migration, as well as limited job opportunities, widespread poverty; easy access to tobacco, alcohol, and drugs;often result in unhealthy choices and decisions.
The absence of parents may lead to increased likelihood of risky behavior.
Young people of Roma etnicity are at particular risk. Studies reveal that about one quarter of Roma aged 16 and older smoke daily. Roma athnics smoke at a rate 10% higher than non-Roma, and 16% of Roma females smoke, or roughly six times higher than the rate of non-Roma women.
In young women, reproductive health risks are higher amongst Roma when compared to non-Roma, because of early sexual activity and childbearing.
Roma women have essentially no access to sexual and reproductive education and are giving birth at an early age.
Given the HIV epidemic trends among young boys and girls, the health information and prevention measures should be equally accessible to the most-at-risk adolescents and youth. We focus on the most vulnerable.
UNICEF works with the adolescents at greatest risk of infection to reduce their vulnerability and ensure their access to quality prevention, care and support services.
In 2001, a programme was introduced to protect young people’s health and development, with a particular emphasis on the needs of the most-at-risk adolescents. This programme began with the establishment of three Youth-Friendly Health Centers. Recognizing adolescents’ and youth’s specific needs, which must be addressed to ensure positive health outcomes, UNICEF has given high priority to supporting the rapid development of youth-friendly health services.
These centers provide integrated services to young people on issues such as HIV, unwanted pregnancy, mental health problems as a result of substance abuse (alcohol, drug addiction), psycho-emotional and identity disorders, health problems resulting from violence, nutritional deficiencies, malnutrition and development disorders during puberty.
We work with HIV-positive adolescents to ensure their needs are being met, and that they have support to stay in treatment.
Additionally, NGOs have been empowered to provide rapid saliva-based tests for HIV, which represents an opportunity to reach the most vulnerable adolescents and the youth who are currently being missed by the public system.
In this regard, UNICEF has supported the activities of the network of Youth Friendly Health Centers and advocated for lowering the threshold of mandatory parental consent for Voluntary Confidential Counselling and Testing from 18 to 14 years.
We also work with the most vulnerable and excluded pregnant women and young mothers to ensure their access to HIV care and treatment.
Youth Friendly Health Centres are now available in all districts in Moldova. Since 2007, when they became part of primary health care, the National Health Insurance Fund covers for the services provided by Youth-Friendly Health Centers.
Funds allocated by the national health insurance fund to Youth Friendly Health Centers increased ten-fold: from around MDL 2 million in 2011 to more than MDL 21 million in 2017.