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Monday, May 7, 2018

Mental Health In Adolescence

 Mental health is defined as an emotional, psychological and social well-being of a person(ASPA, 2013). In 1999, the general report on mental health defines is as a successful performance of mental function, resulting in the performance of activities, integrating with other people, and the adapt to changes (Nopf, Park, & Mulye, n.d.). WHO gave its own definition of mental health as a “state of well-being in which every individual realizes their own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to the community”(WHO, 2014). The WHO report differentiates mental health and mental illness (WHO, 2004). It states that mental illness is referred to as a mental disorder diagnosed to determine the alterations in thinking, mood, or behaviour that are related to distress and/or impaired functioning (Laura Mateescu, Florina Rad, Raluca Grozavescu, & Petrovai, 2009).

A good mental health is gotten from the benefits of the society. However, most adolescents in EU Countries develop emotional and behavioural problems. One out of 8 children are clinically diagnosed with mental health disorder. According to Children and Adolescent Mental Health (CAMH), there is a high rate of ill-mental health among children and youths (Laura Mateescu et al., 2009). Most mental health problems are diagnosed in adulthood which often begins during adolescence from the age of 14. Their ability to cope with the mental health problems includes substance abuse and violence which affects their daily life in areas of building social relationships, and participation in schools and work fields(Kessler et al., 2005).

There is an increased rate of attention on depression among adolescents, which has resulted to a high interest in the aetiology, comorbidities and consequences of early-onset depression. For instance, there are evidence supporting the notion that adolescents who show signs of onset depression or have the tendency to develop depression are at high risk of several adverse outcomes (Fergusson & Woodward, 2002), such as low academic achievement, different mental health complications which includes anxiety disorders, substance abuse, and suicidal behaviors. The relationship between early depression and later outcomes result in reflecting the effects of early-onset depression in developing children and its continuation on depressed mood as it progresses across time (Weissman et al., 1999).
In Romania, over the past 19 years, after the revolution that occurred in December 1989, many things in Romania changed drastically compared with that moment. Many of these changes remain in progress, while there are still some aspects that have unfortunately remained unimproved. A significant moment in terms of child and adolescent mental health was joining the EU, in 2007. In 2005, “the action plan for implementing the mental health strategy by the Ministry of Health proposed a change of the mental health services in Romania”. The results of the mental health situation of children and adolescents in Romania showed in relation to that of the adult mental health, which calls for the proposal of significant changes. Although the objective of the study was to achieve the promotion of mental health human rights, prevention of mental health disorder, collaboration with the civil society, and implementing a mental health strategy, there are gaps which are yet to be filled up (Laura Mateescu et al., 2009)

Studies have shown that socioeconomic status as a risk factor for mental health among adolescents. In the European region, mental health contributes to inequality in the health of an individual. Mental health is relatively associated with poor education, material disadvantage and unemployment (Fryers, Melzer, Jenkins, & Brugha, 2005).  Suicide is more common in areas of low socio-economic status, and social disparities. The vulnerability of disadvantaged persons in every community to mental health problems has been explained by the factors of experiencing insecurity, and lack of hope, lack of social support or social isolation, poor housing, and lack of educational support (BUKA, 2006).
the crisis of the recent economic system is increasing the rate of social exclusion among vulnerable groups such as low-income population within the European regions. The pressure influences the parental mental health or marital interaction, and parenting skills, which has a great impact on the mental health state of children and adolescents (Neppl, Senia, & Donnellan, 2016). For example, out of 1,073,171 (53.3%) of the Romanian adolescents who live in the rural area, about 6.3% of the population do not attend or have access to education between the age of 14-18 years. Out of the overall population, 96% (females), and 91.6% (males) have access to education in the urban areas(Abraham, D. (coord.); Abraham, A.; Dalu, A.M.; Fierbinteanu, C.; Marcovici, O.; Mitulescu, S.; Plaesu, A.; Sufaru & Institutions:, 2013).


1.       Abraham, D. (coord.); Abraham, A.; Dalu, A.M.; Fierbinteanu, C.; Marcovici, O.; Mitulescu, S.; Plaesu, A.; Sufaru, I., & Institutions: (2013). Final report: State of adolescents in Romania. UNICEF, 93. Retrieved from
2.       ASPA. (2013). What Is Mental Health? Retrieved from
3.       BUKA, D. H. R. A. S. L. (2006). The association between suicide and the socio-economic characteristics of geographical areas : a systematic review. Journal of Psychological Medicine, 36, 145–147.
4.       Fergusson, D. M., & Woodward, L. J. (2002). Mental Health, Educational, and Social Role Outcomes of Adolescents With Depression. Archives of General Psychiatry, 59(3), 225.
5.       Fryers, T., Melzer, D., Jenkins, R., & Brugha, T. (2005). The distribution of the common mental disorders: social inequalities in Europe. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 1, 14.
6.       Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry, 62, 593–602. Retrieved from
7.       Laura Mateescu, I. E., Florina Rad, Raluca Grozavescu, D., & Petrovai, A. B. and I. D. (2009). Child and adolesCent Mental health in europe: infrastruCtures, poliCy and prograMMes. Retrieved from
8.       Neppl, T. K., Senia, J. M., & Donnellan, M. B. (2016). Effects of economic hardship: Testing the family stress model over time. Journal of Family Psychology : JFP : Journal of the Division of Family Psychology of the American Psychological Association (Division 43), 30(1), 12–21.
9.       Nopf, D. K., Park, M. J., & Mulye, T. P. (n.d.). The Mental Health of Adolescents: A National Profile, 2008. Retrieved from
10.   Weissman, M. M., Wolk, S., Wickramaratne, P., Goldstein, R. B., Adams, P., Greenwald, S., … Steinberg, D. (1999). Children With Prepubertal-Onset Major Depressive Disorder and Anxiety Grown Up. Archives of General Psychiatry, 56(9), 794.
11.   WHO. (2004). Promoting Mental Health CONCEPTS EMERGING EVIDENCE A Report of the. Retrieved from
12.   WHO. (2014). WHO | Mental health: a state of well-being. Retrieved from

Globalization And Inequalities

The health of the people has been anticipated by international goals which indicate the benefit of life expectancy over the past decades. However, the inequalities in health among the wealthy and the poor continues, while the prospects for the health in future builds upon the new progression of globalization. In the past, the global development was often seen as more or less economic process but today, it is perceived as a broad paradox designed by a majority of factors and events which reshapes the growth of the society (Huynen, Martens, & Hilderink, 2005).

As the world evolves around us with a high rate of complexity and interconnectivity, the health of the population is recognized as an interspersed event of its ecological, social-cultural, economic and institutional determinants. Thus, it can be regarded as a significant indicator which integrates the sustainability of the natural and socio-economic environment. In the recent years, we have observed the expansion of the economic activities which may have a large scale and permanent outcome on the environment affecting the health of the population.  There is evidence on the increasing rate of globalization (that is, the deregulated trade, capital mobility, employment, and low labor standards), and the global advancement in industrialism, cultures, electronic communication, and physical mobility on humans which influences the wellbeing, and health of the population (Martens, McMichael, & Patz, 2000).

Globalization influences health in multiple ways. Its effects intervene with the growth, and distribution of income, economic stability, availability of health, and other social resources, and proliferation. Also, the health status is affected by the previous circumstances of revolutionizing of each country, i.e. the size and international specialization of the economy, the availability and dissemination of assets, the human capital, and framework, and the quality of the domestic policies (Cornia, 2001).

Globalization can incline the informalization of the economy through outsourcing, and out-letting by an enormous partnership. For instance, NIKE depends on an overflow chain of over 10,000 micro subcontractors which supplies much more difficult collection because of the employment in small business, in particular, in unofficial zones, where there is an increased rate of developing countries for over 20 years. In the early 1990s, 58% of the magnitude of such employment attained in the nine biggest Latin American countries, and an estimate of the same values for Sub-Saharan Africa, North Africa, and Asia were 74%, 43% and 62%. Thereby, the eradication of import assessment and export of taxes decrease the revenue. Also, in the world of mobile capital, and immobile labour, developing countries that intend to attract foreign capital may involve in downward bidding which may result to high-income tax, acknowledgement of tax holidays, and allocate different industrial subsidies (Andrea, 2016).

If and when managed efficiently, globalization can improve the benefits of health. The global market forces effective work in domestic markets that are competitive, and non-exclusive, the institutions for regulations are strong, there will be moderation of asset intensity, the access to public health services will be unlimited, the social safety will be secured, and the laws guiding access to the global market will be non-discriminative (Kabir, Mohammad, Haque, & Hasan, n.d.)

 Andrea, G. (2016). The mortality crisis in transition economies, 2054–9571.

           Cornia, G. A. (2001). Globalization and health: results and options. Bulletin of the World Health Organization, 79, 834–841.

          Huynen, M. M. T. E., Martens, P., & Hilderink, H. B. M. (2005). The health impacts of globalization: a conceptual framework. Globalization and Health, 1, 14.

       Kabir, F., Mohammad, R., Haque, M., & Hasan, F. (n.d.). GLOBALIZATION AND HUMAN DEVELOPMENT – REALITIES AND RECOMMENDATIONS FOR DEVELOPING COUNTRIES. CDRB Publication Asian Affairs, 30(1), 32–49. Retrieved from

5   Martens, P., McMichael, A. J., & Patz, J. A. (2000). Editorial: Globalisation, environmental change and health. Global Change and Human Health, 1(1), 4–8.

Tuesday, January 9, 2018

Human Trafficking in Syria

Over five years, Syrians have been migrating from their homes, always on the move to other countries or across its borders. As the war continues, the people’s savings are decreasing, becoming more susceptible to trafficking because they are unable to meet their basic needs. The ICMPD study indicates that families with no viable alternative for survival have increased with no other means that is defined as exploitation and trafficking in the national and international law. The degree of their situation is derived from the war and the violence they face, but also by the constitutional and institutional system, the children, women and men fleeing the war must navigate within Syria and in the four hosting countries (International Centre For Migration Policy Development, 2016).

An estimate of 21 million people are victims to the criminal enterprise of human trafficking. Due to the crisis in Syria, 4.8 million people have been rendered refugees and nearly all of them are prone to human trafficking (Rachel Buchan, 2015). According to UNICEF, children as young as three years are working, and 2.8 million do not have access to education. The U.N High Commissioner for Refugees described the crisis as the “biggest humanitarian and refugee crisis of our time.” Host countries’ infrastructures are buckling under the strain, forcing refugees to rely on smugglers, treacherous migrant routes, and quasi-impossible border crossings in a continual search for protection.

The Syrian government does not meet the minimum standards for the elimination of trafficking and has put no effort to do, therefore, Syria remains on Tier 3. The government does not demonstrate any willingness of addressing the human trafficking through prosecution, protection or prevention measures. The actions of the government have directly contributed to the vulnerability of the population to trafficking and continued to perpetuate human trafficking crimes routinely. The Government The government maintained its forcible recruitment and use of child soldiers, subjecting children to extreme violence and retaliation by opposition forces; it also did not protect and prevent children from recruitment and use by government and pro-regime militias, armed opposition forces, and designated terrorist organizations such as the Islamic State of Iraq and Syria (ISIS). The government continued to arrest, detain, and severely abuse trafficking victims, including child soldiers, and punished them for crimes committed as a direct result of being subjected to human trafficking. The government did not investigate or punish traffickers, including officials complicit in recruiting and using child soldiers, nor did it identify or protect any trafficking victims (Micah Zenko, 2017)


       International Centre For Migration Policy Development. (2016). Trafficking and the Syrian War. Retrieved January 9, 2018, from

       Micah Zenko. (2017). Sex Trafficking and the Refugee Crisis: Exploiting the Vulnerable | Council on Foreign Relations. Retrieved January 9, 2018, from

3    Rachel Buchan. (2015). The Syrian Refugee Crisis: A Greenhouse for Human Trafficking | Human Rights First. Retrieved January 9, 2018, from

Wednesday, November 22, 2017

The Pediatric Association: Millions of Nigerian Children are dying from Preventable Diseases

The Pediatrics Association of Nigeria on Tuesday pledged to support efforts of government and other stakeholders to drastically reduce the high rate of death among children in Nigeria, put at one million annually.
President of the Association, Dr. Ngozi Ibeziaku, made the pledge at a press conference in Kaduna to herald the commencement of the association’s 48th Annual Conference.
She said the focus of the conference would be on child health and evolving strategies to encourage mothers and other stakeholders access health services to ensure the survival of the Nigerian child.
“Children can’t speak for themselves, so we are their voices”, she said, adding that the association would also support policies and programmes to tackle high child death in the country.
She stressed that most of the deaths were preventable, and could be tackled through exclusive breastfeeding, accessing antenatal care, vaccination against killer diseases, environmental cleanliness, use of treated mosquito nets, and hand washing.
Ibeziaku added that the association would continue its advocacy for the provision of safe drinking water, protecting children against child labor, drug abuse and patronage of health facilities for medication.
She noted that Nigeria’s indices on child death were alarming, and every Nigerian needed to contribute towards safe motherhood and the upbringing of children.
“Everywhere in the world, it is the health indicators concerning children especially those under-5, that they use to determine the state of development of nations.
“Unfortunately for us in Nigeria with our large population, our prenatal and neonatal mortality and morbidity rates is one of the highest in the world.
“The same for our under-5 mortality rate, that is children aged under-5. Many of our children don’t live to celebrate their first birthday and even those that did, don’t live to celebrate their fifth birthday, which is a landmark in the life of any child.
“When we look at the under-5 figures, we find that children in the first one month of life contribute more than 45 percent of the deaths of children in the country. So the great problem is in the first month of life,” the president noted.
The News Agency of Nigeria reports that the theme of the four-day conference is “Consolidating child health development in Nigeria through SDGs; Gains and Gaps of the MDGs.”


Public Health Challenges In Africa

In 2005, out of 58.03 million people who died globally, an estimate of 10.9 million (18.8%) were from the WHO African region []. HIV/AIDS (19%) was responsible for the majority of the deaths (64%) that occurred in the region, lower respiratory infections (10%), malaria (8%), diarrhoeal diseases (7%), cerebrovascular disease (4%), ischaemic heart disease (3%), tuberculosis (3%), measles (3%), low birth weight (2%), birth asphyxia and birth trauma (2%) and maternal conditions (2%). Although there are effective public health interventions that can prevent most of the deaths, the coverage is insufficient due to weak and under-resourced health systems. Some of the weakness can be generated from the challenges related to leadership and governance; health workforce; medical products; vaccines and technologies. Information, financing and service delivery [].

Firstly, the leadership and governance is inefficient, which includes weak public health leadership and management []; inadequate health-related legislation and their enforcement; limited community participation in planning, management and monitoring of health services; weak inter-sectoral action; horizontal and vertical inequities in health systems []; inefficiency in resource allocation and use []; and weak national health information and research systems [].
Secondly, extreme shortages of health workers exist in 57 countries of which 36 are in Africa []. The crisis has been exacerbated by inequities in workforce distribution and brain drain. Thus, the delivery of effective public health interventions to people in need is compromised particularly in remote rural areas.
Thirdly, there is rampant corruption in medical products and technologies procurement systems, unreliable supply systems, unaffordable prices, irrational use, the wide variance in quality and safety []. This has contributed to the current situation where 50% the population in the Region lack of access to essential medicines [].
Fourthly, there is a dearth of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills limiting capacities of national health management information systems (HMIS) to generate, analyze and disseminate information for use in decision-making [].

  • WHO Strengthening health systems to improve health outcomes: WHO's framework for action Geneva. 2007.
  • Brinkerhoff DW, Bossert TJ. Health Governance: Concepts, Experience, and Programming Options.Bethesda: Abt Associates Inc; 2008.
  • McIntyre D, Mooney G. The economics of health equity. Cambridge: Cambridge University Press; 2007.
  • Kirigia JM, Asbu Z, Greene W, Emrouznejad A. Technical efficiency, efficiency change, technical progress and productivity growth in the national health systems of continental African countries. Eastern Africa Social Science Research Review. 2007;23:19–40. doi: 10.1353/eas.2007.0008.[Cross Ref]
  • Kirigia JM, Wambebe C. Status of resources for health research in ten African countries. BMC Health Services Research. 2006;6:135. doi: 10.1186/1472-6963-6-135. [PMC free article] [PubMed][Cross Ref]
  • Gething PW, Noor AM, Gikandi PW, Ogara E, Hay SI, Nixon MS, Snow RW, Atkinson PM. Improving imperfect data from health management information systems in Africa using space-time geostatistics. PLoS Med. 2006;3:e271. doi: 10.1371/journal.pmed.0030271. [PMC free article][PubMed] [Cross Ref]

Monday, November 13, 2017

Lead Poisoning in Children

Lead poisoning is responsible for the mortality rate of childhood diseases in a toxic environment. Today, children across the world are at risk of exposure to lead from several sources. Lead poisoning is accounted for 0.6% of the burden of diseases worldwide (WHO, 2009). Traces of lead exposure, prevalence rates of lead poisoning and the severity of its impact varies greatly from country to country, and from place to place within countries. Countries also vary greatly in their degree of recognition of the problem and in the strength and effectiveness of their lead poisoning prevention programmes.

Most countries have programs for monitoring the degree of lead exposure in the blood and the environment. They also have programs for primary and secondary prevention of childhood lead poisoning. Some of these have restricted the use of lead, they have established an environmental standard and developed screening programs. They also have lead hot spots, such as battery recycling plants, smelters, refineries, mines, hazardous waste sites and sites where waste is burned in the open.

Although childhood lead poisoning in relation to exposure to certain substances has been recognized as a public health problem in some countries, they are yet to implement assessment and exposure prevention programs. In some countries, where there is no recognition of lead poisoning as a potential health hazard, there is no existence of screening or surveillance programs. As a result, the public health authorities have little or no knowledge of the magnitude of the exposure towards children.
Because of this heterogeneous situation, the true picture of global and regional lead poisoning in children is not yet fully defined. The contribution of lead poisoning to the global burden of disease and its effect on the global economy and human development is probably still underestimated.

There are multiple international conferences and declarations which have recognized the importance of childhood lead poisoning and the need to intervene to prevent it (see Annex for examples). The 1989 Convention on the Rights of the Child and the 1992 Agenda 21 adopted by the United Nations Conference on Environment and Development both addressed the need to protect children from toxic chemicals. The 1997 Declaration of the Environment Leaders of the Eight on Children’s Environmental Health World Health Organization 14 acknowledged the importance of lead poisoning as a major environmental hazard and called for action to reduce children’s blood lead levels and to fulfill the Organisation for Economic Co-operation and Development Declaration on Lead Risk Reduction. The 2002 Bangkok Statement on Children’s Health and the Environment called for the removal of lead from gasoline (Suk, 2002). In 2005, the Health and Environment Ministers of the Americas agreed in the Declaration of Mar del Plata to “strengthen sub-regional and national actions to achieve a complete elimination of lead in gasoline and its reduction from other sources” (OAS, 2005). The 2006 Declaration of Brescia on Prevention of the Neurotoxicity of Metals recommended: the immediate elimination of tetra-ethyl lead from the gasoline supplies of all nations; the review of all uses of lead, including recycling, in all nations; and urgent reduction of current exposure standards (Landrigan et al., 2007). The 2009 Busan Pledge for Action on Children’s Health and Environment further affirmed the commitment of the global community to end childhood lead poisoning.


Akesson A et al. (2005). Tubular and glomerular kidney effects in Swedish women with low environmental cadmium exposure. Environmental Health Perspectives, 113:1627–1631.

Al-Saleh I et al. (1999). Determinants of blood lead levels in Saudi Arabian schoolgirls. International Journal of Occupational and Environmental Health, 5(2):107–114.

American Academy of Pediatrics Committee on Environmental Health (2003). Pediatric environmental health, 2nd ed. Elk Grove Village, IL, American Academy of Pediatrics. Amitai Y et al. (1987). Hazards of ‘deleading’ homes of children with lead poisoning. American Journal of Diseases of Children, 141:758–760.

 Amitai Y et al. (1991). Residential deleading: effects on the blood lead levels of lead-poisoned children. Pediatrics, 88:893–897. Baker EL et al. (1977). Lead poisoning in children of lead workers: home contamination with industrial dust. New England Journal of Medicine, 296(5):260–261.

Basha MR et al. (2005). The fetal basis of amyloidogenesis: exposure to lead and latent overexpression of amyloid precursor protein and ß-amyloid in the aging brain. Journal of Neuroscience, 25:823–829. Beattie AD et al. (1972). Environmental lead pollution in an urban softwater area.

British Medical Journal, 2(5812):491–493. Bellinger DC, Stiles KM, Needleman HL (1992). Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study. Pediatrics, 90(6):855–861.

Wednesday, November 8, 2017

Social Determinants of Mental Health Among Adolescents

In recent years, depression in childhood has increased attention for awareness among adolescence.13 Although it was believed that depression did not occur in children before the 1970s, recent studies 1,47  have proven that about 2%-8% of young adults experience their first symptoms at the age of 16.
For example, Hankin et al5 discovered that approximately, 6% of young adults in  the Dunedin study cohort met DSM-III8 diagnostic criteria for depression on at least one occasion by age 15. A similar rate was reported by Fergusson et al,4 who found that almost7% of 15-year-olds met DSM-III-R diagnostic criteria for depression.

The increase in the presence of depression among adolescences has led to a growing interest in the etiology, comorbities, and consequences of early-onset depression. For example; there has been evidence suggesting that young people showing signs of early depression or depressive symptoms are at high risk for several adverse outcomes, including further depressive episode,911 impaired social functioning,9,1216 low academic achievement,9,10,12,15,17,18 and a range of other mental health problems, such as anxiety disorders, substance abuse, and suicidal behaviors.12,15,1921 These linkages between early depression and later outcomes are thought to reflect the effects of early-onset depression on normal development and the continuities of depressed mood across time.9


Thursday, November 2, 2017

Prevalence of Mental Illness in Austrlia

Every year, there is an estimate that one of every five Australians experience mental illness. Mental illness is the third leading cause of disability burden in Australia, approximately 27% of the total years lost due to disability. 4% of people who experience depressive episode in 12-month are accounted to effected by mental illness, with 5% of women and 3% of men. 14% of Australians are affected by anxiety disorder within a 12-month period. While 3% of the Australian population are affected by psychotic illness; such as schizophrenia, where is loss of contact with reality during the episode of the illness.

2% of the population with mental illness experience eating disorder, which may occur during their life with women 9 times more than men. 5% experience substance abuse disorder in any 12-month period, men more than twice as likely as women to have substance abuse.

Prevalence of mental disorder decreases with age. The most affected age is between 18-24 years. Women are more prone in developing anxiety disorders (18% compared with 11%), and mood disorders (7.1% compared with 5.3%). A national survey proves that 35% of people with mental disorder have used mental health services and 29% consulted a GP within the 12 months before the survey. Women are more likely than men to receive medical services. In Australia, the prevalence of mental or behavioral disorders among people born abroad is similar to those born in Australia. May violent people have no history of mental disorder and most people with mental disorder (90%) have no history of violence.