Social inclusion is related to mental health in that its absence can lead to poor mental health, and poor mental health can also result in social exclusion. People with mental health problems are often stigmatized and excluded socially in the community… this should not be the case. Given their condition, they need all the support they can get from everyone around them, especially in their community.

Social inclusion is a phrase used to describe the extent to which people are carried along or feel engaged and involved in the activities within their community, based on their choices and preferences. To be socially included means to actively participate, have a sense of belonging, be accepted for whom one is, be valued, have significant roles and have social relationships. It is possible to be born, grow, work, school and live in a community without being, or feeling socially included- especially for people with poor mental health conditions. Social inclusion is a significant social determinant of health which increases the likelihood of happiness, healthiness, peace of mind and longevity. Simultaneously, the lack or absence of social inclusion results in depression, isolation, poor self-esteem and poor health- particularly poor mental health. Mentally challenged people experience life very differently as they are often ignored and do not have any “sense of presence or belonging” in the community. They may also lack access to information, facilities and activities they need, including education and healthcare- which in turn results in lack of opportunities to work, play, learn and participate socially or develop social relationships with people in the community.

Mental health consists of, and influences various components of an individual including the emotional, psychological, and social well-being. It determines one’s thoughts, feelings, action and participation as well as how a person handles stress, relates to others and makes choices. Everyone- including children, adolescents and adults, can be affected by mental health at any stage of life. Factors that affect mental health include genetic composition, life experiences, such as trauma or abuse and family history of mental health problems. Broad symptoms that may suggest an impending mental health problem include poor eating habit, low energy, numb feeling, unexplained aches, hopeless or helpless feelings, excessive use of drugs and alcohol, confusion, forgetfulness, anxiety, anger, worry, severe mood swings, hallucination, hearing voices, self-harm or the thought of it and fear.

Social inclusion can help youth with already existing mental health condition lead a healthier and happier life. It allows them reach their full potential, cope with the stress, work productively, participate and contribute meaningfully to their communities- irrespective of their condition. Connecting with people (social inclusion), in addition to inspiring positive thoughts, physical activity, sleeping and skill development are some common ways to support youths with mental health conditions. Since social inclusion is crucial for positive mental health, it is very important to address the barriers and challenges that reinforce it. Various pathways to social inclusion exist, and of particular significance is recreation due to the meaningful connections that recreation can facilitate.

An early pregnancy is typically classified as any pregnancy occurring in teenagers and adolescents, usually between the ages of thirteen and nineteen (13 and 19). Girls at this age are too young, unprepared and uniformed to manage their situation and progress towards safe delivery. Furthermore, their emotional, psychological and social needs are greater, and more delicate than those of older women. Early pregnancy is a global problem present in all social classes, and in many countries including high, middle, and low income countries. Worldwide, majority of teenage and adolescent pregnancies occur in developing countries, rural areas and marginalized communities. This is mostly caused by poverty, lack of education, early marriage, lack of employment and absence of relevant public health information. Over 20 million girls, below the age of 19 years, become pregnant and give birth in developing regions annually.

Many teenage and adolescent girls face social pressure to marry and have children; about 15 million girls marry by the age of 19 yearly, and they account for 90% of early pregnancies. For others, pregnancy and childbirth occur out of wedlock, so are neither planned nor wanted. Irrespective of marital status and intentions, the leading cause of death for 15-19-year-old girls globally is complications from pregnancy and childbirth. About 23 million girls in developing countries lack access to modern contraceptive; consequently, half the pregnancies among girls in these countries and regions are estimated to be unintended.

Despite the 0overall progress in the decline of global adolescent birth rate from 65 births per 1000 women in 1990 to 47 births per 1000 women in 2015 due to the growth of global adolescent population, projections show that the number of adolescent pregnancies will go up by 2030- particularly in Africa. More so, there has been unequal progress in reducing adolescent birth rates in various regions as shown below:

• 115 births per 1000 women in West Africa
• 64 births per 1000 women in Latin America and the Caribbean
• 45 births per 1000 women in South-Eastern Asia, to a low of 7 births per 1000 women in Eastern Asia

There are several health, social and economic consequences of early, teenage or adolescent pregnancy. It remains a major cause of maternal and child morbidity and mortality, it also results in intergenerational cycle of ill-health and poverty. Adolescent mothers have higher risks of infections, eclampsia and puerperal endometritis, compared to older women. In addition, about 3.9 million unsafe abortions occur among them each year, contributing to maternal mortality and long-term health problems. Babies born to adolescent mothers may have higher risks of low birth-weight, premature delivery and serious neonatal conditions. Adolescent pregnancies also have negative social and economic effects on girls, their families and communities at large. Single pregnant adolescent girls may experience stigma and rejection by their families and friends leading to school drop-out and limited opportunities for employment and self-development, often perpetuating cycles of poverty. Similarly, their married counterparts are more likely to experience domestic violence compared to older women.

The following can reduce early pregnancies and corresponding consequences:

• Delaying marriage until after the age of 18 years; it is estimated that about 10% reduction in child marriage could contribute to a 70% reduction in a country’s maternal mortality rate
• Creating awareness and providing support to reduce pregnancy in females less than 20 years
• Promoting abstinence or the accessibility and use of contraception by adolescents at risk of unintended pregnancy; this could avert a total of 2.1 million unplanned births, 3.2 million abortions, and 5600 maternal deaths annually
• Reducing forced sex and unsafe abortions among adolescents
• Increasing the use of skilled antenatal, childbirth and postnatal care among adolescents
• Introducing stern punishments for rape

Youths are the most populous group of individuals in the world today; even more so when considering the fluid and often broad definition of the word, youths. Consequently, this group possesses the power to shape the future of every society where they exist as well as the world at large. The UN projects that the economic growth following youth empowerment, education and employment will be unprecedented as seen in some Asian countries.
To experience the dividends and benefits of youths through empowerment, education and employment, countries must invest in empowering programs, affordable education and employment opportunities to the advantage of their young people. According to the UN, there are approximately 1.8 billion young people in the world today, representing a bewildering amount of human potential. Unfortunately, too many of them are trapped in poverty, with limited opportunities to go to school, work or learn a skill to earn a decent living. It is deeply disheartening that the group with the highest potential, given their age, strength, brains, population and willingness is often presented with the least opportunities for personal growth and development. A fact to buttress this point is that over 74 million young people worldwide cannot find work.
Given the many benefits of investing in youths, every country needs to make it a national priority.

Youth empowerment is defined as the outcome by which youths- seen as change agents, acquire the skills to impact their own lives, the lives of other individuals as well as their communities or environment. An example of a youth empowerment program is the YES program which uses a three-pronged approach that effectively engages youth in work that challenges them to develop skills, gain critical awareness, and participate in opportunities that enable them to create change. In the context of YES, skill development is the process of strengthening youths so that they know how to effectively make decisions, positively interact with their peers, and act as community advocates or change agents. Critical awareness involves providing resources such as training and information that equip youths to better analyze issues that affect their lives and communities as well as strategize on ways to change them to their advantage. Opportunity means availing youth with platforms for engagement, decision-making and encouraging their active participation in creating community change

Youths desire and deserve better options and opportunities in life. To express this, many of them take risks by migrating, engaging in illegal businesses, sex trade or robbery in order to afford a decent life. The means by which youths are engaged today determines the prospects for future sustainable development. Taking advantage of the potential of youths as change agents requires involving and empowering them in development, education, employment, policies as well as supporting their participation at all levels. If youths in developing countries such as Nigeria are given the opportunity to realize their full potential, there would be significant economic gains. The more young people grow into well-educated adults, the more they are able to accelerate economic growth and development. It is estimated the African continent in general would add up to about $500 billion per year to its economy for as many as 30 years, if youths are given their rightful place.

What is participation/youth participation?

Participation is a fundamental human right- everyone deserves an opportunity to engage meaningfully in his or her community. It involves engaging and taking part in social, economic, financial and physical developmental activities that occur in a given community and society.  Active participation empowers young people and enables them to play vital roles in their personal development as well as in that of their communities. It also helps them to acquire vital life-skills, develop knowledge on human rights and promote positive community action. To effectively participate in any community, young people must be empowered and given the proper tools including information, education and accessibility. To ensure that youths participate in decision-making is a priority area of the UN agenda on youth.

How can youths participate and in what ways can they do so?

It is important to collectively and better understand what youth participation involves as well as how it can be implemented for youths of all ages. In any society, it is a well-known fact that youths are the major human resource for development and key agents for social change, economic growth and technological innovation. Youth participation can be strengthened by ensuring that youths are involved in every aspect and stage of activities including planning, implementation, monitoring, reporting and evaluation of instruments, strategies and programs. Additionally, youth participation can be improved through several approaches such as education, information sharing and capacity building. Using old and modern inclusive technology mediums such as short media messages and internet, youth-friendly information and resources can be developed by or with young people themselves. This gives them some sense of belonging and helps them understand their importance and relevance. When youths are involved in planning and decision-making, activities are more likely to be attractive, relevant and enjoyable for them. Involvement increases the efficiency, effectiveness of programs as well as their attendance, display good behavior, improved self-esteem and skill acquisition. It is also essential to involve every youth including youths with disabilities.

What are the benefits of youth participation?

To guarantee the perpetuation of youth participation, United Nations adopted the World Programme of Action for Youth (WPAY), an international strategy to more effectively address barriers, and increase opportunities for participation in the society. Subsequent WPAY resolutions deal with policies and programs that involve youth and promote their participation in social and economic development. Youth participation is important and has benefits for the young people themselves, the youth group and community as a whole. Young people become more confident and enthusiastic when they see that their views are being taken seriously and acted upon. Finally, youth participation strengthens personal and social development and promotes a more democratic society.

Gender parity can be defined as a numerical concept used to express gender equality. It is related to gender equality in that it’s used to express relative equality in terms of numbers and proportions of women and men or girls and boys. It is often calculated as the ratio of female-to-male values for a given indicator or factor. It can also be referred to as sex or gender ratio when males-to-females ratios are calculated. When compared to gender equality, gender parity describes the contribution and numerical representation of women and men in every dimension of life, including private and public sectors.
One of the major aims of gender parity is to increase the participation of women and lay a foundation for economic prosperity. Increasing the economic participation and advancement of women is essential to ensuring this strong foundation. This is because women account for about half the global labor supply and about 70% of global consumption demand. Ensuring and maintaining gender parity in educational and employment opportunities fosters faster and more inclusive growth because women are more likely to invest in the human capital of their families. Despite being near parity with men in health and education throughout much of the world, women still lag behind in economic participation and opportunity by about 20% in many societies.
Gender parity index (GPI) is a purely numeric value which gives information on the ratio of female to male values of a given indicator. Like every other ratio, the GPI value is obtained by a simple mathematical calculation of dividing the female value of an indicator by the male value of the same indicator using the given values of the indicator. The aim of GPI is to measure the progress towards gender parity in education participation and/or learning opportunities available for females in relation to those available to males. The significance and importance of GPI lies in the interpretation of the value obtained after the calculation. In general, when GPI value equals 1, it signifies parity or evenness between females and males; when GPI value is less than 1, it indicates disparity which favors the male gender while a GPI value greater than 1 indicates a disparity which favors the female gender. However, in some cases where the direction of the GPI interpretation ideally approach 0% (such as dropout and illiteracy rates), a GPI of less than 1 indicates a disparity which favors females while a value greater than 1 indicates a disparity which favors the males. One limitation of GPI is that it does not show whether improvement or lack of it is due to the performance of any of the gender groups. Furthermore, the interpretation of GPI requires trend analysis of the underlying indicators to make complete sense of it.
The United Nations Secretary-General, António Guterres, made the quoted statement below to illustrate the significance of Gender Parity…
“Gender parity at the United Nations is an urgent need and a personal priority. It’s a moral duty and an operational necessity. The meaningful inclusion of women in decision-making increases effectiveness and productivity, brings new perspectives and solutions to the table, unlocks greater resources, and strengthens efforts across all the three pillars of our work.”

Violence can be defined as a form of abuse which involves the intentional use of force or abuse of power, either through verbal threats or actual physical contact, against oneself, another person or a group. Violence and other forms of abuse are most commonly viewed as patterns or forms of behavior intended to establish and maintain control over a person or group of people, reflecting some level of power imbalance between the victim and the abuser. Most forms of violence are rooted in the many types of inequality which continue to exist and grow in societies. Acts of violence may take any of the following forms including Physical, Sexual, Emotional, Psychological, Spiritual, Cultural, Verbal and Financial abuse- resulting in injuries, poor mental health, disability or death. In their various forms, violence and abuse severely affect individual health and impact their well-being. Common victims of violence include oneself, spouse, family or household members, friend, opposition or foe, intimate or estranged partners, colleagues, individuals or groups. This illustrates that most violent offenders are familiar to their victims, however, acts of violence and abuse can also be committed by complete strangers. Violence may occur only once or frequently, escalating over a period of time.

Gender-based violence is any form of violence or abuse rooted in gender differences, disparities or inequalities including gender identity, expression or norms, unequal power relationships and perceived gender. It is sometimes referred to as “violence against women”, since most cases of gender-based violence are inflicted on women by men. Gender-based violence is a global problem, affecting one in every three women according to a 2013 data from World Health Organization (WHO). Gender-based violence is one of the most common human rights violations worldwide- surpassing social, economic and national boundaries. It refers to any act that is perpetrated against a person’s will including threats of violence and coercion. It can be physical, emotional, psychological, or sexual in nature. The consequences of gender-based violence are severe for its victims, yet it remains masked in a culture of silence and negligence. These victims suffer sexual and reproductive health problems, including forced and unwanted pregnancies, unsafe abortions, traumatic fistula, sexually transmitted infections such as HIV, and even death.

United Nations Population Fund (UNFPA) and WHO work to consistently promote gender equality and women empowerment as well as to address the physical and emotional consequences of gender-based violence. Non-governmental organizations such as UNFPA and WHO mentioned above, offer programs that provide therapeutic assistance, psychological support, medical treatment and rape kits to survivors. These organizations also aim to promote the right of women and girls by empowering them to live free of different forms of violence and abuse.

Social Integration is defined as the process by which social minority groups including racial minorities, refugees and underprivileged persons move into the mainstream of societies. Social integration requires that these individuals become proficient in a national common language of the society, accept and abide by all the laws of the land as well as adopt and practice the set of values associated with that society. It ensures that individuals and groups unite in communications and actions, resulting in a common understanding of one another and the society at large. Social integration does not mean that people have to change who they are and become what they’re not. However, it means that they learn to accommodate, tolerate, accept and respect other groups in the society while identifying with the majority ethnicity as the common way of living. Social integration is a naturally occurring phenomenon which increases peace, unity and cohesiveness in a society, giving everyone a sense of belonging. The only detriment of social integration is that children and adolescents born in different racial societies may lose their original racial identity.

Economic integration, on the other hand, is an organized economic arrangement between regions and countries that often include the reduction or elimination of trade barriers as well as the coordination of financial and fiscal policies. The major purposes of economic integration are to reduce costs for both consumers and producers and to increase trade between regions and countries involved in the agreement. Generally, there are fewer barriers to trade and increased political and economic coordination between these regions. Benefits of economic integration include reduction in the cost of trade, increased employment opportunities and stronger political cooperation. Reduction in the cost of trade increases the availability and selection of goods and services which leads to greater purchasing power. Additionally, employment opportunities improve because liberalization of trade increases market expansion, technology sharing and cross-border investment flows. Finally, economic integration increases political cooperation among countries because it leads to stronger economic ties, which can potentially help in conflict resolution and greater stability. Irrespective of the above mentioned benefits, however, economic integration can occasionally lead to trade diversion, resulting in the deterioration of national sovereignty.

As seen in the preceding paragraphs, social and economic integration play unique and significant roles in increasing and maintaining unity within and amongst countries. These factors favor and improve globalization, the increased interconnectedness and interdependence of peoples and countries- a major backbone of global civilization.

Right is an important issue as everyone has some basic human rights including adolescents. These rights often come with a corresponding responsibility to uphold the rights of others such that one person’s right doesn’t interfere with another’s. Knowing and understanding our rights as human beings is essential to preventing bulling and many forms of abuse. For adolescents specifically, reporting to an adult or appropriate authorities is a brilliant way to handle different forms of abuse.

Thefollowing are some basic adolescent rights, and the responsibilities that correspond to them:
• Right: To be cared for and protected by a family.
Responsibility: To care for and respect your family.
• Right: Freedom of speech.
Responsibility: Accord respect to what others say, even if not in agreement.
• Right: To food, shelter, and a healthy environment to live in.
Responsibility: To value and take care of these resources.
• Right: To health care.
Responsibility: To take care of one’s health, and protect oneself from disease.
• Right: To be protected from maltreatment, neglect, abuse or degradation.
Responsibility: To report any act of abuse to oneself or others
• Right: To education.
Responsibility: To make the most of the schooling.
• Right: To equality – this means that people shouldn’t treat adolescents differently based on things like sex or gender, disability, sexuality, race or culture.
Responsibility: To do the same for others, too.

The Convention on the Rights of the Child (CRC) outlines the rights of adolescents and upholds them as the innate benefit of both girls and boys. UNICEF is guided by the CRC and mandated to invest in adolescents as rights-bearers and a marginalized population. The United Nations Joint Statement on adolescents emphasizes the understanding that healthy, educated and skilled adolescents will help build a better future. As the future of the society, adolescents represent a vital part of the population and their empowerment and protection has broad and significant impacts on their behaviours and the society at large. Adolescent girls have a right to education because girls who stay in school, marry later and delay childbearing- having healthier children and being able to earn better incomes that benefit themselves, their family, community and nations.

These past weeks we’ve deliberated on the topic, Adolescent health- discussing various aspects of their health including physical and sexual health. In this write-up, we’ll focus specifically on the sexual health of this group- particularly in the areas of sexual behaviour. Some negative sexual behaviors among adolescents include unprotected sex, sex experimentation and having multiple sexual partners. These behaviors in turn result in unwanted pregnancies, sexually transmitted diseases (STDs) and sex addictions.

Sexual health problem in adolescents is indeed a global matter because it affects all countries and races alike. Additionally, adolescents behave in similar predictable patterns irrespective of their origin or location. Consequently, this group constitute significant sexual disease burden globally. Adolescents engage in negative sexual behaviors for several reasons. First, they’re young, naïve and unable to make good judgment and decisions due to lack of understanding or experience. Secondly, many adolescents are irresponsible and careless because they’re not accountable for their actions and behaviours as their parents are still responsible for them. Thirdly, peer influence is a common reason why adolescents engage in sexual behaviors members of their group consider trendy. Finally, a study on the influence of genetic composition on adolescent behaviors reveals there are unique individual differences due to genes, among adolescents in how and when they become sexually active adults as well as the behaviors they adopt.

Sexual risk behaviors such as unprotected sex place adolescents at risk for HIV infection, other STDs and unwanted pregnancies. According to CDC, approximately 230,000 babies were born to adolescents in 2015. More so, 20 million new STDs are reported annually among adolescents, who also account for about 22% of all new HIV diagnoses in the United States. Data from the Youth Risk Behavior Surveillance System (YRBS), which monitors health risk behaviors in adolescents showed low rates of testing for HIV, high rate of substance use preceding sexual intercourse, low rates of condom use during sex and multiple number of sexual partners.

To reduce sexual risk behaviours and associated problems among adolescents, there’s need for a global education about HIV and other STDs. This includes knowing and understanding their transmission and prevention, as well as which behaviors place individuals at greatest risk for infection. STDs awareness and education should be universally integrated into all forms of educational environments to reach this group.

Substance misuse or abuse is defined by World Health Organization as the harmful or dangerous use of psychoactive substances, including alcohol, illicit drugs and other substances. The use of these substances can lead to a medical condition known as dependence syndrome. Dependence syndrome refers to a cluster or variety of behavioural, cognitive, and physiological phenomena that develop following the repeated use of illicit substances and prescription drugs. Symptoms of this condition typically include: strong recurring desire to take psychoactive drugs, difficulty controlling use, persistent use irrespective of harmful consequences, prioritizing use at the detriment of other activities and obligations, increased tolerance, and occasionally, a physical withdrawal state.

Misuse of illicit drugs and other substances hinders the ability of adolescents to grow, develop and reach their full potential in life. In addition to being an exciting stage of life- filled with self-discoveries and youthful exuberance, many adolescents continue to mature and develop physically. They also become adventurous and experimental with drugs, trying out many new things which may compromise their health. This is why many unhealthy behaviors such as substance misuse are often started during adolescence and continue into adulthood, contributing to the global burden of addiction morbidity and mortality.

Drug or substance misuse in adolescents is on the rise and has become a global concern because it exposes them to dangers from the drug and associated risky or unhealthy behaviors. It is also likely to result in increased drug use in the future. Parents and guardians need to monitor this group and not overlook occasional instances of drug misuse and their significance. Substance misuse has long-term impacts on the developing brain of teenagers and may interfere with family, positive peer relationships, and school performance. The impairment of brain development and function due to drug use by adolescents may result in the present or subsequent development of substance use disorder in adulthood. It is therefore important to identify and intervene in drug use early.

National and global policies which favorably and positively influence the levels and patterns of substance use and consequent harm can significantly reduce the public health problems attributable to substance use. Additionally, interventions at the health care system level can support affected individuals towards health restoration, harm reduction and eventually, quitting substance use. There is need for a collaborative effort that engages multiple partners including government and non governmental agencies, community and international organizations to make recommendations on adolescent health, provide high quality age-appropriate health services and design adolescent focused substance misuse interventions. Given the age of adolescents, the school environment remains the best place to develop healthy behaviors since schools have direct contact with millions of them daily. Research also supports that school health programs reduce the prevalence of risky behaviors among young people as well as have a positive effect on academic performance.