Background of Adolescents and Their Health-related Behaviors
Adolescence, a critical developmental phase, represents the transition from childhood to adulthood and is marked by significant physical, psychological, and social changes. According to the NDHS 2022, adolescents in Nepal make up about 23% of the total population, underscoring the importance of their health and well-being as a public health priority. The behaviors established during adolescence often persist into adulthood, influencing long-term health outcomes. Adolescents in Nepal exhibit various lifestyle patterns that impact their health and well-being. The factors like physical activity levels, dietary habits, and sleep characteristics play crucial roles in determining health status among Nepalese adolescents.
Adolescents in Nepal exhibit lifestyle patterns that significantly contribute to the prevalence of non-communicable diseases (NCDs). Research indicates that a considerable proportion of school-going adolescents engage in behaviors such as physical inactivity, unhealthy diets, and substance abuse, which collectively increase NCD risk factors. The burden of NCDs in Nepal is escalating, with notable prevalence of risk factors like smoking, alcohol consumption, and physical inactivity among young adults. Research shows that addressing health-risk behaviors established during adolescence can prevent or delay approximately 70% of premature adult deaths and the onset of non-communicable diseases like diabetes, obesity, and cardiovascular diseases (Dhakal et al, 2022). Moreover, unhealthy dietary habits and insufficient physical activity are recognized as major global risk factors for NCDs, underscoring the necessity for interventions aimed at lifestyle modifications among adolescents to mitigate the rising NCD burden in Nepal.
Lifestyle Patterns of School-going Adolescents
Physical Activity and Sedentary Behavior: Research has identified low levels of physical activity among Nepalese adolescents. Contributing factors to physical inactivity include limited break time at school, a lack of parks or recreational facilities, and gender disparities, with adolescent girls being less physically active than boys. Additionally, adolescents report high levels of sedentary behavior, such as excessive screen time and prolonged sitting activities. The prevalence of physical inactivity among school-going adolescents of Kathmandu Metropolitan City was found to be 72% (Tandon et al, 2022).
Dietary Habits: Nepalese adolescents display a diverse range of dietary patterns, encompassing healthy, junk food, and traditional food consumption. These dietary behaviors are influenced by various factors, including socioeconomic status, behavioral elements such as screen time and pocket money, and environmental aspects like the availability of fruits and vegetables at home. Notably, many adolescents have inadequate consumption of fruits and vegetables. The prevalence of unhealthy diet among school-going adolescents of Kathmandu Metropolitan City was found to be 41% (Tandon et al, 2022). Inadequate nutrition places adolescents at a high risk of developing chronic diseases, although the harmful effects often manifest later in life.
Substance Abuse: Substance abuse, including drugs, alcohol, and tobacco, has been increasing among Nepalese adolescents over the past two decades, often starting between ages 12 and 25. Commonly abused substances include marijuana, phensidyl, chemical compounds, and alcohol. Key factors driving this trend are peer pressure, curiosity, lack of awareness, family environment, mental health issues, and easy access to substances. Research shows that 11.6% of adolescents use tobacco and 16.3% consume alcohol, with gender, age, pocket money, and living arrangements influencing the usage of substance abuse (Sapkota and Paneru, 2021).
Mental Health: Mental health among school-going adolescents in Nepal is a significant concern, with studies indicating varying levels of emotional and behavioral problems (EBPs), anxiety, depression, and suicidal ideation. Academic pressure, familial expectations, and the socio-economic environment significantly influence adolescents' mental health. Research has found that 12.9% to 17.03% of school-going adolescents in Nepal exhibit emotional and behavioral problems (Banstola, 2017 and Timalsina, 2018). Other factors associated with these mental health issues include age, family structure (e.g., nuclear families), family conflicts, physical/verbal abuse, high academic stress, and low family income.
Possible Interventions
A comprehensive, multi-stakeholder approach targeting the school, family, and community environments is crucial to effectively address the diverse lifestyle challenges faced by school-going adolescents in Nepal.
- Comprehensive Health Education: Implementing school-based health education programs through the help of subject expert that cover nutrition, physical activity, substance abuse prevention, and mental health can equip adolescents with the knowledge to make healthier choices.
- Promotion of Physical Activity: Increase opportunities for physical activity in schools, such as longer recess periods, physical education classes, and access to sports facilities along with community initiatives helps to promote active lifestyles through sports clubs and events.
- Nutritional Interventions: The school-based nutrition education programs should be introduced to improve adolescents' knowledge and attitudes towards healthy eating involving both parents and students. The relevant stakeholders in nutrition sector should work with schools to provide healthier food options in canteens. Engage parents and communities to support the availability of affordable, nutritious foods at home.
- Mental Health Support: Strengthen school-based mental health screening, counseling, and referral services along with training to teachers and school staff to identify and support students with mental health issues. Implement school-based mental health promotion and prevention programs, such as peer support initiatives.
- Substance Abuse Prevention and Control: Enhance school-based drug and alcohol education programs to increase awareness about the associated risks. Strengthen the enforcement of regulations concerning the availability and sale of substances near schools. Provide comprehensive counseling and treatment services for adolescents dealing with substance abuse.
- Policy and Regulatory Measures: Stronger regulations to control the advertisement and sale of unhealthy foods and substances to adolescents are essential. Government policies should also support the development of recreational facilities and mental health services for adolescent at reasonable cost.
Conclusion
Addressing the health and lifestyle challenges of school-going adolescents in Nepal is crucial for their long-term well-being and reducing the burden of non-communicable diseases (NCDs). Adolescents, who make up a significant portion of Nepal's population, face alarming levels of physical inactivity, unhealthy dietary patterns, substance abuse, and mental health issues, all contributing to rising NCD risk factors. Effective interventions include comprehensive school-based health education, promoting physical activity, improving nutrition, providing mental health support, and enhancing substance abuse prevention programs. Strengthening regulations and policies around the availability of unhealthy foods and substances, and developing recreational and mental health facilities, are essential. Collaborative efforts among schools, families, communities, and policymakers can create a healthier environment for adolescents, benefiting their immediate and long-term health and productivity.
References
Ministry of Health and Population, Nepal. (2023). Nepal Demographic and Health Survey 2022. Kathmandu, Nepal.
Dhakal, P., Bhandari, T.R., Paudel, R. and Timilsina, K., Prevalence of risk factors of non-communicable diseases in young adult populations of Shuklagandaki Municipality, Tanahun District, Nepal.
Tandon, K., Adhikari, N., Adhikari, B. and Pradhan, P.M.S., 2022. Co-occurrence of non-communicable disease risk factors and its determinants among school-going adolescents of Kathmandu Metropolitan City. PLoS One, 17(8), p.e0272266.
Sapkota, N. and Paneru, D.P., 2021. Prevalence and correlates of tobacco and alcohol use among adolescents in Nawalpur district, Nepal. Journal of Chitwan Medical College, 11(4), pp.14-17.
Banstola, R.S., 2017. Research Article Psychosocial Problem among School-going Adolescents in Pokhara, Western Nepal. Journal of Interdisciplinary Studies, p.122.
Timalsina, M., Kafle, M. and Timalsina, R., 2018. Psychosocial problems among school going adolescents in Nepal. Psychiatry journal, 2018(1), p.4675096.
