Welcome to Our Inaugural Issue!

(MUCU) are pleased to introduce you to the FIRST of our biannual adolescent newsletters! We are delighted that you have expressed an interest in the care of the adolescent patient. Each newsletter will explore a different issue facing adolescents in Uganda and the surrounding countries in East Africa. OUR MISSION is to provide a forum to share member news, interesting program updates, clinical cases, and discuss the latest in " hot " adolescent topics.

more than 55% are less than 18 years.The population of adolescents continues to grow.Uganda has a very high birth cohort of 1 million per annum and a fertility rate of 6.2 per childbearing woman.Despite the presence of tertiary and regional hospitals in the country, and the presence of well-regarded medical schools in Uganda, there has been an overwhelming neglect of adolescents in the health care system.
In the United States, the birth of Adolescent Medicine began with the vision of one man, J.R. Gallagher, a physician trained in internal medicine and cardiology, who had no formal training in adolescent medicine.During the great economic depression of the 1930's, he found work as a school physician.He recognized that adolescents had their unique strengths and vulnerabilities and would benefit from having a doctor of their own.Dr. Gallagher went on to create the first adolescent clinic in 1951 at Boston Children's Hospital, in the U.S. Sixty years later, multiple adolescent services and training programs exist throughout the country, highlighting how commitment can transform care.
We are confident that your commitment to improving the care of the adolescent patient is what will drive improved services in your location.Thank you for your ongoing participation and we look forward to hearing about member news, your programs, and interesting cases so we can share them in future newsletters.Its mission is to serve as a "medical home" for adolescents; a place where they can be confidentially evaluated, treated and guided through their transition into adulthood.
Young people are our futurethe future workers, parents and leaders of our nations.Yet over the last 50 years, global, social, economic and political changes have adversely affected young people's health, to the extent that adolescence and young adulthood are no longer the healthiest time of life.
The MMCA is accepting both walk-in adolescent clients and referrals.
Standard referral procedures should be followed. Clinic

Medication adherence:
Psychological distress and self-efficacy, defined as an individual's confidence in their ability to take their medication, have been shown to be associated with medication adherence in HIV positive youth (4).Other possible explanations for failure of medication compliance in adolescents include poorer pharmacy refill adherence compared to adults and lack of social support (5).

Safety:
Assessing for safety is important to include during all adolescent visits.If a patient is found to be in an unsafe situation putting plans into place to assure safety is necessary.If available, a sexual/physical abuse referral to the child protection unit would be advised.

Mood state:
Adolescent mothers may be at risk of greater rates of depression compared to older mothers.One thought as to why adolescent mothers have a greater risk of depression is that the teens tend to be less psychologically prepared for pregnancy and this may trigger depression (2).This not only affects the individual but potentially may comprise the care of the infant.

Education:
Many societies do not allow adolescent girls who become pregnant to stay in school.
Because of advocacy for the rights of female adolescents in Uganda, adolescent mothers recently have been allowed to return to school after delivery (6).As noted by the World Health Organization (WHO), supporting education for teen mothers is desirable and overall it is beneficial to both the mother and the baby by providing social, economic, and health benefits to both.

REFLECTION:
Teenage pregnancy remains a recalcitrant problem in Uganda.For change to occur, the first thing that needs to happen is that the problem needs to be uncovered and acknowledged.Once this occurs, providers can begin to confidentially dialogue with their adolescent patients so as to determine the risk profile of each patient seen.(15).Almost all unsafe abortions occur in the developing world and adolescents aged 15-19 years account for 25% of all unsafe abortions in Africa (16).Currently, abortion is illegal in Uganda except under exceptional circumstances that include saving the life of the woman, or preserving her physical and mental health (17).Unwanted and unplanned pregnancies in adolescents coupled with the high teenage pregnancy rates contribute to the high incidence of abortion.
Although abortion is illegal, between 15-23% of Ugandan females aged 15-24 years who have been pregnant have had an abortion and Ugandan adolescents represent 25-33% of females hospitalized for abortion complications (18,19).In Mulago hospital in Kampala, Uganda, almost 50% of the women who died from abortion complications were adolescents (20).Additionally, adolescents tend to seek abortion later than their older peers and are more likely to use unskilled providers.
Latest In….
Teen Pregnancy in Uganda: The Facts

Useful Adolescent Websites
American Social Health Association: http://ashastd.org/ The Society of Adolescent Health in Uganda (SAHU), was launched in November 2012, following a regional training in Kampala, Uganda, that was led by experts from Columbia, and Makerere Universities and the Naguru Teenage Center.The purpose of SAHU is to improve adolescent medicine in Uganda by promoting research, training, clinical care and advocating for best practices.The goal is for SAHU to hold its first Annual Scientific Meeting at the end of 2013, in Kampala.
(14)escents 16 years or younger face four times the risk of maternal death compared to women older than 20 years, and the rate of neonatal death is about 50% higher(14).Additionally, pregnancy can interrupt education.Of females aged 12-19 years who dropped out of school, 10% identified pregnancy as the cause