1.1 FAMILY PLANNING
1.1.1 What is family planning?
1.1.2 Why family planning? -benefits of FP
1.1.3 Who should do family planning?
1.1.4 When to start family planning?
1.2 SAFE MOTHERWOOD
1.3.1 Condom/Barrier Methods
1.3.2 Pills and Injections/Hormonal Methods
1.3.3 Natural Methods
1.3.4 IUD, IUCD, Coop and coil/Intrauterine
1.3.5 TL, Vasectomy/Permanent Methods
2.1 HIV/AIDS AND STIS
2.1.1 Characteristics of HIV
2.1.2 Types of HIV
2.1.3 Mode of transmission
2.1.4 Drugs and Substance Abuse
2.2 TYPES OF STDs and Signs
2.2.4 Genital herpes
2.2.6 Myths and Facts
3. SEXUAL AND GENDER BASED VIOLENCE (GBV)
3.1 Forms of GBV
3.2 The Damage
3.3 Sexual Harassment
4. YOUTH (PUBERTY)
Children are requirement for survival for human race, unfortunately many of them dies from infection, malnutrition and other diseases .In the past it was necessary for parents to have many children to ensure that at least some would survive to become adult. But time has changed and it’s justifiable to raise the question: How many children can we afford? How many children should couples have or should be that one left to GOD? Should parents actually choose the number of children they want and when to have them? How fast can a country, a city, a village, or even a family increase its number without harming its on well being and development?
Economist, sociologist, politicians agriculturalist, planners and others around the world are now asking these questions: Many are concerned about the long-term effect of the current rate of population growth .Introducing population programme which incorporate FP or child spacing is not a substitute for other methods of development; it is essential part of any comprehensive development plans and needs to be considered and embraced by each individuals. While overall policy is a matter for individual family members, there is no question about the immediate health advantages of family planning and health workers and those who serve as bridge between experts and young people; also illiterate people or women who are too timid or shy to seek an advisory services, should focus their attention and efforts on this.
Even more important than the children who die are those who survive, but without the chance to develop to their full physical and mental potential. During pregnancy and for the 1st 1-2 years after birth, the child’s brain and nervous system, as well as other parts of the body, growing rapidly without adequate nutrition, the child’s overall development may be permanently affected so he/she can never be as clever or physically strong as he/she should be. This is also true of child personality which is also being formed in the early years without sufficient love and emotional support from his or her parents, he /she may suffer psychological trauma and never develop emotional maturity and stability.
It is not only the newest baby who suffers when too many children are born too close together.
An older child must be prematurely weaned when a new baby is coming and this can result in mal nutrition for that older child because the food on to which he/she weaned may not be sufficient for proper growth. The breast milk contains antibodies that protect a baby against infection. When the baby is not breastfed long enough because his/her mother is pregnant again, he/she is deprived of this antibodies and therefore becomes susceptible to infections.
The father needs to understand the ill effect of short birth intervals. He is responsible for providing for his family and this becomes increasingly difficult with more children.
Some fathers believe many children are needed to cultivate the land or to find employment and bring it money for the family, but a new born baby or even an alder child is not yet a worker and must be cared for by his/her parent and the community (what does a child need?) some parents fear that if they do not have many children, there will be no one to look after them when they grow old. They must be helped to realize that present-day health services mean more of their children will now live to support them in their old age. Fewer children spaced further apart will enable the father to feed, clothe and educate them better so they can take a useful place in the society.
a child has social fundamental rights to access and receive social services like education, healthcare, love and care, security, life to development, health and health services religious education, free and compulsory education etc. its fundamental rights are mandatory and can only be achieved, met and provided for the child if the family is small and proportional to the resources available.
a family can thrive well if the resources available can meet their fundamental requirements, demands and obligations and hence surplus for income growth.
1.1 FAMILY PLANNING
1.1.1 What is family planning?
Family planning involves consideration of a number of children a woman and a man wishes to have, at what age and when.
It enables people to make informed choices about their sexual and reproductive health!
Reproductive health implies that people are able to have a responsible, satisfying and safer sex and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.
It is achieved through empowerment and use of contraceptives methods. Family planning saves life.
1.1.2 Why family planning? Benefits of FP
Family planning contributes to reduce the population growth, unplanned pregnancies and the spread of HIV/AIDS among couples, women and youths. Also it promotes body awareness.
Every year half a million of women die of problems of pregnancies, child birth, and unsafe abortion. Most of these deaths can be prevented by family planning.
The main burden of raising children usually falls on the mother. A woman needs to be physically and mentally healthy to provide her child with a good start in life. Children born after a short birth interval have higher neonatal and infant mortality rates. She needs a good diet and an adequate interval before the next pregnancy.
If she does not have this good diet and interval, the next baby will receive inadequate nutrition while it is developing in the uterus. As the birth intervals lengthens, chances of survival increase.
As well as saving lives family planning has other benefits:
- Mothers and babies will be healthier, because risky pregnancies are avoided.
- Fewer children mean more food for each child.
- Waiting to have children give time to young women and men to complete their education, work outside the home and achieve their future goals. A low level of education reduces a young women access to jobs and income opportunities.
- Men can pursue education and jobs without pressure of providing for a family.
- Help you and your partner enjoy sex more, because you are not afraid of unplanned pregnancy.
- It allows couples to plan safer pregnancies that reduce risks for HIV or STIs and for mother-to-child transmission. It increases the chance of healthy pregnancy.
Family planning can prevent dangers from pregnancies which are:
Too soon: Women under the age of 17 are most likely to die in childbirth because of their not fully grown bodies. They have a greater chance of dying in the 1st year. Young women especially those under age 15, are more likely than women aged 20 to experience premature labor, spontaneous abortion (deliberate act of removing the fetus before it has the capacity to grow) or miscarriage (it is when abortion happens but is it not deliberate).
Too close: A woman body needs time to recover between pregnancies.
Too many: A woman with more than 4 children has a greater risk of death after childbirth from bleeding and other causes.
1.1.3 Who should do family planning?
- Young women and men
- Unmarried people
- Married Couples
- The Father (the father needs to understand the ill effect of short birth intervals. He is responsible for providing his family.)
1.1.4 When to start family planning?
When a boy or a girl is sexually mature. Puberty is the time when the bodies of boys and girls change. Bodies grow bigger and taller; sex organs mature and hair often start growing in new places. During puberty, a girl is able to become pregnant and a boy is able to father a child. New chemicals produced by the body called hormones, creativenesses in the body and turn young people in to adults.
1.2 SAFE MOTHERHOOD
Safe motherhood is a state of being a mother without risk or without physical danger.
Complications during pregnancy and child birth are the most common causes of death of women in childbearing age.
6 preconditions for healthy motherhood:
- Family planning, spacing method:
Every birth is a major burden for the health of a woman. The uterus becomes overstretched to its maximum to each pregnancy. Too frequent pregnancies inhibit the intractability of the uterus and heavy bleeding are the consequence. After birth, through the intractability of the muscles, it must be able to contract again as much as possible to prevent bleeding after birth in the postnatal period and during the next pregnancy.
- Prenatal care:
When you learn that you are pregnant get in touch with a doctor as soon as possible. You want to make sure that your child arrives safe and in a good shape. By seeing a doctor, you can be certain your health is good and you will raise your chances for a safe pregnancy and a healthy baby. The Doctor do a Blood test (haemoglobin control), blood pressure checks, urine tests, ultrasound (hear beat, position and growth of the child, localization of the placenta), HIV test, malaria test.
- Assisted birth:
During each birth, there can be unexpected complications like: bleeding wrong position of the child, infection, birth stand still, cramps, prolapsed umbilical cord. Life saving measures can be initiated immediately.
- Mothers therapy:
Through Mothers Therapy, women have the possibility to express their fear and their pain. They can be accompanied mentally and physically and can ask many questions. Different Tests are available for them during their pregnancy. These Tests may reduce the risk of birth defects and help a safe development of pregnancy.
Blood tests can be performed to diagnose genetic diseases. Women who suffer from chronic illness, such as diabetes, hypertension, thyroid function disorders, should be informed by their Doctors and give them what they needed. Their Doctors provide them with sufficient vitamin supplies if they suffer from deficiency.
- Immediate protection of the child:
Young babies are particularly vulnerable and need particular attentions like: blood checks, antibiotic, incubator artificial respiration etc. Risks and vulnerabilities should be indentified at the earliest age. It is important to have a contact with professionals during the pregnancy. The first opportunity to have a healthy child come before he/she is born.
- Postnatal care:
The postnatal care is a very important period for the mother as for the new born. Most maternal and infant deaths occur during this time. This should not be neglected. Postnatal care gives special care to the mother and the baby. After childbirth, it is important that the mother and the baby receive a postnatal examination within the 24 hours. These Women can ask many questions and receive advices and recommendations (like pelvic floor exercises in order to prevent later urinary incontinence). It empowered the women, reassure them and make them feel supported.
Since ancient times, methods have been used to prevent or delay pregnancies: we call it Birth control. Since the 20th century, the number of effective and safe methods of birth control that become available, have increased. Using birth control is part of the family planning. Some cultures are against the access of birth control because they consider them as immoral, unreligious and against nature.
Birth control has a lot of benefits:
- It improves child survival by lengthening the time between pregnancies.
- It can help you to protect yourself against STDs and HIV (condoms).
- Contraception reduces the need for abortion (unsafe abortion)
- It reinforces people’s rights to determine the number of their children and the spacing of pregnancies.
- The health risks related to pregnancy are lower.
- Family Planning and contraceptives enables people to be more informed about pregnancy and sexuality.
- Having a smaller family allows parents to invest more in each child that they have.
There are lots of different methods. There are advantage and disadvantages to every method, so it’s important to help each couple select the method that will fit the best for them.
Five different factors to be considered when selecting a child spacing method:
- Effectiveness: how successful is the method in preventing conception when it is used regularly as instructed?
- Acceptabilityto the couples concerned: how easy it is to use and does it interfere with normal sexual activity?
- Availability: how easily and continuously can supplies be obtained?
- Side effects: what side effect may occur and what is their significance?
- Reversibility: how easy can a woman conceive after the method is stopped?
The success of a particular method depends on all these factors, but an effective method cannot work if it is unacceptable or unavailable. An acceptable method that is easy for use will not be continued if it is not effective or has many side effects.
There are five main types of family planning methods:
- Barrier methods: which prevents pregnancy by keeping the sperm from reaching the egg.
- Hormonal methods: which prevent the woman ovary from releasing an egg, makes it harder for the sperm to reach an egg, and keeps the lining of the womb from supporting the pregnancy.
- Natural methods: which help a woman know when she is fertile, so that she can avoid sex at that time.
- IUDs: which prevent the man´s sperm from fertilizing the woman’s egg.
- Permanent methods: these are operations which makes it impossible for a man or a woman to have children
1.3.1 Barrier methods e.g. condom
- Effectiveness: good effectiveness if it’s used every time the intercourse takes place. Condoms are great at preventing both pregnancy and STDs.
- Acceptability: most couples find the condom acceptable, although some argue that it interferes with the natural process of intercourse and reduce pleasure.
- Availability: condoms are available at MCH clinics, chemistry and frequently in other shops and kiosks Side and lodging houses. You do not need a prescription. They are small and easy to carry
- Effects: rarely an allergic reaction to rubber. There is a risk that the condom scratch. If you are using a condom be sure that you use a fresh piece (it cannot be used twice) and know how to use it right. Condoms that have crossed they expired date could break during the intercourse.
- Reversibility: It is possible to get pregnant immediately if condoms are no longer used
Special comments: It’s a good contraceptive method, especially for those couples who have intercourse frequently. Using condoms is a great way to protect against STDs and lower the risk for pregnancy. There exists a condom for women too. But you shouldn’t use a men condom with a female condom. They are designed to be used on their own. Doubling condoms (for example wearing 2 men condoms won’t give you extra protection.). The condoms are 98% effective at preventing pregnancy. You find prescription how to use it. There is a risk of the condom scratching.
1.3.2 Hormonal methods e.g. oral contraceptive (pill), injectable contraceptive (injection)
- Effectiveness: like the pill, this is almost 100% effective
- Acceptability: very acceptable because it allows normal intercourse without prior preparation. The only relative disadvantage is the need to visit clinic every 3 months for injection.
- Availability: because doctors’ decision is required before starting the injection, this can be done only in larger MCH clinics or in hospitals. Injections are becoming more widely available at smaller MCH clinics.
- Side effects: one side effect is the cessation of menstrual periods. Other undesirable side effect may include spotting for some days during the first few months or occasionally, heavy bleeding, weight gain and increase in blood pressure may also occur. Headache, nausea, swelling of the breast, changes in monthly bleeding.
- Reversibility: ovulation and possibility of becoming pregnant may be delayed for as long as 12-14 months after stopping the injection. This should be in mind when discussing and promoting this method
Special comments – depo-provera is not widely accepted as valuable contraceptive method, because of its’ many disadvantages and minimal side effects, its use should be encouraged in those women for whom it is suitable.
1.3.3 Natural methods e.g. rhythm method
Effectiveness – not very effective because of possible irregular menstrual cycle and difficulty in ticking the dates precisely.
Acceptability – requires high level of motivation, which is difficult for many couples, but some people do it successfully
Side effect – no psychological effects, but there may be psychological effects because of possible strain on the marriage relationship.
1.3.4 Intrauterine (IUD, IUCD, coop and coil)
Effectiveness- very effective because it requires no preparation or thought at the time of intercourse. Can remain in place for many years and is almost 100% successful in preventing pregnancy.
Acceptability – very acceptable because it does not interfere with intercourse in any way.
Availability – the IUD must be inserted by a trained health worker at an MCH clinic. This service should be available at every health center. After insertion, the IUD should be checked at the clinic after three months, six months and later once a year.
Reversibility – when a woman with a coil wishes to become pregnant, it can be removed at a clinic. This is done by pulling the thread hanging from the cervix. The woman then has the usual chance of becoming pregnant.
IUCD side effects – increased menstrual bleeding , slight bleeding at any time in the cycle (spotting ), vaginal discharge, increased menstrual cramps, infection , expulsion ( when the coil becomes dislodged and fluids its way out of the uterus)
Special comments – the IUD has the great advantage of needing only one decision and action at the time of insertion. After insertion, it requires little or no thought yet provides effective contraception for many years. It does not interfere with intercourse and should be promoted as a method of first choice for those women without any contraception.
1.3.5 Permanent methods e.g. TL
Effectiveness – with good technique it is almost 100% effective
Acceptability – when a couple understands and accepts that this method is permanent , it is an excellent contraceptive solution with no further action supplies or clinic visits needed.
Availability – the procedure can be done at most hospitals
Side effects – rare, but occasional bleeding, wound infection and possibly psychological problem if the woman later becomes pregnant
Reversibility – irreversible
Special comments – ideal woman who have health or social problems that contraindicate any further pregnancies.
Permanent methods (vasectomy)
Effectiveness – if the operation is properly performed, the method is almost 100% effective
Acceptability – when a couple understands and accepts that this method is permanent, it is an excellent contraceptive solution with no further action, supplies or clinic visits needed. However, there is often a greater reluctance on the parts of men than women to accept their share of the responsibility for contraception.
Availability – the procedure can be done at most hospitals.
Side effects – pain, bleeding, haematoma, infection and possibly psychological problems if the man later changes his mind.
Reversibility – irreversible
Special comments – this method is most appropriate for those couple who have competed their families and want no more children.
2.1 HIV/AIDS and STDs
HIV/AIDS is a viral infection that characterized by a compromised/weak /impaired immune system that affects human being and is caught through contaminated /infected fluids mostly received through unprotected sexual intercourse. The infection ravages all body systems starting with the defense system, a situation that culminates in death of the individual from one of the opportunistic infections. The infection does not have a vaccine (immunization)
THE NATURE OF AIDS
This is a tiny micro-organism to the larger group of organisms called viruses living that cause disease.
2.1.1 Characteristics of HIV
- It is very tiny indeed
- It only survives inside other cells (especially body fluids)
- It is very fragile ( easily killed especially by heat)
- Stays for longer period
- It is made up of RNA (ribonucleic acid)
- It is capable of using DNA(deoxyribonucleic acid) from the cells in order for it to multiply.
- It keeps on changing its nature through a process known as mutation
- It has a very high liking affinity for an immune cells especially (lymphocytes)
- It replicates very fast ( exponentially) in a day about 100 billion of these .
- Belong to the class virus called retroviruses
2.1.2 Types of HIV
There are 2 types of HIV identified so far, namely HIV1 and HIV2. HIV2 was initially found concentrated in west -Africa where HIV1 was found in the rest of the world.
HIV1is further subdivided into different subtype i.e. HIV1a-k and probably others are being discovered
HIV1 strain is more dangerous (virulent) as compared to HIV2 and therefore, people infected with the former progress at a faster rate towards the AIDS stage than those of the latter.
2.1.3 Mode of Transmission
- SEXUAL INTERCOURSE –homosexual (same sexes) intercourse is more likely to spread it as opposed to heterosexual(opposite sexes) intercourse, nevertheless, heterosexuals is very significant
- PARENT TO CHILD – an infected parent (mother ) passes the virus to the baby
- SHARING OF PIERCING AND CUTTING OBJECTS – needles, razor blades, tattooing tools, more important for intravenous drug users (IUDs),circumcision tools.
- BLOOD TRANSFUSSION, especially when screening was not very thorough. Other less significant modes of transmission include:
Pricks especially for medical staff
Contact with open wound (carrier givers)
May be kissing when there are openings in the mouth due to biological and socio-cultural factors, women are more likely to be infected through sex than men
Women are more than men; hence for every multiple sexual partnerships women will definitely be more
The women receive the man’s seminal fluid (ejaculate) in the sex act, which is deposited, inside her birth canal
The birth canal (reproductive tract provides a larger surface area for the virus to penetrate and get into the body)
Due to reproductive functions (pregnancy and giving birth) their immunity is often low. Women can be raped due to their physical weakness.
Some cultural practices may be disadvantageous to women (FGM), wife inheritance, tattooing and dry sex.
Girls and by extension women are socialized to obey men without any question even if it means engaging in risky activities.
Most communities do not allow women to access information and knowledge hence many are variable due to ignorance and illiteracy
In many cultures, sex is more forced on women even if they may not want it or are some beliefs like having sex with a virgin will help one (the man get cured )
The family separation due to economic reasons whereby women are left to find for their families while the husbands are after away working, women is easier for them to get infected
2.1.4 Drugs and Substance Abuse
Many may be complicating the transmission pattern in that those who have abused drugs are likely to engage in risky behavior.
- Once intoxicated, people easily engage in sexual, casual and unprotected sex
- Drug users may share the infection hence easily infecting one another
- Drug users are more likely to engage in rape and defilement
- Drug abuse lowers immunity of a person hence not likely to resist the infection
Sexually transmitted diseases or STDs are infections passed from one person to another during sex. Any type of sex can cause STDs. STDs can be passed from a pregnant mother to her child before birth or during child birth.
Unless they are treated easily, STDs can cause;
- Infertility in both men and women
- Babies born too early , too small or blind
- Pregnancy in the tube (outside the womb)
- Death from severe infections or AIDs
- Lasting pain in the lower abdomen
- Cancer of the cervix
2.2 TYPES OF STDs
2.2.1 Gonorrhea and chlamydia
Both are serious illness. But they are easy to cure if they are treated early. If not, they can cause severe infections and infertility in both men and women.
Signs: A tingling, itching or hurting feelings of the skin on the genital areas or thighs
Is a serious STI that affects throughout the body and can last for many years. It is caused by bacteria and can be treated if detected early
Signs: Small blisters that burst and form painful open sores and on the genitals
Is an STD caused by bacteria it can be cured by medicine if treated early
2.2.4 Genital herpes
It is an STD caused by a virus; it can happen on the genital or on mouth. It produces sores that come and go for months or years. There is no cure for the herpes, but there is treatment to make you feel better. Not all herpes sores on the mouth are spread by sex. Children and adults often herpes sores on this mouths when they have cold fever
Is sexually transmitted disease caused by virus called HIV
Signs: It is spread when blood, fluids from vagina, or semen of someone already infected with HIV into body of another person
HIV – Human Immune Deficiency Virus
AIDS – Acquired Immune Deficiency Syndrome
The first case of HIV was mentioned in 1984.
Response – Denial, panic, Moi regime.
In 1999 Moi called for a national response
üContraceptive use makes women barren
üContraceptive reduce sexual urge
üContraceptives make women to gain weight
üWomen who use contraceptives get children soon after they stop using contraceptives
üSexual urge depends on psychological issues and faithfulness of partners
üContraceptive use reacts differently among women not all women gain weight. Women should consult doctors on which type to use.
3. SEXUAL AND GENDER BASED VIOLENCE (GBV)
To understand what gender based violence is, it is important to define the term gender and violence.
Øgender: Refers to characteristics roles and relations between men and women that are taught and learned. The differences are deeply rooted in every culture and community but can and have changed over time (It refers to the characteristics which are taught by society and are considered acceptable though can be changed.) This also differs greatly within and between cultures.
Øviolence: Refers to any act or behavior that hurts, harms or kills
Gender Based violence refers therefore to any act that hurt, harm or kill that is directed to one just because he or she is a woman or man/boy or girl. It affects disproportionately. It can also be defined as any form of violation/ violence that is directed against a woman or a man, just because he or she is male or female.
3.1 FORMS AND GBV
As Kofi Anna once said, ‘forms of violence against women are perhaps the most shameful human rights violation, and it is perhaps the most pervasive. It knows no boundaries of Geography, culture or wealth. As long as it continues, we cannot claim to be making real progress towards equality, development and peace.”
Gender Based violence can be grouped in the following categories:
ØPhysical Violence: Can be defined as any hurt which results in actual or potential physical harm from an interaction or lack of an interaction, which is reasonably within control of a person of responsibility, power or trust.
ØPsychological/Emotional Violence: This is a pattern of behavior that can seriously interfere with one’s development psyche and self-concept. It may be hard to identify since there is no physical evidence.
ØSexual Violence: Can be defined as any misuse of one for sexual pleasure or gratification. The involvement of children who are not able to fully comprehend, that they are unable to give informed consent. The involved uses persuasion, inducement, enticement or coercion to engage in, or assist any other person to engage in, any sexual explicit conduct or stimulation of such conduct for the purpose of producing a visual depiction of such conduct.
ØNon– touching sexual conduct: Involves indecent exposure or exhibitionism, exposure to pornographic material or any sexual act including masturbation.
ØTouching sexual abuse: This involves fondling, making a child touch an adult’s sexual organs, penetration of a child’s vagina or anus by an adult or an object and any other sexual act with a child.
ØSexual Exploitation: This refers to the engagement of a child or girl for the purpose of prostitution or using her to film or photograph pornography.
ØEconomical Violence: Refers to unreasonably denying someone financial resources which they need and it is their right to have such money for food, school fees, rent, medical charges and other similar expenses. It also involves unreasonably denying someone the right to seek employment or engage in any income-generating activity and not providing enough in return.
3.2 THE DAMAGE
When it comes to damage, there is no real difference between physical, sexual, emotional abuse/violence. All that distinguishes one from the other is the abuser’s choice of weapon and the effect on the survivor.
GBV has serious, often long lasting consequences that extend beyond the individual survivor.
3.3 SEXUAL HARRASMENT
Sexual harassment is bullying or coercion of a sexual nature, or the unwelcome or inappropriate promise of rewards in exchange for sexual favors. In most modern legal contexts, sexual harassment is illegal. As defined by the United States’ Equal Employment Opportunity Commission (EEOC), “It is unlawful to harass a person (an applicant or employee) because of that person’s sex, ‘Harassment can include ‘sexual harassment’ or unwelcome sexual advances, requests for sexual favours, and other verbal or physical harassment of a sexual nature. The legal definition of sexual harassment varies by jurisdiction.
In the workplace harassment may be considered illegal when it is so frequent or severe that it creates a hostile or offensive work environment or when it results in an adverse employment decision (such as the victim being fired or demoted, or the victim quitting the job). The legal and social understanding of sexual harassment, however, varies by culture.
4. FERTILITY AWARENESS
This is the time/period when a boy or a girl experiences changes that occur in his/her body physically, emotionally, mentally- psychologically and anatomy
– Pubic hair grow
– Hips broadens
– Sexual feelings
– Gain weight
– Sex organs enlarge
– Change in mood
during this time or period boys and girls should be able to recognize the changes, signs and master what they mean in terms of sex and reproduction.
– Penis and testis increased in size
– Penis erect more often and has wet dream or ejaculate
– Pubic hair grows
– Sexual feelings
– Gaining weight
– Shoulder broaden
– Changes in mood
When a boy or a girl is sexually mature. Puberty is the time when the bodies of boys and girls change. Bodies grow bigger and taller; sex organs mature and hair often start growing in new places. During puberty, a girl is able to become pregnant and a boy is able to further a child. New chemicals produced by the body called hormones, creativenesses in the body and tern young people in to adults.