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Adolescent Sexual Health

Opinion: Moving From “Shhhhhh…” To Comprehensive Sexuality Education

According to experts, comprehensive sexuality education can empower young people to make informed life choices and equips them with life skills

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Opinion: Moving From “Shhhhhh…” To Comprehensive Sexuality Education

Married off at age 16, forced to drop out of school, or put at risk of anaemia, unintended, high-risk pregnancies, chances of unsafe abortions, or worse – these are some of the threats Pratima (name changed) may have had to face during adolescence. However, thanks to her access to comprehensive sexuality education, she flipped her story instead. All of 19-years-old today, she is continuing her education and even volunteering with a civil society organization in Rajasthan’s Karauli district to raise awareness and empower girls. “Learning about my body, and understanding that I was not physically or mentally prepared to marry or have children, encouraged me to take a stand for myself and not be married off forcefully,” she said.

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The organization she works with partners with Population Foundation of India to raise awareness and provide comprehensive sexuality education for adolescent girls and boys in the district. Ever since she started volunteering with them, Pratima has reached out to more than 300 adolescent girls, via her networks and peer groups, to talk to them about issues ranging from menstrual health and hygiene to the need to adopt improved sexual and reproductive health practices.

Seventeen-year-old Hansraj and his wife live in Bundi, another district in Rajasthan where Population Foundation of India has been implementing its comprehensive sexuality education program through partner Shiv Shiksha Samiti. Thanks to the organization, the couple have been able to take informed decisions regarding family planning.

We did not understand the nuances of marriage, relationships and family planning when we got married at 15. Joining the project helped us understand the complexities of sexual and reproductive health and also to open up to each other. Today, we both respect and consensually take decisions regarding our future, Hansraj said.

While there is no doubt that comprehensive sexuality education can have far reaching benefits for young people, barriers to access can lead to long-term impacts on reproductive and sexual health outcomes, as well as increase the propensity for gender-based violence and adverse mental health issues. The physical, psychological and emotional changes they experience during this time can be confusing. Without the right guidance, adolescents may find it difficult to navigate issues such as getting married or planning a first child at a suitable age, avoiding unintended pregnancies and accessing safe abortion services. Comprehensive sexuality education is also critical in reducing intimate partner violence, handling peer pressure and reporting abuse. The absence of accessible, adolescent-friendly information, counselling and services can affect young girls and boys struggling to comprehend the complexities of puberty.

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Despite its obvious benefits, comprehensive sexuality education in India has been presented, in the past, as being at odds with the country’s social and cultural values. Inhibitions and fears coupled with misconceptions and stigma around sexual and reproductive health, especially for the unmarried, have fostered an environment of uncertainty. Today, with more and more people awakening to the real importance of equipping young people with the knowledge, skills, attitudes and values they need to determine and enjoy their sexuality—physically and emotionally, individually and in relationships. Comprehensive sexuality education helps young people to acquire accurate information on sexual and reproductive rights, information to dispel myths, and references to resources and services. It helps young people develop life skills including critical thinking, communication and negotiation, self-development, and decision-making; sense of self; confidence; assertiveness; ability to take responsibility; ability to ask questions and seek help; and empathy. Furthermore, comprehensive sexuality education nurtures positive attitudes and values, including open-mindedness, respect for self and others, positive self-worth/esteem, comfort, non-judgmental attitude, sense of responsibility, and positive attitude toward their sexual and reproductive health.

In India, adolescents comprise 21% of the total population (Census 2011) and despite the legal age for marriage being 18 years in India, the fourth National Family Health Survey (NFHS-4, 2015-16) revealed that 27% of all women between 20 and 24 years of age were married before 18. The same survey also shows that 8% of women aged 15-19 years were already pregnant during the time of the survey. While only 10% of currently married women aged 15-19 years, and 16% of sexually active unmarried women in the same age group used any modern contraceptive method. This increases young women’s chances of getting pregnant, even before their bodies are fully developed and healthy.

Alongside the risk of early, unintended pregnancy, gender-based violence is another pervasive threat to young people in India. The percentage of women aged 15-19 who had ever been married and experienced emotional, physical or sexual violence stood at 21.2 per cent. Exposure to family and community violence has consistently been linked with violent behaviour among young men. With adolescents forced to stay home, where their exposure to domestic, gender-based violence has the potential to increase, the impact of the COVID-19 lockdown could be far bleaker than we would like to imagine. Of the 650 million girls and women alive today who were married in childhood, half live in India, Bangladesh, Brazil, Ethiopia and Nigeria. According to the United Nations, 10 million additional girls are at risk of child marriage due to COVID-19.

Also Read: Adolescent Sexual Health: Parents, Teachers Need To Break The Cycle Of Silence Around Sex And Sexuality, Say Experts

Several national programs are currently in place to provide information and services to adolescents in India. The Rashtriya Kishore Swasthya Karyakram (RKSK), for example, aims to reach adolescents with comprehensive health services and information including sexual and reproductive health and the School Health Programme, under the Ayushman Bharat, initiative has been launched by the government to make advances towards correct and age-appropriate information on Sexual and Reproductive Health and Rights (SRHR). However, there remains a lot to cover. In the case of the RKSK program, while the model has great potential for ensuring adolescents’ wellbeing, the gaps in its implementation potentially undermine the program’s success. With the disruptions in services during the COVID-19 pandemic, these gaps are likely to increase.

In the current context, it is imperative that adolescents are provided the counselling and resources required to not only navigate the usual challenges of puberty but also cope with the stresses of the pandemic and its associated lockdowns. In this changing landscape, it will be more and more critical to find innovative ways to reach out to adolescents, by bridging the digital divide in order to take conversations online. It is more important than ever that gatekeepers, such as parents, teachers and health providers are sensitized and equipped to sensitively share correct information with adolescents. We need to end the culture of silence around sexuality education and help the Pratima’s and Hansraj’s in India to flip their stories.

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(The article was co-authored by Monica Wahengbam, Programme Manager, and Riya Thakur, Senior Manager (Youth and Adolescence), at Population Foundation of India.)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

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World

22,95,44,435Cases
19,20,52,504Active
3,27,83,741Recovered
47,08,190Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 22,95,44,435 and 47,08,190 have died; 19,20,52,504 are active cases and 3,27,83,741 have recovered as on September 22, 2021 at 3:49 am.

India

3,35,31,498 26,964Cases
3,01,9897,586Active
3,27,83,741 34,167Recovered
4,45,768 383Deaths
In India, there are 3,35,31,498 confirmed cases including 4,45,768 deaths. The number of active cases is 3,01,989 and 3,27,83,741 have recovered as on September 22, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,27,629 3,131

44,269 960

63,44,744 4,021

1,38,616 70

Kerala

45,39,926 15,768

1,61,765 5,813

43,54,264 21,367

23,897 214

Karnataka

29,69,361 818

13,769 617

29,17,944 1,414

37,648 21

Tamil Nadu

26,48,688 1,647

16,993 9

25,96,316 1,619

35,379 19

Andhra Pradesh

20,40,708 1,179

13,905 483

20,12,714 1,651

14,089 11

Uttar Pradesh

17,09,693 13

194 0

16,86,612 13

22,887

West Bengal

15,62,710 537

7,741 69

15,36,291 592

18,678 14

Delhi

14,38,556 39

400 21

14,13,071 18

25,085

Odisha

10,21,216 462

4,844 103

10,08,226 560

8,146 5

Chhattisgarh

10,05,120 26

297 0

9,91,260 26

13,563

Rajasthan

9,54,275 12

99 8

9,45,222 4

8,954

Gujarat

8,25,751 14

133 0

8,15,536 14

10,082

Madhya Pradesh

7,92,410 8

90 6

7,81,803 14

10,517

Haryana

7,70,754 8

328 12

7,60,618 20

9,808

Bihar

7,25,907 6

60 9

7,16,188 15

9,659

Telangana

6,63,906 244

4,938 53

6,55,061 296

3,907 1

Punjab

6,01,359 36

304 3

5,84,554 37

16,501 2

Assam

5,98,864 441

5,081 97

5,87,970 338

5,813 6

Jharkhand

3,48,139 14

65 10

3,42,941 4

5,133

Uttarakhand

3,43,405 12

249 18

3,35,765 29

7,391 1

Jammu And Kashmir

3,28,214 145

1,450 11

3,22,345 154

4,419 2

Himachal Pradesh

2,17,403 263

1,715 99

2,12,033 162

3,655 2

Goa

1,75,690 107

886 76

1,71,507 29

3,297 2

Puducherry

1,25,618 101

922 55

1,22,864 46

1,832

Manipur

1,18,870 197

2,174 9

1,14,861 203

1,835 3

Tripura

83,956 51

353 7

82,794 44

809

Mizoram

82,815 1,355

15,363 223

67,184 1,127

268 5

Meghalaya

79,817 150

1,878 18

76,558 167

1,381 1

Chandigarh

65,195 7

44 3

64,333 4

818

Arunachal Pradesh

54,190 64

413 3

53,504 60

273 1

Sikkim

31,014 43

627 27

30,007 70

380

Nagaland

30,959 52

470 3

29,832 46

657 3

Ladakh

20,743 6

144 6

20,392

207

Dadra And Nagar Haveli

10,670

0 0

10,666

4

Lakshadweep

10,360 1

9 1

10,300

51

Andaman And Nicobar Islands

7,607 7

17 4

7,461 3

129

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