New Delhi: It is an undeniable fact that India’s future lies in the hands of the young. Adolescents – who are between 14 and 19 years old – comprise a significant 20 per cent of the country’s population. Numbering around 253 million as per Census 2011, they are and will be a force to reckon with in the future. It is critical to invest in them so that India can reap the benefit of its demographic dividend.
Adolescents’ needs are different from that of the larger young population (who are 10-24 years old). They have highly specific needs, ranging from access to quality education, healthcare, nutrition, counselling on a range of mental well-being and physiological issues. They need an enabling and supportive environment, especially girls, to acquire skills, explore their potential, pursue their dreams and contribute to society. Investments in adolescents should include their sexual and reproductive health needs, as well as information and services on sexual and reproductive health. It is important to both understand and keep pace with them as they go through quick transitions.
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The need for comprehensive reproductive and sexuality education has been recognized as an integral part of “life skills” education through government programmes such as the Adolescent Education Programme (AEP) and Rashtriya Kishor Swasthya Karyakram (RKSK). Although policies and programmes underscore the need for adolescent health and well-being education in the formal education system as well as for marginalized population groups, their implementation continues to be a challenge due to societal stigma surrounding the subject. Despite their distinct and specific needs, adolescents often lack information and are left to fend for themselves because discussions on adolescent sexual and reproductive health are taboo in families and society, not just in India but across the world. They often get misinformation from unreliable sources in their search for information, a problem that has got aggravated in recent times with the digital boom and unfettered access to the internet. According to an evaluation of the AEP by the United Nations Population Fund, only 15 percent of young men and women (aged 15-24 years) received reproductive health and sexuality education. The absence of information has serious consequences. According to a study, (Timing of first sex before marriage and its correlates: Evidence from India) the first sexual activity among a majority of young people in India is unprotected. For a large proportion of girls and women, it is forced. Lack of information also exposes young people to sexual abuse. A study commissioned by the Ministry of Women and Child Development found that more than 53 per cent of young people surveyed in 13 states reported one or more forms of sexual abuse. This could have been prevented if there was openness and access to appropriate education on these issues.
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India also has the third-highest number of people living with HIV in the world which means that many of those who got infected by HIV did not know how to protect themselves against the virus. The silence about sexual and reproductive health is so deafening that in India a majority of girls learn about menstruation when they get their first period.
With this as the context, 2022 was a year which was remarkably different than the previous two years. For almost two years, the COVID-19 pandemic posed new challenges for every section of society. The relatively healthy and safe adolescent population did not warrant the immediate attention of the health system. However, the post-pandemic environment has unearthed the challenges faced by this seemingly healthy but vulnerable population group, a number of whom reported mental health issues during the period. The challenges posed by the closing of schools and a shift to technology-based platforms for education posed new difficulties and left many adolescents from marginalized sections of society behind even as their families struggled to keep up. With schools closed, adolescent girls coped with increased vulnerability to child marriage, digital divide, additional work at home and exposure to domestic violence. A return to normalcy included the resumption of schools, health services and social support systems which adolescents thrive on.
Despite the efforts made in providing sexual and reproductive health information to adolescents, India’s uneasy relationship with adolescents’ reproductive health and sexuality education continues to exist. In 2020, many heinous crimes against women were reported. Crime against women and girls further restricts the freedom of adolescents and inhibits their growth. A 2020 study conducted on adolescents in Delhi NCR, Online safety and internet addiction, found that 50 per cent of cases of online violence are never reported.
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There is global evidence to prove that comprehensive reproductive health and sexuality education empowers adolescents. This education needs to be delivered in an effective, empathetic and culturally sensitive ways with the involvement of teachers and parents. It is important that both parents and teachers establish themselves as reliable sources of information.
In an effort to provide accurate information in a safe, private and anonymous environment, the Population Foundation of India has developed SnehAI—an artificial intelligence-powered chatbot designed as a digital companion to provide information on adolescent sexual and reproductive health. The organization has also developed an ed-tech platform, Educately.org, which hosts a free teacher-training programme on the basic principles of adolescent health and well-being.
Going forward there is an urgent need for strengthening programmes for adolescents which focus on education as well as services. Equally important is changing the social norms through targeted behavior change programmes. Social change may be slow but it is possible if progressive policies and programmes support it. As we also evaluate the long-term consequences of the pandemic, we must bear in mind that the adversities experienced during adolescence has an impact on the well-being of not only the current but also the next generation.
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(About The Author: Poonam Muttreja is a public health expert and the executive director of the Population Foundation of India.)
Disclaimer: These are the personal opinions of the author.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.