The issues with adolescent health are not limited to just the structure of the policy — it extends to the structure of institutions as well.
A consultation workshop on “Investing in Adolescent Health: Harnessing the Demographic Dividend” was held in New Delhi on 14 December 2019. The purpose of the workshop was to discuss the possibility of scaling up best practices to address adolescent sexual and reproductive health amidst the continued challenges of early marriage, teenage pregnancies, anemia and high incidence of maternal mortality. The core agenda behind the workshop was to provide a platform for convergence among stakeholders like NITI Aayog, state governments, UN agencies, and other national, international and multilateral agencies to promote the progress of adolescent health and development.
The inaugural address by the
Hon’ble Minister of Health and Family Welfare, Dr. Harsh Vardhan via video message, highlighted the immediate need to address the physical health needs of adolescent girls, and prompted for health services to be accessible to adolescents outside medical centers. The Hon’ble minister drew attention to the high levels of teenage pregnancies and child marriages in various pockets of the country, and emphasized on India’s 253 million adolescents being in their formative phase, that requires proper healthcare, nutrition, counselling and education to mature into healthy adults.
Voices promoting enhanced investment in adolescent care resonated with the address by the
NCPCR Chairman, Mr. Priyank Kanoongo as well, as he spoke about sensitizing the population towards the subject of sexual and reproductive health education and highlighted the multi-sectoral approach that will be necessary for improving adolescent health and breaking the inter-generational cycles of ill-health.
Dr. Yasmin Ali Haque stressed on the importance of family care during adolescence. She brought forth the challenge of improving nutritional indicators among adolescents.
Dr. Henk Bekedam pointed to the gender disparities and suggested that mental health needs to be taken into account with physical health, to address adolescent health as a whole.
Mr. Hisham Mundol addressed the concern of rising teenage pregnancies, alongside drawing attention to the physical, domestic and sexual violence that largely impact adolescents. He spoke about how the urgency to prove fertility has traded in a healthy child for a quick one, and discussed potential tools to rectify this behaviour.
Dr. Monika Arora presented an ORF research paper titled “A Landscape Analysis of Adolescent Health in India: The Case of Uttar Pradesh”, that discusses the crucial role played by health of adolescents in achieving India’s sustainable development goals. The paper discussed the health profile of adolescents in India and highlights areas for improvement despite progress in overall health indicators. Most of the programming is done for older adolescents and even though the education levels have substantially improved over the last decade, a lot still needs to be done to remove the disparity in literacy levels.
The issues with adolescent health are not limited to just the structure of the policy, but it extends to the structure of institutions as well. The leading example of this is the decreased attendance of female students in schools, because of the problems accompanying menstruation, and the lack of facilities in schools.
Technical session 1 titled
Adolescent Health Programme- Implementation Challenges and Opportunities was centered around the Rashtriya Kishor Swasthya Karyakram (RKSK) and focused on the challenges as well as opportunities of improvement. The conversation addressed the increased traction in working towards adolescent health as it is the entry point for human capital development and accumulation, and an intrinsic key to further India’s economic growth. It also highlighted the need for managing knowledge about menstruation as well as substance abuse, while equally reaching out to both boys and girls. Involvement of civil society and adaption of alternate methods are needed in the system, as the issues of adolescents are dynamic and can only be understood by cooperation between families, adolescents themselves, and the systems providing services. A collaborative structure that facilitates the interaction between the governments and schools, through which the programmes can be delivered to the adolescents, has to be incorporated with a more localized approach to region specific problems. The session also discussed the social and gender norms about how adolescents are perceived, and advocated for increased use of scientific advancements in improving adolescent health.
Technical Session 2 titled
Promoting Adolescent Health- State Experiences and Sharing of Scalable Models from States, posited that in order to achieve wholesome adolescent health, a multidimensional approach needs to be adopted. A major emphasis was to initiate a behaviour change communication that focuses on healthy lifestyle and reinforces a positive social environment to acquire life skills. The session brought up the concern of heterogeneity among adolescents and the difficulty in devising policies for the same. Because of the enormity of the group, the focus is split amongst several health issues. Though it reflects marginal improvements on some indicators, it does not show groundbreaking improvements on the overall health indicators. However, with civil society organisations like Young India, AACCI and others, attempts to improve adolescent health using life skills education are being continually made. The speakers highlighted that there are a number of adolescents who are still unable to access programmes, and changes will have to be made at family and community levels to resolve this.
States of Madhya Pradesh, Maharashtra and Uttar Pradesh have now taken part in community-based-monitoring schemes of
Saathi and
Super Saathi, which seeks to empower rural women and communities. It has been operating with the aim of bringing in short-term changes, by increasing access to digital resources, and generate awareness around the issues of health, education and sanitation.
The workshop concluded with three take aways. First, teenage pregnancies at the current rate are a national emergency and immediate steps have to be taken to curtail this problem. Second, there is a need to revamp schemes like RKSK in a manner that allows customization suitable to the ground realties and region specific problems. Third, adolescent health care services need to be taken out of medical centers, and made more accessible for the adolescents themselves.
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