A Holistic Approach to Adolescent Health and Well-Being: Harnessing India’s Demographic Dividend


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While some adolescents have access to necessary information and services, many are not supported enough to make the transition from childhood to adulthood.

With 253 million people, India has the largest adolescent population in the world (ages 10-19). This group constitutes about one-fifth of the country’s total population, according to 2011 census data. During their formative years, adolescents face several challenges that could hamper their growth and development.

While some adolescents have access to necessary information and services, many are not supported enough to make the transition from childhood to adulthood.

India is home to the largest number of married children in the world and accounts for approximately one third of the global incidence of child marriage. Early marriages are the result of several factors such as gender inequality, poverty, weak enactment of laws protecting girls, low level of education of girls and their families.

The practice is socially sanctioned in many communities across India. Girls’ lack of agency compromises their education and economic growth.

Family pressure to have children at a young age, coupled with insufficient access to information and services on nutrition and sexual and reproductive health (SRH), makes them vulnerable to teenage pregnancies, unsafe abortions, anemia and health problems.

According to a study by the Guttmacher Institute, about 2 million adolescent girls who want to avoid pregnancy are not using a modern contraceptive method and are therefore classified as having an “unmet need” for modern contraception. About 930,000 abortions take place in adolescent girls each year, 78% of them performed under unsafe conditions.

According to the Fourth National Family Health Survey (NFHS 4 2015-16), more than half (54%) of all adolescent girls in India are anemic. They are also more likely to experience violence and abuse resulting in mental trauma and depression. Low income and the need to financially support families at a young age push many adolescents, especially those from marginalized segments of society, into a state of perpetual poverty, affecting their mental and physical health and self-esteem.

Despite global evidence of the interdependence of nutrition, education, health and wellness, government programs are often designed and implemented in silos by different ministries, resulting in a lack of convergent action.

The Rashtriya Kishor Swasthya Karyakram (RKSK) addresses several adolescent issues such as SRH, nutrition, mental health, substance abuse, gender-based violence and non-communicable diseases. However, it does not focus on adolescent issues from the perspective of the social determinants of health, which can influence health equity positively or negatively.

The societal stigma associated with SRH discourages open conversations on the subject and deters adolescents from reaching out to adolescent-friendly health centers.

The COVID-19[female[feminine The pandemic has exacerbated pre-existing challenges for adolescents in India and around the world. School closures, loss of social networks, mobility restrictions, parental morbidity, increasing responsibilities for household chores and care, and experiences of violence have resulted in helplessness, anxiety and fear that can have a permanent impact on adolescents.

The gender gap in education has almost doubled from 8.7 percent during the pre-COVID period to 15 percent during the pandemic with several teenage girls dropping out of school and being pushed into child marriage. It threatens to reverse decades of progress.

UNICEF projects that up to 10 million more girls are at risk of child marriage during the decade 2021-2030.

School closures have also resulted in a increased unmet need for adolescent sanitary napkins and iron and folic acid tablets. Evidence also suggests that there are long-term implications for adolescents due to the economic stress caused by the pandemic. These include children from marginalized communities pushed into child labor and families who struggle to bear the costs of digital resources.

Several global studies have highlighted the need for adequate investments in adolescent well-being, which in turn can deliver significant returns not only for adolescents, but for the nation as a whole. The Report of the Lancet Commission on Adolescent Health and Well-Being, published in 2017, estimated that investing $ 5.20 (Rs 387) per capita each year in improving adolescent health and well-being could save 12.5 million lives and prevent 30 million unwanted pregnancies.

Going forward, a holistic and convergent approach is needed to improve adolescent health outcomes. Reproductive, maternal and child health and nutrition outcomes are closely linked to the health status of girls and young women at different stages of their lives.

Integrating family planning and SRH services into nutrition programs is therefore an important intervention that should be scaled up.

Second, there is a need to empower girls with education, information, skills and support structures, which improve their capacity for action, autonomy and decision-making. Third, information and services relating to adolescent sexual and reproductive well-being, mental health and nutrition must reach everyone, including those from vulnerable socio-economic populations.

Fourth, strengthening data management systems will help to understand and bridge the gaps between adolescent-specific policies and program implementation. Fifth, the pandemic has highlighted the need for health literacy and to initiate the concept of self-care in adolescents.

WHO defines self-care as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with disease and disability with or without the support of a caregiver. health “.

Self-care interventions can play a critical role in promoting confidentiality, empowerment and self-confidence while ensuring that quality, accessible and equitable services reach adolescents. Finally, in order to make policies and programs more inclusive of the needs of adolescents, it is imperative that their voices are recognized and included in all aspects of decision-making.

Since adolescents and future generations will bear much of the long-term economic, social and health consequences of the pandemic, timely investments in their health and well-being must be made through clearly defined policies and programmatic interventions. defined and targeted. Investing in adolescents is also imperative in order to take advantage of the country’s competitive advantage, its demographic dividend.

As we envision an increased role for adolescents in the nation-building process, it is essential to understand the links between their overall well-being, economic growth and sustainable development.

Poonam Muttreja is Executive Director of the Population Foundation of India. Sanghamitra Singh is Senior Director, Knowledge Management and Partnerships at the Population Foundation of India

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