Jharkhand, villages in Rajasthan hesitate over adolescent health facilities, awareness raising: social audits

New Delhi: Seven of 85 villages audited in Jharkhand and Rajasthan had adolescent-friendly health services, 11 provided quality sanitary napkins accessible to all young women, less than half (37) had clean, usable and separate toilets for girls in public schools, and five had proactive awareness campaigns on the dangers of child marriage and teenage pregnancies, social audits conducted between July and September 2019 found.

Investing in adolescent health is crucial for India Sustainable development goals, improve the health outcomes of adults nationwide and add productive adults to the workforce, such as IndiaSpend reported in November 2017.

A team of 300 girls visited 63 villages in six districts of Jharkhand and 22 villages in three districts of Rajasthan to educate adolescent girls on child marriage, sexual health, education, safety and nutrition. The countryside, ‘Ab Meri Baari‘, was launched in early 2019, by the Collaborative for adolescents 10 to 19 years old, a group of non-profit organizations working on adolescent issues in India.

The team, led by Dasra, a strategic philanthropic organization based in Mumbai, working with 10to19 Adolescents Collaborative, traveled 3,296 km and spoke to primary health workers, doctors, public health officials and other adolescent girls. The team also visited Uttar Pradesh (UP) to carry out awareness campaigns, but no social audit was organized in the UP.

Adolescents understand 22.2% of the population of Jharkhand, 22.9% from Rajasthan and 24.5% of UPs. Together, the three states are home to 28.5% (72 million) of the 253 million Indian adolescents.

Child marriage, early pregnancy

In 2015-2016, nearly one trimester of Indian women aged 20 to 24 were married before they were 18, and 8% of adolescent girls aged 15 to 19 were already mothers or pregnant, according to data from the National Family Health Survey, 2015-16 (NFHS-4).

Early marriage leads to abandonment, childbearing at a young age, and a higher likelihood of domestic and sexual violence. Teenage pregnancies lead to adverse pregnancy outcomes, such as eclampsia (seizures during pregnancy), low birth weight, neonatal death, and birth defects.

Pregnant adolescents are also more likely to drop out of school, which affects their future and that of their family because IndiaSpend reported on January 12, 2019.

In 2010, the Ministry of Women’s and Children’s Development launched SABLA, an adolescent empowerment program, in 200 districts of the country. As part of this program, each district should conduct awareness campaigns to sensitize adolescent girls to early marriage.

Yet there are gaps.

In 2015-16, Jharkhand had the 5th highest proportion (12%) of adolescent girls aged 15-19 who were already mothers or pregnant and Rajasthan had the 18th highest (6.3%), according to NFHS-4.

Likewise, Jharkhand had the 3rd highest proportion (38%) of women aged 20-24 who married before the age of 18 and Rajasthan had the 4th highest (36%), according to the data.

Yet 80 of the 85 villages audited in nine districts of Jharkhand and Rajasthan did not conduct proactive awareness campaigns on the effects of child marriage, according to social audits conducted between July and September 2019.

Awareness, support

16-year-old Swati Kumari is a grade XI student from Barasloy village, Simdega district, Jharkhand. Her friend Naina (not her real name) was forcibly married at the age of 14. Naina had to drop out of school to live with an alcoholic husband. She had a child at 15 – her in-laws forced her despite their opposition. “Due to so many hardships at a young age, she was mentally weak,” said Swati Kumari. In 2018, Naina committed suicide.

Naina’s experience prompted Swati Kumari to act. She is now part of the Ab Meri Baari campaign and, along with other team members, known as ‘champions’, helps raise awareness about child marriage through street theater plays.

Awareness campaigns on child marriage, teenage pregnancy and the dangers associated with it were carried out in anganwadi centers in only 47 of the 63 villages of Jharkhand where the social audit was carried out.

In only three villages, this information was proactively shared and explained through regular campaigns. In 10 villages, nothing was done to raise awareness, the team noted.

The situation was similar in Rajasthan.

Only two of the 22 villages audited have organized regular campaigns of anganwadi centers to raise public awareness of child marriage, teenage pregnancies and the associated risks.

“I got married when I was 7-8 years old, but I still live with my parents,” said Seema Jat, 19, who lives in the village of Udaipur Khera in Rajasthan. “I continue my studies thanks to the support of my family, but not everyone.

Maya, Seema Jat’s friend, also got married at a similar age. “Before she ‘Gauna’ can be celebrated [after which the bride is sent to live with the groom’s family], in class XII, she gave birth to a daughter, ”said Seema Jat. “Her studies were stopped and her husband did not support her. “

Adolescent-friendly health services

Only in 19 of the 63 villages audited in Jharkhand were adolescents educated on the Protection of Children Against Sexual Offenses Act (POCSO) and Juvenile Justice Act (Care and Protection of Children), in island hospitals or community health centers by posting information or awareness campaigns. In 41 villages, the team found no form of awareness raising or dissemination of information on these laws among adolescents.

In 37 of the 63 villages, adolescents received information on sexually transmitted diseases and Acquired Immune Deficiency Syndrome (AIDS). Only in five villages did they receive information on sexual health and hygiene.

In only two of the 22 villages audited in Rajasthan, teachers carry out regular campaigns to disseminate information on reproductive health and rights. In six villages, this information is explained to the pupils; in seven villages this information is only displayed, and in five villages it is not even displayed.

None of the villages have campaigned to disseminate information on the settlement of grievances in cases of sexual violence. Only in 10 villages was this information displayed.

Sanitary towels, separate toilet

In only nine of the 63 villages audited in Jharkhand, quality sanitary napkins were available at health centers and accessible to all adolescent girls. Not everyone had access to sanitary napkins in 17 villages. While sanitary napkins were not of good quality in two villages, they were not available in 35 villages.

Sanitary napkins were not available at anganwadi centers or health centers in Kunjora village of Deoghar district in Jharkhand, said Kumari Priyanka Pandey, 21, a village resident. IndiaSpend. However, her village has a school where sanitary napkins are provided to girls. “We have to travel outside the village to buy towels,” Pandey said.

Ab Meri Bari champion Swati Kumari also has to travel outside her village to Simdega district in Jharkhand to buy sanitary napkins – each pack costs Rs 35-40. “Our school does not distribute sanitary napkins and they are not available in the anganwadi center,” she said. IndiaSpend.

In Rajasthan, anganwadi centers did not have a regular supply of sanitary napkins. In six villages, people did not know that sanitary napkins could be available at Anganwadi centers. In five villages, people knew about it but did not ask for sanitary napkins. In just seven villages, people requested towels from anganwadi centers.

Often, with the onset of menstruation, adolescent girls drop out of school or attend school less frequently – due to lack of hygienic toilets, lack of water and a sanitary napkin disposal system in schools. In rural India, 23% of girls cited menstruation as the main reason for dropping out of school because IndiaSpend reported in June 2017.

Public schools in only 25 of the 63 villages audited in Jharkhand had separate toilets for girls that were clean, safe and usable. In 10 villages, not all girls had access to separate toilets. In 13 villages, separate toilets for girls were neither clean nor usable. In 15 villages there were no separate toilets for girls.

In Rajasthan, public schools in only 12 of 22 villages audited had separate toilets for girls. In two villages, the separate toilets were neither clean nor usable.

Solutions proposed by the team as part of the “Ab Meri Baari” campaign:
  • There should be an appropriate adolescent health center in each block.
  • Health centers should educate adolescent girls about family planning, sexually transmitted diseases, contraceptive methods and drugs.
  • Separate, safe and secure toilets should be provided for girls in public schools. All teens and pregnant girls should receive nutritious food.
  • Sanitary napkins should be available at anganwadi centers.
  • Along with raising awareness of issues such as child marriage, laws relating to sexual abuse should also be openly discussed with adolescent girls, including in schools. Adolescent girls should play an important role in village child protection committees.

(Tiwari is a primary correspondent with IndiaSpend.)

This story was first published here to IndiaSpendHindi.com.

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