NEW DELHI—Recognizing the critical health concerns facing adolescents and the broad benefits of addressing them, the Indian Government today introduced a national strategy to provide health information and services to meet the diverse needs of people aged 10-19. UNFPA, the United Nations Population Fund, helped develop the strategy. The UNFPA India country office has issued the following media brief:
The Government of India launches its National Adolescent Health Strategy to provide health, information and services to meet the diverse needs of adolescents in India. It is the first step towards addressing adolescent health comprehensively, which would help achieve improved health outcomes for the whole population.
UNFPA, the United Nations Population Fund, has provided key support in developing and launching the strategy. The strategy would be launched by the Honourable Union Minister of Health and Family Welfare, Shri Ghulam Nabi Azad, in New Delhi on 7 January 2014.
India is a young country. Adolescents aged 10–19 constitute about one fifth of India’s population and young people aged 10–24 about one third of the population. The large and increasing share of adolescents and youth in India’s population can translate into a demographic dividend only if policies and programmes focus on the health and well-being of this 243 million strong, yet very vulnerable cohort.
By investing in adolescent health today, we invest in the workforce, parents, and leaders of tomorrow, and break the inter-generational cycle of poor health. Investments in adolescents will have an immediate, direct and positive impact on India’s health goals and on the achievement of several Millennium Development Goals (MDGs).
With this view, the Ministry of Health and Family Welfare has designed the Rashtriya Kishor Swasthya Karyakram: the strategy envisions that all adolescents in India are able to realize their full potential by making informed and responsible decisions on their health and well-being.
UNFPA, with its strategic focus on young people, has lent technical assistance to the Government in designing the strategy to best serve the diverse needs of adolescents, especially of adolescent girls and marginalized groups in the population.
The strategy is a paradigm shift from providing clinic-based services to promoting health and prevention. It reaches adolescents in schools and communities, with the help of peer educators, counsellors, parents and the community. Key drivers of the strategy include communication for information and behaviour change programmes and adolescent-friendly health clinics.
The strategy recognizes the importance of encouraging positive behaviours and supporting adolescents in making a healthy transition to adulthood.
Adolescent health and nutrition has an inter-generational effect: more than 33 per cent of the disease burden and almost 60 per cent of premature deaths among adults are associated with behaviours or conditions that began or occurred during adolescence—for instance tobacco and alcohol use, poor eating habits, violence, sexual abuse, and risk taking behaviour.
The Adolescent Health Strategy is underpinned by evidence that adolescence is the most important stage of the life cycle for health interventions. Addressing adolescent health needs would obviate several reproductive, maternal and child health challenges. For example, age at marriage, birth preparedness, appropriate spacing, teenage pregnancy and mortality and morbidity associated with it can be addressed only when we start to work with adolescents, both boys and girls, and their caregivers.
Adolescents in India today face a range of health challenges, including malnutrition and anaemia, lack of knowledge on sexual and reproductive health, substance abuse, communicable and non-communicable diseases, mental health concerns, and injuries and violence, including gender-based violence.
Limited access to accurate information and socio-economic and gender disparities further restrict access to health services.
Key figures on adolescent health indicate the extent of challenges that need to be addressed:
- NFHS–3, the National Family Health Survey, indicates that 56 per cent of girls and 30 per cent of boys aged 15–19 are anaemic.
- Adolescents in India suffer from both under- and over-nutrition issues. In the age group 15–19, nearly half the girls and nearly three fifths of the boys are thin. At the same time, 2.4 per cent of the girls and 1.7 per cent of boys in this age group are overweight.
- Findings from NFHS–3 show that births in the age group of 15–19 years contribute to 17 per cent of the total fertility rate.
- Of all the births in the five years preceding the survey to women aged less than 20 years at the time of birth, 14 per cent were unplanned. Comparison of data from the three rounds of NFHS does not suggest a substantive change in this indicator over time.
- NFHS–3 shows that among adolescents aged 15 to 19, 8 per cent of the girls reported sexual debut before 15 years of age, compared to 2.7 per cent of boys. However, only 3 per cent of girls and 19 per cent of boys who had had sex reported using a condom the first time they had sexual intercourse.
- Preventing gender-based violence remains a challenge. NFHS–3 shows that 34 per cent of ever-married adolescent girls (15–19) had experienced physical, emotional or sexual violence perpetrated by their spouses.
- Non-communicable diseases (NCDs) account for 53 per cent of all deaths in India across all age groups, according to the WHO-NCD country profiles 2011. NCDs cause significant morbidity both in urban and rural populations, with considerable loss in potentially productive years of life.
- A recent study reports that suicides are increasing by 5 to 10 per cent every year across the country. Depression and anxiety occur more often in girls than boys, with gender disparity becoming evident even in early adolescence.
To address these health challenges, the strategy focuses on six key areas of health: sexual and reproductive health, life skills, nutrition, injuries and violence (including gender-based violence), non-communicable diseases, and mental health and substance misuse.
To respond effectively to the concerns of all adolescents, the programme promotes adolescent participation, and enables rights, inclusion and gender equity. It calls for strategic partnerships to implement its vision.
The strategy has been developed in consultation with various ministries, development partners, multilaterals, civil society, academicians and the voices of those who matter the most: the adolescents.