Wednesday, August 12, 2015

 The Unaddressed Need- The sexual and reproductive health needs of Young People

The other day at the chemist's shop I found myself standing next to a girl not more than 14-15 years of age, nervously fidgeting with the money in her hand. She had asked for a pregnancy testing kit. The chemist handed over the kit to her with a scornful look further making the girl nervous. She sped away from the shop hanging her head in shame.

I wonder how many girls like her are dealing with the scrutiny and scornful looks, right from parents to teachers, doctors to even the chemists! How traumatic that experience could be? Why do so many girls approach the chemists looking for a means to find the reason for their missed periods? Why they are not able to practice safe sex?

It is a sad truth that teenage pregnancies are estimated to be around 6% -1 6% of total pregnancies in India by various studies. Practically it means on an average there is one teenage pregnancy for every 10 adult pregnancies!

There is a crying need, therefore, to address the sexual and reproductive health needs of adolescents. Unfortunately, this group is almost invisible in the health care system. While we have child health programmes and reproductive health programmes, adolescent clinics, counseling centers, sex education programmes are conspicuous by their absence in most parts of the country.

Studies have shown, again and again, that more and more teenagers are sexually active and IIPS study titled '
Pre-marital sexual relations among youth in India: Findings from the Youth in India, Situations and Needs Study' said that 15% young men and 4% young women indulge in pre-marital sex in India. It is also true that 47.4% girls are married before the age of 18 and according to a UN report, every year four million teenage girls in India have babies! Both the groups suffer from lack of access to quality SRH services.

The issue gets more complex when we speak of girls who end up with an unwanted pregnancy due to pre-marital sex. The social stigma attached to it leaves no option for them but to seek backstreet abortion services. I remember asking a health worker if she demonstrates condom use to girls and she said “No! Only to married women. Why do girls need to know about it?” Boys are equally ignorant about safe sex practices leading to most tragic consequences of unwanted pregnancies and unsafe abortions.

There is a resistance to sex education to adolescents on the mistaken belief that it leads to promiscuity. However, there is a large amount of evidence that says sex education and life skill development make young adults more responsible towards their partners as well as to themselves. Use of safe sex practices and contraception, understanding of the consequences of unplanned pregnancies and unsafe abortions, awareness and access to quality abortion services, counseling facilities to get information and guidance in managing relationships should form an integral part of any policy that addresses adolescents. Unfortunately, in India unmarried adolescent girls continue to be left out of the legal abortion services.

The newspapers in Mumbai were recently abuzz with statistics stating 67% increase in abortions among young girls in 2014-15. The article brought to notice the fact that more & more teenage girls were accessing abortion services and that too majorly from private clinics. The increase could be attributed to some extent to better reporting from abortion clinics which are required to report any teenage pregnancy to the police under the POCSO Act. The POCSO Act views consensual sex between to underage individuals as a crime. This further creates a new dilemma for doctors as well to conduct abortions in cases of teenage pregnancies.

As long as we do not recognize the fact that teenagers are sexually active and should be empowered to make informed decisions regarding their sexual behavior, it would not be possible to address the unaddressed needs of the vulnerable teenagers. Time we start a dialogue on this today – the International Youth Day. Write to us with your comments and views on this article.

- Anupriya Sathe,  Population First.