In the list of health priorities, adolescent health lags far behind maternal and child health in India. It’s a dangerous oversight given that India is home to the largest number of adolescents in the world. An estimated 253 million adolescents live in India, and one in every fifth adolescent in the world is Indian.
There is enough evidence to show that the period of 10 to 24 years is a critical one as the behavior patterns that form now shapes the health for a lifetime. Yet the world over, two-thirds of the adolescent population is growing in countries that are grappling with issues like child marriages, early pregnancies, HIV/AIDS and depression.
The International Association for Adolescent Health’s 11th World Congress on Adolescent Health, which begins in New Delhi in October, will turn the spotlight on this vulnerable and neglected age group. It is held once in every four years and is themed ‘Investing in Adolescent Health: the Future is Now’.
The Congress aims to push the case for developing a stronger primary care focus on adolescent health as well as kick-start investments in the health force to better respond to the needs of adolescents.
India has many challenges specifically the rise in underage marriages, especially of girls. Despite strong laws, the situation is grim even in rich states like Maharashtra where 16 districts figure in a countrywide ranking of the top 20 districts reporting an increase in child marriages, according to a study by the National Commission for Protection of Child Rights (NCPCR).
“Investment in adolescence has huge implications for productivity and enhanced life skills which has a significant impact on a country’s overall productivity,” points out Dr Sunil Mehra, Executive Director, MAMTA Health Institute for Mother and Child, which are hosting the Congress along with a consortium of partners supported by the Ministry of Health and Family Welfare.
“India has missed out on investing in this age group, which explains the high rate of child marriage which has serious implications for infant and maternal mortality and early pregnancies.”
As a Lancet 2016 study points out, puberty sets off a process of brain development and emotional change that carry through to the mid-20s. This is also a phase where most health problems and risk factors for disease in later life emerge.
“Adolescence is starting earlier now and we know better now that these years reverberate across their lives,” says Dr Susan Sawyer, President, International Association for Adolescent Health.
“If we can keep girls in school longer, their marriages will be delayed, they likely to have children later, breastfeed their babies, immunize them and this will have affect health indicators like infant and maternal mortality”.
Given their significant presence, India needs to look at building a health force targeted at adolescents. Most adolescent interventions are targeted at tobacco and alcohol use and there is a mind block about teaching sexuality education in schools.
One of the most sensitive problems in many parts of the world is that young people are sexually active outside marriage, says Dr Sawyer.
“Given the many challenges, it is important to build health care systems to deal with the challenges that come with adolescence,” she adds.
– Shai Venkatraman is a freelance journalist based in Mumbai. Her Twitter handle is @shaivenkat
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