Accelerating progress towards making health and

gender justice a reality for all young people in UP
More than 60% population of Uttar Pradesh is under-30 years of age, yet young voices are less heard,
particularly in the context of their health needs and how gender interplays on all aspects of health
justice for the young – from issues like what kind of services are made available to who is legally,
socially, culturally, economically, able to access these services and what gets missed. For example,
cultural silence and social barriers related to sexual and reproductive health and rights, not only make
youth vulnerable to sexually transmitted infections (STIs) including HIV, but can also put them at risk of
all kinds of violence, shame, as well as putting their lives at risk. Another stereotype is that young people
are “not supposed” to have sexual and reproductive health (SRH) needs, and there is a range of deepseated social and cultural taboos that make it even more difficult to obtain SRH services even if it is
available and accessible at Adolescent Friendly Health Clinic (AFHC). Shame is a barrier for youth
jeopardizing their access to existing services. Youth voices need to be recognised more in SRHR context,
and youth should be meaningfully engaged in SRHR policy frameworks, programmes, and in service
delivery at all levels. Until we enhance meaningful participation of youth, it will remain difficult to obtain
sustainable, positive impacts and youth-focused SRHR outcomes.
To foster youth-led documentation of young voices, perspectives and opinions, Citizen News Service
(CNS) and partners with support from Youth Champion Initiative (YCI) mobilized a network of under-30
correspondents in UP – speaking their world on youth-specific issues. In July 2015 CNS in association
with Family Planning Association of India, Balarc Foundation, Asha Parivar, Institute for Integrated
Society Development (IISD), Vote For Health campaign, Bharosa Trust, and Yuva Vikas Samiti identified
these young correspondents to document voices related to issues relevant for them in the state.

CNS under-30 correspondents team:
Avantika Chaturvedi, Brihaspati Pandey, Neetu Yadav, Ritesh Tripathi, Vikas Dwivedi, Avinash Tripathi,
Madhumita, Prabhjot Kaur, Vishwapati Verma, Jitendra Kaushal Singh, Shubhangini Chaurasiya, and
Rahul Kumar Dwivedi

Key faculty
Professor (Dr) Amita Pandey, Department of Obstetrics and Gynaecology, King George's Medical
University (KGMU); Leaders of Uttar Pradesh Network of People Living with HIV (UPNP+); Arif Jafar,
noted leader on MSM and transgender issues; Ms Shobha Shukla, CNS Managing Editor; Shailendra
Singh, senior journalist of Delhi Press Prakashan; and Bobby Ramakant of CNS were among the key
faculty members.

Capacity building training
A comprehensive journalists’ training workshop was organized
for the selected under-30 youth correspondents team to give
them hands on experience to (i) write news articles, (ii) learn
basic photography and video recording skills, (iii) interview
experts and affected communities (iv) use social media tools.

A range of sexual and reproductive health and rights (SRHR)
related issues were discussed in detail to help the
correspondents develop their articles focused. Here are the
photos: http://bit.ly/cns-young-photos
The under-30 youth correspondents team has so far produced
nearly 55 news articles, including videos, on youth SRHR
issues such as access to quality SRHR services, sex education,
menstrual hygiene, sexually transmitted infections like
HIV/AIDS, early child marriage, family planning and SRHR
related SDGs (Sustainable Development Goals).


32 Hindi articles: http://bit.ly/cns-young-hindi
7 English articles: http://bit.ly/cns-young-english
16 videos: http://bit.ly/cns-young-videos

Recommendations

Many educationists endorsed the need of imparting culture- and age- sensitive sex education to
adolescents in schools and colleges. The government should proactively consider including this
in the school’s curriculum. The content should be well designed to convey all the necessary
sexual and reproductive health (SRH) information. The curriculum should be developed
scientifically to address the information needs of students of different ages, genders
(transgender, male and female students) and classes. Even as young as 4-6 years old children
should be taught to differentiate between good and bad ‘touch’. Properly imparted culture- and
age- sensitive sex education will go a long way in preventing adolescents from accessing
distorted/ wrong SRH information from porn sites, magazines and peers; and in removing their
misconceptions around sexual and reproductive health. It will also make the youth aware about
sexually transmitted infections (STIs); help the girls in proper menstrual management; and boys
to grow up later into adults who are likely to be more sensitive towards understanding
menstrual hygiene.

Sanitary napkins are being distributed free of cost to girls studying in class 6 to 12 in government
schools of UP under the Kishori Suraksha Yojana (KSY), for achieving 100% menstrual hygiene
among adolescent girls. This laudable scheme is currently operative in government schools only.
It should be extended to private schools as most of the girls study in private schools at Grade 11
and 12 level. The scheme seems to be facing implementation problems due to poor interdepartmental coordination, and only a small number of targeted populations is benefitting from
the programme. Besides there is a lack of knowledge about the benefits of KSY among girls,
teachers and schools principals; frontline health workers (ANM, ASHA, AWW) are not involved
optimally in the programme; and Panchayati Raj department does not seem to have taken
cognizance of the importance of KSY at district level. Hence implementation is weak and
delayed. More over in many schools clean water, sanitation and sanitary pad disposal facilities
are also not functional. The programme should be implemented in earnest at the earliest. Also it
is equally important to reach out to eligible girls for KSY who are currently not going to schools.

Another good scheme of the UP government was the setting up of small units for manufacturing
low cost sanitary pads in the districts. This is a step in the right direction, as it not only promotes
menstrual hygiene (thereby improving general health of girls/ women) but also provides
employment to rural women. But even though such sanitary napkin manufacturing units were
established in 42 districts many of them have become non-functional now due to various logistic
problems - like stock out of raw material, after the first initial supplies. Two such units
established in Sarojininagar block in Lucknow employed 20 women, and were producing around
2000 sanitary napkins daily. But production has stopped since last few months due to nonsupply of raw material. So the government must increase inter-departmental coordination for
smooth and proper functioning of these units. It would also be a good idea to link this scheme
with the free distribution scheme of sanitary napkins-sanitary napkins manufactured in these
units could be used for free distributions to girl students.

Another crucial need is in line with government of India’s HIV programme priorities: to make HIV
prevention services easily available for high risk groups such as MSMs and transgender
populations. The timing of integrated counselling and testing centres (ICTC) should be according
to their convenience. Counselling should be an important component of SRH services for this
population. Proper counselling will not only give them correct information about HIV prevention
but also address their self-stigma and discrimination so that they can avail the services when
needed without any hindrance.

More Adolescent Friendly Health Clinics (AFHC) need to be opened to provide young people
much needed sexual and reproductive health related information, education and services.
Currently there are around 1300 AFHC clinics in 51 districts of Uttar Pradesh which is a laudable
progress but we must ensure quality of services is optimal and utilization of these services is
being done by all the youth.

Early child marriage hinders education of child, and contributes to increased maternal and child
mortality, as well as economic loss. According to Annual Health Survey 2012-2013, 32.6% of
women between 20-24 years were married before the legal age of 18 years, and 35.5% men
between 25-29 years were married before the legal age of 21 years in Uttar Pradesh. Addressing
the problem of child marriage is very important and an indispensable requirement for meeting
Sustainable Development Goals (SDGs) by 2030.

Experts’ voices: Challenges at ground level:
Youth SRH services and education:

An experienced anganwadi worker (community healthcare worker) Sarita Devi from Barabanki
said- “women should be sensitized to take care of their health especially during pregnancy.
Many rural women have the misconception that eating too much of nutritious food during
pregnancy would make the foetus overweight and create problems during delivery. This thinking
is entirely wrong. Pregnant women should take extra care of their diet and maintain general
hygiene”.
Anupama Shukla, Principal of a college in Sant Kabirnagar said—“Families sometimes hide and
keep any incident of sexual assault/molestation of the young girls to themselves, and not lodge
any complaint. This only encourages the culprits, and they roam scot-free. The youth are

sensitive to issues around SRH, but they are not able to get information. As a result, girls have to
cope with many avoidable SRH related problems”.

Menstrual hygiene:

Many young girls in rural India are still ill-informed about menstrual management needs.
Besides, there are many cultural myths and stigmas associated with menstruation which put a
young girl’s life at risk. Many times they seek health advice from local quacks, and fall under the
trap of superstition, which endangers their life.
Om Prakash Pandey, Udhyog Nirikshak of Sarojininagar block in Lucknow said- “we have two
sanitary napkin manufacturing units in which 20 women workers are engaged. We produce
around 2000 sanitary napkins daily. But due to irregular supply of raw material, production of
sanitary napkins is on halt since the last two months”.
Principal of a school in Bahadurpur Block of Basti district said—“The primary healthcare workers
(like ANMs and ASHA workers) should be involved in spreading the message of menstrual
hygiene in villages. There needs to be more awareness at family and community level too. Free
distribution of sanitary pads is a very good scheme and will go a long way in curbing absence of
girls from school. The scheme should be extended for girl students of private schools as well”.
Bindu Singh, Principal of a Junior High School said—“Free distribution of sanitary pads is a very
good scheme to promote menstrual hygiene. But in the absence of proper monitoring, its
benefits are not reaching all the girls. Proper implementation and monitoring is essential".

Early child marriage:

Dr Preeti Misra, posted at a primary healthcare centre in Basti said—“I often come across young
(<19years) married women in my hospital. Most of them either have sexually transmitted
infections or pregnancy related complications, due to which they have to be referred to
secondary care hospitals. Early marriage of girls often leads to repeated abortions, early
pregnancy and poor health of the mother. Early marriage of the girl child should be stopped to
prevent early pregnancy.”
A rural housewife Sushila Devi said—“I got married at a very young age when I was studying in
Class 8. I not only had to discontinue my studies, but also became a mother within one year of
my marriage. Due to early pregnancy related complications, my child died after two months. My
second child died during delivery. I am still suffering from very poor health.”

SRH need of People Living With HIV (PLHIV)

SRH needs of marginalized population (PLHIV and transgender etc) is under recognized. Imraan
Khan, Project Manager of Bharosa Trust, feels that one reason for the MSMs and transgenders
(most of whom work on daily wages) not being able to avail the existing HIV prevention services is
because of the inconvenient timings of integrated counselling and testing centres. Second reason is
discrimination, harassment, and judgmental behaviour of others.
Deepak Kumar Kulshrestha, state co-coordinator for Pehchaan Programme of India HIV/AIDS
Alliance said- “counselling is a very important component of SRH services for young MSMs and
transgenders. It is very important for young MSMs to know about their sexual and reproductive
health so that they can avail the services when needed”.