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ADOLESCENTS IN INDIA

A Profile

December 2003

for

UN SYSTEM IN INDIA

List of Contents

List of Tables List of Figures List of Box Introduction Situational Analysis Policy Frame Work for Adolescents: A Critical Appraisal Programmes and Interventions for Adolescents Legislations Relevant to Adolescents Adolescents: Global Developments and the UN System Future Agenda: A Vision for Adolescents in India References Acronyms 1 19 77 104 143 155 189 196 203

List of Tables Table 1: Table 2: Table 3: Table 4: Table 5: Table 6: Table 7: Table 8: Table 9: Table 10: Table 11: Table 12: Projected Population by Age and Sex (on 1 March) in India, 1991 2016 21 Percentage of Adolescent population to Total Projected Population 22 Age-specific Mortality Rates 24 Mean Age at Marriage for India 25 Age Specific Fertility Rates 29 Age Specific Fertility Level of Education of Women (15-19 years) in India, 1999 30 Literacy Rate by Sex in India: 1951-2001 32 Literacy Rate of Age Group 10-14 years and 15-19 years by Sex in Rural and Urban Areas, India, 1961 to 1991 33 Enrolment by Stages from 1950-51 to 2000-2001 35 Dropout Rate at Different Stages of School Education 36 Gross Enrolment Ratios for SC and ST for the Year 2000-2001 37 Daily average intake of energy and proteins against recommended intake by age/sex/physical activity of rural population for India during 2001. 48 Labour Force and Work Force Participation Rates in India by Usual Principal and Subsidiary Status 52 Working Children and Adolescents in the Age Group 5-14 yrs and 15-19 yrs by Types of Worker, Residence and Sex in India, 1991 (in Million) 53 Crimes against Adolescents 59 Victims of Rape by Age Groups over the Years in India 61 Incidence of procreation of minor girls, selling of girls for prostitution in India 1994-1999. 63 HIV/AIDS Surveillance in India (As on 31st October, 2003) 67 Juvenile Delinquents Apprehended for Crimes (1999-2000) 71 Minimum Legal Age Defined by National Legislation 78 Summary of NGOs Programmes for Adolescents 137 UN Conferences/Conventions and Issues Related to Adolescents 157 Activities on Adolescents by UN Organizations 171 Areas of Work for Adolescents by UN System 180 Mapping of Member Programmes and Activities Relating to Adolescents 182
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Table 13: Table 14:

Table 15: Table 16: Table 17: Table 18: Table 19: Table 20: Table 21: Table 22: Table 23: Table 24: Table 25:

List of Figures Figure 1 : Figure 1.1: Figure 2: Figure 3: Figure 4: Figure 5: Figure 6: Figure 7: Figure 8: Figure 9: Figure 10: Proportion of Adolescents in Total Population of India Age Distribution of India 2004. Projected Population by Age and Sex (on 1st March) in India 1996-2016 Mean Age at Effective Marriage of Female by Residence, India, 1999 Percentage of Females uner 18 years of Age at Marriage by Residence India in Bigger States, 1999 Age-groupwise Unmet Need for Contraception Percentage of Literacy by Age and Sex Prevalence (%) of Anaemia Among Adolescent Girls State wise Distribution of Working Children Victims of Rape Children living with HIV/AIDS 20 21 22 26 27 30 34 46 54 60 66

List of Box 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. Rights Approach to Adolescents Development: Landmarks Adolescence : Seeking Identity Onset and End of Adolescence Traditional Indian Texts and Adolesence Consequences of Limited Investments in Adolescents Reproductive Health and Development Rights Denied by Child Marriage / Early Marriage National Literacy Mission : Goals and Objectives Goals of the Sarva Shiksha Abhiyan A Changing World Documentation under NPEP Linking Adolescence to Adult Role and Work. Policy Directives: Guiding Principles Waking up and taking action Nutrition Policy Provision Child Health and Nutrition Goals and Achievements Harsh Realities of Child Labour The SACCS Experiences 125,170 Drug Addicts in India, says UN Report Some Estimates The ABC Approch Constitutional Provision Ninth Plan Strategy Highlights of IPEC Programme in India Lok Jumbish in Rajasthan Schemes to Improve the Outreach of Services Global Consensus on Adolescent Reproductive Health Objectives of Kishori Shakti Yojana Six Themes of Population Education Strategic Focus of Each UN Agency within the National Response Lessons for the Future Observations of the Court in the M.C. Mehta Case: The CRC Separate Legislation on Child Abuse Planned Principal Social Security Laws of India Population : Sustained Economic Growth and Poverty 3 4 6 7 15 28 34 38 42 43 44 47 49 50 55 56 58 62 68 79 81 107 109 112 113 115 117 121 142 145 147 151 163

Introduction

Preamble
In pursuance of the commitments and recommendations of the International Conference on Population and Development (1994) and South Asian Conference on Adolescent (1998), the UN Agency Working Group on Population and Development (IAWA&PD) prepared the document entitled Adolescents in India: A Profile in the year 2000. The aim was to give visibility to the adolescent as a crucial segment of the population within policy framework and programmatic efforts existing in India. Serving as an advocacy document, it provided a review of the status of the policy and programme implementation. It elucidated and highlighted the role of the UN System delineating the joint ventures related to the interventions for the development of the adolescents. With an objective to take stock of the progress made during last the three years in policy, programmes and partnership level, the present document Adolescent in India: A Profile (2003) has been prepared. It is an updated version of the earlier publication. In view of the fact that on World Population Day the year 2003 has been declared as the Year of One Billion Adolescents, the revision of the document at this juncture is a timely initiative. The high fertility rates in the eighties and the population momentum of the nineties have led currently to the presence of a large number of adolescents in Indias population. Since adolescents comprise a major part of reproductive group, they are likely to play a significant role in determining the future size and growth pattern of Indias population. They stand at the threshold of adulthood, and it is imperative
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that safe and enabling environment is provided to them to develop capacities for shapeing their own future as well as that of the nation. The vulnerability of the adolescent as a risk group has increasingly been recognized in the national development process during the last decade. In cognizance of this a Working Group

Rights Approach to Adolescents Development: Landmarks


Article 24 of the Convention on the Rights of the Child affirms that children have the right to attain the highest standards of health and to health care, including family planning education and services (a right also recognized in earlier conventions and conferences). In June 2003, the UN committee that monitors the implementation of the Convention elaborated: States Parties should provide adolescents with access to sexual and reproductive information, including on family planning and contraceptives, the dangers of early pregnancy, the prevention of HIV/AIDS and prevention and treatment of STIs. In addition, States Parties should ensure access to appropriate information regardless of marital status, and prior consent from parents or guardians. The Convention on the Elimination of All Forms of Discrimination against Women (1979) supports womens rights to reproductive health information and services and to equity in productive decision-making and matters of sexual health. In 1999, the committee that oversees the implementation of this treaty urged state signatories to accept that whenever the Convention uses the term women it applies to girls and female adolescents as well.

In 1994, the International Conference on Population and Development (ICPD) stressed the importance of adolescence to sexual and reproductive health through the life cycle. It also recognized that adolescents have particular health needs that differ in important ways from those of adults, and stressed that gender equity is an essential component of efforts to meet those needs. The ICPD Programme of Action urges governments and health systems to establish, expand or adjust programmes to meet adolescents reproductive and sexual health needs, to respect rights to privacy and confidentiality, and to ensure that attitudes of health care providers do not restrict adolescents, access to information and services. It further urges governments to remove any barriers (laws, regulations or social customs) between adolescents and reproductive health information, education, and services. The 1999 Special Session of the general Assembly, ICPD+5, recognized the right of adolescents to the highest attainable standards of health, and provision of appropriate, specific, user-friendly and accessible services to address effectively their reproductive and sexual health needs including reproductive health education, information, counselling and health promotion strategies (paragraph 731).

Source: UNFPA(2003), State of World Population Investing in adolescents health and Rights p.4. 2

on Adolescents was set up to provide inputs to the Tenth Five Year Plan of India. The concept of holistic integrated approach with need based programme/ intervention content, to be implemented through active participation of adolescents, was endorsed by this group. The involvement of family, community and civil society in partnership with UN agencies has been recommended as an approach to ensure well being of adolescents. The present document accordingly, has attempted to include analysis of the current situation of the adolescents, the capacity of existing national system to provide interventions, as well as analytic assessment of policy and legal provisions. The perspective is embedded in the Constitutional Provisions, CRC, ICPD and other relevant international tools emphasizing the rights approach. The strategies for advocacy, capacity building and networking for synergy within and across organizations/agencies can be mounted on the information presented in the document. It would help in evolving workable strategies to translate the provisions of the 10th Five Year Plan into concrete actions both at policy and programme implementation levels. It is hoped that the endeavour would contribute towards creating safer and supportive environment for the holistic development of Indian adolescents in the new millennium. Understanding Adolescence In the life cycle of a homosapien organism, adolescence is a period of transition from childhood to adulthood. It is characterized by rapid physical, biological and hormonal changes resulting in to psychosocial, behavioural and sexual maturation between the age of 10-19 years in an individual. Adolescence is often described as a phase of life that begins in biology and ends in society (Sharma 1996). It means that physical and biological changes are universal and take place due to maturation
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but the psychosocial and behavioural manifestations are determined by the meaning given to these changes within a cultural system. The experience of adolescents during teen years would vary considerably according to the cultural and social values of the network of social identities they grow in.

Adolescence : Seeking Identity


being in vigorous motion between two landings one representing childhood and the other adulthood, who must let go his safe hold on childhood and reach out for a firm grasp on adulthood. He also theorized adolescence as a stage of life during which inner identity is to be achieved and called it a period of identity crisis. The crisis term has been used by Erickson in a developmental sense to connote a threat of catastrophe, but a turning point, a crucial period of increased potential (Erickson 1968, P-69).

The concept of adolescence as it is commonly understood as a period of storms and stress was initiated by G. Stanley Hall of Clark University in the U.S.A at the turn of the century. Subsequently the Adolescent Psychology with an emphasis on psychological upheaval during this stage dominated the literature for several decades. Erickson (1975) a well known psychologist, viewed adolescence as a natural period of uprootedness in human life. Drawing a parallel between an adolescent and trapeze artist, he conceptualizes the young person as

It is pertinent at this juncture to raise the question Has the period of adolescence been recognized universally having the same meaning? In reality, there are markedly different notions of adolescence in different parts of the world. These stand apart from western account of what does or should happen during this transitional period between childhood and adulthood (Brown et al. 2002). The evidence in literature from cross-cultural studies both supports and challenges the hypothesis that adolescence is a difficult period in development. There are cultures where adult status is granted to both boys and girls through initiation rites at puberty, amounting to an abrupt transition from childhood to adolescence and adulthood. But it clearly confers the adult identity on the individual. However, it may be an extended period of transition in other cultures. Socialization
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process, it is acknowledged plays an important role in how inevitable biological changes are dealt with. There is little reliable date on the relative influence on their lives of peers, family and community. But it is essential that resources are provided to growing youngester through propolicies, programme and councelling and guidance. Documented work related to experience of young people, across the globe, indicates that the forms adolescence takes within culture, let alone across cultures, are diverse and distinctive. Still, one can certainly identify common features related to biological, cognitive and psychological imperatives of human development. Further, with the world becoming a global village through increased communication has led to the emergence of world youth community, resulting in to commonalities in interest of adolescents across cultures such as style of dressing up, eating habits, music preferences and sexual explorations. However, these commonalities get coloured, adapted and transformed to give different meaning within a cultural system. There is therefore, a cautionary note for all those who work with adolescents and youth may it be researchers, practitioners, employers, policy makers and parents not to have a universalistic notion about adolescence. Adolescence needs to be understood in historical and cultural context and its variegated and tentative nature be acknowledged and appreciated (Brown and Larson 2002). It is particularly significant when policies are formulated and interventions are planned for adolescents to ensure their well being with reference to a particular culture/country. Adolescence: Indian Context In contemporary India while adolescence is a comparatively new term, the word youth is better known and has been used at the levels of policy formulation and programming (Singh 1997).
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Onset and End of Adolescence


changes of pubescence signal the beginning of this phase. Sociological criteria such as achievement of adult status and privileges, marriage, the end of education and the beginning of economic independence frequently mark the termination of adolescence. The stage of adolescence is likely to end earlier in primitive cultures and later in technological ones. (Sharma1996 p 25)

The interplay of biological changes and social attitude will determine the psychological meaning of puberty for its members. The common themes and assumptions, which are relevant in this context are: The onset of puberty marks the beginning of adolescence. There are individual as well as cultural differences in the length of adolescence and in the age of onset and completion. While the physical

However, even the ancient text of Dharamashastra recognized the crucial nature of adolescence and prescribed specific codes of conduct for the phase. These codes are deeply rooted in the Indian psyche and continue to influence cultural practices towards adolescents in a powerful manner (Verma and Saraswathi 2002). To contextualize the cultural milieu, in which adolescents grow in India, the relevant traditional cultural values and themes that shape and affect the environment of adolescents during growing years need to be described. The family universally is acknowledged as an institution of socialisation, however, it plays a major role in the life of an Indian. Despite the fast pace of social change, it continues to have a direct bearing on adolescents development, since most young people stay in family until adulthood or even later in the case of joint family set-up. Most Indian families observe sacred ritualistic ceremonies at various stages of life cycle (Kakar 1979, Saraswathi & Pai 1997). These are markers of progressive attainment of competencies both in social and behavioural aspects of life. The onset of puberty is acknowledged by the family and new code of conduct is prescribed both for boys and girls.
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Traditional Indian Texts and Adolesence


(1959), an ancient text authored by Bhanu Datta a young girls has been referred to as sviya (the one who loves only her husband ) and given three titles based on her age and experience. Mugdha (youthful and inexperienced), madhya (the adolescent) and pragalbha (the mature). This classification seems so close to three stages of contemporary Adolescent Psychology (pubescence /early adolescence (10-12 years), puberty/mid adolescence (13-15 years), adolescence/late adolescence (16-19 years).

In the traditional texts of the Dharamashastra- which prescribes the code of conduct for each stage of development, a crucial place has been assigned to adolescence in the process of enculturation. The terms Kumara and Brahamchari that refer to the stage of celibacy and apprenticeship/acquisition of knowledge especially describes period of adolescence for young males from upper class (Verma and Sarswathi 2002). There was interestingly no mention of young girls in that text. However, in Rasamangri cited by Randawa

Several studies have indicated that parents rarely provide the desired support to growing adolescents regarding biological and physiological changes as also the meaning attached to these. Youth sexuality stands out as an important aspect which is inadequalely understood; taboos to access information and lack of counselling services make youngsters turn to peers and other sources of information (Abraham 2000; Abraham & Deshpande 2001; Sachdev 1998; Murthy 1993). We need to be aware that distorted information has consequences related to exploitation, abuse, mental health problems and risk of HIV/AIDS. Providing awareness services and strengthening capabilities of institutions like family, community and school to act as sources of correct information are thus important and need to be given attention. Varied Images of Indian Adolescents Adolescents include both boys and girls but in Indian context these two have very different experiences during growing years including adolescence, the cultural differences are vast with regard to their conduct and are based on traditional adult roles stereotypes. Growing as a female in India carries with it the connotation of
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inferior status, and lesser privileges-as compared to a male child. It cuts across all social classes of the society and through entire lifespan. For a girl, the onset of puberty implies more restrictions on her movement, fewer interactions with boys and men, and more active participation in household chores. Boys begin to exercise greater freedom to move about, expected to seek educational and vocational pursuits as a priority and to take adult roles. Besides age old gender distinctions, there are many variations in the current images of adolescents in India. The variations arise from factors such as urban, rural and tribal residence, ethnicity and socio economic levels of the family. Lifestyle of urban adolescents from upper SES is quite different from that of middleclass and lower-class adolescents. Former have access to private, good quality education and are influenced by western ways of life style through travel and exposure; their preferences for music, clothes and interaction with opposite sex are very close to the western counter parts. On the surface there does not appear to be any gender discrimination in the families of these adolescents but covertly they do exist. Pursuing educational endeavours is encouraged both in upper and middle urban class. Urban Adolescents from lower class have to struggle for survival and grow in impoverished, disadvantaged environment making them vulnerable to several risks. Malnutrition, risk of poor health, becoming victims of antisocial activities, brewing and sale of illicit liquor, sex exploitation, prostitution and drug peddling were reported threats for adolescents from slums in a multi indicator survey (Khosla 1997). The picture of rural adolescents is different; the disparity between boys and girls is even greater among them. Less emphasis on formal education makes boys and girls participate in adult activities at home and outside at an early age. The boys are expected to join men in work to earn their living, may it be on a farm or a
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factory or a traditional craft at home. The routine of a pre-adolescent/adolescent rural girl is demanding-cleaning the house, cooking, washing, fetching water, bathing younger siblings. Rural girls rarely pursue education beyond primary school level. Early marriage as a trend is common even now, both for boys and girls in rural India. The traditionalism and familialism are evident in various facets of family life, both in rural and urban settings (Bhende 1994; Pathak 1994). Parental involvement and control is high. Emotional interdependence among family members, respect for elders and family solidarity are characteristics of an Indian family. It has implications for social responsibilities of caring for old parents, protecting sisters and providing support to other dependents as a traditional duty, valued within the culture, and these values are emulated by growing male adolescents. Adolescent girls are groomed to become good wives and mothers having sacrifice, tolerance and dependences as an integral part of their disposition. There is also a general acceptance of double standards for males and females in matters related to premarital sex and selection of marriage partners, with considerably more freedom for males (Uplaonkar 1995). Indian Family In Transition The rapidly changing social, political and economical scenario in the world has not left Indian family untouched. It is going through structural and functional modifications that have a bearing on adolescents socialization and parent child relations. Weakening of social support from kinship, movement of women empowerment, exposure to media, increasing competitive demands of the market economy and higher standards of achievement are a few aspects that have changed the family dynamics in the recent past. The need for differential values,

competencies and coping styles between parents and adolescents are a source of anxiety and stress both for adolescents and parents (Verma and Saraswathi 2002). The ambiguity of values that adolescents observe in the adult world, the absence of powerful role models, increasing gaps between aspirations and possible achievements, not surprisingly, lead to alienation and identity diffusion (Sing & Sing 1996). Parents themselves appear ill prepared to cope with social change, having grown up in hierarchically structured and interlinked social and caste groups that provided stability (Sinha 1982, cited in Singhal & Misra 1994). The conflict between parents desire to help their adolescent children cope with the changing demands of their own rootedness in tradition expresses itself in the cold feet syndrome when things go wrong. Parents who apparently seem modern, but if their child breaches established social codes, intergenerational conflicts related to marriage, career choice, or separate living arrangements result in the tendency to fall back on tradition (Saraswathi & Pai 1997) Amidst all this turmoil, while the outward form of family is changing, Indian family has the advantage of its heritage with well defined value system related to social relations and prescriptions of the ideal way of life. Adolescents across all sections of the society thus have a family as an anchor that supports them to cope with challenges of transition to adulthood. Family as an institution in India therefore, has a potent role in influencing adolescents. Capacity building of its members to provide timely support and monitoring signs of dangers to save adolescents from slipping into risks, can be an important strategy/approach. Involvement of parents has increasingly now been used in planned interventions of governmental and voluntary sectors.

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Developmental Needs of Adolescents Adolescence is marked as a period of growth spurt and maturation, extent of physical growth is not determined by genetic, heredity factors alone but also on availability of adequate nutrition, micronutrients in the diet and access to health services. Inadequate nutrition during adolescence can have serious consequences throughout reproductive years and beyond. Extra nutritional requirements include increased intake of calcium, iron, iodine, minerals and proteins. Unmet nutritional needs lead to several public health problems such as stunted and retarded growth, impaired mental development, anaemia, complications during pregnancy and low birth weight babies. Adolescence is also a stage when young people extend relationships beyond their parents and family. It is a time of intense influence of peers, and the outside world in the society. A desire to experiment and explore can manifest in a range of behaviours-exploring sexual relationships, alcohol, tobacco and other substances abuse. The anxiety and stress associated with achievement failure, lack of confidence etc are likely to lead to depression, anger, violence and other mental health problems. Adolescents as they mature cognitively, the mental functioning process becomes analytic, capable of abstract thinking leading to articulation and independent ideology. These are truly the years of creativity, empathy, idealism and with bountiful spirit of adventure. Thus, if nurtured properly youth can be mobilized to contribute significently to national development. Overview of Research Unmet needs during this critical period have serious consequences not for the individual alone but for the family, community, society and nation at large. The relevant empirical evidence in this context reported here has implications both for
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policy and designing services. The major source of these references is Adolescence in India an annotated bibliography compiled by Verma and Saraswathi (2002). The data available from the reviewed literature on physical growth, nutritional and health status demonstrate that health scenario of a large proportion of adolescents in India is plagued by undernutrition, anaemia, and infectious diseases resulting from poor environmental sanitation and ignorance. While the consequences of poverty do not spare the adolescent boys, the girls come through as the endangered sex (Anand et al. 1999, Chaturvedi et al. 1996, Kanada et al. 1999). In the absence of general overall socio-economic development, availability of safe drinking water, environmental sanitation, and better access to public health care, including control of recurrent viral, bacterial, and parasitic infections, nutritional and dietary supplementation are recommended in the review as strategic interventions to reverse the trends. (Patel and Capoor 1996; Kanani 1995; Baroda Citizen Council 1998). There is a spate of work in the area of sexuality and reproductive health. Much of this information relates to opinions taken from illiterate, as well as school and college populations. Increase in the sexual activity, incidence of STDs/HIV and clinical abortions among unmarried adolescents are reported (Abramham, 2000). But we are confronted with is a mixed bag of problems related to premarital and marital sex pertaining both to the largely rural and predominantly illiterate group as well as the urban literate population. Matters are further compounded by gender bias, myths and misconceptions associated with sexuality and reproductive health among adolescents combined with reluctance on part of the parents and schools to talk more freely about sex (Awasthi and Pande 1998; Bahulekar and Garg 1997; Aggarwal 1999; Mamdani 1999). Traditional beliefs regarding families role in selection of life partner with preference for arranged marriages among both rural
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and urban youth, and more conservatism regarding girls sexual behaviour and marriage is expressed by both young men and women (Abraham 2000; Uplaonkar 1995; Desai 1993). It is evident that fertility control through stringent implementation of the legal age for marriage, nutrition and sex education, and protection of unmarried adolescent girls, demand urgent attention. Even though there is now a large body of information on sexuality, there is uneven coverage of studies on adolescents out of school as well as on the street related to their sexual practices (Pandey 2000; PANOS 1999). Studies on Mental health, well-being, and behaviour problems among the adolescents remain limited. The data suggest the need for curative, preventive, and promotive measures dealing with mental health problems among the adolescents Malhotra et al. 2001; Bijlani 2000; Verma and Singh 1998). Probe in to the sorry state of many of the existing mental hospitals, recommends that para professionals may assist in preliminary screening at the community level and instead of professional institution based care family-oriented home care be opted to rehabilitate mentally ill individuals. Building a reliable data base related to victimization, sexuality, and reproductive health with greater sensitivity to gender bias requires priority. Investment in Adolescents Within the framework of human rights established and accepted by the global community, certain rights are particularly relevant to adolescents and youth with respect to the opportunities and risks they face. These include gender equality, the right to education, nutrition, health, including reproductive and sexual health information and services. Efforts aimed at granting these rights are likely to lead to several positive out comes: realization of the potential of adolescents, empowering

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young individuals, ensuring psychological wellbeing, slimming HIV/AID pandemic, reducing poverty and improving economic and social progress. It is well realized and acknowledged now that investing in young people will yield large returns for generations to come. Failing to act on the other hand, may result in tremendous costs to individuals, societies and world at large (UNFPA 2003). Meeting these challenges would mean adolescents are put in centre stage, a priority area in nations development. Knowledge and information related to understanding of the complex and sensitive needs and problems of adolescents in a particular culture would be an essential pre-requisite to the process. Further, efforts are required for strategic involvement and partnership of adolescents themselves, family, community, government, civil society and UN agencies in working together for ensuring well being of adolescents. Consequences of Under-investment in Adolescents Young people alive today present a unique economic opportunity. With appropriate investment in health and education supported by conducive economic policies, countries can mobilize potential of their young people to launch an economic social transformation; on the other hand, limited investments can have serious consequences (Box 5). The United Nations System, accordingly, is working with a wide range of partners in several nations to address the needs of young adolescents as per cultural ethos and in line with human rights standards. This document therefore, examines the situation of Indian adolescents in the cultural context recognizing their needs and concerns and attempts to review policy provisions, programmatic interventions and identifies gaps to promote partnerships amongst stake holders for holistic development of the youth.
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Consequences of Limited Investments in Adolescents Reproductive Health and Development


Contributing Factors Consequences for Self Consequences for families, Society & National Development Higher infant and maternal morbidity and mortality Higher health care costs Higher social welfare costs, especially in the case of single and unmarried mothers Abandonment of newborns Reduced prospects of eradicating poverty (as educational level of mother is key factor in breaking inter-generational transmission of poverty Reduced skilled human capital for socio-economic development; less skilled workforce; reduced earnings Increased dependency of young mothers on male providers (even if abusive), related to persistent gender inequality and lack of womens empowerment. Increased population momentum; reduced demo-graphic bonus

Reproductive Health Consequences

Early Pregnancy & Early marriage childbearing Poverty (motivates early pregnancy/early marriage for economic and personal security). Gender discrimination/low value of girls/sense of identity and control/status based on roles as wives, mothers; low self-esteem Lack of information, education, counselling and services for prevention; lack of information about pregnancy risks at too young an age. Inability to negotiate contraceptive use, fertility decisions, or postponement of pregnancy due to gender age and sociocultural expectations Lack of reproductive rights.

Risks of complications from pregnancy (obstructed labour, obstetric fistulas. Anaemia / hemorrhage, death) School drop out Diminished employment and income-earning options Poverty Responsibilities, pressure of childrearing too much, too soon before socio-economic and psychological development Potential for selfdevelopment curtailed

Unwanted pregnancy

Lack of reproductive rights Low access to contraceptive information, education, counselling and services Myths and misconceptions about pregnancy and contraceptive safety Gender relations-pregnancy is womans responsibility; attitudes of lack of male responsibility for pregnancy prevention or consequences; gender stereotypesgirls not equipped with negotiating and assertiveness skills submissiveness and ignorance expected of girls Sexual violence Forced sex and forced pregnancy as weapons of war Poverty (less years of school or more years out school; less access to information and services or to sexuality education; girls less informed about their bodies)

Recourse to abortion, including unsafe abortion (with high risks of maternal morbidity or death) Reduced investments in childrens needs and Single and early motherhood development Larger family size than the Reinforcement of gender partners desire inequality-loss of socioeconomic opportunities Reduced chances for self- and womens full development and skills- development potential building to break out of poverty Increased population momentum

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Reproductive Health Consequences

Contributing Factors

Consequences for Self

Consequences for families, Society & National Development Persistence of gender violence and sexual abuse of children and adolescents (violating universal values and human rights related to respect for human dignity, personal and bodily integrity, freedom and selfdetermination, and fundamental reproductive rights) Reinforcement of acceptability of violence Diminished educational attainment increased absenteeism from work and reduced productivity and loss of income to employers Increased crime, reduced law and order, increased corruption (from sexual trafficking) Depression Slowed progress against HIV/AIDs Low productivity and investments Hopelessness and anomie Agricultural, health, education and other systems fail Disruption of social and economic systems Overburden on health care system Destruction of family networks National stability and security harmed Economic growth and social development reduced Increased marginalisation Low social mobility Poor health, nutrition and education Disenfranchised youth as a source of civil unrest Lack of inputs from young people in the development of policies and programmes Lack of social and political tolerance

Sexual Abuse, Violence Children and adolescents, especially girls, subject to sexual & Exploitation abuse and incest-silence kept from fear, lack of education, marginalisation, lack of protection, and social norms and taboos Poverty (false promises of increased income for self and family) Sexual trafficking and slavery profitable; limited enforcement corruption, etc. lack of protections for at-risk or already enslaved girls Conflict and post-conflict situations (increased sexual abuse and rape because of fragmented social and family fabric) Low status of girls and young women; low self-esteem; male power and sociocultural legitimacy of sexual violence

Psychological, physical and emotional trauma Unwanted pregnancy, unsafe abortion, STIs/HIV/ AIDS Impaired ability to establish trusting relations, intimacy, sexual relations; increased prospects of repetitively abusive relationships Reduced freedom, life in fear and violence, including freedom of movement

STIs/HIV/AIDS

lack of Information on safer sex Gender discrimination/lack of decision making power Lack of access to methods of protection Sexual abuse, violence and exploitation Poverty (leads to transactional or intergenerational sex) Multiple sexual partners

Premature death or potential self-development curtailed Discrimination and stigma Increased poverty Infertility Cervical cancer and other sequelae of some non-fatal infections Orphanhood

Under-employment

Weak job creation Low entrepreneurial skills Low entrepreneurial skills Socio-economic exclusion Gender discrimination in employment and remuneration and unrecognized labour

Lack of skills Unsafe exploitation Child labour, and sexual exploitation, transactional sex Poverty

Low civil and social Lack of settings/institutions for including young people participation Restrictions on girls mobility and gender segregation Social and political exclusion

Lack of opportunities to participate and voice concerns Inability to use democratic institutions

Source: UNFPA (2003. The State of World Population 2003, investing in Adolescent health and rights. New York; pp 11-12

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The Demography of Youth: Trends in India Demography plays a fundamental role in shaping adolescents futures. Changes in the number and ethnic diversity of adolescents are likely to also affect their futures. In developing nations, high birthrates mean that the numbers of children and adolescents will continue to grow dramatically over the next several decades, straining the resources that are of particular importance to young people; such as space in schools and jobs. Rapid population growth, in these countries, means that young people experience diminished opportunities to develop their capabilities and for transition to adult employment. Unless income disparities are reduced, daily life for a large numbers of adolescents in poor families in the developing world will continue to be dominated by hunger, inadequate nutrition, and the struggle for survival. Rapid population growth, especially in urban areas, is undercutting efforts to contain old and new communicable diseases, which continue to inflict more than half of the deaths in India and Africa (World Resources Institute 1998). Although adolescents are often the age group that shows the lowest rate of immediate mortality from these environmental hazards. It is this group that would suffer large cumulative effects on their long-term health and life expectancy. These problems and hazards need to be addressed adequately for checking adverse consequences later. The other major demographic event currently occurring in industrialized countries and soon to hit developing countries is the dramatic increase in number of elderly (Fussell and Greene, 2002). Expansion in their numbers may mean diversion of public service resources (e.g., education, other services, and even counselling and research) away from the youth. Growing ethnic diversity intensifies the importance of inter-ethnic group relations among adolescents. This is a global issue: in India too, ethnic identities are becoming increasingly salient, due to
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population pressures and competition for resources and reservations related to opportunities for education and employment. The intense retaliation of youth in the beginning of nineties towards reservation for scheduled caste for admission in educational institutions and employment as per recommendations of Mandal Commission created a stir in India. There is a need, therefore, to be sensitive to reactions of the youth and adopt ways and means to heighten their tolerance for coexistence and mutual regard for diverse ethnic, religious and caste groups.

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Situational Analysis

Data Availability on Adolescents Lack of uniformity in the age parameter for defining the group of adolescents is a major constraint. Adolescents are most often subsumed with youth or with children or with young adults. Different policies and programmes define the adolescents age group differently. For example, adolescents in the draft Youth Policy have been defined as the age group between 13-19 years; under the ICDS programme adolescent girls are considered to be between 11-18 years; the Constitution of India and labour laws of the country consider people up to the age of 14 as children; whereas the Reproductive and Child Health Programme mentions adolescents as being between 10-19 years of age. Internationally, the age group of 10-19 years is considered to be the age of adolescence. It is evident that in India, age limits of adolescents have been fixed differently under different programmes keeping in view the objectives of that policy or programme. Keeping in view the characteristics of this age group, it is widely felt and recommended that it would be most appropriate to consider adolescents as between 10-19 years of age. The lack of reliable data and information on the adolescent age group is a major impediment in preparing a profile of adolescents. Further, age group of 10-19 years is rarely considered as a distinct age group in official statistics. Moreover, the emphasis on youth (15-35 years in India) results in greater and better quality information regarding older adolescents in comparison with the younger ones. In
19

many instances disaggregated information by gender is lso not available. There is a need to reorient national reporting system to provide data sets that can facilitate planning and programming for adolescents in the age group of 10-19 years and be made available up to district level for undertaking area specific needs of the young adults.
Figure 1 : Proportion of Adolescents in Total Population of India

Adolescents 22.8%

Rest of the Population 77.2%

Source: Report of the Working Group on Adolescents for the Tenth Five Year Plan, GOI, Planning Commission, June 2001

Adolescent Population: Size and Composition As on March 2001, adolescents accounted for 22.8% of the population of India (Fig. 1). There are around 239 million adolescents in India in the age group of 1019 years presently. Over the next two decades the number of adolescents is likely to increase further but their share to population will decrease marginally as per the projections (Planning Commission 2001.) The genderwise breakdown of the adolescent population does not show any significant disparity between the sexes, with female adolescents accounting for the same proportion of the total female population as male adolescents for the male

20

st Table 1: Projected Population by Age and Sex (on 1 March) in India, 1991 2016 (in 000) Age group 10-14 yrs. Male Female Person 15-19 yrs. Male Female Person 10-19 yrs. Male Female Person 1991 52,487 46,749 99,236 43,482 38,701 82,183 95,969 85,450 181,419 1996 57,939 51,606 109,545 47,999 42,721 90,721 105,938 94,327 200,266 2001 63,566 59,339 122,905 57,675 513,89 109,064 121,241 110,728 231,969 2004 61,465 58,620 120,085 62,182 56,980 119,161 123,647 115,600 239,246 2011 53,977 51,229 105,206 58,664 56,420 115,085 112,641 107,649 220,291 2016 56,698 53,736 110,461 53,792 51,079 104,871 110,490 104,815 215,332

Source: Census of India, 1991, Population Projections for India and States 1996-2016 Report of the Technical Group on Population Projections constituted by the Planning Commission, August 1996. Registrar General, India, New Delhi. p. 19. 1991-94. Figure 1.1: Distribution of Population by Age and Sex in India 2004.
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 39 30-34 43 25-29 20-24 15-19 10-14 5-9 0-4 61 63 57 56 55 53 51 35 31 26 22 18 13 10 7 3 4 3 4 7 10 12 16 19 23 29 34 39 41 45 55 59

Males

Females

80

60

40

20

20

40

60

80

Millions

Source : Census of India 1991

population (Fig. 1.1). However, the problem of adverse sex ratio is also evident in the adolescent age groups (Fig. 2).
21

Figure 2: Projected Population by Age and Sex (on 1st March) in India 1996-2016
140

120

100 59 in thousands 52 80 47 43 60 39 51 59 57 51 56 54 51

40 52 20 43 58 48 64 58 61 62 54 59 57 54

0 10-14 Yrs. 1991 15-19 Yrs. 10-14 Yrs. 1996 15-19 Yrs. 10-14 Yrs. 2001 15-19 Yrs. 10-14 Yrs. 2004 15-19 Yrs. 10-14 Yrs. 2011 15-19 Yrs. 10-14 Yrs. 2016 15-19 Yrs.

Male

Female

Table 2: Percentage of Adolescent Population to Total Projected Population


Age Group 10-14 15-19 All ages* M 11.95 9.90 1991 F 11.48 9.51 P 11.73 9.71 M 12.14 11.01 2001 F 12.14 10.51 P 12.14 10.77 M 11.22 11.36 2004 F 11.44 11.19 P 11.33 11.24 M 8.89 9.67 2011 F 8.95 9.86 P 8.92 9.76 M 8.74 8.29 2016 F 8.75 8.31 P 8.74 8.30

439,230 407,072 846,303 523,780 488,606 1,012,386 547,556 512,468 1,060,030 606,744 572,145 1,178,889 648,886 614,657 1,263,543

Note: Source :

* Total population all ages (in thousands) Census of India, 1991, Population Projections for India and States 1996 2016 Report of the Technical Group on Population Projections constituted by the Planning Commission, August 1996. Registrar general, India, New Delhi. pp. 1991-94

According to the 2001 Census, the sex ratio is 933 females per 1000 males a disturbing indicator of gender discrimination. State-wise sex ratios vary from 1058 females in Kerala to 861 in Haryana. The change over time, therefore, will depend on change in the ratio of individual states/UT and their relative share in population. The four most populous states namely U.P, Bihar, Rajasthan and M.P constitute 36
22

percent of Indias population and have below national level sex ratios and therefore contribute significantly to over all decline in sex ratios. The strong preference for a male child, which manifests itself in the form of sex selective abortions, infanticide, malnutrition, neglect and exploitation of girls and women, is a major cause behind the adverse sex ratio. Strong measures are required in the cencerned states to abate the trend that does not appear to augur well for the nations future. The sex ratio for adolescents in the 13-19 age group declined from around 898 girls to 1000 boys in 1981 to 884 girls in 1991. Substantial evidence is also available to show that there is a high level of female mortality in the 15-19 year age group. National Family Health Survey II reveals that 54% of girls (15-19 years) are married and 50% of first births were among those under 19 years. The two findings put together imply that the maternal mortality of teenage mothers contributes to the high rate of mortality found in the age group 15-19 years. One in five of all maternal deaths is attributed to anaemia during pregnancy. Anaemia in adolescent girls is a consequence of inadequate nutritional status which gets further compounded during pregnancy, due to growth of the foetus and maternal tissues (Kanani and Ghanekar 1997). It points to the urgent need of raising the age at marriage and first birth and meeting nutritional needs of teen age girls during growth and pregnancy. It also highlights that any endeavour related to adolescents must consider gender dimension which is a cultural reality. The adverse effects of neglect during childhood need to be corrected during adolescent years, a period of growth spurt. Both CRC and CEDAW explicitly address discrimination against girls and women, challenging the underlying values that perpetuate gender inequality and

23

denying opportunities and rights to the female gender. Concerted efforts are required to change the gender discrimination scenario by reorienting policies, strengthening legal provisions and making enforcement machinery efficient, designing programmes to address specific discriminating practices and a powerful advocacy campaign to alter the age old attitudes of devaluation of the girl child. The present generation of adolescent girls need to be treated as a special group and given a second chance to realize their potential.
Table 3: Age-specific Mortality Rates Age group (in years) 0-4 5-9 10-14 15-19 20-24 35-39 45-49 55-59 All Ages 1980 F 43.5 4.0 1.7 2.9 3.8 4.6 7.3 16.7 12.4 M 40.1 3.3 1.7 2.0 2.3 4.7 9.6 21.5 12.4 F 27.9 2.8 1.4 2.5 3.1 3.2 6.3 14.4 9.6 1990 M 24.8 2.3 1.4 1.7 2.4 3.9 9.0 20.9 9.7 1995@ F M 25.3 2.7 1.4 2.0 2.7 3.1 5.2 11.8 8.7 23.2 2.2 1.3 1.7 2.1 3.7 8.1 17.5 9.3 1998 F 24.1 2.4 1.2 2.0 2.7 3.0 5.2 13.7 8.8 M 21.0 2.1 1.0 1.7 2.3 4.2 7.4 18.9 9.2 F 21.1 2.1 1.3 2.1 2.8 2.8 5.3 13.0 8.2 1999 M 19.8 1.6 1.2 1.7 2.3 4.8 8.5 19.4 8.9

Note:@ excludes Jammu and Kashmir. Source:(i) CSO, Women & Men in India, 2001 p.12 (ii) Office of the Registrar General, India, Sample registration system, Statistical Report 1999 p.147

Age Specific Mortality Mortality rates during adolescence years are comparatively lower than other age groups (children and older age groups). As a result, while planning health intervention by and large this age group is by passed. However, it is noteworthy that despite being biologically stronger, female mortality rates are higher as
24

compared to males across all stages of growing years. It is particularly noticeable for child bearing age group (20-24 years) and showed a dip over the years which could be due to increased access to RCH services. However, mortality rate for girls in 15-19 years age group showed no change and this endorses the earlier contention that early marriage, and value associated with child bearing result in pregnancy at an early age. Since large proportion of girls at this age are malnourished and short statured, they are at a greater risk of complicated birth resulting in high infant and maternal mortality/ morbidity. It also prolongs the span of fertility years resulting in larger number of pregnancies, risk of infection unsafe abortions and several other consequences. Age at marriage, therefore, has far reaching consequences on fertility rate, child bearing and other health issues. Age at Marriage Early marriage continues to be the norm in the country, although mean age at marriage has been increasing steadily from 1951 onwards both for males and females. It is at present 19.6 years for females and 24.5 for males.
Table 4: Mean Age at Marriage for India Year 1951 1961 1971 1981 1992 1996 1997 1998 1999
Note:

Female 15.4 16.1 17.1 17.9 19.5 19.4 19.5 19.5 19.6

Male 19.9 22.3 22.7 23.3 NA NA NA NA NA

Source:

Figures for 1951, 1961, 1971 and 1981 are singulate mean age at marriage based on population census data. After 1992, the figures are the mean age at effective marriage based on sample registration system. (1) Govt. of India. Ministry of Statistics and Programme Implementation, Central Statistical Organization, Women and Men in India, New Delhi, 2001 P.13. (2) Sample Registration System Statistical Report, 1999 Registrar General of India, New Delhi. Jan 2002. p. 23.

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As compaired to urban areas, the age at marriage is about one and half year lower in rural areas due to traditional belief and social practice of marrying young (Fig. 3). In 1998-99, sixty one percent of women in the age group of 20-24 years were married before the age of 18 years. Out of these 59 percent were in rural areas

Figure 3: Mean Age at Effective Marriage of Female by Residence, India, 1999

25.0

23.5 23.3 23.9 21.0

20.0 16.2 16.2 16.3 15.0

18.9 18.9 19.0

19.6 19.3

10.0

5.0

0.0 <18 18-20 21+ Age at Effective Marriage Total Rural Urban All Ages

and 41 percent in the urban area (NFHS 1999). Average age at marriage for educationally disadvantaged female is 15 years, it is 22 years for women who have completed school. Thirty percent of adolescents in the age group 15-19 years are married (IIPS-2000). There are wide inter state variations in the percentages of girls married under the age of eighteen years (Fig. 4). It ranged between 33% in Andhra Pradesh and 1% in Himachal Pradesh (SRS 1999). It is emphasized that early marriage violates a number of rights of the girl and inhibits her holistic development (Box 6).

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Figure 4: Percentage of Females uner 18 years of Age at Marriage by Residence in Bigger States of India 1999

H i mach al P r ades h

1 2. 2 3. 7 4. 3 5. 1 9. 4 11. 5 11. 7 1 2. 5 1 3. 3 1 5. 7 17 1 8. 1 1 8. 7 24. 2 24. 3 33. 3

P un j ab

K er al a

T ami l N adu

Guj ar at

U t t ar P r ades h

K ar nat ak a

H ar y an a

27

Or i s s a

A s s am

I ndi a

M ahar as h t r a

W es t B en gal

R aj as t han

M adhy a P r ades h

B i har

A ndhr a P r ades h

Source : Sample Registration System Statistical Report, 1999, RGI, New Delhi p. 23

Rights Denied by Child Marriage or Early Marriage


vocational information and guidance (Article 28). The right to seek, receive and impart information and ideas (Article 13) The right to rest and leisure, and to participate freely in cultural life (Article 31)

Early marriage of girls undermines a number of rights guaranteed by the Convention on the Rights of the Child. The right to education (Article 28) The right to be protected from all forms of physical or mental violence, injury or abuse, including sexual abuse (Article 19) and from all forms of sexual exploitation (Article 34). The right to the enjoyment of the highest attainable standard of health (Article 24) The right to educational and

The right to not be separated from their parents against their will (Article 9) The right to protection against all forms of exploitation affecting any aspect of the childs welfare (Article 36).

Source: UNFPA, The State of World Population 2003 p. 15

Lack of awareness about legal age of marriage is a common phenomenon in rural areas. Publicity of Child Marriage Restrain Act is poor and enforcement virtually non existent. Even through millions of girls in the country are married before attaining the age of 18 years, the number of cases registered under the Act in a period of six years 1994-2000 were only 391 (NCRR-2001). Concerted efforts are required to raise the age at marriage for ensuring well being of adolescents. Measures such as advocacy, promoting education of girls, stricter enforcement of minimum legal age of marriage be promoted to change the practice of early marriage particularly in rural areas. Fertility Rate The much cherished goal of stable population seems unattainable as we are already 14 million more than what was estimated for 2002. It seems that stable population is difficult to be achieved even by 2045, unless path breaking initiatives

28

are taken to control/reverse the trends of population growth by reducing fertility rate, particularly for the age groups 15-19 years and 20-24 years. Despite adopting family planning measures as early as in 1950s, the birth rates could not be brought down to control the population growth. It clearly points that fertility can not be checked alone by technology and supplies of contraceptives. It has behavioural dimensions influenced by several factors like educational level of women, freedom to take decisions related to reproduction, child survival, standard of living, availability and access to official and friendly reproductive health service system including contraception (Bose 2003)
Table 5: Age Specific Fertility Rates Age Group 15-19 20-24 19801 1990 1991b 1992b 1993b 1994b 1995b 1996b 1997b 1998 1999 88.2 83.1 76.1 74.4 69.6 68.1 55.2 55.3 53.7 54.0 52.1

246.1 237.0 234.0 235.2 234.4 244.6 238.4 229.1 225.6 220.3 213.1

Note: b excludes Jammu and Kashmir. Source: (i) Sample Registration System, Statistical Report, 1999. Office of the Registrar General of India, New Delhi, 2002, p.34. (ii) Selected Socio-Economic Statistics, 2001. Central Statistics Organisation, Ministry of Statistics and Programme Implementation, Govt. of India, New Delhi, 2002. p. 35.

While knowledge about family planning is wide spread, availability and use of contraception seems to be lacking; sixteen percent of currently married women have unmet needs of family planning; being highest in the age group 15-19 years (Fig. 5). Child bearing is concentrated in the age group 20-29 years which contributes to 62 percent of total fertility. Around 19 percent of total fertility is in the age group 15-19 years. Level of education has a direct bearing on fertility rate. At the national

29

Figure 5: Age-groupwise Unmet Need for Contraception


30 30 27

25

22 19

20 14 15 10 10

0 1 5 -1 9 2 5 -2 9 A g e -g r o u p NFHS 1 NHFS 2 3 5 -3 9

level in 1991, Total Fertility Rate for women with educational status, illiterate was 4.1 and among the literate it was 2.3 (Table 6). There was gradual decline of TFR with increase in the level of education (SRS-Statistical Report 1999).

Table 6: Age Specific Fertility Level of Education of Women (15-19 years) in India, 1999 Age group Illiterate Educational Level Literate Total Without Below Primary Middle literate and primary formal education 15-19 15-19 15-19 89.0 93.1 60.8 33.1 38.0 22.5 86.0 91.3 58.1 Total 64.3 29.2 Rural 65.8 30.8 Urban 57.6 24.5 20.5 22.9 15.8 Class X Class XII Graduate and above

18.8 22.9 14.1

13.7 18.7 10.5

21.1 35.9 13.9

Source: SRS Statistical Report. 1999, p. 106.

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Sexual activity among adolescents is normally initiated within marriage. Among women aged 20-24 years as many as 22% of rural and 8 percent urban cohabited by the age of 15 years. Data on premarital sexual activity is scarce. However, review of studies indicate that the age at which sexual activity is initiated range between 16-18 years among males and even earlier among females. Sexual activity among adolescents, therefore, is much higher and begins at an earlier age than what is commonly believed (Abraham 2000; Rangaiyan 1996; Jejeebhoy 1996). The adolescents thus are vulnerable and at risk of unwanted pregnancies due to ignorance and lack of access to contraceptives during early teens. Other reproductive health related problems such as STDS, HIV/AID and RTIs are also on the rise amongst adolescents in the age group 15-19 years. Literacy and Education A positive correlation between womens education, lower fertility, child mortality and other social development indicators is well established. Education acts as a catalyst for social upliftment enhancing the returns on investments for almost all aspects of developmental efforts, be it population control, health and hygiene, women empowerment or poverty reduction. Considering benefits of education, raising level of literacy and education of its people has received top priority in the agenda of national development in India. However, the achievements in raising literacy levels have been modest. There are around 300 million illiterate in the country and the number comprises one third of the population of age 7 years and above (Census 2001). While literacy rates both for males and females have been increasing, the gender gap between males and females is narrowing down gradually. In 2001, the gap reduced to 21.7% against around 25% in earlier year.
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Table 7 : Literacy Rate by Sex in India: 1951-2001 Census year 1951 1961 1971 1981 1991 2001
Note: 1.

Persons 18.33 28.30 34.45 43.57 52.21 65.38

Males 27.16 40.40 45.96 56.38 64.13 75.85

Females 8.86 15.35 21.97 29.76 39.29 54.16

Male-female gap in literacy rate 18.30 25.05 23.98 26.62 24.84 21.70

Literacy rates for 1951, 1961 and 1971 Censuses relate to population aged five years and above. The rates for the 1981, 1991 and 2001 Census relate to the population aged seven years and above. 2. The 1981 Literacy rates exclude Assam where the 1981 Census could not be conducted. The 1991 Census Literacy rates exclude Jammu & Kashmir where the 1991 Census could not be conducted due to disturbed conditions. 3. The 2001 Census, literacy rates exclude entire Kachchh district, Morvi, Maliya-Miyana and Wankaner talukas of Rajkot district, Jodiya taluka of Jamnagar district of Gujarat State and entire Kinnaur district of Himachal Pradesh where population enumeration of Census of India, 2001, could not be conducted due to natural calamities. Source: Provisional Population Totals Census of India 2001. RGI, New Delhi 2001. p.115.

A positive trend of female literacy is more pronounced in the age group 10-19 years. The gap between male and female in this age group in 1991 is less than 10% against more than 20 percent in earlier years. Between 1961-1991, female literacy for all ages rose by 24 percentage points; for the age group 10-14 years & 15-19 years it was around 31 percent. The corresponding increase for boys between 1961-1991 was 12.6 percent and 23.3 percent for the two age groups respectively (Table 8). However, there are still wide rural urban differentials; in census data of 1991 and in a later study, only 42.9% of boys and 34.5% girls in 15-19 years age group progressed upto middle school in rural India, the corresponding figures for urban areas are 83.6% for boys and 65.9% for girls (NFHS-1998-99). The female literacy for 10-14 years in 1991 (59.7%) is almost 20 years behind the male literacy rate in 1971 (59.8%).
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Table 8: Literacy Rate of Age Group 10-14 years and 15-19 years by Sex in Rural and Urban Areas, India, 1961 to 1991 Age Year Rural Urban Total (yrs.) Male Female Total M-F Male Female Total M-F Male Female Total M-F 10-14 1991 1981 1971 1961 15-19 1991 1981 1971 1961 73.4 62.2 54.6 49.1 71.0 60.4 57.4 45.2 52.3 36.5 30.0 20.7 45.8 33.6 28.5 16.3 63.4 21.1 50.1 25.7 43.1 24.7 35.9 28.4 59.3 25.2 47.8 26.8 43.7 28.9 31.1 28.9 87.8 82.3 80.9 78.0 86.4 82.1 82.8 77.7 81.3 73.2 71.1 62.7 78.3 71.1 69.6 56.7 84.7 78.0 76.2 6.5 9.1 9.8 77.0 66.7 59.8 54.4 75.3 66.2 63.4 52.0 59.7 44.8 38.2 28.4 54.9 43.3 37.7 23.8 68.8 17.3 56.4 21.9 49.6 21.6 42.3 26.0 65.7 20.4 55.4 22.8 51.3 25.7 38.4 28.2

70.8 15.3 82.6 8.1

77.0 11.0 76.7 13.2 68.3 21.0

Source: Census of India.

Achievements and progress in literacy can be attributed to the nationwide programme called National Literacy Mission (1988) and its revamped alternative model Total Literacy Campaign covering almost the whole country. The functional literacy imparted is a meaningful effective education. It has a potential to give dividends in increased productivity, improvement in health care and family welfare. In the context of adolescents, it has significant relevance and has emerged as an opportunity, particularly for the ones who were school drop outs and others who never went to school and were non-literates. With integration of population education within literacy programme funded by UNFPA, the literacy programme has further benefited adolescents having several social impacts, it has demonstrated outcomes such as women empowerment, health and population stabilization along with environmental awareness.
33

Figure 6: Percentage of Literacy by Age and Sex


80.0 70.0 59.8 60.0 50.0 38.1 37.7 40.0 30.0 20.0 10.0 0.0 Male 1971 Female Male 1981 10-14 Yrs. Female Male 1991 Female 44.8 66.8 66.1 77.0 75.3 68.8 65.8

63.4

43.3

15-19 Yrs.

National Literacy Mission : Goals and Objectives


family welfare and general betterment of the social and political life of the community. Besides this age group, persons outside this age limits are not excluded from the programme; particularly the children in the age group of 9-14 years who are also dropouts.

The goal of National Literacy Mission is to attain full literacy, i.e., a sustainable threshold level of 75 percent by 2007 by imparting functional literacy to non-literate in 15-35 years. Its purposeful and effective education gives rich dividends in increased productivity, improvement in healthcare,

Source: Department of Education Annual Report 2002-2003 Pg. 84

The literacy levels of adolescent age group are a measure of overall progress in educational endeavours. The gross enrolment as a percentage of total age group are given in the Table 9.
34

Table 9: Enrolment by Stages from 1950-51 to 2000-2001 (in million) Year Primary (I-V) Boys 1950-51 1960-61 1970-71 1980-81 1990-91 1995-96 1996-97* 1997-98* 1998-99 2000-01 13.8 23.6 35.7 45.3 57.0 60.9 62.5 61.2 64.1 64.0 Girls 5.4 11.4 21.3 28.5 40.4 46.2 47.9 47.5 49.5 49.8 (43.7)* Total 19.2 35.0 57.0 73.8 97.4 107.1 110.4 108.7 113.6 113.8 Middle/Upper Primary (VI-VIII) Boys 2.6 5.1 9.4 13.9 21.5 22.7 24.7 23.7 25.1 25.3 Girls 0.5 1.6 3.9 6.8 12.5 14.8 16.3 15.8 17.0 17.5 (40.9)* Total 3.1 6.7 13.3 20.7 34.0 37.5 41.0 39.5 42.1 42.8 High/Hr. Sec./Inter/ Pre.-Degree (IX-XII) Boys 1.3 2.7 5.7 7.6 12.8 14.6 17.2 17.1 17.2 16.9 Girls 0.2 0.7 1.9 3.4 6.3 8.3 9.8 10.2 11.0 10.9 (38.6) Total 1.5 3.4 7.6 11.0 19.1 22.9 27.0 27.2 28.2 27.6

Note: Source:

*Figures in parenthesis are percentages. Ministry of Human Resource Development, New Delhi, Deptt. of Secondary & Higher Education. (2000). Selected Education Statistics 2000-2001. New Delhi, the author. p.12.

It is evident that the enrolment figures have improved over the years. But the gender disparities are persistent for enrolment at primary, upper primary, and secondary levels. Girls account only 43.7 percent of enrolment at primary level, 40.9 percent at upper primary level and 38.6 percent at secondary level. Girls enrolment has risen considerably at all stages from 28.5 million to 49.8 in 2001; at primary level from 6.5 million to 17.5 million, at upper level, 3.4 to 10.7 million at Higher Secondary level. However, it is still below 50 per cent level at all stages. As in case of other development indicators, there are wide regional variations. For example in Kerala, the gender differential in enrolment 11-14 years is only around 4% whereas it is as high as 45% in Rajasthan. Even with increased enrolment, the other challenge is to keep children and adolescents in school and to maintain retention rates. With measures being taken to improve school facilities and improve quality of education through several
35

measures, there has been a decrease in the dropout rates; but, the problem still persists due to higher incidence of dropout and stagnation for girls at all stages (Table 10).
Table 10: Dropout Rate at Different Stages of School Education (Percent) Year Primary (I-V Classes) Girls 1980-81 1990-91 1995-96 1996-97 P 1997-98 P 1998-99 P 1999-2000 P 2000-2001 P *
Note:

Elementary (I-VIII Classes) Girls 79.40 65.13 61.90 51.89 58.61 60.09 58.00 57.7 Boys 68.00 59.12 56.70 52.77 50.72 54.40 51.96 50.3

Secondary (I-X Classes) Girls 86.60 76.96 73.90 66.82 72.67 70.22 70.60 71.5 Boys 79.80 67.50 66.70 73.04 67.65 65.44 66.58 66.4

Boys 56.20 40.10 41.40 38.35 38.23 38.62 38.67 39.7

62.50 46.00 43.20 39.37 41.34 41.22 42.28 41.9

Source:

Total dropout during a course (stage) has been taken as percent of intake in the first year of the course (stage), Primary, Middle and Secondary stages consist of classes I-V, I-VIII, I-X, respectively. P Provisional. (1) CSO, Women and Men in India 2001 P.87. (2) Selected Educational Statistics 2000-2001, Department of Education, Ministry of Human Resource Development, Government of India, New Delhi, 2002. p. 68.

There is a massive attrition in the education system. The dropout rates in class I to X is around 70%. However, some improvements are visible, such as increase in pass percentage from 79 percent to 85 percent for the secondary and 83 percent to 86.4 percent for senior secondary level (HRD Education Department Annual Report 2002-2003). Concerns are expressed and recognised about further improving the quality of education. The poor attendance in schools, lack of accessible middle schools in rural areas,

36

unimaginative curricula, dysfunctional schools in remote areas, low motivation of teachers and early entry to the work force are a few challenges which need to be met to improve the availability of educational opportunities to adolescents. For girls, the situation is worse due to burden of sibling care, early assumptions of domestic responsibilities, early marriage, absence of female teachers and reluctance on the part of parents for continuing their education; these impediments need to be resolved to achieve gender equality and womens empowerment. It is pertinent at this stage to take a review of educational status of scheduled caste and scheduled tribe communities. These backward and marginalised groups have special needs and require special attention. The Gross Enrolment Ratios for SC and ST are comparable to Gross Enrolment Ratios at the national level across stages of elementary education; in fact in the middle and upper classes it is on the higher side. It is noteworthy that gender disparities are narrower both for SC and ST groups. As per the 55th NSSO Round (1999-2000), the achievements made in literacy rates of SC (53%) and ST (49%) are also much higher as compared to Census rates in 1999 which were 37.4 percent and 29.6% respectively.
Table 11: Gross Enrolment Ratios for SC and ST for the Year 2000-2001 Year Primary (I-V) Age Group (6-11) Boys SC ST
Source:

Upper Primary Age Group (11-14) Boys 76.2 72.5 Girls 53.3 47.7 Total 65.3 62.2

Elementary Age Group (6-14) Boys 97.3 102.5 Girls 75.5 73.5 Total 86.8 88.0

Girls 85.8 85.5

Total 96.8 101.1

107.3 116.9

Ministry of Human Resource Development, Department of Education. Selected Educational Statistics 2000-2001. p.

37

The better coverage and performance can be attributed to a number of steps taken by the government to strengthen the educational base of SC/STs and these include provision of opening educational institutions on a priority basis in the areas predominantly inhabited by these communities, incentives like scholarships, freeships, mid day meals, free uniforms, books and stationary and reservation of seats in higher educational institutions. The major programmes of the Department of Education DPEP, Sarva Shiksha Abhiyan, Lok Jumbish, Shikshakasrmi, Education Guarantee Scheme etc are according priority to areas of concentration of SCs and STs. Significant measures have been taken to achieve the goal of Education For All (EFA). A land mark towards achieving this goal is the Constitutional Act (86th Amendment) notified on 13th December 2002 making Elementary Education as a Fundamental Right for all children in the age group (6-14 years). Since 2000, a Scheme of Sarva Shiksha Abhiyan has also been launched to facilitate achieving the EFA goals and it focuses in particular to the educational needs of girls, scheduled caste and scheduled tribes and children in difficult circumstances.

Goals of the Sarva Shiksha Abhiyan


All children in the 6-14 age group in school/EGS centre/bridge courses by 2003 All children in the 6-14 age group complete five years of primary education by 2007 All children in the 6-14 age group complete eight years of schooling by 2010 Focus on elementary education of satisfactory quality with emphasis on education for life Bridging of all gender and social category gaps at primary stage by 2007 and at elementary education level by 2010 Universal retention by 2010

Source: Department of Education Annual Report 2002-2003

38

An Appraisal The official statistics show a massive increase in enrolment figures and progressive decrease in dropout rates of primary as well as middle stages both for boys and girls. These are positive welcoming trends. Nevertheless, we are aware that all children enrolled may not be attending school. The Net Attendance Ratio, a more refined indicator which measures percentage of children attending school, reveals that at primary stage, it was 66% and for middle and upper stage it was 43% (NSSO 1996). The truth and reality is that a large number and high percentage of children are not covered by formal school system. Unfortunately the non formal education, an important extension of elementary education, suffers from lack of motivation and effective implementation. The poor infrastructure of schools, unstimulating learning environment, inappropriate pedagogy, low motivation of teachers, weak school administration etc are matters of deep concern. The class divide as also rural and urban divide in educational opportunities and its quality are likely to have serious consequences and could end up in social upheaval. The poor and unprivileged have access only to state run schools and these institutions provide poor quality education. The masses are adversely affected or have fewer employment prospects due to lack of higher technical and professional education. This inability to provide equal opportunities to children and youth is likely to accentuate the divide between have and have nots (Bose 2003). The poor and disadvantaged have increasingly realised the value of education and aspire for good quality education. Their expectations have been belied by the above mentioned short comings. It is imperative that concerted efforts are taken by the government, NGOs, UN agencies and civil society to improve the existing system of education and provide better life chances for under priviledged rural and
39

urban children and youth. This is also to fulfill our commitment made as a nation in several declarations and in national and international forums. Vocational and Value Education There is an acute need of educational/vocational programmes that address unemployment and self development needs of adolescent boys and girls. At the terminal stages in secondary and higher secondary school, options should be available to youth to enter into the world of employment or pursue higher education. A vocational bias to education has been recommended for long in the educational system. It needs to be focused at enhancing capacities of youth to have employability, reduce mismatch between demand and supply of skilled man power and provide an alternative to higher education for those who can not pursue further education due to economic or family reasons. The contemporary formal education system in India does not have these provisions. The scheme of vocationalisation of education initiated in 19996-97 was evaluated by ORG and CERPA and found a host of shortcomings including poor quality of its implementation. However, private sector and NGO run programmes have competence based courses, linked with market potential. National Institute of Open Schooling is the only system that is providing Open Basic Education and Pre-Vocational Courses and Vocational courses. Around 60 vocational education courses in agriculture, business, commerce, engineering, technology, para medical, health, applied sciences and social service sectors have been introduced. Similar efforts are made by Indira Gandhi Open University using distance education mode to offer certificate and diploma courses. These courses aim at self development and economic enterprise with an objective to meet needs of women learners, in particular for awareness generation, self employment and wage employment. These

40

efforts are likely to absorb about 25 percent of adolescents into some kind of vocational streams. Around 7000 schools all over the country have such provisions, thereby creating capacity for diversification of students at secondary school level. These courses have benefited several adolescents in the age group 15-19 years through 2000 study centres linked with 10 Regional Centres. Within this sector, Information Communication Technology has gained a lot of importance in the last few years. The state run schools have not been able to keep pace with the advancement in the technology. However, the mushroom growth of private training centers and NITT have filled this gap, at least in the urban areas. Adolescent girls are also being helped through Self Help Groups modality to receive literacy skills for income generating activities under several programmes initiated by government and NGOs; Support of Training Cum Employment Programme (STEP), Development of Women and Children in Rural Areas (DWACRA), Employment and Income Generating Training Cum Employment cum Production Unit for Women (NORAD). Value and Life Education The above scenario presents a grim picture of the youth in the age of 15-19 years. Many of them who are out of school have to enter work force and become productive by earning. Girls suffer burden of sharing household work and are confronted with matrimony and child bearing. In the absence of any training or educational inputs, which would prepare them for life, they feel lost at the cross roads of life. In the rapidly changing world, exposure to media and different life styles, majority of youngsters feel that they have inadequate competencies to take of, and lack confidence to cope up with adolescence period and demands made of them by the community and society.
41

A Changing World
certain social groups Decentralisation of decision-making. Changing nature of work, requiring new skills and capacities. Urbanisation and migration. Emerging and resurgent diseases, particularly HIV/AIDS.

Adolescents are inheriting a rapidly changing world increasingly shaped by global influences, among them: Globalisation of trade, investment and economic relationships. Mass communications media and the development of a youth culture Modes of governance and exclusion of

Source: UNFPA-State of Worlds Population 2003 Pg. 5

Studies have indicated that depression, due to academic pressures, among adolescents is on the rise (Verma et al. 2002; Taj 1999, Katyal and Vasudeva 1999). The inability to find appropriate vocational avenue, lack of information and social pressures further compound this trend. These psychological problems along with stress and strain of the growing years lead to aggression, deviancy and anti social behaviour (Pratt 1999, Kashyap 1996 Verma et al. 1995, Rai 1993, Rajamanick am and Vasanthal 1993, Albuquerque et al. 1990). The need of imparting life skills ability for adaptive and positive behaviour that enables individuals to deal effectively with demands and challenges of every day-is well acknowledged by experts and emphasised by WHO (1993). In order to ensure rewarding growing process, adolescents require right space, reliable and appropriate information, friendly counselling/guidance on issues of concern to grow in confidence and self assurance. An integrated approach could include range of inputs such as vocational training, life skill training, sports, recreational and creative and cultural activities. All these are likely to channel the energy of adolescents in a self enhancement direction and give them a sense of pride (Farah 2000).

42

The efforts related to Institutionalisation of Population Education in the school system has similar objective and can ensure well being of adolescents. The National Population Education Project (NPEP), a multi agency endeavour involving MHRD and MHFW, NACO, NCERT funded by UNFPA, has shown some positive results. The documentation of the project activities has useful information for strategies for further expansion and integration within the existing education system.

10

Documentation under NPEP


Skill Building in Adolescence Education: Test Tools Awareness and Attitude of Students towards Adolescent Reproductive Health: A Baseline Survey National Population Education Project: Status Report 2001

Young Peoples PERCEPTIONS of Population and Development. Population Education Bulletin (Two issues) A Report on Annual Project Progress Review Meeting 2001 (Mimeographed) Skill Building in Adolescence Education: Training Package

Source: Annual Report 2002-2003 Department of Education GOI.

Preparation for Future It may be concluded that it is imperative that educational and other socialization and preparatory activities need to be expanded and are made available to all adolescents rather than to a few elite sector populace. In order to facilitate their process of taking adult roles, it is important that a range of choices are made available to them to develop their capabilities (Sen 1999). Whether these are specific subjects in school; particular skill in work place or generic behavioural tracts like tolerance and getting along with other etc., these need to be geared for grooming them to move progressively towards adult hood (Shankar et al. 2002). In short, adolescence must be viewed as a preparatory period during which youth acquires relevant educational and informative occupational experiences in anticipation of
43

economic opportunities; to go beyond these implications the guiding principles and policy directive recommendations are given in the Box 11.

11

Linking Adolescence to Adult Role and Work. Policy Directives: Guiding Principles

Strategically invest in youths education and health, to capitalized on the demographic gift the window of opportunity. Educate and train people in ways consonant with existing economic opportunities and future possibilities, there is a need to redesign educational curricula accordingly from an indigenous perspective. Educational opportunities be universalized, gender disparities be brideged. It makes good economic sense because educated women have fewer children, are healthier, and make greater contributions to the economy than uneducated women. Improvements in school continuation will require improved opportunities and services for families to be able to send children to schools. The training of teachers (encompassing both pedagogy and substantive expertise) needs to be enhanced. Teachers should be equipped with

knowledge and skills that enable them to critically revise curricula with the relevance of subject matter for the labour market opportunities. Closer communication between school and work is necessary, to enhance the character of youths early occupational experiences, as well as foster vocational exploration. Youth employment should be regulated. The banning of youth/child employment is ineffective if children do not have educational opportunities. There is a need to work with employers schools, families, and youth to move toward changes that protect young people and that allow them to become educated and to develop marketable skills. There is also a need for well-developed structural articulations or institutional bridges between school and work at the time of educational completion. For example, a diploma with vocational credentials, could more effectively link a persons with jobs in the labour market than a college degree.

Source: Based on Shanahan et. al (2002) in Read La rson et al. (eds) 10 p. 113-115.

Nutrition and Health Status During adolescence period, 50% of adult weight, 20% of adult height and 50% adult skeltal mass are acquired. Besides genetic factors, nutritional intake determines the extent of growth and maturation at this stage. Poor nutrition is often
44

cited as a major reason for the delay in the onset of puberty in Indian adolescents. Malnutrition has low visibility during childhood but the damage it can cause due to cumulative affect on puberty is often not appreciated. Surveys by National Nutrition Monitoring Bureau (NNMB), National Family Health Survey and DWCD have reported that half the children are under weight and 56 per cent stunted. Several micro level studies have reported similar findings (Ray et al. 1997, Yadav Singh 1999). On reaching adolescence, due to growth spurt, malnutrition of these children gets further accentuated. The additional requirements for iron, calcium and zinc for increments in skeltal mass, body size and bone density make nutrition a critical factor in growth and development of adolescents. It is a positive shift that, in addition to children and mothers, now some information is being collected about nutritional status of adolescents as well. The National Nutrition Profile 1998 has included school age children and adolescents as two separate groups. Average intake of nutrients was also classified according to age and sex. As per a survey in rural north India, stunting (WHO standards) was prevalent in 37.2% boys and 41.0% girls. Anemia was observed in 51%of girls (12-14 years) as compared to 38.5% in older girls (15-18 years) (Anand et al. 1999). The mean hemoglobin was higher in boys than in girls. Poor nutritional status of adolescent girls has further been endorsed in a study where 8.7% subject suffered from chronic energy deficiency (BMI 17.85), 6.59% from second degree (BMI 16-17) and 78.75 form third degree (BMI below 16) (Chaturvedi 1996). Due to non availability of data for adolescent girls, the NFHS II data collected for women up to 20 years without any child can be used as a proxy for adolescent girls. The study indicated that the anemia among adolescent girls was about 52%, whereas for eastern region it was 60.8%. The National Family Health Survey 199845

99 reported that 36% of even married women age 15-49 have Body Mass Index below 18.5 indicating high prevalence of nutritional deficiency. ICMR multi centric study (DNP 2001) is another major source according to which average overall anemia levels are about 90% throughout the country (Fig. 7). Average intake of vitamin A was about 50% of RDA in most part of the country and 30,000 children go blind annually due to VAD.

Figure 7: Prevalence (%) of Anaemia Among Adolescent Girls

DE H R ADU N

58. 2

B AR AM U LLA M ANDI

86. 3

87. 7

B IK ANE R LAK HIMP U R K HE R I

90. 3

92. 2

M AINP U R I

95. 2

S R I N A GA R B ADAU N 79. 3

99. 3

1 00

B ISHNU P U R

K OH I M A

88. 9 91 .9

GA Y A D I B R U GA R H N A GA ON

93. 9 94. 6 97. 8 91 .8 87 90. 1

P AT NA M E H B OOB N A GA R R A I GA R H A L L D I S T R I CT S

Source: Micronutrient Profile in India Population ICMR, New Delhi, 2001.

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The National Nutritional Anemia Control has hardly made any impact. The NFHS survey 1998-99 reported that only in 48 per cent live births case during three years preceeding the survey, pregnant women had received iron/folic tablets. In Bihar percentage was only 20%, Utter Pradesh 21 per cent and Rajasthan 31 percent. Nutritional disorders such as pallor and vitamin A deficiency have also a wide prevalence among adolescent girls (Aggarwal et al 1998). It is only recently that adolescent girls are being covered by poplylaxis of iron/folic tablets under Kishori Shaskti Yojana of ICDS.

12

Waking up and taking action


District and block task forces have been established in two districts of West Bengal to review the progress every month and plan for the next month. IEC material and information to school teachers, students and the community are shared on a regular basis. All school-going girls in the age group of 10-19 years (2,000,000 girls) in two districts of West Bengal are receiving IFA tablets on a weekly basis. The teachers submit a monthly IFA consumption report to the district authorities.

The National Nutritional Anaemia Control Programme aims at significantly decreasing the prevalence of anaemia in pregnant women, lactating women and preschool children through the supplementation of iron and folic acid (IFA) alone. Despite the fact that the programme has been operating for over two decades, the prevalence rate of anaemia is still as high as 60% among pregnant women in West Bengal. To avoid this, it is imperative that interventions be targeted towards adolescent girls. The development of a district-based intervention for controlling anaemia among adolescent girls, initiated in West Bengal in 1999 has been a major step forward in addressing the intergenerational cycle of malnutrition and more specifically, nutritional anaemia.

The project is progressing well and its experience will provide valuable insights for the design of Kishori Shakti Yojana interventions in West Bengal.

Source: Department of Women and Child Development , Kishori Shakti Yojana 2002.

47

The gravity and enormity of the problem of micronutrient in India is evident from the fact that more than 320 million people suffer from Iron Deficiency Anemia (IDA) prevailing amongst women and children. Over 200 million people suffer from Iodine Deficiency Disorders (IDD) resulting in series of mental and physical disorders. A major measure of nturitional or health status of any population is the average intake of energy, protein and iron against the recommended daily allowance (Table 12).
Table 12: Daily Average Intake of Energy and Proteins against Recommended Intake by Age/Sex/Physical activity of Rural Population for India during 2001. Age (years)

Sex

Energy (kcal/day) Intake RDI 4 2190 1970 2450 2060 2640 2060 2425 2875 2875 2225

Protien (g/day) Intake 5 40 39 49 44 55 49 59 61 48 52 RDI 6 54 57 70 65 78 63 60 60 50 50

Iron (mg) Intake 7 40 12.1 15.4 12.9 16.7 15.3 17.5 18.7 14.1 16.2 RDI 8 34 19 41 28 50 30 20 76 30

1 10-12 13-15 16-17 > 18 > 18*

2 Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls

3 1524 1500 1856 1689 2114 1856 2225 2371 1878 2020

Source :

National Nutrition Monitoring Bureau (NNMB) Diet and Nutritional status of Rural Population, Hyderabad NIN, 2002 pp. 39-55 based on repeat survey conducted during 2001 in rural areas of Kerala, Tamil Nadu, Karnataka, Andhra Pradesh, Maharashtra, Gujarat, Madhya Pradesh, Orissa and West Bengal. RDI : Recommended Dietary Intakes NPNL : Non Pregnant Non Lactating

The intake could be considered adequate for above 18 years but younger age groups have deficient intake for almost all age groups and much below the RDA for girls as compared to boys.
48

Nutritional status of the girl child has received considerable attention in the last few years by policy makers due to intergenerational consequences. Anemic adolescent mothers are at a high risk of miscarriage, maternal mortality, giving still births; also, low birth weight babies with low iron reserves (Bhat and Ravi Kumara 1996). Poor nutritional status of adolescents is an outcome of socio cultural, economic and public policies relating to household food security. Further, it has behavioural dimensions which need to be tackled through awareness generation and change of attitudes. Nutritional intervention programmes, both related to supplementary nutrition and micro nutrient deficiencies, have not been properly implemented to achieve the desire results.

13

Nutrition Policy Provision


affiliated Departments to enhance the synergistic impact of related services on the nutritional status of the Indian population. It already has a comprehensive National Nutrition Policy (NNP). The national nutrition goals as set forth in the National Plan of Action on Nutrition (NPAN) are still unfulfilled. To realise these goals in the coming decade, a number of changes will be required: a high level of political will and commitment; strong technical and managerial expertise for programme management; appropriate food technologies; adequate resources; and community participation.

The Indian Constitution recognises nutrition as a pre-requisite for the attainment of a persons full physical and intellectual potential. Article 47 of the Constitution of India States that The duty of the State is to raise the level of nutrition and the standard of living and to improve public health. The State shall regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties. The Department of Women and Child Development (DWCD), Ministry of HRD, GOI is the lead agency to develop nutrition policies, strategies and guidelines for implementation. It coordinates with the other Source: Nutrition Policy Provision DWCD

India is a signatory to the Alma Ala Declaration (1978), it had committed itself to achievement of the goal of Health for all by AD 2000 and also adopted National Health Policy (1983) which had set targets. As can be seen from the Box there has
49

been slipppages on almost all targets related to nutritional indicators. It seems concerted efforts are needed to fulfill the promises made and ensure that Health for All does not continue to be an elusive and distant dream. (Bose 2003).

14

Child Health and Nutrition Goals and Achievements


Goal Achivement Target Set Reduction in moderate & severe malnourition by half (NPAN) Year 1992-3 (NFHS-1) 1998-9 (NFHS-2) Target reached 52 per cent children under 3 years underweight & 47 per cent stunted. 47 per cent children under 3 years. Underweight and 45 per cent stunted. Comment Achievement far below target Achievements for below target only a modest decline of under weight and stunned children.

Indicator Percentage of undernourished children 2000

Year

Anaemia among pregnant women

2000

Reduction to 25 per cent (NPAN)

1998-9 (NFHS-2)

52 per cent ever married women 1549 yrs.

Micro studies from different parts of the country, too, point to continued presence of milder forms of iron deficiency anaemia. Micro studies from different parts of the country point to continued presence of milder forms of vitamin A deficiency No survey done. Empirical studies from different parts of the country point to its decline after the step up in the salt iodization programme.

Vitamin A deficiency

2000

Elimination of blindness due to vitamin A deficiency

Not available

Not available

Iodine deficiency

2000

Reduction to 10 per cent

Not available

Source: Bose (2003). The State of Children in India promises to keep, pp 141-142.

50

Employment and Work Force Participation Child and adolescent labour is a part of Indias historical tradition (Dube 1981). Assistance provided by children on farm or family based occupations was accepted as a normal process of growing up and learning adult roles. Young people were apprenticed for their adult occupations. However, it was in contrast with the exploitative labour of the industrial and post industrial eras (Verma 1999). A distinction between children engaged in work and child labour may be drawn. Help by children/adolescents is perceived as a necessity by families in certain sectors of economic actively and if it is not at the cost of schooling, play, recreation or growth, it is not to be considered as undesirable. Like other developing countries, in India, poor and landless families have also been forced to depend on wage and contractual employment. Children and adolescents are also required to work out side home. Work situations of the unorganized sector are not covered under labour laws and could be harsh and exploitative (Bose 2003). Indian sub continent probably has the largest number of working children. According to the live register of the employment exchange over 20% of total applicants were below 19 years of age and out of these 22.2% were females. The unemployment rates for 15-19 age group in 1993-94 were 54.7% for males and 30.7% for females (Planning Commission 2001). Estimating the magnitude and number of working children/adolescents is difficult due to the problem of definition of a worker. Census includes only those children who are engaged in economic activity as workers. In rural areas several activities undertaken within household or out side household are not included in the category of worker, for instance collecting wood, fetching water, taking care of cattle or assisting in the farm or crop growing. These and several other activities though generate income but are left out during enumeration. Census figures,
51

therefore, have a shortfall in numbers and are commented upon as being under estimates. The NSS estimates for forty third round (1987-88) were also not found realistic though these showed decline in child workers as compared to 38th round (1983). Estimates available related to age specific work participation rates present a better indication of the extent of involvement of children in workforce (Table 13).

Table 13: Labour Force and Work Force Participation Rates in India by Usual Principal and Subsidiary Status Person per 1000 Labour Force Participation Rates 5-9 1993-94 (50th Round) NSS Rural Male Rural Female Urban Male Urban Female 1999-2000 (55th Round) NSS Rural Male Rural Female Urban Male Urban Female 10-14 15-19 20-24 5-9 Work Force Participation Rates 10-14 15-19 20-24

11 14 5 5

140 141 69 46

598 371 404 141

902 469 771 230

11 14 5 5

138 141 66 45

577 364 356 123

859 456 674 180

7 7 3 2

93 96 52 37

532 314 366 121

889 425 755 191

6 7 3 2

91 96 49 36

503 304 314 105

844 409 658 155

Source: Report for the Working Group on Adolescents for the Tenth Five Year Plan, Govt. of India, Planning Commission, June 2001, p. 10.

Labour Force and Work Force Participation Rates have registered a decline in 1999-2000 as compared to 1993-94 and could be due to increased educational opportunities. According to 1991 census, India had around 12 million child worker (5-14 years) constituting about 5.2 per cent of total work force and of the total number,

52

around 5.10 million were female workers, most of them as main workers (3.4 million) and one third as marginal. The adolescent age group (15-19 years) constituted another 28 million.
Table 14: Working Children and Adolescents in the Age Group 5-14 yrs and 15-19 yrs by Types of Worker, Residence and Sex in India, 1991 (in Million)

Location Age Rural 5-14 15-19 5-14 15-19 5-14 15-19 M

Main Workers F 3.17 6.18 0.25 0.60 3.42 6.78 P 8.13 20.95 0.95 3.81 9.08 24.76

Marginal Workers M 0.50 0.46 0.03 0.06 0.53 0.52 F 1.63 2.74 0.05 0.10 1.68 2.85 P 2.13 3.21 0.08 0.16 2.21 3.37 M 5.46 15.23 0.73 3.27 6.19 18.50

Total F 4.80 8.92 0.30 0.70 5.10 9.63 P 10.26 24.16 1.03 3.97 11.29 28.13

4.96 14.77 0.70 3.21 5.66 17.98

Urban

Total

(Main workers are those who work for 183 days ormore in a year) Source: Based on Census of India 1991 series-1 India. Socio-cultural Tables volume-2 Registrar General and Census Commissioner, India pp. 216-218.

Estimates of child workers by NGO and activists figure up to 60 million (UN System in India 1998 on Child Labour). The decline in the proportion of child workers (main) to total workers (main) from 5.03 per cent in 1981 to 3.78 percent in 1991 need not be a reason for complancy as these are unacceptably large numbers. As can be seen in both rural and urban economies, a higher number of females are engaged as marginal workers. It is difficult to draw the profile of child and adolescent workers, disaggregated data and empirical evidence are sparse. The contention that adolescent and children have joined the work force as apprentices has been challenged by activists and researchers (Burra 1997). Minors are preferred to adults as they are cheaper, more productive and obedient. Despite adult unemployment, employers like to engage
53

children and young adolescents both in unorganised and organised sectors. The labour participation rate differences for rural and urban for age groups may be seen in Table 13. Majority of children in work force are agricultural laourers (87%). Another 8.2 percent are in live stock tending, forestry, fishing hunting and plantation. About 8.6 percent are engaged in manufacturing and processing, 8.7 percent in housing and small industries (Census India 1991). Besides these it is a common sight to find adolescents and children working as shoe shiners, Scavengers, rag pickers and domestic servants. The state with the highest number of child labour is Andhra Pradesh (1.66 million), other states where child labour population is more than one million are Madhya Pradesh, Maharahtra and Utter Pradesh (Fig. 8).

Figure 8: State wise Distribution of Working Children

8 .7

9 .5

4 2 .6 12

1 2 .5

1 4 .7

Ot her s M adhya P r ades h

A ndhr a P r ades h M ahar as ht r a

U t t ar P r ades h K ar nat aka

Source: Annual Report 1999-2000- Ministry of Labour, GOI.

54

15

Harsh Realities of Child Labour


abuses of the workers have been documented from these places (Chaudhry 2002). Physical punishments meted out to children, ranges from physical assult to refusal to take even food. There Instances of Sexual harassment and sexual abuse of girl child workers has been reported. These evident psychological and physical hazards not only causes suffering but curtails the working span of their lives (Dharmalingam 1993; Sekar 1993).

Several cities are specifically known for their wide spread incidence of engaging minor children. Figuring among these are powerloom centre in Bhiwadi (Maharashtra), the match and fire work industries in Sivakasi (Tamil Nadu) diamond cutting in Surat (Gujarat), gem polishing in Jaipur (Rajasthan), Carpet weaving in Jammu and Kashmir, brass ware in Muradabad (U.P). Most of these occupations are extremely hazardous and have damanging effect on health of the workers. Many of the cruelest

The domestic servants, majority of whom are adolescent girls, are the most exploited and abused category. As a result, National Human Rights Commission issued a memorandum prohibiting government and civil servants to employ children below the age of 14 years as domestic servants. Early entry into the labour force is characteristic essentially of the lowest onethird of the population who fall below the poverty line. For the adolescents from the lower-middle and middle classes, the employment scenario is more positive and hopeful. Parents in these social classes view education as a means to upward mobility and make enormous personal sacrifices to ensure that their children complete school and college education. Higher educational qualifications and professional training are correlated with social class, and sometimes caste. Adolescents from the lower-middle class opt for vocational training after school or for a college degree in arts or commerces, where entry is easy, ensuring a white-collar job as typist, clerk, accountant, postmaster or similar position. The upper-middle and upper-class adolescents, both boys and girls, compete for courses in professional training such as medicine, engineering,
55

finance and management and more recently in the computer sciences in elitist institutions (Verma 2002). In the competitive environment, it is the socio-economic back grounds that determine the future more than the talent and ability. India is one of the few countries where the employment of children is constitutionally prohibited. The issue has been addressed both under Fundamental Rights as well as in the Directive Principles of the State Policy and provision of several legislations. National Policy on Child Labour (1987) has Several steps to curb, and eventually eliminate child labour. Legislative support for child welfare services in India is found in the Child Acts of various states. However, these laws are not as effective as they should be. Recognising the fact that legislation alone would not be sufficient to tackle the problem of child labour, the Government of India in 1987 made the National Policy on Child Labour (NPCL). It needs to be accepted that legislation alone would not be sufficient to tackle the problem of child labour. A band of social activists and NGO presently are engaged in tackling the issue of child labour, using different strategies and approaches. While some advocate outright abolition and elimination of child labour, others are committed to its gradual elimination.

16

The SACCS Experiences


and pressure building; mass consciousness and cadre building; trade interventions for social accountability; child participation and unionization of unorganised workers. These strategies should be used in combinations that may be determined by situational specificity, as no single approach can effectively combat child labour.

South Asian Coalition on Child Servitude (SACCS) which have taken positive steps to help minor workers and ensure their wellbeing for two decades recommends ten strategies to effectively combat child labour. These time tested strategies, as SACCS refers to them include: advocacy; direct action; alliance buildings; legal enforcement; rehabilitation; lobbying

Source: VHAI (2002), Seen but not heard p-92.

56

Drug Abuse In recent years Drug substance abuse amongst adolescents has emerged as a major problem having far reaching socio-medical and economic consequences. As a consequence of industrialization and urban drift, stresses and strains of modern life have rendered adolescents vulnerable to substance abuse more than ever before. The abuse of alcohol, opium and cannabis has been known for long, but the consumption of drugs like heroin, hashish, LSD is altogether a new trend. The extent of usage of such drugs in various segments of society has acquired alarming dimensions. Today, India is no more merely a transit country for illicit trafficking of drugs from the golden triangle or golden crescent, but is also becoming a significant consumer in the global scenario. With its spread amongst all sociocultural and economic strata and an increasing perception of its disruptive influence on the individual, the family and society at large, drug abuse has emerged as a vital issue. The estimated or projected number of drug abusers in India is around 3 million and that of drug dependants 0.5-0.6 million (UNDCP 2000). Drug addiction is especially severe in the North-eastern states of the country. Adolescents and youth with their penchant for experimentation and exploration are in particular vulnerable to drugs. It is estimated that the most drug users are in the age group of 16-35 years with a bulk in the 18-25 years age group. The rates of current abuses are low in early adolescents and high during late adolescence. Tobacco consumption especially smoking is considered to be the starting point in getting initiated into other hard drugs (Brown et al. 2002). The peer group with pressure for conformity introduces drugs to adolescents. Several studies have reported that street children and lower SES youths are pushed into the drug abuse by drug peddlers in the form of wages for work.

57

17

125,170 Drug Addicts in India, says UN Report


had also witnessed an upward trend with such users now estimated to be around 40,000. Dependence on psychotropic substancs is of very recent origin. Most of these substances are medicinal compounds that are controlled, and obtained through the illicit market, it said. Pointing out that drug users were mostly unmarried, from the lower socio-economic strata and self-employed, it said 33 per cent of them were engaged in anti-social activities. The report said while traditional use of opium was continuing in Punjab, Rajasthan, Madhya Pradesh, Uttar Pradesh and Gujarat, injectable heroin was more prevalent in the north-eastern states.

Of the four million registered drug addicts in South Asia, 125,170 are in India, according to latest figures quoted by a United Nations report. Among the drugtakers in India, 42 per cent use alcohol, 20 per cent opium, 13 per cent heroin, 6.2 per cent cannabis and and 18 per cent other drugs, according to the Drug demand reduction report on South Asia of the United Nations International Drug Control Programme (UNDCP). Stating that there had been reports on increase in abuse of prescription medicines like buprenorphine, morphine, pethidine, propoxyphene, nitrazepam and diazepam, the report said adulterated heroin (smack) abuse Source: United Nations Information Service

A two-pronged strategy of supply, control and demand reduction of drugs has been adopted in the country. While the aspect of control of supply is taken care of by the Narcotics Control Bureau and the police, the Ministry of Social Justice and Empowerment has the responsibility for the educational and rehabilitation aspects of drug addiction. Soico-economic factors such as literacy, economic background, unemployment and gender factors put illiterate and semi-literate youth from rural communities most vulnerable to the abuse. Street children constitute another major risk group. The risk of contracting HIV/AIDS, and crime and anti-social behaviour are two serious consequences of drug abuse. A culturally sensitive and easily accessible health care system, capable of responding to the individual needs of adolescents for STDs and HIV/AIDS treatment, prevention and rehabilitation is required.

58

Integration of awareness of drug abuse and its consequences in the curriculum, reinforced by life skills education to negotiate and withstand peer pressure and reduce risky behaviour can be identified as the other effective strategies to deal with the problem. Violence Against Adolescents There is no separate classification of offences targeted particularly at adolescents. The National Crime Records Bureau provides some age specific data related to crimes such as rape, kidnapping, abduction, trafficking and domestic violence, this can be the basis to ascertain the extent of violence against to adolescents (Table 15).
Table 15: Crimes against Adolescents
Upto 10 yrs Crimes Victims of Murder M F T M 11-15 yrs F T M 16-18 yrs F T M All ages F T

586 547 1133 499 249 748 2061 701 2762 31755 8618 40373 (1.84) (6.35) (2.81) (1.57) (2.89) (1.85) 6.49) (8.13) (6.84) (100) (100) (100) 41 21 62 64 19 83 224 57 281 3391 585 3976 (1.21) (3.59) (1.56) (1.89) (3.25) (2.09) (6.61) (9.74) (7.07) (100) (100) (100)

Victims of C.H not amounting to Murder Victims of kidnapping and abduction Victims of rape cases (Total)

358 226 584 546 1881 2427 1432 5623 7055 7608 15330 22038 (4.71) (1.47) (2.55) (7.18) (12.27)(10.58)(18.82)(36.68)(30.76) (100) (100) (100)

744 (4.51)

2388 (14.48)

4622 (28.02)

16496 (100)

Sources : Crime in India, 2000.Natioanl Crime Records Bureau, Ministry of Home Affairs. pp. 142, 144, 148, 207.

The prevalence of sexual abuse of both boys and girls cuts across economic and social classes. Limited empirical evidence indicates that in most cases the abuser is a family member, including father (Ganesh 1995, MARG 1996). In case of boys (12-17 years) who are victims of homosexual abuse, heterosexual advances
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by older women are also not that uncommon as a phenomenon. (Seshadri 1995, Madiratta et al. 1996). Crime against adolescent girls and women take many shapes and forms ranging from eve teasing to abduction, rape, prostitution, battering to sexual harassment at work place. All these crimes are rarely registered due to social taboos. Even when cases are registered and prosecution takes place, conviction rates are very low, reflecting poor performance of prosecution in bringing guilty to book.
Figure 9: Victims of Rape

Source: National Crime Records Bureau.

The rape accused, pending for trial, numbered 95860 in 2000. The trial for 15807 accused was completed during the year; out of these only 4442 (28.1%), were convicted. Still 79727 cases were pending at that time. The numbers have increased in the period from 1988-2002 and the disturbing feature is that the increased cases are of rape in the age group below 16 years. The sexual violence and rape are violation of human rights. It inflicts severe mental and physical injuries to the victim. There is hardly any research evidence available to understand the situational factors that lead to this crime. The lack of support
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Table 16 : Victims of Rape by Age Groups over the Years in India Year 1988 1991 1995 1999 2000
Source :

Below 10 years 233 1099 747 731 744

10-16 years 1869 2630 3320 2422 2388

16-18 years 3849

4622

1. Women and Men, India 2001, Statistical Organization, p. 118 2. Crime in India, 2000, National Crime Records Bureau, Ministry of Home Affairs, p 207.

services required to help the traumatized, victim and the family are inadequate; only, a few NGOs are doing some examplery work in helping rape victims. A close look is required at providing support services and at functioning of law enforcement agencies. Sensitisation of personnel involved in apprehension, prosecution and hastening of trials are other aspects that need to be attended to. Trafficking in Young Women and Girls Trafficking, prostitution and abduction have been known to exist for long in the country. To deal with it, Immoral Traffic in Women and Girls Act was enacted as early as in 1956, later amended and retitled as Immoral Trafic (Prevention) Act (ITPA) in 1986. In recent years trafficking and Prostitution have received attention of media and policy makers due to increased incidences of illicit and clandestine movement of young girls across national and international borders. The convention on Elimination of All Forms of Discrimination Against Women (CEDAW) also enjoins State/Parties to take appropriate measures to suppress traffic of women and young girls.

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18

Some Estimates
A study by the Central Advisory Committee and the Indian Health Organisation (IHO) revealed that one in five prostitutes in Mumbai are children under the age of 12. According to IHO statistics, the number of child prostitutes in some major cities are as follows.3 City Mumbai Calcutta Delhi Pune Nagpur Child Prostitutes 70,000 50,000 20,000 20,000 10,000

There are no reliable estimates on the number of prostitutes in India. Virani, quoting a government survey, says that there are an estimated 2 million child prostitutes in our country between the ages of five and fifteen. According to her, child prostitution (including trafficking, sex tourism and pornography) in India accounts for Rs. 11,000 crore of the Rs. 40,000 crore commercial sex industry.1 According to another source, nearly 200 girls and women enter prostitution everyday. The total number of prostitutes is pegged at 9 lakhs. Of these, an estimated 2.70 lakhs are minors.2

Source: 1. Virani, P.; Bitter Chocolate; Penguin; New Delhi; 2000. 2. Gathia, J.; Child Prostitution in India; Concept Publishing Company; New Delhi; 1999. 3. Ibid.

The magnitude of prostitution and number of young girls in brothels are difficult to be ascertained. The adults and pimps who control the trade are aware of their crime and they keep young girls hidden, virtually under detention, from the view of authorities. The setting of young women into sexual bondage is a serious violation of their rights. Extreme poverty, low status of women and girls, lax border checks and the collision of law enforcement officials all contribute to its expansion. Survey conducted by GOI on the six major cities (Calcutta, Mumbai, Delhi, Chennai, Hyderabad) in (1994) gives some idea of the profile of prostitutes in India. Thirty per cent of prostitutes in these cities were under the age of twenty years; around 40 per cent of these entered the trade before they had turned 18. Two third of these girls were from very poor families and belonged to SC/ST communities. Economic stress and discrimination within the family and incest advances episodes were the causes that forced them to enter into prostitution. The demand for young
62

girls is linked to the social and cultural conceptions relating to virginity (it is commonly believed that sex with a virgin is a cure for STDs, including HIV/AIDS) and gender relations. For certain communities with a history of Community based prostitution, e.g. the Bedias and Bancharas and religion-based through the custom of devdasi in southern states of India, the exploitation of girls is routine and part of the ritual of growing up. For young girls, lack of negotiation power increases their vulnerability to HIV/AIDS; besides, trafficking results in loss of freedom and a host of other physical and emotional problems. These conditions make young girls easy targets of traffickers. Girls from rural and backward areas are lured to cities with false promises of better life chances and opportunities. The rising trend of sex tourism, pardophilia and pronogrpahy are also spreading their tentacles which are making matters worse. Young sex workers, both female and male, are at high risk of HIV infection, HIV prevalence among young workers indeed is around 48 per cent (Msimarg and Wilson 2002). The children of sex workers are also at high risk of exploitation in the uncongenial environment of brothels having serious consequences to their well being.

Table 17: Incidence of Procreation of Minor Girls, Selling of Girls for Prostitution in India 1994-1999. 1994 Procuration of minor girls Selling of girls for prostitution Buying of girls for prostitution 206 34 4 1995 107 17 19 1996 94 6 22 1997 87 9 13 1998 171 11 13 1999 172 13 5

Source: National Crime Records Bureau.

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The above figures are a small fraction of the incidence of the problem and are far removed from ground reality. The offenders are rarely convicted, the rescued girls have a bleak future due to rejection by the community and family. The detention homes are managed poorly and the chances of a rescued girl leading normal alternate life are virtually non existent. There is a need for broad policy shifts, improved law enforcement and promotion of awareness and education amongst the community, particularly in traffic prone areas. Vigrous investigation and prosectuion are essential to curtail operations. Inter country sharing of information and protocols are imperative. Implementation of compulsory primary education, retaining girls in schools and empowering them with confidence seem plausible to deal with the problems of exploitation of girls. Medias support is required to inform the public and community about child prostitution and trafficking. Lately these issues have increasingly been printed which is a healthy development and doing much to break the silence shrouding this understandably sensitive subject (UNICEF 1995).

Sexual Activity and Behaviour Young girls and boys, in all cultures, experience sexuality in diverse ways. The concept of sexuality includes not only sexual identities, sexual norms, sexual practices and behaviours, but also feelings, desires, fantasies and experiences related to sexual awareness, arousal and sexual acts within heterosexual as well as homosexual relations. This includes subjective experiences as well as the meanings attached to them. Thus, the concept of sexuality encompasses not only the biological and psychological, but also the social and cultural dimensions of sexual identity and sexual behaviour.

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In modern societies, education and mass media have emerged as two agencies playing an important role in the shaping of sexuality, especially of youth. There is a great reluctance to accept that young people may be engaging in risky premarital sex. It is generally believed that because premarital sex is a taboo in India and because the family exerts control over young people, the youth abstain from premarital sex. Further, there is an impression that premarital sex is a phenomenon limited to the upper economic classes (Abrahm 2000). Twenty to 30 per cent of all unmarried males (17 to 24 years) are sexually active (Goparaju 1993; Savara and Sridhar 1994; Sharma and Sharma 1995; Watsa 1993). Self-report figures for females are much lower, i.e, 6 to 9 per cent (Bhende 1994; Savara and Sridhar 1994). An exceptionally high incidence of 40 per cent is reported in the case of tribal girls in one unique study by Bang and colleagues (1989), using direct clinical examination of all adolescent girls in the area. The experience of adolescence as a stage in India by boys is almost diametrically opposite to the experience of adolescence by girls. The sexuality related experiences of girls and boys are largely shaped by the constructions of gender caste, class and community nroms. Double standards are evident, unmarried adolescent boys are far more likely than adolescent girls to be sexually active. Boys are also far more likely to approve of premarital sexual activity for themselves, and have far more opportunities to engage in sexual relations, but are more disapproving of girls freedom to engage in sexual activity (Bhende 1994; Jejeebhoy 1996). The girls also concur with the view of dual standards (Bhende 1994; Kumari 1985). Commercial sex workers seem to be the most frequently cited sex partners in the case of males (Bhende 1994; Goparaju 1993; Sharma and Sharma 1995) though older married women in the community, friends, relatives, and fiances are also reported as

65

partners, ranging from 2.5 to 25 per cent among the rural and urban students surveyed (Watsa 1993). Review of studies on youth sexuality in India indicates that premarital sex among the youth is on the increase especially in urban areas (Watsa 1993; Savara and Sridhar 1993). For instance, a recent study among the students (16-18 years) of a Delhi secondary school showed that about 60 per cent of the boys and fewer girls were involved in sexual activities. Sexually Transmitted Diseases (STDs) including HIV/AIDS Spread of HIV among young people in India is a growing cause for concern. Large number of reported AIDS patients in India are below the age of 24 years having contacted the disease through sex (Goparaju 1993). The surveillance data show that a large per cent of the infected persons are between the age of 20-40 years and had contacted the virus early in life. (National AIDS Control Organisation 1994: 16). Data collected from twelve hospitals/blood banks between 1988 and 1994 reveal that nearly 34 per cent of HIV cases were within the age group of 16-25 years (Bharat 1996). It is estimated that around 160,000 children are living with HIV/AIDS (UNAIDS) (Fig. 10).
Figure 10: Children living with HIV/AIDS
thousands 165,295

134,067

1997

2000

Source : UNAIDS. Joint United Nations Programme on HIV/AIDS Facts & Figures. 66

The urban adolescent/youth in India are sexually initiated at an early age due to crowded living conditions, changing aspirations and role models, the influence of mass media and the reduced age at menarche of urban girls (Watsa 1993). The Task Force on survillance made an assumption for HIV estimates for 2001, it comes to 3.31 million cases in adult population (15-49) years. Taking in other unaccomted cases, the working estimate of 3.97 million is arrived at. The trend of HIV prevailence can be seen from sentinal Surveillance conducted in 232 sites for high risk groups (Table 18). As the Data available indicates, the incidence of STDs and the process of urbansiation appear to go together. Maharashtra, with a high rate of urbanisation has the highest percentage of reported STDs in India (32.6 per cent of the national total).
Table 18 : HIV/AIDS Surveillance in India (As on 31st October, 2003) Aids cases in India Males Females Total Risk/Transmission Categories Sexual Perinatal transmission Blood and blood products Injectable Drug Users History not available Total Age Group 0-14 yrs. 15-29 yrs. 30-44 yrs. >45 yrs. Total Male 1311 12780 24274 3191 41556 Cumulative 41556 14595 56151 No. of Cases 47775 1528 1531 1338 3979 56151 Female 815 6681 6304 795 14595 This month 278 109 387 Percentage 85.08 2.72 2.73 2.38 7.09 100.00 Total 2126 19461 3986 3986 56151

Source : NACO, HIV/AIDS Surveillance in India 67

The HIV epidemic though is still spreading but there is a gradual decrease in new infections, this trend may continiue if a strong effective programme of prevention is not implemented. 49 districts in the country have been designated as high prevalence districts.

19

The ABC Approach


Sometimes D, for Drugs, is added to the message, referring to intravenous drug use and recreational use of alcohol, which can increase the likelihood of unsafe sex. Some also refer to ABC+, which includes the message to get tested and treated for STIs (which increase the risk of transmission of HIV in unprotected sex). Each component of the ABC message should be presented in a comprehensive and balanced way.

In 2001, the United Nations General Assembly Special Session (UNGASS) endorsed the ABC approach to preventing HIV infection. The ABC approach to behaviour change gives three clear messages for preventing the transmission of HIV. ABC stands for: Abstain from having sexual relations or, for youth, delay having sex; Be faithful to one uninfected partner; and use Condoms consistently and correctly.

Source : UNFPA, State of Worlds Population 2003, p. 26.

Unwanted Pregnancy The incidence of teenage unwanted pregnancies and abortions has shown a steady increase in recent years. In 1997-98 there were 0.5 million reported Medical Termination of Pregnancies (MTP) and by 1999-2000 the figure increased to 0.7 million (Government of India); within a span of two years, this is a rather high number. Unsafe abortions are a major source of reproductive mortality and morbidity in India. Many abortions in India are done illegally and often without adequate professional support, leading to serious reproductive morbidity. It is estimated that around 5 million abortions occur annually in India and out of these, 4.5 million are done illegally (UNICEF 1991). Ten percent malernal deaths are due to unsafe abortions. It has been observed that adolescents constitute a sizeable proportion of
68

the abortion seekers and the typical adolescent abortion seeker is an unmarried girl. (Jejeebhoy 1996). It has been reported that STDs are the third major communicable disease group in India (Kapur 1982 as cited in Ramasubbam 1992). Of concern, however, is the fact that around 10 per cent of the total STD cases are estimated to be male students (Ramasubban 1992). Decline in the traditional control over youth by family and schools, increase in age at marriage, changes in social values and exposure to media and aspirations are some of the features of the modern society which have hightened the permissiveness in sexual experimentation and lad to incidence of HIV/AIDS. It may be concluded that adolescents are poorly informed about physical well being, health, their bodies and sexuality. Inadequate information tends to render them helpless and confused most of the times. The ignorance gets accentuated by lack of proper sex education, low educational attainment and the influence of sociocultural background. The reluctance among parents and teachers to impart relevant information is a matter of concern. In fact, parents want their children to be uninformed about matters related to sex and reproduction, since sex and puberty are considered to be extremely embarrassing. Condom use is absent or irregular among sexually active (Sharma et al. 1996) and general population of school going adolescents (Tikko et al. 1995). Postponement of early marriage among adolescent girls, addressing their nutritional needs, providing sex education and information on anatomy and physiology and contraception are the urgent needs. The family, community and society must respond sensitively to the special needs of unmarried adolescent girls and boys. (Jejeebhoy 1996).

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Adolescents in Conflict with Law Incidences of vagrancy, delinquency and crime have been growing in the last few years. Children from broken homes, homeless, raised in slums and abandoned are a vulnerable group. Some recent studies have pointed out that even children of affluent and well to do homes and families commit crimes. The deviant behavior, therefore, is not a manifestation of economic impoverishment alone. A host of causal factors associated with delinquency are: Uncongenial family environment-presence of alcoholism, drug addiction and other illegal activities being undertaken by any member of the family Lack of parental involvement, emotional deprivation, physical and emotional abuse and neglect Unhealthy and undesirable peer influence Inability to continue schooling due to poor performance and fear of punishment by parents and teachers leads to truancy and illegal activities. It is difficult to ascertain the magnitude of crimes committed by adolescents. Juvenile Justice Act, 1986 considered violation of law by a boy above 16 years and girl above 18 years as offences. The Juvenile Justice (Care and Protection of Children) Act 2000 passed by Parliament recently replaces the JJ Act of 1986; it follows a child friendly approach and has provision for care and protection of children and there ultimate rehabilitation. The other major change is the uniformity brought in age for boys and girls as 18 years to be booked as offenders. The reported cases are a small part of the incidences that take place. The National Crime Record Bureau (NCRB) compiles these incidences, including a wide range of crimes, from petty thieving to heinous crime like murder. These are

70

categorized under too groups; crimes registered under the Indian Penal Code (IPC), and crimes under Special and Local Laws (SLL). Some latest figures in of the juveniles apprehended in 2000 are given in Table 19.
Table 19: Juvenile Delinquents Apprehended for Crimes (1999-2000) Year 1999 2000 7-12 Years No % 4039 3292 21.9 18.3 12-16 Years No % 10311 11389 55.9 63.3 16-18 Years No % 4110 3301 22.3 18.4 Total 18460 17982

Juvenile Delinquency (SLL) Under Different Crime Heads and Percentage Variation in 2000 over 1999 Crime Head Gambling Act Excise Act Prohibition Act Immoral Traffic (P) Act Indian Railways Act SC/ST (Prevention of Atrocities) Act Number of Cases Reported During 1999 2000 113 75 733 75 105 18 131 113 519 82 78 25 Percentage Change in 2000 over 1999 15.9 50.7 -29.2 9.3 -25.7 38.9

Source : Crime in India 2000 NCRB Ministry of Home Affairs GOI.

Older age group due to mobility is likely to indulge in juvenile acts more. A look at their profile reveals that boys outnumber girls. Most of them are illiterates or have studied up to different classes of primary stage (40% primary, 38%illiterate). Various other studies have also reported that a large number of offenders are school drop outs (Sharma and Qureshi (1997).The disposal of cases of juveniles varies from state to state; so are the number of cases registered. Madhya Pradesh had highest number of offenders (3541) followed by Maharashtra (2161), Gujrat (1109), and Rajasthan (908) Andhra Pradesh (827) [NCRB 2000]. The probation homes

71

where the offenders are kept have poor quality services. Cases of exploitation of inmates have also come to light. Hopefully, the new Act would improve the functioning of these homes. Conclusions Emergence of a consensus amongst governmental circle, activists, NGOs and UN system to designate 10-19 years age group as adolescence is a welcoming development. Besides greater understanding about the special/sensitive needs of the age group, adolescents get the desired visibility in the national planning process. Further, it facilitates formulation of supportive policy framework, designing workable intervention strategies/approaches, and also promotes synergy and holistic partnership. The process of planning and programme designing by stake holders is being constrained by non-availability of relevant data/information and empirical evidence related to diverse situations in which Indian adolescents grow. Top priority needs to be given to improve data base disaggregated by gender and age groups of 11-14 years and 15-19 years to cater to the specific needs of both stages. The two age groups therefore, need to find place in the national reporting system (Census, NSSO and other data generating organizations).It will also serve as an effective tool for advocacy and monitoring changes in the situation of adolescents and provide direction for future policy. There is also an acute paucity of research evidence related to antecedent consequent relationship between several conditions in which the adolescents are growing. The extent of influence of these on their lives and development if could be made available would add to our understanding of the process of growth. It would help in planning interventions to meet specific needs of adolescents in diverse settings. Undertaking of large surveys and macro and micro-level studies on crucial issues should be flagged as an important priority area for action.
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The situational analysis has highlighted the wide ranging threats and risks faced by majority of Indian adolescents. It may be appreciated, that generalization of the profile of Indian adolescents is not possible due to socio economic, ethnic and cultural diversities. There are some cultural themes and characteristics common to the growing process of most Indian adolescents. The family continues to play an important role in socialization during growing years. The head of the family has the authority to take major decisions related to the family matters and parental control is high. Gender discrimination prevails across all sections of the society; the girls and women have less access to opportunities and resources and have an inferior status. Outward forms of family may seem to be changing; but, in matters related to sexuality, choosing of a marriage partner, reproduction and vocational choices etc are based on conservative traditional values as a norm with a few exceptions. The Indian Youth by and large emulates cultural and family values prescribed by the religion, caste and Ethnic group of their identity. Organizing services for adolescents in India are constrained by several inter linked factors, such as: large target population, wide spread poverty, illiteracy, inadequacy of resources for universal access to basic services of good quality and poor implementation and management of programmes. Multi pronged strategies involving several stakeholders concerned at different levels of programme implementation, convergence of inter-sectoral services of health education, nutrition and skill building at the community/family level are required to provide inputs for ensuring holistic development of adolescents. Setting up of the Working Group on Adolescents, (for the first time), to give inputs for the Tenth Five Year Plan is a testimony of the growing concern about the needs of adolescents. The immediate challenges for action are:

73

Reduction in levels of poverty and ensuring access of the poor to basic services. Poverty is linked with several of the risk factors faced by adolescents arising from impoverished living conditions. The increasing trend of adverse sex ratio needs to be checked. Particularly in state below national sex ratio. Gender equality to be ensured in all spheres of life. Reduction in fertility rates. Reduction in female adolescent mortality rates, particularly maternal mortality rates due to abortion and unsafe delivery, and unwanted pregnancies Raising the age at marriage, for girls in particular Improvement in nutritional levels of adolescents, reduction in prevalence of malnutrition and micronutrient deficiencies. Universalization of literacy, raising levels of education of adolescents, bridging gender disparity and creating avenues for vocational education and employment. Promotion of reproductive health of adolescents through access to user friendly health services, provisions for imparting appropriate information on sexuality, and counselling for safe and protected sex inculding repareible sexual behavour. Prevention and control of spread of STD, HIV/AIDS amongst adolescents Abating sex abuse and sex exploitation Protecting and providing special services to adolescents in difficult circumstances- children of prostitutes, homeless adolescents, mentally challenged and those in conflict with law. Ensuring mental health of adolescents.

* *

* * *

* * *

Supportive policy provisions in India, covering almost all facets of Childs development is an asset. It has helped in making provisions for interventions in the areas of health, education and other sectors of development. But there is no specific policy meant for adolesents perse. A critical appraisal of these policies is presented in the next section of this document. India has also ratified and endorsed all international conventions and declarations relevant in the context of adolescents.
74

The major ones that are of importance are: Convention for the Rights of the Child (CRC), Convention on Elimination of All Forms of Discrimination against Women (CEDAW), International Conference on Population and Development (ICDP), United Nations General Assembly Special Session (UNGASS). The Articles within these instruments prescribe goals and standards that have to be achieved in a phased manner by the country concerned. Thus, India will have to orient its policy framework, legal provisions and gear its programmes to protect rights contained in these instruments. In line with goals prescribed, adequate investments have to be committed to translate goals into actions. The increasing trend of forging partnership with organizations with similar goals and also areas of concern has shown positive results. Best practices identified are being replicated and expanded to benefit adolescents. In India, the UN system is supporting endeavours related to wellbeing of adolescents. A review of the same is described in the subsequent section of this document. It may thus be concluded that strategic investments in health, nutrition, education, employment, improvements in administrative set up; and legal enforcement machinery, modifying policy and legal framework and active involvement/ participation of adolescents are recommended as major priority areas of action. It needs to be acknowledged that it is difficult for the governmental efforts alone to achieve goals set up, particularly related to social development. Active participation and partnership between state, voluntary organizations, civil society and international agencies, and UN system can go a long way to achieve goals. The Tenth Five Year Plan has also endorsed similar approach. The above suggested measures, taken in a time bound manner can improve the situation of adolescents. Judicious planning and designing of intervention is required

75

to meet needs of adolescents from different sections of the society. With a large number of adolescents existing in the population of today, it is an opportune moment for India to capitalize on the open demographic window by building and harnessing capabilities of adolescents and shape them into an effective work force of tomorrow. A challenge worth meeting.

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Policy Frame Work for Adolescents: A Critical Appraisal

Worldwide changes are altering the conditions under which adolescents are getting prepared for adulthood. Working of thoughtfully tailored youth policies and programmes are essential to address the needs of the contemporary adolescents. Particularly, sexual and reproductive issues are sensitive and any endeavour related to these cannot survive in an hostile climate. Interventions, if designed, within the mandate of a supportive policy are easier to implement and can get the desired inputs of the administrative set up. Policy has political will subsumed in it, and ensures availability of resources over a period of time to make programmes sustainable. Further, legislative measures are mostly embedded in some kind of policy frame work. When advocacy and other policy measures do not lead to the desired outcomes, legislations are enacted to make things work. For instance the age of marriage has been regulated by Child Marriage Restraint Act and also now that the elementary education has been made a Fundamental Right, a Central Legislation is being brought in, to make provision under the Right operational. It is imperative, therefore, to have an appropriate policy frame work to achieve any goal or objective. The process of policy formulation begins with the decision about the target group. In the context of policies for youth, there is a conceptual difficulty in fixing the target group. In most cultures, until recently, adolescents were never considered a special target group. The stage of adolescence is the bridge between childhood and adulthood. Accordingly, the populace is categorized in two groups-children and adults. Adolescents are subsumed in children in most cases, till such time that they are ready as per cultural
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expectations/norms to take adult roles. It would thus, vary from culture to culture and on the age capacity for different roles prevalent in the society. For instance, minimum legal age at marriage has been set for girls as 18 years and for boys 21 years in India. Varying ages of legal capacity/rights is a phenomenon common to exist in many countries. In the contemporary scenario, CRC has resolved this problem to a great extent by defining child as every human being below the age of 18 years. It also allows for minimum age to be set, under different circumstances across nations. However, it is considered essential that there is some synchronization of the upper age limit for childhood. India has achieved to resolve this upper age limit issue to a large extent (Table 20). However, a legislation has been recently enacted to make 18 years
Table 20 : Minimum Legal Age Defined by National Legislation Age (Years) Boys Girls End of compulsory education* 14 14 Marriage* 21 18 Sexual consent** Not defined (Section 375 of the Indian Penal Code) Voluntary entistment in 16 the armed forces* (A person is allowed to take part in active combat only at the age of 18) Admission to employment or work, 14 14 including hazardous work, part-time and full-time work* Criminal responsibility* PC 12 Juvenile crime 18 (The Juvenile Justice and protection of children) Act, 2000 Capital punishment and life imprisonment* Giving testimony in court, in civil and criminal cases*** 18 To conduct property transaction 21 Consumption of alchohol and other controlled substances** 21 21 Sources:* NI/PC/SAP/132/2000/908 dated July 31, 2000, National Institute for Public Cooperation and Child Development, Government of India (GOI) ** Responses to the List of Issues raised by the UN Committee on the Convention on the Rights of the Child, Department ofWomen and Child Development, GOI. ***Child and Law, Indian Council for Child Welfare, Chennai, Tamil Nadu, page 507. 78

the general age of majority in India. Following the commitment made under ICPD (1994) and its Programme of Action to which India has also endorsed, it is obligatory for the countries concerned to translate the consensus related to Adolescents Reproductive Health into policies and programmes. To quote, countries must address adolescents needs, either through existing policy and programme mechanisms, if appropriate, or through specific policies and programs designed to meet the unique needs of adolescents and young adults. The Indian scenario in this respect is very positive, a large set of policy frame work relevant to the development of the youth is available. It mainly flows from the provisions made for children (0-14 years) in the Constitution of India (Box 20).

20

Constitutional Provision
14 years shall be employed to work in any factory or mine or engaged in any other hazardous employment. Directive Principles of State Policy Article 39:Right of children and the young to be protected against exploitation and to opportunities for healthy development, consonant with freedom and dignity. Article 42: Right to humane conditions of work and maternity relief. Article 45: Right of children to free and compulsory eduction. Article 46: To promote educational and economic interests of weaker sections to protect them from social injustice. Article 47: The State shall endeavour to raise the level of nutrition and standard of living and to improve public health.

Fundamental Rights Article 14: The State shall not deny to any person equality before the law of the equal protection of laws within the territory of India. Article 15: The State shall not discriminate against any citizen... othing in this Article shall prevent the State from making any special provisions for women and children. Article 21: No person shall be deprived of his life or personal liberty except according to the procedure established by law. Article 23: Traffic in human beings and beggar and other forms of forced labour are prohibited and any contravention of this provision shall be an offence punishable in accordance with the law. Article 24: No child below the age of

Source : First Periodic Report on CRC DWCD 2001, p. 4. 79

Most of the policies are aimed at taking specific measures to improve various sectors of development such as nutrition, education and health to promote well being of children or adults. In both cases, adolescents also get covered as a group. This section of the document reviews some of the existing policies and identify aspects contained there in relevant to adolescents. The approach and guide lines available in the 9th and 10th Five Year Plans related to adolescents have also been culled out and discussed. The Ninth Five Year Plan The Ninth Five Year Plan (1997-2002) outlines the development plans and policies of the government, and reflects the governments concerns and approach. In the document, adolescents are mentioned mainly in the sections on women and children, health and youth. Specific mention of adolescents in the Ninth Plan includes its commitments towards the child to universalise supplementary feeding with a special emphasis on adolescent girls, to expand the Adolescent Girls Scheme and to assess the health needs of adolescents in the Reproductive and Child Health (RCH) programme. Nevertheless, adolescents continue to be a sub-group of women, children or youth and there appears to be no move to consider adolescents as a separate category. The expansion of the scheme for adolescent girls is mentioned in terms of the underlying rationale ...in preparation for their productive and reproductive roles as confident individuals not only in family building but also in nation building (Planning Commission, Government of India 1998). It is in appropriate approach that adolescents are seen as `human capital, in relation to their future productive role alone. At the same time, the Ninth Plan explicitly makes a commitment to human development, which is centred on the basic recognition of human beings as
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people, with every individual adolescent having rights to survival, development, protection and participation, which must be fulfilled in the present. During the Ninth Plan, health care needs of adolescents were being addressed under the RCH Programme. The Department of Women and Child Development also initiated in selected blocks the Kishori Shakti Yojana, a comprehensive intervention aimed at improving nutritional and health status of adolescent girls. It also had inputs to promote their self development by raising awareness and enhancing skills. Specialised counselling and IEC material relevant to crucial areas of concern were developed and disseminated at the community level through NGOs during the Plan period. However, coverage under these programme has been very low.

21

Ninth Plan Strategy


Appropriate antenatal care to be provided to high risk adolescent pregnant girls Inter-sectoral coordination between RCH and KSY is being strengthened in blocks where ICDS Centres have an adolescent care programme.

Efforts to educate the girl her parents and the community to delay marriage; Programmes for early detection and effective management of nutritional (under-nutrition, anemia) and health (infections, menstrual disorders) problems in adolescent girls;

Source : Report of Stering Committee on family welfare for the Tenth Plan, Planning Commission GOI, p. 74.

The Tenth Five Year Plan The Working Group on Adolescents constituted for the Plan made specific recommendations. These were considered by different steering committees and crucial areas of concerns related to adolescents were integrated in the respective reports of these committees. An attempt has been made here to highlight these recommendations.
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Family Welfare Steering Committee. In the Health Section specific reference was made to improve coverage and quality of health care to vulnerable and under served adolescents. Under-nutrition, anaemia, poor antenatal care and discriminatory child feeding practices inevitably lead to perpetuating the intergenerational cycle of under nutrition in girls. In order to break this cycle during Tenth Plan, in addition to education, nutrition health interventions, and IEC, efforts to delay the age at marriage will be strengthened through intersectoral coordination. Under-nourished adolescent girls of 51 backward districts will be provided foodgrains free of cost and nutrition education addressed to the family, aimed at proper intra-family distribution of food will be under taken in these pilot project. National Nutrition Mission will be set up with the objective of reducing under-nutrition and micro-nutrient deficiencies. In Reproductive and Child Health Programme the following components for nationwide implementation will cover adolescent girls health concerns Prevention and management of unwanted pregnancy, Services to promote safe motherhood, Services to promote child survival Prevention and treatment of RTI/STD Reproductive health services for adolescents;

Realising the gravity of the adverse consequnces of teenage conception, it is proposed to consider adolescent girls as a high-risk group, and will be provided with adequate nutritional and health care. The health personnel should be sensitized to the needs of this very vulnerable group.
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Effective antenatal and intra-partum care will remain the focus and well be further strengthened in states where teenage pregnancies are common.

Meeting the felt but unmet needs for contraception. Improve access to safe MTP services including non surgical methods of MTP Effort should be made to ensure 100% registration of pregnancies, deaths and births so that reliable district level estimates of MMR are available.

Education and Youth and Sports Sleering Committee For the first time, a new programme for the holistic development of adolescents will be started. The delivery mechanism for the programme will be largely in collaboration with NGOs. Various cross cutting issues like health, nutrition, alcohol/drug abuse, life skills etc., will be addressed through the programme. Gender sensitisation will be a prime concern and efforts will be made to involve adolescents in nation-building activities, and also to generate awareness amongst peers on health, nutrition, family planning, HIV/AIDs, sanitation and environment, etc. Youth Development Centres are to be set up in each of the 5000 blocks in the country. These centres will function as information technology centres as well. The Vocationalisation of Education in the Tenth Plan will be a new thrust area. As a result of the universal elementary education initiatives mentioned earlier, there are going to be a large number of middle school pass-outs adolescents. While some of these will pursue higher studies, there will be others who would need vocational education. To equip them better for finding suitable employment opportunities. In view of this, there

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is an urgent need to formulate a clear-cut integrated policy on vocationlisation of education. Appraisal It is noteworthy that in the Plan document, adolescents girls have been bunched with either women and children except in case of nutritional needs. The desired focus on adolescents is missing. The boys and the male youth have received negligible and little attention, which is not a balanced approach. Boys are important both in terms of their own wellbeing and influence they have on girls. When it comes to juvenile delinquency and risks imposed by special situations, adolescent boys are becoming very vulnerable and require attention. Minimal attention has been given in the Tenth Plan to these aspects, only a passing reference is made under J.J. Act revision and in implemention of the Act. The paradigm shift in making health services decentralized and target free, involvement of NGOs and private sector are healthy developments. Community based interventions are being promoted as a strategy, and are likely to promote participation of youth in their own development. The rights approach has also been reflected in the strategies proposed and recommended. The sheer number of adolescents today indicate that they can not be ignored by policy makers and planners or service providers. We need to address adolescents first and foremost as individuals in their own right. Hopefully, the proposed setting up of a National Commission for Children during the Tenth Plan will ensure protection and safeguard of the rights of children including adolescents. It is to work on the lines of National Human Rights Commission. It will investigate and redress individual complaints and grievances as well as provide legal support and services.
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Content Analysis of Policies The profile of adolescents is determined by present conditions as much as by the conditions/circumstances experienced during the growing years. The relevant aspects identified in the policy analysis, therefore, duly acknowledge the crucial role of the life cycle approach. The tabular analysis of major policies, presents the summary of provisions which need to be tapped for meeting unique needs of adolescents in the existing frame work. The remarks column, mentions inadequacies positive aspects of the policies in the context of adolescents. Policy Frame Work: Relevant to Adolescents 1. National Policy for Children 1974 Extracts of the Policy Introduction ....Childrens Programmes should find a prominent part in our national plans for the development of human resources, so that our children grow up to become robust citizens.....(1) In the policy, children in the age group (0-14 years) are covered Remarks

Crucial role of childhood has been highlighted for Human State to provide adequate services to Resource Development. children, both before and after birth and through the period of growth, to ensure their The policy duly acknowledges the full physical, mental and social development. life cycle approach and responsibility of the State to (3) provide adequate services to children. Policy Measures Coverage of all children by comprehensive Available provisions cover the 10health programme 14 years of age group in the Free compulsory education for children (0- context of adolescents who are entitled to these services. 14 years)

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Extracts of the Policy Focus on children from weaker sections and girls Other forms of education facilities for those unable to attend school Provisions will be made for physical education, games, sports and recreation in schools and other institutions Socially handicapped and delinquents shall be provided education, training and rehabilitation Children to be protected against neglect cruelty and exploitation. Strengthening of family, community and neighbourhood. 6. Role of Voluntary Organisations.

Remarks

It shall be the endeavour of the State to Endorses the concept of encourage and strengthen voluntary action so partnerships that State and voluntary efforts compliment each other. Promotes voluntary action and 8. Peoples Participation peoples participation. The Government of India also calls upon the citizens and voluntary organisations to play their part in the overall effort to attain these objectives. Policy modifications require extending the age coverage upto 18 years. Interventions to be geared to the needs of specific age groups Adolescence phase be given a special place to meet unique needs of both boys and girls. While formulating the proposed Charter for Children these suggestions be considered by GOI.

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2. National Plan of Action (1992) Extracts of the NPA Remarks

As a follow up of the World Summit for It has devoted a separate section Children, NPA was evolved. to the Adolescent Girls, a Programme for the adolescent girls should paradigm shift to recognise embrace a whole range of activities, such as unique needs of the age group. nutrition, health, education, health and Covers all areas of development nutrition education, recreation, upgradation and endorses holistic approach. of home-based skills and promotion of her decision making capability. Adolescent girls who are one of the most critical human resource, particularly at the village level need to realise their potential. Objectives i) to cover girls in the age group of 11 to 18 years; ii) to improve the nutritional and health status of girls in this age group; iii) to provide them the required literacy and numeracy skills, through the non-formal stream of education, to stipulate a desire for more social exposure and knowledge and to help them improve their decision making capabilities, especially on issues regarding their future; iv) to train and equip the girls to improve and upgrade home based skills; v) to promote awareness of health, hygiene, nutrition and family welfare, home management and child care, to take all other measures as would facilities their marrying only after attaining the age of 18 and, if possible, even later.

Health and nutrition given due attention. No specific measures suggested for empowerment.

Delaying age suggested.

at

marriage

DWCD the nodal department may like to ensure that National Plan of Action for Children under revision considers these suggestions and gives due focus to adolescents in the national and state level plans. The rights approach and the recommandation of CRC, CEDAW, UNGASS and ICPD relevant to adolescents be kept in mind.
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3. National Plan of Action for SAARC Decade of the Girls Child 1991-2000 Extracts of the NPA Remarks

Holistic policy approach for development Separate mention made about the of the adolescent girl importance of the period of adolescence. Safe motherhood Child bearing A few aspects of development touched but views adolescent girl Crucial role of adolescence stage mainly in the role of a mother. highlighted Mean age at marriage 4. National Policy for Education 1986, PAO-1992 * Eradication of illiteracy in the age group 15-35 years * Commitment to universalisation of primary education * Vocational courses at the higher secondary level Extracts of the Policy Reorganisation of Education 5.4. A full integration of child care and preprimary education will be brought about, both as a feeder and a strengthening factor for primary education and for human resource development in general. In continuation of this stage, the School Health Programme will be strengthened also. Elementary Education 5.5 The new thrust in elementary education will emphasise two aspects: (I) universal enrolment and universal retention of children up to 14 yeas of age, and (ii) a substantial improvement in the quality of education. Adolescent group forms part of Primary and Elementary Education (10-15 years) as also Adult Literacy (15-35 years). Remarks

Supportive Services to release girls for elementry education, and Non-formal Education for adolescents are proposed for the first time.

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Extracts of the Policy Non-Formal Education 5.8. A large and systematic programme of non-formal education will be launched for school drop-outs, for children from habitations without schools, working children and girls who cannot attend whole-day schools. Vocational courses at secondary Level

Remarks

Literacy related needs of working Adolescents get covered. Vocational education proposed for older age group. Captures both younger & older adolescent age groups.

Education for womens equality. Provision Specifically focused at for educational programme of adolescent educational needs adolescent girls. girls. POA-1992 Universal enrolment Retention Attainment of minimum levels of learning Covers SC/ST & girls in backward areas. Aspects such as (MLL) ICT and Technology when Reduction in disparities integrated are likely to add value Protection of Environment and give new direction to the growing adolescents. Educational Technology ICT Value orientation on Education Population Education Population Education addresses adolescents special needs related to sexuality and reproductive health.

Takes care of quality aspects in education

Adolescent-centred approach should be integrated in the formal and nonformal educational system at various levels. Efforts related to bridging gender disparities in education should not be only focused at girls and women but include adolescent girls as a separate group. Population Education and Life Skill Education to be formally integrated in the educational curriculum.

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5. National Policy on Child Labour (1987) Extracts of the Policy 2.1 A Child Labour Technical Advisory Committee has been set up to advise the Central Government on addition of occupations and processes to the Schedule contained in the Child Labour (Prohibition and Regulation) Act, 1986 (hereinafter referred to as CLA, 86). 2.3 Government will also bring forward legislation to delete the provision contained in the Minimum Wages Act allowing different wages to be fixed for children, adolescents and adults. In other words, children will have to be paid the same as adults. This will remove the economic incentive to employ child labour on lower wages. National Child Labour Policy in 1987. The policy consists of three complementary measures: Legal action plan: The policy envisages strict enforcement of the provisions of the Child Labour (Prohibition and Regulation) Act, 1986, and other child-related legislation. Focus on general development programmes benefiting children, wherever possible: The policy envisages the development of an extensive system of non-formal education for working children withdrawn from work, and increase in the provision for employment and income-generating schemes meant for their parents. A comprehensive statement but lacks in implementation strategies and coordination with other partners for providing related services to adolescents in work/ Labour Force. No data of violation of the Act Published. Judiciary has taken pro action under PIL. Remarks A positive development to check exploitation of young work force.

As on 2001, 13 prohibited occupations and 57 prohibited process are in the schedule.

No amendment to the Minimum Wages Act has been made so far. GOI not ratified ILO convention 138 also.

Area specific projects to be set up in areas Number of projects in creased


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Extracts of the Policy

Remarks

known to have high concentration of child over the years. labour and to adopt a project approach for Active role by NGO and ILO identification, withdrawal and rehabilitation of working children. Despitc acceptance in the policy of the protective role to be performed by the state in prohibition and eliminating of child labour, the implementation of measures and legislations has been poor and tardy. Pronuncements, declarations need to be backed by concrete actions, monitoring and setting up of an effective enforcement mechanism. 6. National Nutrition Policy (1993) * Adolescent girls as a specially vulnerable group * Redress the nutritional problems of adolescent girls Extracts of the Policy Intensified efforts within ICDS to address nutritional needs of adolescents Nutrition and health education for girls and their families. Remarks

Identifies adolescent girls as a specially vulnerable group Nutritional needs and problems highlighted. However, the concern emerges for them only as mothers and care givers. No additional funds allocated for meeting nutritional needs. Nutrition surveillance covering adolescnts Policy silent on needs of growing adolescent boys. Participation of women/girls in food Well being of the age group for self development and special production and processing nutritional needs and micro nutrient requirements ignored. Policy weak in implementation strategies. Suggested modifications include: nutritional supplementation for adolescents (boys & girls) to match needs of the growth spurt. Nutrition and health education concepts to be integrated in the school curricula. Involvement of adolescents to educate family and commuity members in NHE. Intrafamilial distribution of food be improved to bridge gender disparities in consumption of food.
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7. The Draft National Policy on Health (1999) * Adolescent girls as a special group * Health care of adolescent girls * Nutritional needs of adolescent girls Extracts of the Policy Problems requiring attention (i) Nutrition Time-bound plan to ensure adequate nutrition for all segments of the population. Maternal and Child Health Services to be provided priority. Highest with a special focus on the less priviledged sections of society Progressively all deliveries to be are conducted by competently trained persons. Comprehensive programme providing ante-natal, intra-natal and post-natal care. Remarks The policy expresses concerns for health of adolescent girls only with regards to nutrition as a specific group. Adolescents are invariably grouped with children or pregnant women within MCH services. It is only the pregnancy and maternity related health and nutrition needs that are emphasised. Adolescents specific needs as a group are not covered. A posiive aspect added in the health system are occupational hazards control and provision of school health services. These have to coverage be expanded furthers for universal.

ii) School health programme: Organise school health services, linked with the general, preventive and curative services. iii) Occupational health services. There is urgent need for launching well-considered schemes to prevent and treat diseases and injuries arising from occupational hazards. Health Education The public health education programmes should be supplemented by health, nutrition and population education programmes in all educational institutions, at various levels.

Health policy identified population education as a specific component which is relevant to adolescents in schools. What about the ones out side school?

Suggested changes in policy focus is to include adolescents as a specific group in addition to women and children in RCH. Sexual & reproductive health issues to be integrated in the school health programme.

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8. Draft National AIDS Policy (2000) * Interventions for age group 18-40 years Extracts of the Policy Remarks

Firm commitment to prevent spread of Covers a wide range of 18-40 HIV/AIDS years. Adolescents conspicously Special facilities for treatment of missing as a group vulnerable groups, street children and sex workers Increasing awareness through use of media Vulnerability of drug addicts and Universities Talk AIDS to be expanded sexually abused younger age group (10-14 years) does not find through youth groups (NYKS) adequate mention. Mobilising partnership and involvement of Within intervention strategies for NGOs, CBOs in prevention and alleviation IEC, the coverage of adolescents of HIV/AIDs. is there but not mentioned Awareness and information about HIV/ explicitly as a group AIDs to be integrated in schools population education (sec c) Vulnerable groups identified sex workers and street children. HIV/AIDs included in Population Education a good development. It is suggested that in programmes on AIDS Education within students focus on adolescents need to be specified and strategies be identified in particular. The mandatory screening/testing before marriage be pursued as a policy priority as it has crucial implications for adolescent groups. Voluntary testing be promoted amongst sexually active adolescents during counselling.

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9. National Population Policy (2000) * Inclusion of adolescents the category of under-served population * Mention of adolescents in information, nutrition, contraceptive use, STDs and other population related issues * Developing a health package for adolescents. Extracts of the Policy The NPP has sought to address these challenges towards achieving TFR of 2.1 and it lays down specific goals to be achieved by 2010. Those which impact the adolescents are: Address the unmet needs for basic RCH services, supplies and infrastructures; Promote delayed marriage of girls, not earlier than the age of 18 years and preferably after 20 years of age; Achieve 80% institutional deliveries and 100 per cent deliveries by trained personnel; Achieve 100 per cent registration of births, deaths, marriage and pregnancy; Bring about convergence in implementation of related social sector programmes so that family welfare becomes a people centred programmes. Decentralised planning and programme implementation. The Panchayati Raj Institutions (PRI) are an important means of furthering decentralized planning and programme implementation in the context of the NPP, 2000. Convergence of service delivery at village levels, with an integrated Health Package of essential services at village and household levels. Empowering women for improved health and nutrition. Women health and nutrition problems can be largely prevented or
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Remarks The NPP 2000 has devoted considerable space to relevant concerns of adolescents. Recognises critical role played by adolescents in controlling the size of population. Suggests plan for enforcing the child Marriage Restraint Act 1976 (Sec 26) Goals related to RCH services are likely to improve coverage of adolescent girls.

Involvement of local community.

Developing of the Health Package and covering requirements of adolescents is a welcoming component of the policy.

Extracts of the Policy mitigated through low-cost interventions designed for low-income settings. Meeting unmet needs for family welfare services. Increased participation of men in planned parenthood. Adolescent: Programmes should encourage delayed marriage and childbearing, and educate of adolescents about the risks of unprotected sex. Collaboration with and commitments from NGOs and the private sector. There is a need to put in place a partnership of non-government voluntary organizations, the private sector, Government and community. Contraceptive technology and research on RCH. Government must constantly advance, encourage, and support medical, social science, demographic and behavoural science research on maternal, child and reproductive health care issues. Information, education and communication. Information, education and communication (IEH) of family welfare messages must be clear, focused and disseminated everywhere. For comprehensive and multi-sectoral coordination of planning and implementation. The National Commission on Population and State Commission on Population as structures are recommended.

Remarks

The Policy perhaps is one of the most comprehensive statement covering Reproductive Health aspects of adolescents in a systematic manner.

Policy if translated into action has far reaching implications for changing health scenario and well being of adolescents

Under modifications proposed, it is suggested that there should be a separate strategic theme on Adolescent Health and Development encompassing holistic needs. Special needs like counselling and accessibility to contraspective services should be ensured. Adolescent clinics should be set up in urban and rural areas.
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10. National Policy for the Empowerment of Women (2001) * Elimination of discrimination against girls * Nutritional needs * Protection against trafficking and prostitution Extracts of the Policy Goal and Objectives Empowerment of women, enjoyment of all human rights, equal access to participation and decision in social, political and economic life of the nation Equal access by women to health care quality education at all levels, career and vocational guidance, employment, equal remuneration, occupational health and safety, social security and public office Strengthening legal systems aimed at elimination of all forms of discrimination against women; Changing social attitudes and community practices by active participation and involvement of both men and women; Elimination of discrimination and all forms of violence against women and the girl child; Remarks Section on elimination of discrimination against the Girl Child. The other issues concerning adolescent girls, such as nutrition, violence, protection of rights and protection against trafficking and prostitution are covered.

Most interventions directed at the girl child would undoubtedly have an impact on adolescent girls, due to the increased attention of the policy commitment to this age group. To reiterate again adolescents girls as a distinct category have not been viewed. Their unique physical, psychological and social needs are not taken care of. While a sub-set of these would be covered by other categories, there are some needs which are specific to the age group of adolescents. Policy recognizes the critical need of men Addresses Reproductive Health and women to have access to safe, effective needs and affordable methods of family planning Mens participation solicited in of their choice. empowerment a positive change. Training in areas where they have special skills like communication and information technology.
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Extracts of the Policy Measures and programmes will be undertaken to provide special assistance to victims of marital violence, deserted women and prostitutes etc; Institutions and mechanisms/schemes for assistance will be created and strengthened for prevention of such violence, including sexual harassment at work place and customs like dowry; for the rehabilitation of the victims of violence Measures to deal with trafficking in women and girls will be taken Eliminating child labour, there will be a special focus on girl children Collection of gender disaggregated data by all primary data collecting agencies. All Ministries/Corporations/Banks and financial institutions etc. will be advised to collect, collate, disseminate and maintain/publish data related to programmes and benefits on a gender disaggregated basis. The PRIs and the local self Governments will be actively involved in the implementation and execution of the National Policy for Women at the grassroots level. The policy will aim at implementation of international obligations/commitments in all sectors on empowerment of women such as the Convention on All Forms of Discrimination Against Women (CEDAW), Convention on the Rights of the Child (CRC), International Conference on Population and Development (ICPD+5).

Remarks

Directly relates to violence and abuse of adolescent girls

It is an important area and can go a along way in generating reliable data to assist planning, and monitoring of services and assessing impact of programmes. It endorses partnerships at all levels. Highlights rights approach.

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Extracts of the Policy International, regional and sub-regional cooperation towards the empowerment of women will continue to be encouraged through sharing of experiences, exchange of ideas and technology, networking with institutions and organizations and through bilateral and multi-lateral partnerships.

Remarks

Addresses women empowerment adolescents girls are mostly covered as a group within female gender.

Specific concerns of adolescent girls not addressed. Adolescents not mentioned either in the section of gender discrimination or violence. No elaboration of preventive or punitive measures.

11. National Youth Policy and Adolescents) * Inter-sectoral approach * Distinction between adolescence and age of maturity * Nutritional requirements Education need * Educational needs Draft National Youth Policy 2001 The National Youth Policy, 2001 reiterates the commitment of the entire nation to the composite and all-round development of the youth. The Policy is based on recognition of the contribution that the youth can, and should, make to the growth and well-being of the community. Policy also stresses that the youth of the country should enjoy greater participation in the processes of decision-making and execution at local and higher levels, the emphasis being more on working with the youth than for the youth. Youth in the age group of 13 to 35 years are covered. Age of adolescence (1319 years) has been separated from the age of attainment of maturity and (20-35 years). The age group 13-19, which is a major part of the adolescent age group, will be thus regarded as a separate constituency. The thrust areas of the policy include youth empowerment, gender justice and inter-sectoral approach.
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Youth Enpowerment Attainment of higher educational levels and expertise in the youth, in line with their abilities and aptitudes, and access to employment opportunities accordingly. Development of youth leadership, and its involvement in programmes and activities pertaining to National Development. Access to facilities relating to Sports, Cultural, Recreational and dance activities.

Gender Justice For ensuring gender justice elimination of gender discrimination in every sphere has to be achieved Domestic violence will be viewed as violation of human rights. Young men, particularly the male adolescents will be properly oriented to respect the status and rights of women.

Inter Sectoral Approach The Policy recognizes that an inter-sectoral approach is a pre-requisite for dealing with youth-related issues It, therefore, advocates the establishment of a body to act as a coordinating mechanism. Information & Research Rajiv Gandhi National Institute of Youth Development (RGNIYD) will serve as the apex information and Research Centre on youth development issues. The policy recognizes all important sectors of development namely, education; training and employment; health and family welfare; preservation of environment, recreation & sports; art and culture, science & technology and civics and citizenship.

Major Strategies Key sectors of youth concern lessen the differences between the daily average intake of energy and proteins and the recommended daily allowances (RDA).

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Health education and health consciousness to be included in the curricula of regular/formal education, and in interaction with the youth. Establishment of state-sponsored free counseling services for the youth, with a view to ensure better mental health. The drug and substance abuse, HIV/AIDs as issues should be tackled on a priority Reproductive Health Education should form a part of the educational curriculum. Establishment of Adolescent clinics in large hospitals and similar projects in rural areas. Population education to sensitize adolescents with regard to correct age for the first pregnancy, sufficient spacing between births and limiting the size of the family. Youth Organisations to develop Family Welfare Services for young people and provide counseling services. Young people will be recognized as Health Promoters. Community involvement in preservation of the environment and halting its degradation. Young people to play an increasingly significant role in mobilising the public, at large, in this national endeavour. Sports and games to be promoted as a mass movement by making it a way of life. Adequate provisions to be organized for it in schools, colleges and communities.

It may be concluded, at the end, that the Youth Policy provides a comprehensive over view of youth issues and concerns. Policy has followed the ICDP guide lines to quite an extent. It has emphasised participation and involvement of youth in the implementation strategies. Gender inequality has been adequately addressed. The Draft Youth Policy 2001 is definitely an improvement over the earlier drafts of the Policy (1997 & 2000). It presents more refined concepts and strategies of implementation. Clear cut modalities of inter sectoral coordinations have also been suggested and conceptualised.
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The distinction drawn between the sub groups of the target group 13-35 years is a positive move. The two sub groups viz 13-19 years and 20-35 years at least bring out the distinction between the stages; the adolescence years being 13-19 and attainment of maturity between 20-35 years. However, this grouping is still not in line with enumeration of data i.e. 10-14 years and 15-19 years normally followed in the national reporting system. This divergence suggests that the definition and concept related to adolescence as a age group is yet not resolved in the governmental circle. The measures and strategies for the age group 20 plus are quite inadequately provided for in the policy. The monitoring and evaluation strategies and coordination mechanisms need further refinement though the policy surely is a leap forward to bring youth and adolescents in centre stage of planning. An Overview of Policies Most of the policies have not covered adolescents as a separate category. In the government agenda, the unique needs and crucial role of the age group (10-19 years) is yet to receive the due attention and recognition. Recently enumerated Youth Policy has suggested a gradual shift in recognition of adolescents as a distinct group. However, within the target group specified, only 13-19 years adolescents get covered. The younger age group (10-13 years) and onset of puberty are out side the purview of the policy. Adolescents, when covered as subsidiary target groups as is happening presently, fail to get their multifaceted needs met adequately. All Ministries and Department of the government have well specific mandate to work. The priority for action in planning, designing interventions and resource allocation is determined by the mission/goal of the Ministry/Department. In the absence of a separate

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department to address needs and concerns of the adolescents, it will continiue to be a marginalised target group. The result is diffusion of efforts, even if made by several departments in relation to adolescents. Lack of vertical and horizontal coordination results in poor implementation and impact of various interventions. Creation of a department within the government to plan, implement coordinate and monitor programmes and interventions related to adolescents could be considered as a possibility to focus on adolescents as an exclusive group. There is a tendency to over emphasize reproductive health needs, due to vulnerability of the age group to risks in policy stalements. The policy makers need to appreciate that adolescence have several other developmental and psychosocial needs which are equally important. During the last two decades, gender disparities and discrimination within Indian culture have received considerable attention of the policy makers. Girls and females have been identified as a target group in all developmental efforts; a positive indication that deserves appreciation. But when it comes to needs of adolescents, boys and the male youth, the are virtually missing in policy frame work related to adolescents during this stage and they also need attention. Boys have very distinct and different needs as compared to girls. Little empirical evidence is available on impact of programmes, imposing constraints in reorienting implementation strategies or formulation of new policy thrusts. The need of such a feedback should be built into all intervention programmes. India is presently at the cutting edge in terms of formulating policy that attempt to address adolescents in a holistic and integrated manner. There will always remain a challenge in implementation of a policy with such a broad perspective. Crucial issues need to be identified within each major department and a commitment solicited for needed focus allocations fund. The diverse profile of Indian adolescents
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from different regions, ethnic groups, class, caste and urban, rural settings requires area based approaches. It is thus imperative to build flexibility both in policy provisions and programme implementation strategies. The gap between cultural and traditional norms and focus of services under policy needs to be resolved through appropriate advocacy measures. The involvement of target group in planning, implementation and monitoring is a key issue and must be addressed at policy formulation stage. The issue of partnership is equally relevant. Government, NGO and international partnership is required to move the agenda of adolescents forward. The ICPD has redefined policy frame work in terms of rights and choices. It is to underscore the need to further the understanding of government and civil society, so that effective policies/strategies could be designed to translate rights into reality, of adolescents lives (Pachauri 1999). Millennium Development Goals
In 2000, 189 governments signed on to a set of Millennium Development Goals (MDGs), most to be achieved by 2015, outlining progress from 1990 levels. 1. Eradicate extreme poverty and hunger. 2. Achieve universal primary education. 3. Promote gender equality and empower women. 4. Reduce child mortality. 5. Improve maternal health. 6. Combat HIV/AIDS, malaria and other diseases. 7. Ensure environmental sustainability. 8. Develop a global partnership for development. As UN Secretary-General Kofi Annan stated in 2002, The Millennium Development Goals, particularly the eradication of poverty and hunger, cannot be achieved if questions of population and reproductive healt are not squarely addressed. And that means stronger efforts to promote womens rights, and greater investment in education and health, including reproductive health and family planning.

Source : UNFPA, State of World Population 2003, p. 53.

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Programmes and Interventions for Adolescents

Governmental Sector As India witnesses the entry of the largest ever generation of adolescents, compelling arguments are being made to examine the special needs of this neglected vulnerable population sub group. Early discussions are beginning to focus on how adolescent programmes be designed and implemented. Should there be special programmes or needs of adolescents be met out of the existing programmes? What strategies should be designed to reach adolescents in school or outside schools. How to involve family and community? How can multiple needs be addressed holistically and sensitively? These are among the many challenges facing stakeholders attempting to work for adolescents (Pachauri 1998). Although all Department and Ministries in some manner or other may be implementing programmes that are benefiting adolescents, only three Departments have actively integrated adolescents in their programmes. These are: Department of Youth and Sports Affairs, Department of Women and Child Development, and Department of Welfare and Social Justice. Other departments take care of adolescents as subsidiary target groups in their programmes covering specific areas within their purview. The interventions targeted at adolescents are either implemented in nation wide programmes or in state specific programmes. Some of these are supported and implemented in collaboration with multilateral/bilateral international agencies. In

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this section, selected important governmental programmes are described briefly under sectors of economic development, education, health and social and population education. Economic Development : Vocational Training Youth, both in the rural and urban areas, are facing the problem of unemployment. Lack of vocational skills and training inhibits their absorption in the skilled occupations. There are several schemes that are aimed at enhancing the skills of youngsters, such as: Swaran Jayanti Gram Swarojgar Yojna and Swaran Jayanti Shahri Swarojgar Yojna are initiatives to build capacities of the rural and urban youth from under BPL families. It is currently in operation in 9 States. Deen Dyal Swavlamban Yojna is another project on similar lines. These projects are managed by Nehru Yuva Kendra Sangathan, an autonomous body of the Ministry of Youth Affairs and Sports. Entreprenueship Development Programme equips the youth with the skills in designing and planning projects to set up micro enterprise. The Rajiv Gandhi National Institute of Youth Develoments implementing the scheme presently in North East Region. The Department of Women and Child Development in 1987 launched Support to Training Employment Programme (STEP) for women and is being implemented through NGOs/agencies. It is aimed at upgrading skills of poor women including adolescents in traditional occupations, broadening their employment opportunities including self-employment. With assistance from Norwegian Agency for Development, DWCD implements another programme called Swawlamban to train young girls in popular unconventional trades such as computers, medical transcription, electronics etc. Through distance education mode, Indira Gandhi National Open University (IGNOU) is offering certificate course to women and

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young girls of SHGs in entrepreneurial skills. Ashram Schools are residential schools where skills in craft and vocations are imparted along with general education to the tribal youth. Punjab government has been very active in the realm of vocational education particularly for socially disadvantaged and has set up several centres for training and employment in the State. Similarly Society for Employment and Training in the Twin Cities (SETWIN) in Andhra Pradesh, Self Employment Scheme of West Bengal and the Land Army Programme of Karnataka are worth mentioning illustrations of state initiatives related to capacity building of the youths for employment. Swashakti, a women empowerment programme and Kishori Shakti Yojna, a programme for Adolescent Girls of the Department of Women and Child Development have components of vocational training to enable adolescent girls engage themselves in income generating activities. Similarly in the adult literacy programme Mahila Samkhya of the Education Department, adolescent girls out of school receive vocational training, among other things they learn in the programme. With the Swarana Jyoti Gram Swarozgar Yojna being launched, the erstwhile programmes with similar objectives such as Training of Rural Youth for Self Employment (TRYSEM) and Development of Women and Children in Rural Areas (DWCRA) are no longer in operation. To support vocational training of young girls who come from villages to cities for work, a provision for hostel accommodation is made through a scheme of Working Womens Hostel for which funds are provided to NGOs by DWCD to construct hostels. The recommendations related to vocational training and counselling to youth given in the section of situational analysis of the document are reiterated here. Concrete measures are required to bridge the wide gap that exists in the educational system and vocational training for the youth. The major challenge is to ensure
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employability of youth through training with marketable skills. Industrial Training Institutes were set up with this objective and have been performing the role of imparting training in different crafts. In terms of both quantity and quality, available services of ITIs are awfully inadequate. World Bank has provided financial assistance to upgrade equipment, skills of trainers and for expansion of these institutions. As a followup of Supreme Court Judgement in 1996, children working in hazardous occupations were withdrawn. Department of Labour under National Child Labour Project (NCLP) established 3154 special schools in 91 districts to provide nonformal education, supplementary nutrition, stipend, health care and vocational training to the children withdrawn from hazardous employment. International Programme on Elimination of Child Labour has also taken some concrete and constructive measures for rehabilitation of young adolescents and children in the labour force.

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Highlights of IPEC Programme in India


Combating child labour in stone quarries and brick kilns Setting up a child labour cell in the State Labour Institute, Orissa Integrated area-specific approach against hazardous and exploitative forms of child labour in Ferozabad Four integrated area-specific projects to be implemented by NCLPs in Mirzapur (Uttar Pradesh), Jaipur (Rajasthan), Tripur (Tamil Nadu), and Virudhunagar (Tamil Nadu).

National Consultation with trade unions Survey of child labour in sports goods industry State-based approach against child labour in Andhra Pradesh UN -system support of community based education Devleopment of training packages on child labour for NCLP project directors Project for providing pre-vocational training skills and basic education/literacy to child labourers released from bondage

Source: Annual Report, 1999-2000, Ministry of Labour GOI.

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Education and Literacy The provision of Universal Elementary Education has been the salient feature of the educational system. The Honble Supreme Court, in its order in the Unni Krishnan Case (1993) declared education of children upto the age of 14 years as a fundamental right. As per a recent survey, around 79% of children of 6-14 years age group are attending schools. In order to mainstream children who are at present out of school and to improve the quality of instruction for those in school, the Government has been making concentrated efforts. Some of the major initiatives are: Recruitment of teachers and provision of teaching-learning material under the scheme of Operation Blackboard; The District Primary Education Programme (DPEP) to achieve universal primary education; Provision of foodgrains and cooked meals to children under the National Programme for Nutritional Support for Primary Education; State-specific initiatives like Lok Jumbish and Shiksha Karmi in Rajasthan; and Experimental and innovative projects in the non-formal education sector. The Central Government has reviewed the existing elementary education schemes to provide for flexibility of approach and for implementation of universal elementary education in a mission mode. Based on the recommendations of the report of the committee of education ministers, a holistic and convergent programme viz. The Sarva Shiksha Abhiyan, (Education for All) has been launched. Sarva Shiksha Abhiyan (SSA) has the central objective of mobilising all the resources-human, financial and institutional-necessary for achieving the goal of UEE. The objective of SSA is to provide quality elementary education to all children in the age group of 6-14 years by 2010. There will be special focus on girls, children
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belonging to SC/ST communities, urban slum dwellers, and low female literacy blocks. Under innovative programmes some recent innovations worth mentioning are: Lok Jumbish, an innovative project (LJP-Peoples Movement for Education for All), was undertaken in Rajasthan in 1992 with the assistance from the Swedish International Development Authority (SIDA). The basic objective of the project is to achieve education for all, through peoples mobilisation and participation. A variation within it called Muktangan allows children to come any time during the day to get education. Sahaj Shiksha Programme (SSP) is another initiative that caters to dropouts and out-of-school children, especially girls. It works with the community; and has resulted in an increase in the learning ability of students as also the attendence in the centres.

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Lok Jumbish in Rajasthan


objective of LJP is to achieve universalisation of primary education, that would include (i) universal access and participation in primary education of all children up to the age of 14 years, (ii) universal retention in school till they complete the full cycle of primary education, and (iii) universal achievement of at least the minimum levels of learning (MLL) laid down for the primary stage of education.

The Lok Jumbish Project was launched in 1992 with the main objective of achieving education for all (EFA) by the year 2000 through mobilisation and active participation of people in the development of education in rural areas. The project is being funded by Swedish International Development Agency (SIDA), GOI and Government of Rajasthan. It completed its first phase in 1996. The main

Source: Annual Report Department of Education 2002-2003 P. 13.

Systematic Programme of Non-Formal Education (NFE). It is an integral component of the strategy to achieve UEE. It caters to children (6-14 years) who remain outside the formal system of education due to various socio-economic

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constraints. At present, there are 297,000 NFE centres, covering about 7.42 million children in 24 States/Uts. Another Programme that encourages scientific temper and creativity of children is National Bal Bhawan (NBB). An autonomous institution, fully funded by the Department of Eduction, has been working towards enhancing creativity amongst children in the age-group of 5-16 years, especially from the weaker sections of the society. The activities for children are so designed, so as to explore their inner potential through participation in creative and performing arts, environment, astronomy, photography and science-related experiments. There are state branches of it in almost all states. The Shiksha Karmi Project (SKP) aims at universalisation and qualitative improvement of primary education in remote, and socio-economically backward villages of Rajasthan, with primary attention on girls. At the grassroot level, panchayat samitis, shiksha karmi sahyogis, subject specialists of NGOs, shiksha karmis and the village community constantly interact with each other to achieve the aims of the project. Prehar Pathshalas (school of convenient timings), under SKP, provide educational programmes for out-of-school children who cannot attend regular day schools due to their preoccupations at home. Angana Vidyalaya has been specially designed for adolescent girls who are out of school. The teacher at the school is from the same community and is referred to as the saheli (friend). The school curriculum, apart from mathematics, language and environmental studies, includes knowledge and skills relevant to adolescent girls. It helps to build awareness on the biological changes that take place during adolescence. The strategy was started in 1988. It drew inspiration from the Jagjagi centres under the Mahila Samakhya. A total of 467 Angana Vidyalayas are operational, covering more than 15,000 girls. These centres run for four hours daily,
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the timings being suitable for girls. The programme duration is two years, divided into four semesters, each of six months duration. Janshala is a joint programme of the Government of India and five UN Agencies (UNDP, UNICEF, UNFPA, UNESCO and ILO). The programme aims at providing support to ongoing efforts towards achieving UEE and is community based with a special focus on girls and children in deprived communities, marginalised groups, SC/ST minorities, working children and children with specific needs. Janshala is block-based intervention, and is being implemented in 139 blocks and 10 cities in 9 states of the country. The programme has three main objectives. 1. To enhance and sustain community participation in effective school management and the protection of child rights. 2. To improve performance of teachers in the use of interactive child-centred and gender-sensitive methods of teaching in multi-grade classrooms 3. To improve attendance and performance of difficult to reach groups of children, especially girls. The Government of India has launched a scheme to establish on an average, one Jawahar Navodaya Vidyalaya (JNV) in each district in the country, with the objective to provide good quality modern education including a strong component of cultural values, environment awareness and physical education to talented children. JNVs are run by the Navodaya Vidyalaya Samiti, an autonomous organisation under the MHRD. The scheme started with two experimental schools in 1985-86 and has grown to 480 schools covering as many districts in 33 states and Union Territories. The good performance of JNVs in serving SC & ST students has been
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acknowledged and commended by the Standing committee for Human Resource Development in 1997. General Health and Reproductive Health Health is a major concern of the Government of India. There are extensive and wide areas of preventive promotive, curative and rehabilitative services for ensuring survival and health of the people. Within these services, the Reproductive Child Health (RCH) programme is most relevant to health needs of adolescents. It is an integrated programme that combines family welfare, women and child health services.

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Schemes to Improve the Outreach of Services


Organising RCH camps has been introduced. During the camps, services of specialists (gynaecologist and paediatrician) is also made available to the beneficiaries. Dai Training Scheme has been initiated in the district which otherwise report a safe delivery rate of less than 30 per cent.

To cater to the RCH needs of people living in far-flung, difficult-to-reach areas, the MOHFW is operationalising several outreach schemes. Notable amongst these is the Border Districts Cluster Project. Selected districts are provided additional support for mobility of staff, improvement in quality of services and generation of demand for services.

Source: Newborn Health-key to Child Survival Department of Family Welfare GOI.

As a follow up of ICPD, Government took a bold step of making a paradigm shift from achieving demographic targets, to meeting health needs of women and children. The renewed emphasis and focus of RCH has been elaborated under Tenth Plan strategies in the section on policy. It is relevant to point out here that a substantial portion of health services in India lie outside the government sector. There are wide variations in the success of the programme throughout the country and a gender bias against the girl child and women exists in most places. Reproductive health is inextricably linked to the issue of rights. Women in India
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have few life choices and can hardly take decisions about anything, including their own health. Is reproductive choice a reality in this context? Reproductive rights cannot be realised if gender disparities prevail (Pachauri 1999). It is clear that while provision of health services for the entire population is the first imperative, the empowerment of women is essential if these services are to be successfully accessed and utilised. The movement of empowerment of women within the governmental efforts has been institutionalised by Mahila Mandals. Mahila Swasthya Sangh (Womens Health Groups), Self Help Groups (SHG) under different names in several state and national programmes like : Swashakti, Swaym Sidha, Nari Shakti. Awareness about reproductive health and nutritional needs finds a prominent place in these programmes, including ICDS. A significant number of older adolescent girls are benefiting from these interventions also.

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Global Consensus on Adolescent Reproductive Health


sexual and reproductive health information, in a manner consistent with the evolving capacities of adolescents. Sexually active adolescents will require special family planning information, counselling and health services, as well as [information and services on] sexually transmitted diseases and HIV/AIDS prevention and treatment. Countries should ensure that programmes an attitudes of health-care providers do not restrict the access of adolescents to appropriate services and the information they need, including for the prevention and treatment of sexually transmitted diseases, HIV/AIDS and sexual violence and abuse.

The United Nations five year review of the (TCPD Programme of Action called on governments to meet adolescents needs for appropriate, specific, user-friendly and accessible services to address effectively their reproductive and sexual health needs, including reproductive health education, information, counselling and health promotion strategies. The goal is to enable them to make responsible and informed choices and decisions...in order, inter alia, to reduce the number of adolescent pregnancies. The 1999 agreement also states: Governments should ensure that parents and persons with legal responsibilities are educated about and involved in providing

Source: UNFPA. The State of World Population, 2003. P 59 113

Information, Education and Communication (IEC) on health activities have been organized on a priority basis by MOHFW in the most vulnerable districts of India. Greater emphasis has been laid on a more judicious media-mix on the basis of localspecific media forms and need-based interpersonal communication schemes. Stress has been laid on grassroot level communication for those audience segments which cannot be reached by the conventional mass media channels. Remote areas have been covered by adopting a multi-media strategy, song and drama programmes and print material designed for semi-literates and neo-literates in a systematic manner. The IEC strategy is now being focused on the socio-economically backward districts as well as in the weaker States. Feature films on reproductive health issues by an eminent film-maker. Shyam Benegals Hari Bhari, on problems of women in Muslim families has been completed. A radio programme, based on folk music Lok Jhankar (Information for People), is broadcast to enlighten the audience in Hindi-speaking areas on RCH and family welfare issues. A number of audio-visual programmes were produced in Hindi and other regional languages. Haseen Lamhe (Beautiful Moments) programme covered family welfare, RCH and population issues in an interesting and absorbing manner. The media unit of the Ministry of Information and Broadcasting provide communication support to the family welfare programmes. The Food and Nutrition Board (FNB), a non-statutory ministerial wing of the Department of Women and Child Development (DWCD) is engaged in nutrition education of the people in rural, urban and tribal areas as one of its primary activities. The FNB strives to create nutritional awareness through mass media communications as well. A radio-sponsored programme, Poshan aur Swasthya (Nutrition and Health), with 30 episodes on various aspects of nutrition, has been prepared and launched. Vigorous awareness campaigns on malnutrition and its

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prevention throughout the country has been undertaken by the board through its units in States. Kishori Shakti Yojana (KSY) is a mean to empower adolescent girls. It is viewed as a holistic initiative for the development of adolescent girls. This scheme is a redesign of the already existing Adolescent Girls (AG) Scheme, being implemented as a component under the centrally sponsored Integrated Child Development Services (ICDS) scheme. The new scheme dramatically extends the coverage of the earlier scheme with significant content enrichment and a stronger training component, particularly in skill development aspects aimed at empowerment and enhanced self-perception. It also fosters convergence with other sectoral programmes, addressing the interrelated needs of adolescent girls and women.

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Objectives of Kishori Shakti Yojana


improve/upgrade other life skills; To promote awareness of health, hygiene, nutrition and family welfare, home management and child care and to take all measures, so as to facilitate their marrying only after attaining the age of 18 years and if possible, even later; To enable a better understanding of environment-related social issues and their impact on the lives of adolescent girls; and To encourage adolescent girls to initiate various activities so that they may become productive and useful members of society.

The objectives of the scheme are as follows: To improve the nutritional and health status and self-development of girls in the age group of 11-18 years; To provide the adolescent girl with the required linkage with education, life skills, literacy and numeracy skills through the non-formal stream of education to stimulate a desire for more social exposure and knowledge, and to help them improve their decision making capabilities; To train and equip the adolescent girl to

Source: Reaching Adolescent girls, Kishori Shakti Yojna DWCD p. 31.

The UNFPA supported Integrated Womens Empowerment and Development Project (IWEDP), implemented in collaboration with the Government of Haryana
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through its Department of Women and Child Development (DWCD), was undertaken in this context with the long-term goal of improving the quality of life of men, women and adolescents through population and sustainable development strategies with emphasis on gender equity and equality and quality reproductive health. The first phase initiated in 1994 showed that the project had contributed substantially to creating awareness among women, especially the sanjeevanis (animators), mobilized rural women into groups, and initiated the process of womens and community empowerment. The strategy in the second phase was to continue to create opportunities for collective action by rural women through a process of community mobilization and collective empowerment. The interventions built around this process have ranged from training and information, education, communication strategy to gender sensitization of line departments, and life skills development for adolescent girls. At the same time, the project has attempted to provide more space for male participation in order to bring about the desired attitudinal changes in men towards womens empowerment, and gender equity. Feedback indicates women have experienced gradual changes, which have had far-reaching consequences in terms of gender equity and equality, and reproductive rights and choice. Population Education Projects in India with UNFPA assistance have been implemented for two decades. The first was the National Population Education Project (NPEP) launched in 1980 and implemented by the National Council of Education Research and Training (NCERT). In 1986, the University Grants Commission (UGC) for higher education and the Directorate of Adult Education (DAE) for adult literacy and continuing education implemented two other projects. In 1988, a project with the Ministry of Labour was also implemented for incorporating population education in vocational training.
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The National Policy on Education in 1986 made specific mention abaout Population Education and its importance was furthered in the revised policy document in 1992. Five out of the ten co-curricular areas stipulated in the policy document have been identified as the major components of population education. The major innovation of the approach to the population education programme is that it is being conceived as a comprehensive programme with linkages among all three sectors, that is, school, higher education and adult and continuing education. Inter-sectoral coordination among these education sectors aims at not only maximizing the use of resources but also at establishing better linkages between the education sectors and health delivery services. Since adolescents are mainly covered by the school system, the project Population Education in School which has now entered its fourth phase (1998-2001), will be discussed here.

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Six Themes of Population Education


quality of life Health and education - key determinants of population change Population distribution, urbanisation and migration.

Population and sustainable development Gender equality and equity for empowerment of women Adolescent reproductive health Family - socio-economic factors and

Source: Adolescents in India a Profile, UNFPA 2000, p. 55.

National Population Education Project (NPEP), was launched in 1980 with a view to institutionalising population education in the general education system. Since then, the project has completed four phases. The fourth phase began in 1998 and has focused on the emerging concerns of population and development, i.e. gender equality and equity, reproductive health, sustainable development, family and its changing structure and role, population distribution, urbanisation, and migration. The reproductive health concerns have occupied centre stage and have
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been conceptualised as Adolescence Education. Adolescence education has three main components: process of growing up, HIV/AIDS, and substance abuse. The project is implemented through the National Council of Education Research and Training (NCERT) at the national level and SCERTs at the state levels. Population Education has achieved acceptability in the school education system and state governments have contributed considerably in this respect. In the current phase of the project, efforts are being made to reach out to a wider target group; therefore, sub-projects have been taken up with the National Open School (NOS), Central Board of Secondary Education (CBSE), National Council of Teacher Education (NCTE), Kendirya Vidyalaya Sangathan (KVS) and Navodaya Vidyalaya Samiti (NVS). A sub-component of the project on peer education is being implemented by UNESCO. The National Population Education Project has focused on two major thrusts: (1) Integration of elements of the Post-ICPD Re-conceptualised Framework of Population Education; and (2) Introduction of elements of Adolescent Reproductive Health, conceptualised as Adolescence Education. Two broad approaches have been adopted in order to meet the requirements of the existing school education system: The formal curricular approach to continue in order to facilitate an effective integration of population and development education elements reflected in the re-conceptualised population education in the school education system. The co-curricular approach has been emphasised in order to reach various target groups at the earliest without waiting for these elements to formally become an integral part of the school syllabi and textbooks. The implementation of NPEP has yielded rich experiences in respect of
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strategies for the introduction of educational innovations. Population education has been provided a distinct treatment in Para 8.16 of the National Policy on Education 1986, as revised in 1992. Population education has also been incorporated as an important strategy in the National Population Policy (2000) adopted by the Government of India. The co-curricular approach has yielded very rewarding experiences, activities like painting/poster contests, debate competitions, quiz contests, essay competitions, and one-act plays have been very popular; these have succeeded in communicating the messages effectively. Another example is of the consistent effort of Meera Sansthan a NGO in Rajasthan to get a Population and Development Education Course of six months duration in Jai Narain Vyas University, Jodhpur. The need of integrating issues related to population education in the foundation inservice training programmes of Government Schemes functionaries is being slowly accepted. HIV/AIDS Adolescents are at greater risks to infection by HIV/AID due to their vulnerability to drug abuse and indulgence in unprotected sex. The National AIDS Control Organisations (NACO) was set up to review the policies on the prevention and control of HIV/AIDS. NACO has set up a National AIDS Helpline, which offers counselling services round-the-clock. The telephone is linked to a computerised voice response system, which gives information on various issues related to HIV/ AIDS, such as general information, symptoms of HIV infection/AIDS, facilities for testing of HIV, provision of care and support service for those infected and affected by HIV/AIDS. Interested callers can also avail of personal counselling. Such services have been successfully implemented in 35 cities across the country. The scheme of universities Talk AIDS is run through NSS and now has been

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redesigned as Students Talk AIDS. It is reaching large number of adolescents even in rural areas. Communication continues to be one of the most important strategies in the fight against HIV/AIDS. It is imperative to continue intensive communication efforts that will not only raise awareness levels but also bring out behaviour change for its prevention. The strategic response to the threat of HIV epidemic has led to a partnership of GOI and UN agencies Leisure & Play The National Policy for Children, 1974, recognises and ensures the right of the child to rest and leisure, including play and recreational activities. The Convention has several articles which refer to the right of the child to experience and be exposed to his or her own cultural environment. The National School of Drama is an autonomous body under the Department of Culture, Ministry of Tourism and Culture. The Sanskar Rang Toli, formerly known as Theatre in Education (TIE) Company, under the National School of Drama, was established to educate young people between the ages of 8 and 17 years through the medium of theatre. The Toli encourages and trains children to participate in cultural and artistic activities. The activities also have recreational value. The Centre for Cultural Resources and Training (CCRT) is another autonomous organisation under the Department of Culture. The CCRT organises a variety of educational activities for children belonging to the underprivileged sections of society and those in non-formal schools. One of the schemes of Sports Authority of India (SAI) introduces the concept of stay, play and study in the same schools. This scheme is designed to select physically fit children in the 8-12 years age-group and groom them scientifically in SAI-adopted schools. In order to tap rural youth,
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28

Strategic Focus of Each UN Agency within the National Response


Working with NGOs and partnerships with civil society including PLWAs. UNFPA will work within its core areas of support, related to HIV in condom programming, reproductive health, and adolescent reproductive health, and adolescent reproductive health. Specially drawing on its 38 district level projects in six States, to model and define approaches to integrate HIV/STD control into RCH and the PHC system, and carry out research on population projections on HIV and operational research on the female condom, and microbicides. UNICEF will take a lead with WHO in demonstrating feasible strategies for MCT; and within its CRC mandate, develop strategies for involvement of youth, especially tackling discrimination; and supporting formative research on areas related to vulnerability of children (street children/orphans, etc.,) ILO will initiate actions in promoting the active involvement of its social partners (Employers and Unions) in tackling HIV especially at workplace interventions and protecting rights of HIV positive workers.

WHO will continue to focus on surveillance, blood safety; clinical care; and STDs (especially on syndromic management), UNDCP will focus on introducing HIV/ AIDS issues into existing national drug demand reduction projects, currently planning to be supported by UNDCP (especially in the north-east of India), establishing linkages between the two programmes and identifying strategic gaps in drug related HIV programmes. UNIFEM will assist in building capacities of womens organisations bringing in gender perspectives to the national HIV policy and programme, and help forge a partnership between Government and womens organisations in addressing issues of HIV and AIDS. UNESCO will take lead in reaching young people out-of-school in non-formal education and include HIV in curricula across the spectrum of educational programme. UNDP will facilitate empowerment of vulnerable and marginalised populations, making HIV an integral part of its Human Development goals,

Source: India Responds to HIV/AIDS: A strategic response to the HIV epidemic by the GOI, the UN and its Development Partners in India.

there is a scheme for the adoption of akharas. Under this scheme, talented boys under 14 years of age, are adopted by SAI under the NSTC scheme and a stipend is given towards diet and school expenses. The Nehru Yuva Kendra Sangathan (NKYKS) is an autonomous organization of the Department of Sports and Youth Affairs, with its offices in nearly all the
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districts of India. NYKS is the largest grassroots level apolitical organisation in the world, catering to the needs of more than eight million non-student rural youth. Cultural initiative undertaken by NYKS seeks to promote and encourage local folk, art and culture of rural India, and through this to convey important social messages. Activities such as nukkad nataks, skits, one-act plays, folk dances, folk songs and puppetry are organized. Environment The Ministry of Environment and Forests interacts actively with NCERT and MHRD for introducing and expanding environmental concepts, themes and issues in the curricula of schools and colleges. Environment education in the school system has been included as a sub-component under the World Bank-assisted Environmental Management Capacity-Building projects, being implemented by the Ministry. The World Wildlife Fund (WWF) India Conservation Education programme was started in 1969. Aimed primarily at the countrys youth, WWF-India has a network of about 700 Nature Clubs across the country with a membership of about 20,000 school children. The Nature Clubs encourage young members to undertake voluntary work in awareness building, tree planting, running campaigns against wildlife trade and conducting conservation activities. Youth for Youth, a movement started in early 90s, encourages better-off youth to work for the more needy youth. The movement organises various street and railway station contact meetings, where basic literacy programmes, medicine and recreational facilities are offered. The children of Ashalayam invite children who stay on the streets to their House of Hope. Educational programmes (awareness of drugs, health issues, etc.) games and sports, dramatics, singing and dancing, films
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and good food are organised with a view to make the children experience love and affection and eventually lead them away from the streets. National Service Scheme National Service Scheme, poplarly known as NSS, was launched in Gandhijis Birth Centenary Year, 1969. Today, NSS has over 19 lakh student volunteers spread over 176 Universities and 22 Senior Secondary Councils. The National Service Scheme has two types of programmes, viz Regular Activities and Special Camping Programmes undertaken by its volunteers. Under Regular Activities, students are expected to work as volunteers for a continuous period of two years, rendering community service for a minimum of 120 hours per annum. The activities include improvement of campuses, tree plantation, constructive work in adopted vilalges and slums, work in welfare institutions, blood donation, adult and non-formal education, health, nutrition, family welfare, AIDS awareness campaign, etc. Under Special Camping Programme, a 10 day camp is conducted every year in the adoped villages/areas on specific themes like Youth for Afforestation and Tree Plantation, Youth for Mass Literacy, Youth for Rural Reconstruction. NGO Activities and Programmes for Adolescents Governments in collaboration with non-governmental organisations, are urged to meet the special needs of adolescents and to establish appropriate programmes to respond to those needs (ICPD-POAs, paragraph 7.47). Much before the recommendations of the ICPD to involve NGOs, in India there has been a long tradition and culture of voluntary action in issues related to the welfare of the society NGO/Voluntary organisatgions have emerged today as an important third sector playing a by role in social development. This has lessened the burden of the government on expenditure. NGOs not only mobilise resources
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for their operations but are able to involve people in their activities leading to sustainability. Voluntary organisations have also been achieving desirable results in the impact and outcomes of the programmes. This could be attributed to several factors, with respect to NGOs such as: close proximity with community, good rapport, small geographical area of operation, dedication, commitment, expertise and sensitivity in dealing with social issues and flexibility in operation. The initiatives of NGOs cut across diverse range of social issues. There are only a few organisations which are working exclusively for adolescents; others have built in interventions related to adolescents in the existing programmes. A few selected programmes related to interventions for adolescents are described in this section. The criteria for section have been the relevance of the content/inputs of the programme to adolescents concerns, and the innovation in both designing and implementation of the programme. Relatively successful projects/programmes have been included. The objective here is to synthesise the elements and strategies that make programmes work. The lessons drawn would facilitate programme designing at different levels. The identified guide lines could be used for replicating, expanding or re-structuring similar porgrammes both at micro and macro levels. It is pertinent to mention that the projects cited here are out of the projects that have been widely documented; it is likely that several successful and effective programmes could not find place in the section due to lack of documentation. It is difficult to organise this section as per sectors of development namely, health, education, sexual reproductive health etc. There is an increasing trend in the community-based programmes to have an holistic approach. The interventions thus have integrated several components based on the needs or felt needs of the target group.
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The profile of randomly selected programmes is presented here as snap shot for ready reference. ADITHI With a family-type organisational structure, ADITHI aims at changing biased social norms to create a more gender egalitarian society. It started the Balika Kishori Chetna Kendras which act as awareness centres for young, unmarried girls (11-18 years). Helping girls to enhance their decision-making skills, increasing their selfreliance and imparting legal education and administrative information are some of the features of the programme. For expanding their outreach to girls in other areas, they avail help from various other organisations. The kendras also provide life skills education to teach girls several coping mechanisms. Income-generation activities are conducted that serve as an incentive for parents to send their daughters to the kendras. The kendras have experimented with various ventures like goat-rearing, poultry, candle-making, applique work and vegetable gardening. ADITHI believes strongly in the fact that involving boys (916 years) in their programme is an important step towards changing gender relations, promoting human development, stereotypical gender role biases as also arousing in them a sensitivity to the need for doing away with such social ills as dowry and female infanticide. RUWSEC RUWSEC (Rural Womens Social Education Centre) works in Tamil Nadu which while being one of the more developed states in India, presents a mixed picture in terms of development and womens status. RUWSEC is a grassroots womens organisation which also aims at providing life-skills education to adolescent girls and eventually to adolescent boys as well. Non-formal education
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through literacy and numeracy, access to information on vocational training and income-earning opportunities along with involvement in community activities and developing a positive self-image are some of the specific objectives of the programme. It also believes that without basic literacy, achieving most of those objectives would be difficult, and that working with adolescents is a long-term commitment. It has added education empowerment project for adolescent girls and is supporting two youth centres. These youth centers cater to about 250 young people (both men and women) from villages. RUWSEC has integrated into the life skills approach an explicit gender analysis and a trainign focus. It thus advocates a comprehensive approach, aiming at addressing the adolescent in his or her totality. CINI ASHA CINI ASHA (Child in Need Institute), a Calcutta-based NGO, was born in response to the cry of poor children living in degrading conditions. Its aim is to educate street children, child labourers and children of sex workers between the ages of 4 and 20 and place them in formal schools. CINI ASHA in partnership with UNESCO has been working to meet the needs of these children in areas most crucial to their survival, growth and development. In the first phase, facilities such as Drop-In-Centres, Night Shelters, Short stay residential homes (Half-Way-House), Clinic, Sick Bay, HIV/AIDS prevention programme for street children, preparatory centres and coaching centres for child labourers and evening centres for children of sex workers have been provided. In the second phase, launched in 2000 all children in the project area are to be enrolled and retained in formal schools. Special focus is being placed on the sustainability of the programme. The local community, therefore, is involved in the overall project. So are the Calcutta Municipal Corporation Ward councillors. Formal school teachers are being trained/oriented to gradually take up the activities carried
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out by CINI ASHA. The chief result of this programme is on: establishment of staff training sessions on teaching methodology, child psychology, child rights, counselling skills and communication in skills; use of innovative educational material in Bengali, Hindi and Urdu; vocational training courses and weekly theatre workshops. NGO Forum for Street and Working Children The NGO Forum for Street and Working Children, established in 13 cities, with more than 60 organisations working with street children, has played an important role in awareness building and empowerment of street children. The primary objectives of this group are to promote networking and coordination among NGOs, groups and individuals concerned with street children and to initiate and promote a common programme of action in the areas of health care, education and awareness-building, etc. The Bachpan Bachao Andolan came into being during the Uttar Pradesh Legislative Assembly election in 1993. It emerged as a strategy by the South Asian Coalition of Child Servitude (SACCS), a Delhi-based NGO, to inject the issue of child labour into the electoral campaign. This group organises direct action like raids and freeing children from bondage; mobilising public opinion on the issue and building pressure groups for an effective implementation of child labour laws and rehabilitation schemes. The Andolan has State units in UP, Bihar, Madhya Pradesh, Rajasthan, Maharashtra, Haryana and Delhi. SACCS is the first Asian joint NGO initiative against bonded child labour and servitude. The initiative has freed more than 27,000 children from servitude through raids and with the help
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of Supreme Court and High Court orders-from the carpet, glass, brick kiln, stone and construction sectors. The group has developed the Rugmark label. Non-formal schools for working children and two rehabilitation centres for freed child labourers have been started. SUTRA SUTRA (Society for Social Uplift Through Rural Action) was established in 1977. Encouraging professional volunteerism, developing basic technical and socioeconomic services with human values, and training rural women and youth in various skills to make them self reliant are some of the objectives of this organisation. Mahila Mandals (womens groups), panchayats (local governing councils) and Yuvati Sangathans (adolescent girls groups) act as the main forums for action. SUTRA also uses the strategy of Sahyogins (village-based activists) to convince family members of the usefulness of allowing their daughters to attend these camps. In addition, SUTRAs newsletter, Yuva Sathin, tries to raise awareness about gender stereotypes propagated in textbooks used in the government primary schools. Adolescent girls have benefited a great deal from the residential camps organised for them. They have learnt about reproductive health and legal rights and have been sensitized towards the patriarchal value system inculcated in them. Developing confidence, reducing inhibitions and dealing with the challenges of dayto-day life are only some of the changes seen in a majority of adolescents reached through this initiative in this state. CEDPA The programmes of the Centre for Development and Population Activities (CEDPA) are a global initiative to expand life options for girls, and by doing so,
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challenging gender inequity. CEDPA, has been implementing the pioneering Better Life Options Programme (BPL) for adolescents in India since 1987. A unique feature of this organisation is its holistic approach integrating education, livelihoods and reproductive health. Over the years it was recognised that the specific needs of adolescent girls and young women were not being addressed, which is when the BPL programme was launched. This programme challenges the life inequities and expands the options of low-income adolescent girls and young women aged 12-20 years. The organisation also focuses on increasing public awareness regarding gender discrimination and working with both boys and girls of the same age. Expanding the choices of girls related to marriage, fertility, health, vocation and civic participation and sensitising the stakeholders are the programme components. The most important fact in the entire approach is the flexibility of the programme to enable implementing NGOs to respond to the local needs. A community-centred approach is used and alumni clubs are formed through which networking is encouraged. Between 1989 and 1999, the BPL programme has trained over 10,000 adolescent girls and young women and the number has been increasing constantly ever since. Community awareness and participation are key factors in its success. The model of CEDPA has been emulated by several other organisations; and it works in partnership with afew NGOs as well. The Urivi Vikram Charitable Trust The Urivi Vikram Charitable Trust (UVCT), a Delhi based NGO, has been striving since 1991 for the welfare of young adults through its two projects-Prerana, involving student counselling and career guidance; abd Shakti, mainly to channelise the enormous energies of the school dropouts by giving them a direction in life through personality development and aptitude assessment. Depending on the

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individuals aptitude and abilities, efforts are made by the Trust to send the adolescent to a vocational course either run by the Trust or by a governmental or a non-governmental organistion. UNFPA in 2000 provided funds and inputs for training and documentation of the project. Self Employed Womens Association SEWA is backed by its large membership of about two lakh women in Gujarat, and has vast experience of organising them. SEWA has identified health awareness and access to health services as the key issues in addressing the primary health concerns of its members throughout their life cycle. Recognising the need for and strengthening knowledge and skills on RCH, strengthening grass root-level services and maintaining their quality are the strategies adopted to improve health status of its members. The project aims at reproductive and child health awareness, health education, information and training on health for women, men, girls, and boys. It also has an objective to build the capacity of grass root-level workers on adolescent reproductive health. Adolescents formed a part of the training groups of 817 camps conducted in the last few years. KIDAVRI KIDAVRI is a group of Delhi-based NGOs, Institutions, and individuals who are committed to helping adolescents in marginalised sections of society. KIDAVRI, an acronym of Kishore Dakshta Vridhi which means Enhancing Adolescents Skills, grew out of the collective efforts of organisations and individuals who decided to synchronize their efforts to address adolescent concerns. Organisations and individuals working on adolescent issues got together to share their views and experiences at a round table meeting convened by Swaasthya (Health). As a follow-

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up of this meeting, representatives from 10 NGOs decided to form a network, which was subsequently joined by other members. Kidavri network is a mix of religious, social action, social research and humanitarian organizaitons including Don Bosco Ashalayam (rehabilitating Street Children), The BahaiI Community (promoting communal harmony), society for promotion of youth and masses (running programmes for disadvantaged adolescents). At present, the network has over 23 individual and institutional active members, a common goal, that is, to empower the adolescent, but with different paths leading to the same destination is the objective of KIDAVRI. Working in small pockets, the members felt the need to join hand, pool their resources, and thus strengthen their respective programmes and efforts. Here the Network played a major role by introducing the concept of pooling the resources of partners so that member could have easy access to existing resources and services. The objective is to build the capacity of its member NGOs in their work related to adolescents. CARE CARE India developed Improved Health Care for Adolescent Girls in Urban Slums, Jabalpur. This project was based on a study conducted for a situational analysis of Jabalpur city in 1993. The study brought out the facts that adolescent girls in slums had limited knowledge about their reproductive system. The use of reproductive health services was limited due to societal, familial, and institutional barriers. Girls were vulnerable to sexual exploitation, infection, unwanted pregnancy, and abortion, and this state of affairs contributed to the high rates of morbidity and fertility in this age group. Key processes and strategies that have been used in this project include; community mobilisation and social sanction campaign, girlto-girl approach and formation of a cadre of Adolescent Girls Health Guides.

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Adolescent Resource Centres (ARCS) for spreading adolescent and reproductive health messages, skill building and income-generation activities, follow-up activities, and sustainability have been set up. Society for Rural Education and Development (SRED) Society for Rural Education and Development (SRED) that works primarily with landless labourers and small farmers in rural Tamil Nadu. SRED does not run an adolescent reproductive health programme as such, but its clinic is open to men, women and adolescents. SREDs main focus is on providing safe, legal and confidential abortion services to adolescents. It is unique in its approach. Not only does the organisation facilitate and meet all the costs of an abortion if the girl elects to have one, but it also lends support to the unmarried adolescent mother to carry her \baby to term if she chooses to do so. SRED tries to ensure that the mother and baby are accepted in the family and the community at large. It is worth noting that the impetus for starting SRED was initiated on the rape of an 11 years old girl, and sexual violence remains a very important point of focus for the group. Society for Education Action and Research in Community Health (SEARCH) SEARCH runs Youth Life Education and Personality Development Programmes for adolescent girls and boys from the tribal population in rural Maharashtra. The focus is to help youth to enhance communication and negotiation skills to enable girls to negotiate safe sex or say no to sex with confidence; and change risky behaviours. These linkages are essential to provide access to reproductive health services, and help youth to translate knowledge into action. In the absence of any follow-up data, however, it is not clear how effective these programmes have been in their objective of addressing adolescent reproductive health needs.

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Parivar Seva Sanstha Parivar Seva Sanstha, is a well known and established organisation with its family planning clinics in large parts of the country is functioning effectively for three decades. A Family Life Education Project which offers structured knowledge on various aspects of health, reproduction, sexuality, contraceptive and interpersonal relationships is also run by the organisation. Among the various groups covered are school children, including adolescents from all sections of the society. CHETNA Chetna, began in 1980 as a small initiative to improve the impact of a supplementary feeding programme in 100 villages in Ahemdabad, Gujarat. It has expanded, its purview and works with adolescent girls as well in an effort to build local capacity to address their needs. It also provides health services to adolescent girls in collaboration with local level NGOs. Organisation of Yuvati Shiviris (fairs for girls) to explore and highlight factors that affect the integrated development of girls is a regular feature. Prevailing gender based discrimination problems for adolescent girls are attended to. It has covered a range of topics related to adolescents. It has also developed Life Skill Education Modules. CHETNA has a branch in Jaipur as well. Deepak Charitable Trust The trust focuses on adolescent boys and girls, involving a family life Skills Education Programme and aims at providing counselling services to married adolescents and imparts health awareness, including reproductive child health care. The NGO is based in Vadodara Gujarat.

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PRERANA The CEDPA model has been successfully used by Prerana in its adolescent programmes. The latter aims at creating an enabling environment for adolescents to develop their full potential, self-esteem, and ability to contribute to family, community and societal development. The Better Life Demonstration Project for Girls and Young Women aged 12-20 years was started in 1990 and an innovative step has been taken now of developing a parallel programme named, Better Life Development Project for Boys and Young Men. Prerana is changing the perception of the community on adolescent issues. For example, by providing girls with video training, instead of training in traditional skills, it has increased the confidence of girls and improved their position within the community. The parallel programme for boys aims at making boys and young men partners in empowering girls and challenging stereotyped gender roles. Sandhan Research Centre Sandhan with its past experience in training and research in elementary education revealed that the educational interventions had limited outcomes in the absence of forward linkages. Children need to have some role models before them; they need to view their future in a positive and holistic manner. For this, the group that can provide hope and vision is that of adolescents. Sandhan had no focused work with them earlier. Based on need assessment and perception of adolescents, a curriculum content has been identified in partnership with Doosra Dashak and community members of an urban slum in Jaipur. In action research mode, a programme has been planned to run a two-hour educational centre six days a week, for a whole year with adolescent girls and community teachers. Short duration residential camps are organized for 4-7 days over a stretch of six months . From the experience it was felt that there is a need to focus attention on issues pertaining to adolescents anxiety, anger, and sense of isolation in order to enable them to
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develop a coherent sense of self. A Peer Education Project is also run by Sandhan, where a band of Peer Educatotors are trained; UNFPA is funding the proejct. MAMTA MAMTA - Health Institute for Mother and Child was established in 1990 in Delhi. It is an NGO with a special consultative status with United Nations. Its primary objective is to enhance health status of women and children from disadvantaged sections of the society. Subsequently, adolescent and young people were included in the work of MAMTA, who have now become a major thrust of its work. MAMTA over the years has developed linkages with governments, apex institutions and international institutions and organisatioins. Mamta, uses non-formal education as an entry point to address adolescent health needs through clinics, counselling services, information, capacity-building programmes with advocacy and research on advocacy issues. It stresses on delaying marriage and child bearing and views dissemination of health education to adolescent girls as an important step in preparing them for womanhood. It is, however, increasingly advocating a holistic approach towards adolescent issues. Mamta has recently reviewed policies and programmes on adolescents in ten states of the country, with support from UNFPA and MOHFW. It has undertaken research on adolescent issues and has produced some excellent documents related to policy issues. UNFPA is funding the policy/advocacy programme of the Institute currently. Don Bosco Self-Employment Research Institute (DB-SERI), Howrah, West Bengal, is an example of pioneering NGO working in the vocational education sector, catering to the needs of underpriviledged school dropout youths, by imparting skill training for producing marketable items so that they can earn their livelihood. The Institute is running 12 non-formal vocational trades of one-year duration
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such as welding, house-wiring, motor winding, machine shop training, computers for handicapped, jute products and other allied trades without any fees. Sixty five per cent of the total strength of the Institute consists of girls and housewives. Once the training is complete, each trainee is supplied with a machine and tools of his/ her trade. The product produced is sold in the market through the marketing organisations set up by the Institute. Since the commencement of DB-SERI, over 1200 trainees have passed out in the last few years, about 95% of them are selfemployed and are capable of earning their livelihood. Bal Niketan Sangh A pioneer Institute of early childhood education which has extended its activities in urban slums and tribal areas in and around Indore. While working with the community adolescents have been taken as an important target group now for years. The areas of concern range from literacy, health conncerns, gender issues to self development amongst girls. Mobile Creches A Delhi based organisation with branches in Pune and Calcutta, working with migrant construction workers comunity, has also taken adolescent in its folds as a target group. Its activities have a holistic approach providing nonformal education, vocational skills, medical check up and recreational activities along with other routine interventions. Recently it has started Peer Educator Project meant both for boys and girls in the age group 13-18 years. It is focusing in particular on violence, children rights, child abuse, health, sexuality and HIV/AIDS. Sakshi An intervention centre based in Delhi specialises in counselling legal reach and issues of sexual abuse. It conducts workshops on sexuality issues and provides referral services.
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Table 21 : Summary of NGOs Programmes for Adolescents


Range of Programmes Health Broad Issues Addressed Organisation

family life education health education health and hygiene physical growth and development - nutrition and micro-nutirents - clinical services for adolescents - public health services

SEWA, Bal Niketan, CARE, CHETNA, MAMATA, Deepak Charitable Trust, Mobile Creches

Reproductive and - reproductive and sexual health awareness Sexual Health - sexual transmitted diseases - HIV/AIDS-population education - Contraception-sexuality - Sexualy behaviour - Early marriage - Early pregnancy Education Non-formal education Youth/adult literacy Education for all Girls education Retention of children in school

SEWA, Bal Niketan, CEDPA, KIDAVRI, CARE, SEARCH, Parivar Seva Sanstha, Deepak Charitable Trust, Mobile Creches

Bal Niketan Sangh, CARE, ADDTHI, SANDHAN, Mobile Creches

Employment/Skill - Vocational training - Crafts and Development development - Capacity building - Income generation - Poverty reduction

design

SEWA, Bal Niketan Sangh, PRERANA, CEDPA, UVCT, DBSERI, RUWSEC, CINI ASHA

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Range of Programmes

Broad Issues Addressed

Organisation

Gender Equality

Gender sensitisation Girl child Economic empowerment Enhancement of selfconfidence Leadership development Womens right Domestic violence Sexuasl abuse

SEWA, Mandir, Adithi, Bal Niketan Sangh, CEDPA, C H E T N A , P R E R A N A , MAMTA, RUWSEC, CINI ASHA, SUTRA

Personality Development

- Leadership development - Organising games and sports for physical/mental development - Talent search for extra curricular activities - Recreation activities - Awareness and sensitisation about environment - General awareness Commercial sex workers Street children Children of sex workers Orphans and mentally challenged children Legal aids Drug and alcohol abuse Mental health Superstitions, beliefs

Bal Niketan Sanch, P R E R A N A , S A N D H A N , FUWSEC, UVCT, Mobile Creches

Group with Special Needs -

CINI ASHA, NGO FORUM for Street Children

Others

SRED, Sakshi

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Conclusion Feed back through formal and informal sources points to the fact that the services of the health system related to adolescents health are both inadequate and inaccessible particularly to unmarried girls. These are limited to RCH issues only, Health personnel are neither trained nor sensitive to the needs of adolescents. Contraceptive programmes/services are under utilised by boys and men (IIPS). Logistics of drug supply and position of health staffs availability remain poor (Planing Commission 2002). Both content and quality of the envisaged integrated services are far below the desired levels. Improving of service delivery of the health system continues to be a challenge due to its large size. Despite the paradigm shift in implementation approach to decentralisation and target free services, lack of counselling services, follow up services and poor quality of the services are the daunting draw backs. If adults and children who are the primary target groups are unable to benefit, chance of adolescents getting benefitted by the system is a far fetched dream. It is hoped with the focus of 10th Plan on adolescents, the scenario would improve. The educational sector presents a very similar picture but with innovative strategies such as Saravshiksha Abhiyan, Janshala and integration of population education in the regular school curriculum, things are looking up. The lack of coordination is observed in programmes requiring intersectoral approach. This is mainly due to inability of setting up of mechanisms needed for convergence. As a result, the comprehensive and integrated programmes also remain sectoral. Policy and programmes are not inter linked in most cases. Since there is no comprehensive policy for adolescents to guide the designing of interventions, it is not supprising that the patch work attempted to reorient existing programmes

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for adolescents is unable to meet their unique needs. The centrally planned services do not have the desired flexibility to meet diverse needs of communities and cultural groups. The top down approach further curtails the scope of participation and involvement of the community. The components related to adolescents, whenever, are dovetailed with the existing programmes, the additional funds are rarely allocated. It virtually makes that effort defunct due to non availability of resources. The International agencies of the UN System have come forward in a big way during the last decade to work in partnership with government and to support several specific interventions for adolescents. These are in the area of health education, population education and life learning skills. Noteworthy of these partners are, UNFPA, UNICEF, DANIDA, WHO, UNESCO, ILO etc. A review of these will be presented in the next section of the document. The interventions of the voluntary sector on the other hand have made significant contributions in meeting the needs of adolescents. Most of these programmes have integrated and comprehensive package of services with specific objective/objectives. Systematic supervision and monitoring are strengths of NGOs endeavours. Due to small size of operation, the mid course modifications in content of the programme and implementation strategies take place as a routine activity. The innovative approaches such as campaigns, camps, exhibitions and folk media for advocacy are high lights of programmatic strategies. Most NGOs have a built in training and capacity buildinng of the personnel projects. The upgradation of skills such as communication, leadership, group formation, use of participatory methodology is built in the programmes itself. The lessons learnt from NGOs experience are valuable and need to be emulated in other intervention programmes. The limitations of NGO interventions include

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small coverage of adolescents and micro level projects operating, in restricted geographical areas. The initiation to work with adolescent in case of majority of NGOs happened incidentally; while working with communities on broader issues of social development, the NGOs realised the significance of working with this special group. The adolescents thus were integrated as a target group in the on going activities. Participation of adolescents and community members and PRI institution is an integral part of these endeavours and a sure reason of their success. The NGOs are able to create enabling environment to work with adolescents due to wellestablished rapport with the community. Synergy is created by involving all stakeholders and that helps in sustainability as well. Attempts are made to include boys and men along with adolescent girls and women in some programmes. To sum up, the following guiding principles for designing interventions for adolescents could be considered. (i) Research and empirical evidence be used to design programmes for adolescents. (ii) Comprehensive Adolescent Policy be enacted to guide programmes formulation and implementation. A separate department be set up to coordinate planning and implementation of programmes of adolescents. (iii) Holistic and integrated programmes be designed to meet a range of unique needs of adolescents. (iv) Gender issues to be given special emphasis. (v) Interventions be designed in line with cultural background of the community (vi) The target group 10-19 years including both boys and girls should be

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covered to meet the gender specific and different needs of early and late adolescent age groups. (vii) Partnership between government, NGOs and international agencies and the UN System be attempted (viii) A cadre of personnel to work with adolescents be created. (ix) Documentation of best practices be attempted (x) Adolescents be involved in planning, implementation and monitoring of the interventions meant for them.

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Lessons for the Future


women-to better satisfy family, economic and social responsibilities. Prevention of too-early childbearing and of STIs and HIV should be addressed together educationally and in service programme, with an emphasis on safer sex practices and dual protection] Some key needs for future attention include: Basic information about programmes, including cost data, needs to be collected systematically and made available so all can learn from disparate experiences. Basic programmes, such as sexuality education and youth-friendly services, need to be scaled up, especially if infrastructure exists to build on. Better programme models for reaching out-of-school youth ned to be developed and tested. Models need to be tested for programming in traditional societies Documentation and evaluation efforts need to be strengthened.

Programmes to address adolescent sexual and reproductive health concerns have advanced considerably since the ICPD in 1994. Sufficient experience now exists to guide programmes planning and identify key tasks for the future. Some of the lessons learned include: Policy makers, government leaders and civil society leaders must be involved in establishing positive policies and programmes Community support is needed to increase acceptance and use of youth-friendly services. Youth participation and youth-adult partnerships are essential for programme relevance, ownership and effective use. Gender awareness and equity need to be an integral part of programming. Increasing the legal age of marriage, supported by social mobilisation of for its implementation, will be one of the efforts needed to aid young people-men and

Source: UNFPA The State of World Population, 2003. P. 58.

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Legislations Relevant to Adolescents

There is a broad recognition that ideals for humanitarian welfare and provisions in policy frame work are not sufficient to ensure well being and social justice of people in a society. Sound judicial foundations in the form of legislative measures and political will are equally important. All initiatives and programmes, particularly for children who are powerless sections of the society, are essential for achievement of social goals. The increasing emphasis on rights approach also endorses this view. Commitments under the CRC has made it obligatory that provision of appropriate legislations is made for realization of rights articulated in the CRC. In India there are a set of legislations that have been enacted from time to time to protect the interests and rights of children. Primary amongst these are: 1890 1929 1948 1956 1958 1960 The Guardian and Wards Act The Child Marriage Restraint Act (Amended in 1979) The Factories Act (Amended in 1979) Hindu Adoption and Maintenance Act Probation of Offenders Act The Orphanage and Other Charitable Homes (Supervision & Control) Act 1971 1986 1986 Medical Termination of Pregnancy Act Juvenile Justice Act (Amended in 2000) Immoral Traffic Prevention Act
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1986 1994

The Child Labour (Prohibition and Regulations Act) The Pre-natal Diagnostic Technique (Regulation, Prevention and Misuse) Act

1996

The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act.

However, the adequacy of these laws for protection of children is questionable and the enforcement of these is impoverished. It is unfortunate that ideals and norms set forth in our Constitution, laws, regulations and policies have not bee completely implemented. If effective enforcement is achieved, the quality of life of children would improve tremendously. A unique feature in India in recent times has been the active role played by the judiciary and in particular by the Supreme Court, in upholding the rights of the child. The Supreme Court of India has developed the concept of jurisdiction under which any individual can approach the Court with regard to the violation of a fundamental rights. This concept of social action litigation in India represents an effort to use the legal system to ensure action to realise constitutionally guaranteed rights. Some of the most important examples of social action litigation for children in the recent past are the following cases. Each of which has been a landmark in the process of ensuring childrens rights: a. b. c. d. e. Laxmikant Pandey vs. Union of India [AIR (1984) SC 469, AIR (1986) SC 276, AIR (1987) SC 232] on Adoption. Shiela Barse vs. Union of India [AIR (1986) SC 1883, AIR (1988) SC 2211] on Trafficking of Children. Uni Kkrishnan vs. State of Andhra Pradesh [1993 1 SC 263] on Child Labour. M.C. Mehta vs. State of Tamil Nadu [JT (1990) sc 263] on Child Labour. Gita Hariharan vs. Reserve Bank of India (1999) 2, SC 228] on Guardianship.
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f.

Centre for Equiry into Health and Allied Themes (CEHAT) & Others vs. Union of India & Others (2000) SC 301] on implementation of pre-natal diagnostic Techniques, Regulation and Prevention of Misuse, Act (PNDT).

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Observations of the Court in the M.C. Mehta Case: The CRC


particularly to abolish child labour, and the Court has been at pains to pragmatise the whole situation. The right to free and compulsory education of children has been, by Court ruling, given the status of a fundamental right. The finest investment in the future for any country to make is in nourishment, physical and mental, to babies, boys and girls.

The gamut of the Convention covers the full personality of the child in every dimension. Having acceded to the said instrument, that very fact is reinforcement of the tryst of the Republic with the children of India, which shall be redeemed. Constellations of legislations have been enacted and many occupations and processes have been prohibited for children. Quite a few directives have been issued to the States, Source: India: First Periodic Report on the CRC P.8

This section presents and elaborates on the selected legislative provisions relevant in the context of adolescents. The Child Marriage Restraint Act, 1927 The Act prescribes the minimum age for marriage as 21 in case of males and 18 in case of females. It also provides for punishment in case where the statutory prescription of age is violated (Section 3 to 6). No woman can be punished under the Act. However, while the Act prohibits marriages below the age of consent, child marriages are valid under all personal laws except in the case of Parsis and those married under the Special Marriage Act. The Child Marriage Restraint Act is applicable to all Indian irrespective of their religion. The Guardian and Ward Act All personal laws till 1998 recognised the father as the natural guardian, giving
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mother only the right of custody, mother could become the guardian only after fathers death or when the father was unfit to be a guardian of the child. On February 18, 1999, the Supreme Court handed down a landmark judgment in the Gita Hariharan case, that can be described as a ray of hope for Indian women on the eve of the new millennium. The mother can act as the natural guardian of the minor. The Court added that all her (the mothers) actions would be valid even during the lifetime of the father who would be deemed to be absent for the purposes of the two sections of the Act. Under the GWA, a guardian is appointed for the person and property of the child. A guardian need not always be a parent. And while appointing a guardian the court must always take note of what is in the best interest of the minor. The Act is exhaustive, with 51 sections dealing with matters pertaining to a minors property and person. The ultimate aim is to safe guard the interest of the child which is in line with CRC Article 3. The Indian Penal Code Child abuse is an extremely complex phenomenon, which has only recently started receiving the attention that it deserves. Child sexual abuse is the physical or mental violation of a child, coupled with sexual intent, usually by an older person who is in some position of trust or power vis-a-vis the child. The Indian Penal Code has laid down provisions for action against child abuse such as rape, molestation and prostitution. Appropriate legislative, administrative, social and educational measures have been taken to protect children from all forms of physical and mental violence, injury, neglect, maltreatment, exploitation and abuse.

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The Government has also enacted a number of legislation measures such as: Immoral Traffic Prevention Act, 1956 The Immoral Traffic Prevention Act, 1956 (ITPA) supplemented by the Indian Penal Code (IPC) prohibits trafficking in human beings, including children and lays down severe penalties. The ITPA and IPC prescribe punishment for crimes related to prostitution. The Child Labour (Prohibition and Regulation) Act, 1986 An Act to prohibit the engagement of children in certain employments and to regulate the conditions of work of children in certain other employments. The Juvenile Justice (Care and Protection of Children) Act, 2000 The Juvenile Justice (Care and Protection of Children) Act, 2000, lays down a uniform legal framework for the country as a whole to deal with the problem of social maladjustment. It has replaced all the corresponding laws on the subject and other State Laws and is the most comprehensive piece to legislation for protection of children (sec 77 Act in the section).

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Separate Legislation on Child Abuse Planned


rape laws make no distinction between the rape of a minor and that of an adult. The twoday workshop, jointly organised by the National Human Rights Commission (NHRC) and Aga Khan Foundation, an NGO working for the rights of the children, was held in December 2000 in New Delhi. The workshop stressed on the need to review the very definition of rape as for the purpose of Section 375 of the Indian Panel Code, the definition of rape applies equally to an adult and a minor.

The Government is contemplating the introduction of a separate legislation on child rape and sexual abuse. It is time we think of a separate and specialised legislation for the new methodology of trial and proof for the offence of child rape, stated the Law Minister, while inaugurating a Sensitisation Workshop on Child Rape and Child Sexual Abuse in December 2000. Rape, by itself is one of the most obnoxious crimes but child rape is perhaps the most offensive, requiring special treatment. Unfortunately, the existing Source: The Times of India online December 2000.

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Juvenile Justice Act 2000 The Juvenile Justice (Care and Children) Act 2000 replaces the existing Juvenile Justice Act 1986. This law has a child friendly approach and provides for care, protection, treatment, development and rehabilitation of neglected or delinquent juveniles and for the adjudication of certain matters relating to delinquent juveniles. These children, though a separate category, are also covered by the juvenile justice system. Under the JJA the authorities competent to take action in these cases are the juvenile courts. Section 5 of the JJA, empowers the State Government to constitute Juvenile Courts for any specified area by notification in an official gazette. For the purpose of supervision, the State Government (Section 53 of JJA) may constitute an advisory board that will advise it on matters related to the establishment and maintenance of homes, mobilization of resources, provision of facilities for education, training and rehabilitation of neglected (abandoned) juveniles and delinquent (in conflict with the law) juveniles and coordination among the various official and non-official agencies concerned. The issue has been dealt with in detail under the Article on Administration of Juvenile Justice. Under the Juvenile Justice (Care and Protection of Children) Act, 2000, Section 15 lays down six avenues to be explored so as to ensure that every opportunity is accorded to a child to reamin with his/her family. It is only when these six avenues are not successful that the Board will direct that he/she be sent to a special home. Review of the quality of care and treatment provided to the child who has been placed in institutions for care and protection is another responsibility laid on the State. For this purpose, Social Welfare Officers are appointed. They monitor the situation of children placed in homes and foster care. The Juvenile Justice (Care and Protection of Children) Act, 2000, has a provision for involving voluntary organizations in the inspection of childrens homes.
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The Persons and Disabilities (Equal Opportunities Protection of Rights and Full Participation) Act, 1995 It is a comprehensive law dealing with definition of various disabilities, prevention, early identification, implementation, mechanisms, education, employment, affirmative action, non-discrimination, care of the severely disabled, recognition of institutions offering services to the disabled, access to built environment, transportation and information. For effective implementation of the specifications laid down in the Act, coordiantion committees are proposed to be set-up at the Central and State levels. Adoptions India is a country of diversities, and various sections of the society have their own personal laws. There is no uniform civil code for people belonging to various religious and cultural groups; hence there are no universally applicable procedures. Legislation related to adoption fall into two broad categories: (i) The Hindu Adoption and Maintenance Act, 1956 (HAMA) (ii) The Guardians and Wards Act, 1890 (GWA) HAMA applies to all Hindus, Buddhists, Jains and Sikhs. The Act authorises any adult male of sound mind to adopt a child and if he is married, he can do so only with the consent of his wife. On the other hand, a female of sound mind may adodpt even if she is unmarried or a divorce, but can only be a consenting party to the adoption, if she is married. HAMA also declares all adopotions to be irrevocable and says that all ties of the child with the family of his/her birth shall be deemed to be severed from the time of the adoption. The personal laws of Muslims, Christians, Parsis and Jews do not recognise complete adoption and hence persons belonging to these communities who are desirous of adopoting a child can take a
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child only in guardianship under the provisions of GWA, 1890. This does not provide the child the same status as the child born biologically to the family. This Act confers only a guardian-ward relationship. The current legislation in India has a few lacunae. The greatest inadequacy is the absence of a uniform law for adoption, which would apply to all Indians. Besides this, the adoptive mother (if married) is not a joint petitioner, but only a consenting party. The GWA, 1890 confers only the status of a ward to the adopted child and not the status of a biologically born child, hence there is no security for either the adopted child or the adopotive parents. The Tamil Nadu Adoption Bill has been prepared in consultation with NGOs and experts. This legislation, when enacted, will help adoption of children by all families irrespective of religion. Social Security Laws There are also laws enacted and schemes established by the Centre/State Governments providing for social security and welfare of specific categories of working people. The (box 32) Summarizes various social security laws applicable in India. Most of the laws are applicable to workers belonging to the organised sector. At the same time, the benefits reach the children of workers indirectly. The Beedi and Cigar Workers (Conditions of Employment) Act, 1966, the Plantation Labour Act, 1951, the Contract Labour (Regulation and Abolition) Act, 1970, the Inter-State Migrant Workmen (Regulation of Employment and Condition of Service) Act, 1979, The Factories Act, 1948 and the Building and Other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996, lays down provision for establishment of creches for the benefit of women workers. Further the maternity Benefit Act, 1961 and the Building and Other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996 provide maternity

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32

Principal Social Security Laws of India


Objective To provide compensation in cases of industrial accidents/occupational diseases resulting in disablement or death. To provide for health care and cash benefits in case of sickness, maternity and employment injury. To provide Compulsory Provident Fund Pension Deposit Linked Insurance To provide for maternity protection before and after child birth. To provide for payment of gratuity on ceasing to office

Act The Workmens Compensation Act, 1923 Employees State Insurance Act, 1948

Employees Provident Funds and Miscellaneous Provisions Act, 1952 Maternity Benefit Act, 1961 Payment of Gratuity Act, 1972

Source: Annual Report, 1999-2000, Ministry of Labour, GOI.

benefit to the female workers. The GOI gives three months maternity and 15 days paternity leave to its employees. Further, the maternity leave can be extended to one year without loss of pay. The Plantation Labour Act, 1951, provides that

women workers be provided time off for feeding children.Some of the developments and improvements which have been made in social security with respect to children during 1999-2000 are as follows: Disabled children have been made eligible for social security for their entire life, irrespective of the number of children in the family. Minimum amount of child-pension and minimum orphan-pension has been enhanced with effect from 12 January 2000.

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Medical Termination of Pregnancy Act, 1971 Efforts to improve availability and access to contraceptive care in India during seventies and early eightees resulted in a rise of couple protection rate. However, unwanted pregnancy incidences continued to be high. Many couples were resorting to induced abortions performed under unsafe conditions, leading to high number of maternal deaths. The MTP Act 1971 was enacted to manage unwanted pregnancy and illegal abortions. It enables women to opt out of an unwanted/unintended pregnancy in certain specified circumstances, without endangering her life. The act made a provision under sub section (4) termination of pregnancy by a registered medical practitioner with the consent of the pregnant women. In case of minors the consent of guardian is needed. The termination is to be done only within twelve weeks of the gestation period. The Immoral Traffic Prevention Act, 1956 The Indian Penal Code penalises procurement, kidnapping, trafficking, and sexual offences against children. The Immoral Traffic (Prevention) Act, 1956 (as amended up to 1986) (ITP Act) covers both boys and girls. The Act has made offences involving children and minors more stringent, putting the onus of proving innocence in specified situations on the person accused. It provides for the appointment of trafficking police officers empowered to investigate offences having interstate ramifications. Enforcement of the laws, however, continues to be very poor as is evident from the low figures of registration of cases under the IPC and ITP Act, and the considerable inter-state variation, which is more a reflection on the enforcement machinery than on the intensity of the problem

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The Narcotic Drug and Psychotropic Substances (NDPS ) Act 1985 The act provides a frame work for drug abuse control in the country, the Act mainly deals with supply reduction activities. However, it has provisions for health care of drug dependent individuals. It authorizes GOI to take necessary measures for identification, treatment, after care and rehabilitation of addicts and preventive education. The Act permits supply of drugs to registered addicts and use of these substances for medical treatment. Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994 The discovery of scientific procedures of aminiocentsis and sonography was considered a boon to ensure health of foetus and the mother by the medical practitioners as it facilitated in detection of abnormalities during prenatal period. But in India it has increasingly been used to determine the sex of the unborn child/ foetus and eliminate it if found to be a female. Unfortunately the availability of MTP Act and its misuse gave it the status of a legal option. To put an end to this malpractice, in the PNDP Act 1994 came into force in 1996. The Act makes family members of pregnant women, the concerned doctor, and the testing clinic liable for punishment if the above procedures are used for sex determination. It is permitted solely for detecting foetal abnormalities. Disclosure of the sex of the foetus is prohibited. The implementation and enforcement is weak. Some states have also banned female foeticide. Conclusion The Government of India is in the process of undertaking a comprehensive review of the legislation concerning children and women, which are applicable to adolescents as well. With the National Commission for Children on the anvil and
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National Commission for Women in place, the process of review that has begun will get an impetus. The Law Commission and National Human Rights Commissions have been giving active inputs. As per the requirements of the CRC and CEDAW, the Department of Women and Child Development is coordinating these efforts of amendment, review and enacting of new laws. Beside these efforts, it is imperative that the civil society and community be involved in strict enforcement and speedy redressal of grievances. Wide spread dissemination of information on, legal rights, human rights and entitlements through specially designed legal literacy programmes can go a long way in making individuals aware of their entitlements. Setting up of Child Help Line and Women Help Line are good initiatives and have to be expanded. The ultimate aim is to make legal-judicial system to be more responsive to needs and rights of women and children including adolescents.

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Adolescents: Global Developments and the UN System

The global trends in business and politics including terrorism and wars have mixed implications for the future of nations as well as for the adolescents. It is not within the scope of this document to elaborate on these. However, the recent trend of the world community to develop a consensus on several social issues has been a positive development. There has been a dramatic growth in constellations of likeminded organizations, what Salamon (1995) calls a global association revolution. There is a positive influence of these bodies, their non profitable nature enables them to provide funding to national governments and NGOs for community development projects. These endeavours have demonstrated more responsiveness to local human needs than the government bureaucracies (Salamon & Anheier 1997). The expanding positive influence of this sector is evident in the increasing amount of attention being paid to the rights and human development needs of children, adolescents and their families. The wide arrays of heterogeneous groups comprising the sector have managed to arrive at a consensus about rights of children and are actively attempting to enforce the same globally (UNDP 2000). Interrelated to this trend is the development of globalised standards of behaviour amongst governments. This may ensure more orderly and caring world for adolescents (Larson 2002). Adherences to these standards have become an unspoken criterion of membership to a family of civilised nations (Donnelly 1998). The so called global civil culture, hopefully, will promote actions of human rights. In this context
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the international instruments related to rights of children (up to the age of 18 years) and women, namely: The UN Convention on the Rights of the Child (1989) and the Convention on the Elimination of All Forms of Discrimination Against Women (1981) have had a powerful influence on the policy process in nations across the world. India has also signed and ratified the above conventions and several other conferences, which have served as useful advocacy tool for increasing policy attention towards adolescents. The 1994 International Conference on Population and Development (ICDP) occured at a defining moment in the history of international cooperation. International consensus had already developed through a series of international activities beginning with the World Population Conference (1973) at Bucharest followed by the International Conference on Population (1984) in the Mexico City. The main emphasis of these was to consider the broad issues of interrelationship between population, sustained economic growth and sustainable development, and advances in the education, economic status and empowerment of women. Similar issues were deliberated in subsequent conferences held in post ICPD period and are listed here for information. a) The World Conference to Review and Appraise the Achievements of the United Nations Decade for Women: Equality, Development and Peace, held in Nairobi in 1985, b) c) The World Summit for Children, held in New York in 1990 The United Nations Conference on Environment and Development, held in Rio de Janeiro in 1992 d) e) The International Conference on Nutrition, held in Rome in 1992 The World Conference on Human Rights, held in Vienna in 1993
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f) g) h)

The International Year of the Family, 1994 Fourth World Conference on Women (1995) Beijing World Congress against Commercial Sexual Exploitation of Children (1996) Stockholm.

A summary of the relevant issues in context of adolescents deliberated in these conferences are presented in Table 22. Table 22: UN Conferences/Conventions and Issues Related to Adolescents
Conference/Convention The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) (1981) Issues (Relating to adolescent girls) Protection from commercial sexual Exploitation Participation in decision-making Equal access to education and training, in an environment free of the stereotyped images of the role of women and men Access to employment opportunities, with protection from discrimination and support services to combine work and family responsibilities Access to health services Access to financial credit Consent and choice in marriage, and in decisions on the number and spacing of children. Principle 21: The creativity, ideals and courage of the youth of the world should be mobilised to forge a global partnership in order to achieve sustainable development and ensure a better future for all. Entire chapter on contribution of youth and participation of youth in decision-making Sustainable development and youth participation in decision-making Youth as guardians of the future Youth rights Right against intolerance and racism

United Nations Conference on Environment and Development (UNCED) (1992), Brazil

World Conference of Human Rights, Vienna (WCHR) (1993)

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Conference/Convention World Health Summit, Alma Ata, (1977)

Issues Health for all Access to health services and information Reduction in maternal mortality Reeducations in nutritional anemia Reproductive health care Access to education Improved access for girls Learning through adolescence and adulthood Special focus on adolescents Right to information about their sexuality to make responsible decisions Reproductive and sexual health needs Integrated and multi-sectoral approach, with the participation of youth Mainly relating to adolescent girls, although it recognises the needs and interests of young men. Access to education about sexual and reproductive health Sensitisation of boys to gender equality See CEDAW

World Conference on Education for All (1990)

International Conference on Population and Development (ICPD ) (1994), Cairo

Fourth World Conference on Women (FWCW) (1995), Beijing

Beijing Plus Five (2000) Programme of Action document

Violence against women Trafficking Health Globalisation Armed conflict and human rights Adolescents access to reproductive health services, education and life skills. Child prostitution Trafficking Sale of children for commercial and sexual purposes Protection of vulnerable children and support for recovery and social integration of child victims. Reduction in nutritional deficiencies Healthy diets and food security

World Congress Against the Commercial Sexual Exploitation of Children (CSEC) (1996), Stockholm

International Conference on Nutrition (1992), Rome

Source: Commonwealth Youth Programme, Global commitments to youth rights, London: Commonwealth Secretariat, 1997. Action document being document. 158

The issues identified in the table have made significant contributions in altering the social policy framework, which has been a welcoming trend. These areas of concern also found place in the agenda of other important international events such as the World Summit for Social Development, the Fourth World Conference on Women: Action for Equality, Development and Peace, the Second United Nations Conference on Human Settlements (Habitat II), the elaboration of the Agenda for Development, as well as the celebration of the fiftieth anniversary of the United Nations. The heightened interest in reproductive health and development of adolescents is further endorsed by organization of some recent international meets with a specific objective of sensitizing stakeholders, planners, politicians and civil society and to reaffirm collectively the concern for adolescents. Sharing of resources, technical inputs and commitment for partnership are the highlights of the consensus that have emerged. A brief account of these events confirms these contentions. World Youth Forum The World Youth Forum, hosted by the Government of Senegal, in 2001 had its central purpose, the empowerment of youth to participate more effectively in every aspect of society. The forums recommendations cover youth concerns in the ten areas addressed by working groups; namely, education, information and communications technology, employment, health and population, hunger, poverty and debt, environment and human settlements, social integration, culture and peace, youth policy, participation and rights, young women and girls, and youth, sports and leisure-time activities. The meeting reflected the vision and perception of the youth and the desire to participate in their own development. The recommendations were regarded by observers from the United Nations agencies, bodies and

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organizations to plan partnership strategies accordingly. The UN Assembly Special Session on Children (2002) Eleven years later to the World Summit for Children, in the UN General Assembly Session in 2002, the world leaders made a joint commitment and issued an urgent, universal appeal to give every child a better future-We hereby call on all members of society to join us in a global movement that will help building a world fit for children through following principles and objectives: Put children first Eradicate poverty: invest in children Leave no child behind, care for every child Education every child, protect children from harm and exploitation Listen to children and ensure their participation and protect the Earth for children. There is a need to address the changing role of men in society, as boys, adolescents, and fathers. Children including adolescents must have the right to express themselves

International Conference on Reproductive Health (2001) The International Conference on Reproductive Health was, organised jointly by the Indian Society for the Study of Reproduction and Fertility, and the UNDP/ UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction to review what has been achieved since ICPD and whether implementation of the ICPD Programme of Action needs revision of population and developmental policies and related institutional changes, including possible legal and constitutional reforms.

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Global Consultation on Child and Adolescent Health and Development (2002) To ensure achievement of millennium goals, WHO and UNICEF convened the consultation with support from the Government of Sweden. It highlighted the plight of millions of children and adolescents, and the global challenge to scale up interventions to reach every child and every adolescent. Cost-effective interventions are readily available now and these need to reach everyone. These commitments contribute to momentum and build hope for the worlds children and adolescents. The time has come for the global community, national governments, communities and families to deliver on these commitments. The outcomes of the above meetings and conferences held in the last decade have univocally stressed the need to make greater investments in people and to develop a new agenda for the women empowerment to ensure their participation in social, economic and political lives of their communities. Amids all these developments, International Conference on Population and Development (ICPD) turned out to be a historical land mark , an opportune moment, when a consensus was emerging about the need for increased international cooperation, and recognition of the linkages between population and sustainable development. The post ICPD period witnessed changes in content and strategies of reproductive health policies in many countries; a testimony of a positive response and acceptance of its outcomes. The ICPD was a triumph for those seeking an end to the great debate that had plagued the population field since the first World Population Conference at Bucharest in 1974; a debate between advocates of development who believed that development is the best contraceptive and, therefore, a necessary precondition to sustained fertility decline and those who asserted that family planning services must be implemented to meet the high demand for fertility

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control which they believed existed (Pachauri 1999). The ICPD took giant strides toward resolving this conflict by placing the population problem squarely in the development context and focusing attention on individual needs instead of demographic targets. In the rapidly changing world, with several new opportunities, a comprehensive concept of Reproductive Health including family planning and sexual health has emerged. The new perspective suggests integration of population dimensions in other development related policies. The Programme of Action of ICPD has both relevance and special significance for India. Its objectives and goals of sustained economic growth in the context of sustainable development; education, especially for girls; gender equity and equality; infant, child and maternal mortality reduction; and the provision of universal access to reproductive health services, including family planning and sexual health are applicable to the contemporary Indian scenario. Implementation of the Programme of Action clearly requires additional resources which will have to be mobilised. However, the increasing trend of partnership at national and international levels would help in overcoming this constraint. Widespread poverty remains a major challenge for India. Poverty accompanied by unemployment, malnutrition, illiteracy, low status of women, exposure to environmental risks and limited access to social and health services are a host of interlinked issues to be addressed in developmental endeavours. These factors further contribute to high levels of fertility, morbidity and mortality, as well as to low economic productivity. The agenda for development in India includes an effort to slow down population growth, to reduce poverty and to achieve economic progress to improve quality of life of its people. The actions proposed in POA for integration of population and development strategies provide guiding principles for
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refining our developmental policies for sustainable development (Box 33).

33

Population : Sustained Economic Growth and Poverty


Meeting the needs and increasing the opportunities for information education jobs skill development and relevant reproductive health services of all underserved members of society. Measures should be taken to strengthen food nutrition and agricultural policies and programmes for strengthening of food security at all levels.

Investment in human resource development in accordance with national policy frame work.

Plan programmes specifically directed at increased access to information education skill development employment opportunities both formal and informal and high-quality general and reproductive health services including family planning and sexual health Bridging gender inequities and barriers to women empowerment through education and skill development of women and girls and the granting legal and economic rights of women and in all aspects of reproductive health including family planning and sexual health.

Special efforts should be made to create productive jobs through policies promoting efficient and where required labour-intensive industries and transfer of modern technologies.

The international community should continue to promote a supportive economic environment particularly for developing countries and countries with economies in transition in their attempt to eradicate poverty and achieve sustained economic growth. Source: UNFPA 2001, ICPD Programme of Action P 8.

ICPD - Relevance to India These actions present a long term perspective and contemporary national development process of India is in line with this approach. However, these recommendations and outcomes of the global conferences including ICPD-POA have provided a logical framework and strengthened the justification of introducing major policy initiatives in India related to Reproductive Health in the recent past.

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In this context the three major noteworthy changes are: (i) (ii) removal of centrally determined contraceptive targets, decentralization and community involvement, and

(iii) launching of the Reproductive and Child Health Programme (RCH) in 1997 (Sugathan 2001). The Programme of Action endorsed by the ICPD called upon all countries to provide reproductive health services through the existing primary health care system. The reproductive health services should include counselling and services on family planning, provision of antenatal care, safe delivery and postnatal care, prevention and management of infertility, prevention and management of complications of abortions, prevention and treatment of reproductive tract infections, sexually transmitted diseases and other reproductive health conditions. The RCH programme has been designed to address the major areas of concerns as per strategies of POA. In subsequent years of its implementation, it has been further strengthened. The 10 Five Year Plan has also proposed several measures to improve quality of services of the programme. It is envisaged that the achievement of the objectives of the programme will contribute to: (a) reducing the unmet need for family planning (particularly for spacing methods); (b) improve the health status of women and children; and (c) reduce maternal, infant and child mortality. ICPD document clearly stated that partnership is the key to implement the broad agenda effectively. The present document in the previous section has attempted to review some of the initiatives undertaken by NGOs in India. The activities of the UN System related to adolescent in India will be presented later in this section.
th

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During the last two decades International Agencies have evinced a great interest in adolescent issues and have entered in to international cooperation and partnership with governments and NGOs to implement community based interventions in different countries. International Cooperation International cooperation in population and development activities has reflected a greater awareness of the magnitude, diversity and urgency of unmet needs. As a result countries that formerly attached minimal importance to population issues now recognize them at the core of their development challenge. There is a strong consensus on the need to mobilize significant additional financial resources from both the international community and donors within countries. A number of difficulties and shortcomings need to be addressed in international cooperation process. One of the major problem is the inability to expand interventions to keep pace with ever expanding needs. Adhering to national priorities requires a new clarification related to reciprocal responsibilities among development partners both internationally and nationally. An urgent challenge to the international donor community therefore is to translate their commitment to the objectives and goals of the Programme of Action of ICPD. Which has evolved guide lines for the United Nations Population Fund and other United Nations organizations, multilateral financial institutions, regional banks and bilateral financial resources. They need to coordinate their financing policies and planning procedures to improve the impact of their complementary contributions to the achievement of the population programmes. International financial institutions may consider to increase their financial assistance, particularly in population and reproductive health, including family planning and sexual health care of adolescents. Recipient countries also have

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the responsibility to use the assistance received for activities effectively related to adolescents. Partnership with NGOs Non-governmental groups are well recognized for their comparative advantage in relation to government agencies, for working with communities because of innovative, flexible and responsive programme design and implementation, including grass-roots participation. However, most NGOs are poorly served and hard to reach through government channels. In order to promote an effective partnership between all levels a dialogue with all concerned and local community groups for participation in designing projects is recommended. Private-sector involvement needs to be explored and encouraged in our country; except for education and health sector their involvement is negligible in supporting social sector activities. Adolescent Development in India: Role of The UN Agencies Several United Nations agencies have at least one of their thrust areas related to adolescent health and development issues. The United Nations Development Programme (UNDP) has United Nations Volunteers (UNV) programme in which youth are trained as volunteers to help UNDP in development activities in other countries. UNV-DDS (Domestic Development Service), Field workers and UNDP fellowships are other schemes which create opportunities for youth across the world. The UNV concept is unique in trying to involve the youth in the mainstream of development activities. The World Bank supports several programmes for primary education such as District Primary Education Programme (DPEP) in Rajasthan focusing on girls and

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the disadvantaged groups. Other areas of the World Bank relates to health including AIDS, girls health education and nutrition and malaria. It is also working to check the growth and incidence of HIV/AIDS in the country. The work on nutrition and overall health is expected to have impact on reproductive health and population relevant to adolescents concerns. Further, the World Bank is actively involved in bringing quality improvements in ICDS projects which cover adolescent girls. United Education, Sciences and Cultural Organisation (UNESCO) directly relates to the school and student population. India is one of its founding members and supports it goal of the fortification of the defense of the peace of minds of men that can be fulfilled only by education. In creating opportunities for exchange in the areas of science and technology and education, it fulfils educational needs particularly of the youth. Further, in many of the programmes such as the current culture of Peace initiative, it encourages the involvement of student population of the country. In India along with (UNICEF) it also promotes the NYKS programme and DPEP and other educational activities. United Nations Childrens Fund (UNICEF) UNICEF has a detailed perspective on adolescents and has laid out a separate entity in recognition of their differential needs and concerns. This further states their roles and responsibilities of advocacy in the communities and civil society. The need to ensure the fundamental rights of adolescents and the provision of information and support services to them has also been the concern of UNICEF, a relatively recent phenomenon which is gaining momentum. UNICEF now adopts the definition of child less than 18 years and focuses on AIDS that covers teenage group or 15-19 years. It has advocacy and education programmes related to AIDS and has done documentation related to it. As a Secretariat for Special Session of

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UN General Assembly on Children, UNICEF had prepared a paper, Emerging Issues for Children in 21st Century in which adolescence was clearly marked as a period requiring specific interventions to ensure their development and human rights. United Nations Population Fund (UNFPA) The UNFPA has been pioneering its efforts for adolescents in and outside the country. It has initiated studies and programmes for adolescents. Its work is centrally informed by the gender perspective and focuses relatively more on disadvantaged adolescent girls. It actively supports the nations population education programme of the government and has succeeded in introduction of population education in curricula at different levels and also supports several community based projects at grass roots in partnership with governments and NGOs (Table 23). The World Health Organisation (WHO) It has a unit devoted to Child and Adolescent Health and Development Programmes. Major focus of WHO is on health issues, it has advocacy and programme designing as other important areas of concern. A multi-centric study sponsored by WHO under took situational analysis of adolescents in countries of South East Asian Region and development of models for interventions (1988). Within the RH care package developed, adolescent health has been included as a component. WHO/SEARO model has been used by several countries. WHO has prepared documents on counselling techniques and manuals for workers. The International Adolescent Study Group also included India as a participating country. Connection to parents and social initiative aspects within this sudy have direct implication to plan interventions for checking anti social behaviour and depression found in Indian adolescents. The work of WHO on Integrated Management of
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Childhood Illness (IMCI) has a direct relevance for young teenage mothers. The strategy has been adopted by India and training package developed in partnership with CARE has been field tested. The United Nations Development Fund for Women (UNIFEM) The UNIFEM largely works in the area of gender inequalities and empowerment with areas of concern economic security, governance and human rights. Its media campaigns and awareness programmes against child/early marriages and girl children trafficking are of direct significance for adolescent girls. The core strategy promotes partnerships and capacity building of NGO networks. Many of the bilateral agencies are actively involved in the area of adolescents. For instance, United States Agency for International Development (USAID) supports Institutes and sponsors research and other activities and exchange programmes in supporting academic endeavours related to reproductive health, infectious diseases, gender and child survival (through anganwadis includes young mothers); in the broad sense, it covers adolescents. A few other agencies also address issues relevant to adolescents and young people, such as broader goals of better standard of living, attaining good health and so on. Among these are Swedish International Development Agency (SIDA) and Norwegian Agency for Development Cooperation (NORAD). Both these agencies also work in the areas of sexual health and rights of young people. SIDA is also supporting Education for All programmes in Rajasthan. The Population Council The council is involved at the global level initiatives for adolescents. It has supported research studies and programmes that have also been the genesis for their

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policy perspective on adolescents. It is now actively involved in advocacy for gender-sensitive adolescent policies. Other organizations such as Action Aid have addressed adolescents though their central goal of poverty eradication and gender justice. It is felt that these larger goals can be achieved only through addressing children and adolescent needs. An Overview The project activities of International Organizations in India related to adolescents are presented in Table 23, the details of programmes are based on either interaction with the focal points at each organisation or on documented information available. The length of programme details is not necessarily an indication of the intensity or level of support for adolescents. Each organisation has provided different types of information (for instance, some have provided information on projects, others on programmes) and the number of programes also differs from organisation to organisation, therefore, these are not comparable. The activites have been catagorized as direct and indirect. As the term imply, direct activities refer to those programmes and projects in which adolescents are mentioned explitictly in the objectives or in the target group as participants. Converely, indirect work with adolescents refer to activites in which adolescents refer to activities in which adolescents form a part of the target group or are affected by the programme, or in which adolescents are integrated in to the overall programme.

170

171

172

173

174

175

176

177

178

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An overwhelming tendency of all programmes is to be clustered around health issues, particularly reproductive health issues, and it is not surprising, as it is in response to the needs of adolescents. Perhaps more importantly, addressing the health needs of adolescents is critical for improving the general reproductive health status of the country and for reversing population trends. ICPD also highlighted the health aspects of adolescent concerns, and their importance in this sphere. Nevertheless other areas, such as education, employment, political and social empowerment are also being addressed to by UN organizations. It is sometimes difficult to demarcate interventions into sectoral strategies as, increasingly, a holistic and multi-sectoral approach is being adopted by most organizations. Table24 attempts to make such broad demarcations to identify the areas of work on adolescents (indicated by ) by different UN Organisations. Table 24: Areas of Work for Adolescents by UN System
Organisation Health Education (including population education and creation of attitudinal change) Economic issues Advocacy, Laws & Policies Other

FAO ILO

(workers rights, employment)

UNAIDS UNCHS UNCTAD UNDCP UNDP UNESCO UNFPA UNCHR UNIC UNICEF UNIFEM

(Shelter)

Information

Source: UNFPA 2000. Adolescents in India a Profile P-37. 180

This classification has been attempted mainly for the purpose of obtaining an overall idea of the programme focus of UN organizations. Clearly, health (mainly reproductive health) emerges as the main sectoral focus. The prominence of education activities can be attributed to the inclusion of population education (which is also related to health). Similarly, some of the economic activities, although separated and classified as economic activities, are part of the RH and Life Skills programmes. Greater emphasis needs to be placed on other issues such as improving the quality of education, linking education and employment, fostering economic independence. Indeed, this has been expressed by all UN organizations, and any future strategies could reverse this skew towards health-related programmes. This change in focus is endorsed by POA as well. Considering crucial role of the family there is a need to build capacity of the members of the family to provide effective support to the growing adolescents. Disadvantaged adolscents have little access to sports, play, leisure and creative activities. Governmental services are awfully inadequate. Exchange and exposure visits and creation of infrastructural facilities for recrational purposes could be added in to the programmatic activities of UN agencies particularly in rural areas. The geographic spread of current projects on adolescent, agency wise, is given in the Mapping Chart (Table 25).

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Table 23: Activities on Adolescents by UN Organizations


UN Organisation FAO Direct Activities The Youth against Hunger campaign promotes activities that aim to raise awareness of environment and food security issues (through school orchards, horticulture projects and information dissemination) and to encourage the participation of youth and adolescents in solving the problems of world hunger (i) Indirect Activities Research and training on population and development dynamics in fishing communities looks at the dynamics of adolescent populations. (ii) Programmes on food quality and safety affect vulnerable adolescent consumers. (iii) Adolescent girls are major beneficiaries of programmes for the elimination of micronutrient includes planned programmes for leprosy patients. (iv) Studies on food insecurity and vulnerability information and mapping systems (FIVIMS) examine indicators affecting adolescents such as child birth, early pregnancy and so on. ILOs general programmes for worker rights would affect working adolescents, particularly in the older age group. Its emphasis on separate programmes for women would also affect adolescent girls. Janshala - (UN System Joint Project)

ILO

(i)

ILO is committed to the elimination of child labour (which includes adolescents) through its International Programme (ii) ILOs Programme for Youth Employment highlights and analyses issues of youth unemployment. Past activities include a study on youth unemployment in India (iii) The ILO-SAAT office supported a programme for Womens Entrepreneurship by the NGO MAMTA which aimed to increase the entrepreneurial skills of adolescent girls. (i) The World AIDS Campaign for three successive years, 1977 (Children Living in a World with AIDS), 1988 (Force for Change - Campaign with Young People) and 1999 (Listen, Learn, Live!) focused on raising awareness among youth and adolescents about HIV/AIDS and on strengthening AIDS programmes with children and young people. 171

UNAIDS

UNAIDS emphasis on high-risk groups would indirectly affect adolescents, for example, the children of commercial sex workers. Janshala - The UN System Project

(ii) Young People Talk AIDS, now called a Students Talk AIDS is a nationwide campaign to educate and mobilize youth as also school students around the issue of HIV/AIDS. (iii) UNAIDS is actively working to integrate the issue of HIV/ AIDS and Reproductive Health education into the school curriculum. (iv) UNAIDS is working with the government to reactivate and energise a Task Force on Youth (v) The Networking Project to reduce risks of drugs amongst young people in South Asia has been started in 2002. India is a participating country in it. The other partners in this are SIDA, NORAD and UNODC. UNCHS (i) The programme for improvement of slums in Hyderabad would also benefit adolescent slum dwellers. (ii) The Forum on Safer Cities would benefit vulnerable adolescents, mainly street children (iii) The 1999 World Habitate Day Forum on Cities for All provided a platform for the voices of the poor, including adolescents. (i) UNCTAD is increasingly concerned about the issue of child labour and is planning to initiate activities in India on this issue (i) UNCTADs studies on the impact of globalization on vulnerable groups like women, children and adolescents raise awareness on these issues. (ii) Projects on Trade, Investment, Environment and Development in the manufacturing sector affect adolescents, many of whom are employed in lowskills manufacturing industries.

UNCTAD

172

UNDCP

(i)

Youth and adolescents are the main focus of the Community Wide Drug Demand Reduction programme in the Northeast where the percentage of adolescent drug users is perceptively higher than the rest of the country. (ii) UNDCP supported efforts to reduce risk taking behaviour related to drug abuse, HIV/AIDS and STD among street children in four metropolitan cities. (iii) The Community Wide Drug Demand Reduction programme in India targets adolescents and children both in and out of school. (iv) A sub-programme of the nationwide community drug demand reduction programme aims to use sports to divert attention away from drugs and induce behavioural change among youth. (i) The school health programme will concern itself with the health problems of older school going children from deprived families and address the issue of absence from school due to poor nutrition. (Programme yet to be signed) Activities in the HIV/AIDS programme include the rehabilitation of children (including adolescents) of commercial sex workers The Health Programme will include a separate focus on support for children with disabilities and their integration into the education system. The Janshala project attempts to address the special needs and vulnerabilities of adolescent girls. Educating adolescent girls through non-formal system. (UN System Project in AP, Bihar, Rajasthan, UP and Delhi.) The sub-programme on Community Adoption and Monitoring Programme for Schools (CAMPS) strives to provide students with the technical know-how and training to asses the environmental status of their localities. Bio devcreity and livelyhood programmes. 173

(i)

The DAPC (Drug Abuse Prevention Centre) grant for innovative NGO projects can be used for adolescent projects, for example, it provided funds for a project (completed) on street children.

UNDP

(i)

(ii) (iii) (iv)

Concerns of adolescents such as health, education, early marriage, child labour and so on are addressed in an integrated manner by the Community Based Pro-poor initiatives. As the sub-programmes develop, it is possible that a separate focus on adolescents will evolve. (ii) Information Computer Technology Project to support Minisry of CIT - Pilot Project of MIS development with youth for Disaster management in Gujrat and Orissa.

(v)

UNESCO

(i)

The HIV/AIDS programme places emphasis on peer education for adolescents, and HIV/AIDS education for adolescents in formal, non-formal and adult literacy schools (ii) The peer based approach to adolescent and reproductive health education for in-school and out-of-school youth promotes sexual and RH education and the participation of young people in RH activities. (iii) The GOI-UN system joint programme on education aims to provide life skills education for adolescent girls. (i) Population and Development Education Programmes in schools, in the Higher Education system, in post-literacy and Continuing education in Vocational Training Programme along with an integration of adolescence education in schools aim to increase awareness of population and development issues among adolescents. The Population & Development Education in Schools, in Higher Education system and in post Literacy and continuing Education were undertaken during 1995-2002 with MHRD and Population Education has been integrated in curricula at different levels. (ii) The Reproductive Health sub-programme supports NGO initiatives for adolescent health. For example, CARE is running a programme on adolescent health in Jabalpur, Madhya Pradesh. (iii) The media module developed as part of advocacy initiatives to sensitise the media includes a half-day session on adolescents. (iv) Currently 16 projects are on ground with support from UNFPA related directly to adolescents issues. These are in collaboration with MOHFW, GOI and state governments (6) and are located in Maharashtra, Gujarat, Orissa, Rajasthan, Kerala and Madhya Pradesh. The Haryana Inegrated 174

(i)

UNESCO promotes the involvement of youth volunteers and adolescents in nation-building activities. (ii) Youth are actively involved in the activities for the International Year for the Culture of Peace. (iii) Youth initiatives are being prepared in all thematic areas of UNESCO work. (iv) Janshala - community mobilization for effective school management (Joint-UN System Project.) (i) The Haryana Integrated Womens Development Programme impacts upon the health and status of adolescent girls (ii) The Integrated Population and Development Projects and the District Reproductive Health Projects covering a total of 39 districts examine issues of access to and quality supply of reproductive health services to adolescents. (iii) UNFPAs advocacy initiatives attempt to create an enabling environment for building public support on the issues of adolescent empowerment, including health and education. Most of the initiatives for adolescents are pilot initiatives. For example, initiatives to sensitise parliamentarians on reproductive health and population issues include fostering awareness of adolescent health needs. (iv) Support to Janshala Programme in collaboration with MHRD. Other partners are UNICEF, UNDP, UNESCO and ILO.

UNFPA

Womens Development Project is implemented in partnership with DWCD of the Government of Haryana. The other nine projects are being implemented by NGOs in the States of Gujarat, Bihar, West Bengal, Rajsthan (4) and UT Delhi (2).

UNHCR

(i)

The India Office follows the guidelines of the UNHCR Policy Guidelines for Refugee Children and Adolescents and the Machal study on the Impact of Armed Conflict on children (UNCHR runs on a case-by case, not a programme basis.) (ii) A special school for refugee children and adolescents has been established in Delhi as part of UNHCRs policy to provide education to all refugee children and adolescents.

(i)

As part of its overall health care for refugees, UNHCR provides health services and access to health care for adolescents. (ii) Refugee adolescents also benefit from vocational training courses provided by UNHCR.

UNIC

UNIC raises awareness about issues of concern to the UN, including the role of adolescents mentioned in the ICPD. (i) The HIV/AIDS programme attempts to provide adolescent health education, including AIDS prevention education (ii) The Reproductive and Child Health programme directly relates to improving the health status of adolescents, particularly in the Safe Motherhood and the Community Action for health projects. (iii) One of the major goals of the Childhood Development and Nutrition programme is to reduce malnutrition among adolescent girls and to increase outreach to adolescent girls through ICDS. (iv) Provision of safe water and sanitation through the Childs environment, sanitation, hygiene and water supply 175 (i) The Community Convergent Action programme builds the capacity of communities (including adolescents) to plan and achieve convergence on services for the child, which includes adolescents. (ii) The Advocacy and information for Child Rights programme advocates attention towards the rights of the girl child. (iii) The Planning, Monitoring and Evaluation porgramme works to strengthen strategic planning, and the capacity to monitor progress on womens and child rights (which includes adolescents).

UNICEF

programme will reduce the drudgery of fetching water supply programme will reduce the drudgery of fetching water from long distances for young girls, and sanitation in schools will help young girls realize their basic right to education. (v) The Primary Education programmes encourage the establishment of community schools which target adolescent girls. (vi) UNICEF is committed to the elimination of child labour (vii) The Child Protection programme facilitates collective action to eliminate child trafficking and prostitution, which affects many young adolescent girls. UNIFEM (i) Sensitisation, research, documentation on trafficking and prostitution aims to help reduce the problem of trafficking and prostitution of young adolescent girls. (ii) The Violence against Women campaign highlights violence against children and adolescent girls. The campaign actively seeks to increase the participation of young people and advocate for policy, change and behavioural change. (iii) The HIV/AIDS and Gender programme aims to sensitise womens organizations to HIV/AIDS issues. Young adolescent girls are viewed as particularly vulnerable to HIV infection. (iv) UNIFEM is currently having four projects that have a direct bearing on issues related to adolescents. These are implemented in partnership with NGOs in the states of Gujarat, Kerala, Punjab, Meghalaya, Rajasthan, Andhra Pradesh and UT of Delhi. It covers issues related to gender equality, combating trafficking and vocational training for girls. (i) Entrepreneurial Skills and Vocational training programmes for women also benefit older adolescent girls and assist them in attaining economic independence and self-reliance. (ii) Gave inputs to engender the 2001 Census also direct attention towards the girl-child (iii) Establishing a South Asian Network of Home Based Workers would include a large number of adolescent girls, who are employed as home based workers in South Asia. (iv) The Human Rights programme raises awareness on issues of women rights, and thereby, also of adolescent girls.

176

UNV

(i)

By educating young people on artisan lifestyles and incorporating the artisan lifestyle into the ICSE curriculum, UNV hopes to increase awareness on alternative value systems and artisan lives among young people.

(i)

UNV promotes and encourages the spirit of volunteerism among youth.

WB

(i)

The Reproductive Health Programme in the next phase (2000-2003) will specifically focus on adolescents, with the conscious inclusion of boys. The current RH programme, with capacity-building, and the development of IEC strategy also focuses on adolescents. (ii) Adolescents have been a clear focus of the IPP VIII projects, and have benefited from adolescent workshops, awareness generation (on family planning, contraceptives etc.), and vocational training. (iii) A major goal of the Women and Child Development progrmme is to improve the health and nutritional status of adolescent girls through activities such as supplementary feeding, access to health care and so on. (i) The success of the Adolescent Girls scheme in Jhabua, Madhya Pradesh, in improving KAP (Knowledge, Attitudes and Practices) among adolescent girls on health and nutrition issues encouraged the government to introduce the Adolescent Girls scheme in the ICDS. (ii) The Adolescent Tribal Girls scheme aims to improve the KAP on nutrition and health, improve the quality of services provided through the ICDS and empower adolescent girls. (iii) WFPs support to ICDS includes a major component to improve the health and nutrition status of adolescent girls.

(i)

The HIV/AIDS programme focuses on high-risk groups, but adolescents will be indirect beneficiaries.

WFP

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WHO

(i)

(ii)

(iii)

(iv) (v)

(vi)

Sensitisation through Intercountry Orientation Training for professionals in Adolescent Health is a part of WHOs overall strategy to increase the focus on adolescent health. Adolescent health needs are specifically addressed through the Reproductive health and Research, Child Maternal and Adolescent Health and Development programme. The Women, Health and Development Programme addresses the health needs of adolescents as part of the life-cycle approach The Tobacco Free Initiative works to reduce and prevent tobacco use by adolescents. WHO is actively working to implement a situational analysis of the health of adolescents and to develop national strategies on adolescents. Along with UNICEF, UNAIDS, UNFPA, UNDCP, WHO has developed a framework on adolescent health. WHO is currently undertaken establishment of friendly Health Services which involves need assessment, quality improvement in Health Services developing of IEC material and capacity building. The project is implemented in collaboration with Medical Colleges in West Bengal, Haryana and Uts of Delhi and Chandigarh.

(i)

A focus on adolescent health is integrated into all WHO programmes.

WSP

WSP supports the Rajiv Gandhi Mission to provide school sanitation facilities in all rural schools. This will help increase awareness of sanitation among school students, and through them, the wider community. Provision of school sanitation facilities will also encourage parents to send girls to school and enable them to realize their basic right to education.

178

UNIAWG, P&D

During 1999-2002, UNFPA and the UN Inter agency group got prepared a Life Skills Education Module for out of school Adolescents. Project Charca is being implemented in six districts to create enabling environment for girls and young women to access and demand RCH services

International Agencies Cooperation UNFIP Royal Netherlands, SIDA, AUSAID, UNODS

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Table 25: Mapping of Member Programmes and Activities Relating to Adolescents IAWG on: POPULATION & DEVELOPMENT As on May 2003 Group Members: UNFPA, UNHCR, UNAIDS, UNODC, FAO, ILO, UNDP, UNESCO,UNIC,UNICEF,UNIFEM, UNV, WB, WFP, WHO-SEARO, WHO (India) Information provided till May 2003 by: UNFPA, UNHCR, UNODC, UNAIDS, UNIFEM, WHO India The Secretariat has been informed of no activity undertaken on adolescents by: WFP, WB, UNIC, THE Secretariat is yet to receive info/crores. from: WHO SEARO, UNHCR, UNICEF, FAO, ILO, UNDP, UNESCO Name of project* And Date: Start-End (estim.) Support to Gender Issues (IND/99/P09) State District or City Delhi Approx. pop. Covered Agency(ies)* Implementing partners** Budget (estim.) (in USD) Areas and Activities Activities incorporating Adolescent Sexual & Reproductive Health

Delhi

4 urban slums & resettlement colonies of Delhi-Trilokpuri, Raja Bazaar, Uttam Nagar, Shadipur 27 villages in Nandesar

NGO, UNFPA

Mobile Creches & 29,91,450 Society (support NGO), VHAI

Support to Gender Issues (IND/99/P09)

Gujarat

Vadodara & Ahmedabad

Deepak Charitable Trust (DCT) Vadodara & CHETNA (support NGO), Ahmedabad NGO, UNFPA

44,10,000

Activities incorporating Adolescent Sexual & Reproductive Health

Support to Gender issues (IND/99/P09)

Rajasthan

Jaipur, Bikaner

4000 students each yr in 5 private & 5 Govt schools/colleges, Jaipur

NGO, UNFPA Support to Gender Issues (IND/99/P09) West Bengal Siliguri & Jalpaiguri districts (WB) 3000 students in 20 schools in 2 districts NGO, UNFPA

Concerned 24,63,163 citizens for community health & Dev. Jaipur; URMUL Rural health research & Dev Trust, Bikaner West Bengal Voluntary Health Association (WBVHA) 9,42,900

Activities incorporating Adolescent Sexual & Reproductive Health

Activities incorporating Adolescent Sexual & Reproductive Health

182

Support to Gender Issues (IND/99/P09)

Rajasthan

Bharatpur

1225 boys & 1225 girls in 35 villages

NGO, UNFPA

Lupin Human Welfare & Research Foundation, Bharatpur Daudnagar Organization for rural Development (DORD)

25,47,268

Activities incorporating Adolescent Sexual & Reproductive Health

Support to Gender Issues (IND/99/P09)

Bihar

Aurangabad

3000 adolescent girls & 3000 women & community members

NGO, UNFPA

35,43,000

Activities incorporating Adolescent Sexual & Reproductive Health

Haryana Integrated Womens Empowerment & Development Project (IND/98/P02)

Haryana

Mahendragar h and Rewari districts

GOH, UNFPA

Haryana 10,00,000 Integrated Womens Empowerment & Development Project (HIWEDP), GOH, WCD, NGOs Foundation for Education & Development, NGOs, Sandhan, 10,00,000

Gender sensitization through workshops, network meetings, advocacy through Bal Melas, camps for adol boys and life skills training for adolescent girls and training of peer educators. Peer education for ASRH

Doosra Dashak

Rajasthan

Kishanganj in Baran dist. And Bap in Jodhpur dist, Rajasthan Jodhpur, Baran & Jaipur districts

46 villages in Kishanganj and Bap blocks

NGO, UNFPA

Peer Education as a strategy to build Life Skills among adolescents

Rajasthan

Urban: 50 girls. Rural: 150 girls & boys. Tribal: 300 boys from Kishanganj 2 batches of trainers for LSE Course

NGO, UNFPA

SANDHAN

7,48,000

Peer Education for ASRH

Life Skills Education Programme (Phase I & II) Documentation & Extension of Counselling services

Delhi

Delhi

NGO, UNFPA

Urivi Vikram Charitable Trust (UVCT), UN IAWG P&D

LSE-6,38,000 & Life Skills Education Documentation & Counselling services 7,25,000

183

Inegrated Population & Development Project, Maharashtra (IND/97/P17

Maharashtra

Thane, Pune, Dhule, Chandrapur, Gadchiroli districts, Urban

150 adols. Girls (pls GOM, MoHFW, UNFPA check) in 5 slum vocational centes; 5 employment guidance service centres; 33 high schools, 5 colleges 5000 adolescents

Thane Corporation, Depts of FW & Education, NGOs, SNDT, TISS

Activities incorporating Adolescent Sexual & Reproductive Health

Integrated Production Development Project, Gujarat (IND/97/P18)

Gujarat

Banaskantha, Sabarkantha, Surendranagar, Kutch, Dahod Districts in Gujarat Rayagada, Koraput, Nabarangpur & Malkangiri districts in Orissa

GOG, MoHFW, Depts of FW & UNFPA Education, NGOs, Tmg institutes, ICDS, WCD

Rs. 55,000,000

Activities incorporating Adolescent Sexual & Reproductive Health

Integrated Population & Development Project, Orissa (IND/97/P07)

Orissa

Schools: 25 residential tribal schools, 35 govt schools, Out-ofschool: 2 blocks, 94 National reconstruction volunteers 12389 adol. Girls in 560 villages in 21 blocks of 7 districts

GOO, MoHFW, Depts of FW & Rs.1,12,00,000 UNFPA Education, NGOs, Tribal Welfare, School & Mass education, WCD, Higher Education

Activities incorporating Adolescent Sexual & Reproductive Health

Integrated Population & Development Project, Rajasthan (IND/97/P15)

Rajasthan

Alwar, Bharatpur, Sawai Madhopur, Bhilwara, Chittorgarh, Udaipur Kannur, Kasargode, Wayanad districts of Kerala

GOR, MoHFW, UNFPA

Departments of Rs. 80,00,000 FW & Education, NGOs

Activities incorporating Adolescent Sexual & Reproductive Health

Integrated Population & Development Project, Kerala (IND/97/P30)

Kerala

Adolescents: 588 (peer) educators, Balika mandals); Adults working with adolescents: 723 (teachers, NGO/NYK members, PTA members)

GOK, MoHFW, Depts of FW & UNFPA Education, NGOs, WCD, Youth

Rs. 8,49,315

Activities incorporating Adolescent Sexual & Reproductive Health

184

Integrated Population & Development Project, Madhya Pradesh Pradesh (IND/97/P01)

Madhya

Sidhi, Rewa, Panna, Chattarpur & Satna districts in MP

School dropouts-380 animators, 7600 adol girls from 380 villages of 14 blocks in 5 districts of Chattarpur, Rewa, Sidhi Satna and Panna 1600/yr 540/yr. majority in age-1

GOMP, MoHFW, Depts of FW & UNFPA Education, NGOs, Dept of Pediatrics, SS Medical College, Rewa

Rs. 18,33,785

Activities incorporating Adolescent Sexual & Reproductive Health

1. Education support-Refugees 2. Self Reliance Refugees

NCR NCR

NCR NCR

UNHCR UNHCR

YMCA, N.Delhi 102,520 Don Bosco Ashaly 171,370

Subsidy for schooling vctnl tmg/English/Life skills

* All UNHCR projects are signed for a period of one year, but these will continue in the coming year. 1. Extraordinary responses reducing HIV related risk among young drug users by fostering regional and national alliances and development of partnerships between CBOs, NGOs and governments 2. Information sharing between countries and 3. Evidence based advocacy in the region

Networking for reducing risktaking behaviour related to drug abuse and HIV/ AIDS amongst young people in South Asia, 2002-2004

India and five other South Asian countries

400 million

Government Counterparts in the six South Asian Countries dealing with Drug Abuse, HIV/AIDS as well as NGOs and UNAIDS, SIDA, CBOs as identified by NORAD, the project US $ 460,000 UNODC partners

A pilot decentralized participatory project is envisaged in six districts in India: Aizawl, Bellary, Guntar, Kanpur, Kishenganj and Udaipur and will initiate interventions based on local level priority by enhancing sustainable capacities of young married women and girls, aged 1325, at the district level, by creating an enabling

185

environment for open discussion on sexual issues, sexuality, vulnerabilities of UN co-sponsors, the target population and UNAIDS, NACO their sexual partners, State AIDS Control increase demand for Societies, District gender friendly and level Authorities, appropriate services and UNF/UNFIP, build or enhance Royal civil society support structures necessary Netherlands organizations, for vulnerable women Embassy, Bilaterals womens and girls to seek such as SIDA groups US $ 1,000,000 redressal. AUSAID, CHARCA 2003-2006 Exploring Masculinity Mizoram Gujrat, Kerala, New Delhi Punjab, Meghalya Aizawl Baroda Thiruvanthapuram, New Delhi, Chandigarh, Shillong 100000 UNODC UNIFEM AAKAR The agency organized as a pilot a multi-disciplinary travelling seminar in five universities of India exploring masculinities the seminar includes academic Papers, activist narratives and film screenings. The agency organized residential camps for boys and girls in the age group 11-20 years in an attempt to foster a gender aware culture and break the inter-genera tional cycle of stereotypcial & gender roles that often lead to discrimination & violence. The project hopes to meet the basic learning needs of this group, relating it to their

Doosra Dashak

Bap & Kishanganj Blocks

Doosra Dasha

UNIFEM

Foundation for Education & Development

Rajasthan

186

Prevention & Combating Rafficking June 2001Trafficking June 2002

New Delhi

New Delhi

UNIFEM

STOP

The organization collabo rates with the Police to help rescue girls (may of them are adolescents) and young women who have been traf ficked into the brotheis in New Delhi (mainly G.B. Road). Post rescue the organization works to repatriate and rehabilitate these girls in collaboration with other NGOs. Legal action is also The organisation works to provide skill training to girls and young women who have been victims for trafficking, as well as girls who are vul nerable to being trafficked.

Navashakti Dec 2001-Dec 2002 Andhra Pradesh Anantpur &* Cuddapah

UNIFEM

STHREE

187

Establishment of Adolescent Friendly Health Services Kolkatta Medical College, Kolkatta West Bengal Kolkatta WHO, India Department of Paedoatri 13,900 Need Assessment, Provision of health services, Develop ing appropriate IEC/BCC, Communication, Counsel ling, capacity building and training and Networking

Family Planning Association of India, Panchkulla, Haryana Hindu Rao Hospital, New Delhi National Institute of Public Cooperation & Child Development Government Medical College, Vadodra NB Medical College, Darjleeng District Hospital Maida Government Medical College and Hospital, Chandigarh Support for National task force for startegy development

Haryana New Delhi New Delhi Gujarat West Bengal West Bengal Chandigarh

Panchkulla New Delhi New Delhi Vadodra Darjling Malda Chandigarh

WHO, India WHO, India WHO, India WHO, India WHO, India WHO, India WHO India

FPAI Department of Paediatrc Public health Department of SPM Department of PSM District Hospital DoP Depatt of Paediatrics

16000 8450 10000 14000 14000 11000 13500

WHOP India Total

10000 111,950

Source : Coordinator P11/2403 UN-IAWG, 2003.

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Future Agenda : A Vision for Adolescents in India

In the present document every chapter ends with a summary of issues raised in that section. An attempt is made here to highlight the points for future actions. These will serve as guiding principles for planning strategies to create an enabling environment for development and well being of the Indian adolescents in the 21st century. Adolescence: A Critical Phase Raising knowledge and awareness, to recognize adolescence as a time of opportunity and risk. Building a concencus to designate 10-19 years as the period of adolescence for policy and programme planning. Acknowledging that problems faced by adolescents have common roots and are interrelated. Appreciating that all adolescents are not equally vulnerable. Recognizing the role of socio cultural and environmental variables on the development and profile of adolescents. Accepting that gender differences are fundamental in the Indian context. Understanding the crucial role of family in shaping lives of the adolescents.

Situational Analysis The priority areas for action are: Reduction in levels of poverty as large number of adolescents are raised in impoverished conditions (BPL 26% - 1999) Checking adverse sex ratios, ensuring equality for females in all spheres of life across life cycle stages.
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Reduction in fertility. Reduction in mortality and morbidity rates of adolescents and women. Raising age at marriage, through advocacy, education and enforcement of Child Restraint Marriage Act. Reduction in prevalence of malnutrition and micro nutrients deficiencies, particularly anemia amongst girls and women (55%). Universalization of literacy, raising levels of education, creating provisions of vocational education and employment. Bridging gender disparities. Making Population Education available through school system at all levels and non formal education programmes. Improving quality of education for achieving Minimum Levels of Learning. Promoting access to health services and counselling services for safe and protected sex to all adolescents. Prevention and control of STD and HIV/AIDS amongst adolescents - a vulnerable group Abating violence and sex abuse of girls/boys. Controlling trafficking of young girls/children. Protecting adolescents in difficult circumstances, street children, child labour, prostitutes, mentally challenged and adolecents in conflict with law. Provision of appropriate services for these groups need to be expanded.

Policy Framework and Designing of Interventions Analyses of the existing policies and interventions have pointed to the need of making policies more supportive and interventions more comprehensive. Some of the guiding principles that have emerged from the review are presented here. These may be considered by policy makers and other stake holders in bringing changes in the existing policies and programmes or while formulating new ones to meet the specific needs of the adolescents.

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Policy Framework Adolescents (10-19 years) to be recognized as a priority target group and reflected as such in the national programmes. Building of a strong political commitment to ensure wellbeing of adolescents Advocacy to promote partnership amongst stakeholders to share this responsibility jointly to synergies the impact of the interventions targeted at adolescents. A separate national policy on adolescents may be enacted to address interrelated and holistic needs of adolescents, with multisectoral approach instead of sect oral, catering only to one set of needs at a time. There is a need to have a nodal department in the Government to plan, implement, monitor and coordinate endeavours related to adolescents. Generating relevant data base / information at the national level relating to adolescents, having uniformity in categorization of age groups (10-15, 16-19). Data sets be disaggregated by sex, rural, urban and tribal groups to meet their diverse needs. To base policies on current knowledge and scientific evidence Empirical research related to crucial aspects of adolescents should be undertaken to understand the role of conditions/factors influencing development of adolescents in India. The research evidence would facilitate formulation of realistic policies and need based programmes/ interventions. In the present document while doing content analysis of the existing policy framework, gaps have been highlighted along with suggestions for policy modifications. These may be found useful in taking appropriate decisions for reorienting implementation of the policy to meet needs of adolescents. This interim action would provide immediate solution to crucial issues related to adolescents till such time that a comprehensive policy is formulated. Policies need to be sensitive to the cultural and local traditional values accordingly, flexibility may be a built in for implementation.
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Participation of youth in policy framing can go a along way in making it sensitive to the felt needs. This is a well proven strategy for sustainability of projects. Gender dimension s to form an integral part of the policies to deal with age old discrimination. Empowerment of adolescent girls and women be aimed at. The rights approach be honoured in policy formulation and provisions should be made in line with Articles of CRC , CEDAW and ICPD directly relevant to survival, development and participation of adolescents.

Programmes and Interventions Increasing access to services and expanding these for universal coverage. Integrated Programmes to be designed at the community level with assessment of the felt needs of adolescents and involving them in planning the same. The components of the programmes depending on its objectives may vary from project to project, however, the essential service in the context of adolescents are:

Services Counselling and Friendly Clinical Services Adolescents Health Services Reproductive and Sexual Health

Education Formal Education Non-Formal Education Adult Education Adolescents Health Education - Nutrition and Reproductive Health - Psychological and Mental Health Vocational Education

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Value Education and Life Skills Technical Education Information and Computers Technology.

Recreation Sports and Games Music and Dance Arts and Crafts

Reproductive Health and Reproductive Rights are two crucial aspects of interventions for of adolescent due to their age specific needs. These require provision of population education as an integral part of the curricula of the educational system. Inter vention programmes meant for out of school adolescents should essentially include this components. Special care needs to be taken to respond to the gender differential needs in the interventions (boys/men, girls/women). The staff and personnel working for programmes of adolescents be oriented and trained to respond to the special needs of the age group with the desired sensitivity. System of monitoring needs to be evolved for programmes/interventions to ensure effective and efficient delivery of services Community members may also participate in the process and give periodic feed back. Evaluation of Projects/Interventions need to be carried out to learn lessons for improving implementation and impact. Documentation of best practices and their dissemination to be encouraged. Knowledge related to effective project management be built. Alternative service/intervention models be evolved to serve adolescents in different settings.

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Legal Frame Work Priority action to review existing legislations relevant to adolescents, these may be reorient in line with provisions in the Articles of CRC and CEDAW. Strengthening enforcement machinery for speedy redressal of grievances and cases. Promoting legal literacy and making adolescents and society aware of their rights and legal entitlements. Making legal/legislative system gender sensitive and responsive to adolescents needs.

The UN System Identification of unmet needs in the sectors of health, education, RH with respect to needs of adolescents in governmental and voluntary sectors. Present review indicated inadequancies of, programmes of RH services, counselling, innovations in education, inadequate emphasis on vocational and value education and services for adolescents with special needs are few areas for UN suystem to consider for providing support. Locating projects in unreached locations and communities. UN Agencies need to translate commitments goals and objectives of ICPD and develop service models/intervention programme in line with the purview of their operations. Honour commitement of partnership and sharing of resources. Reorientation and coordination of financial policies with in respective organizations to ensure contributions towards population issues in India. Upscaling and increasing financial assistance for projects related to reproductive health, family planning, sexual health care and gender empowerment of adolescents. Multiple agency cooperations be augmented for comprehensive/integrated projects to meet holistic needs of adolescents. Some of these have already been in operation (Mapping chart Table 25).
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Strengthening technical know how and inputs in designing and management of programmes. Capacity building of Government personnel and voluntary sector in the State of Art for designing interventions for adolescents be considered. Advocacy measures to promote importance of the crucial nature of adolescence years and considering it a priority group. Recommendations of the Study Group on Programming for Adolescent Health be reviewed and revisited to see their relevance in Indian context. Complementary activities be advanced and a joint programme of action for the UN System in India be developed with respect to adolescents. Illustrative frame work for country programming for adolescent health developed by WHO, UNFPA & UNICEF in 1997 still has relevance.

It may be concluded at the end that one of the most important commitments that communities and countries can make is to safeguard the future economic, social and political progress and stability of adolescents. This can be done by building a strong political commitment to address the health, social and development needs of adolescents and youth. We must therefore, strive to create an environment where the young can enjoy trusting relationships with their families as well as adults in their community. A world where no young person will grow up neglected, abused or uncared for. A world without violence and misery. Where the young can grow up strong and physically and mentally healthy as confident and balance individuals, working together to promote harmony between peoples and nations. The future looks promising for adolescents and youth. The challenges are there but the potential is far greater. Everyone must work together to harness it for the greater good of all. Such an effort will enable young people to be healthy and creative, and to shoulder the responsibilities demanded of them in the 21st century. (WHO, 1997)
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Acronyms
ACEE & FO : ADC AE AHD AIDS ARC ASRH ATS AusAID AWARE BLO CARE CBSE CCC CDC CEC CEDPA CHC CSO CSW CTS DAINET DANIDA DCT : : : : : : : : : : : : : : : : : : : : : : : Adult Continuing Education, Extension and Field Outreach Adolescence Development Centre Adolescence Education Adolescents Health and Development Acquired Immuno Deficiency Syndrome Adolescent Resource Centre Adolescent Sexual and Reproductive Health Apprenticeship Training Scheme Australian Agency for International Development AIDS Warrants Adolescent Reproductive Health Education Better Life Options Council for American Relief Everywhere Central Board of Secondary Education Career Counselling Centre Child Development Centre Continuing Education Centre Centre for Development and Population Activities Community Health Centre Central Statistical Organisation Commercial Sex Worker Craftsmen Training Scheme Development Alternative Information Network Danish International Development Agency Deepak Charitable Trust
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DFID - UK DGET DPEP DWCD DWCRA FED FPAI HIV

: : : : : : : :

Department for International Development United Kingdom Directorate General of Employment and Training District Primary Education Programme Department of Women and Child Development Development of Women and Children in Rural Areas Foundation for Education and Development Family Planning Association of India Human Immuno Deficiency Virus Inter Agency Working Group on Population & Development Integrated Child Development Service International Conference on Population and Development Information Education and Communication International Labour Orgnisation Industrial Training Institute Kishore Dakshta Vridhi Kendriya Vidyalaya Sangathan Life-Skills Education Mobile Creches Maternal and Child Health Ministry of Human Resource Development Minimum Levels of Learning Ministry of Health and Family Welfare Ministry of Human Resource Development Ministry of Labour National AIDS Control Organisaton National Council for Educational Research and

IAWG-P&D : ICDS ICPD IEC ILO ITI KIDAVRI KVS LSE MC MCH MHRD MML MoHFW MoHRD MoL NACO NCERT : : : : : : : : : : : : : : : : :

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Training NIPCCD NORAD NOS NPE NSS NSSO NVS NYK PDE PE PERC PHC PL PRI PTA RCH RTIs SEWA SGSY SHG SIERT SOSVA SRC TBA TISS TRYSEM UDC UEE : : : : : : : : : : : : : : : : : : : : : : : : : : : : National Institute of Public Cooperation in Child Development Norrwegian Agency for Development Cooperation National Open School National Population Education Project National Service Scheme National Sample Survey Organisation Navodalaya Vidyalaya Sangathan NEHRU Yuvak Kendra Population and Development Education Peer Education Population Education Resource Centre Primary Health Centre Post Literacy Panchyati Raj Institutions Parent Teacher Association Reproductive and Child Health Reproductive Tract Infections Self Employed Womens Association Swarnjayanti Gram Swarozgar Yojana Self Help Group State Institute of Education Research and Training Society for Service to Voluntary Agencies State Resource Centre Traditional Birth Attendant Tata Institute of Social Sciences Training of Rural Youth for Self-Employment Urban Deprived Children Universalisation of Elementary Education
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UGC UNAID UNAIDS UNDAF UNDP UNESCO UNFPA UNICEF UNIFEM USAID UVCT VEC WB WBVHA WHO WHO/ SEARO WWH ZSS

: : : : : : : : : : : : : : : : : :

University Grants Commission United Nations Programme on HIV/AIDS UNAIDS United Nations Development Assistance Framework United Nations Development Programme United Nations Educational Scienctific and Cultural Organisation United Nations Population Fund United Nations Childrens Fund United Nations Development Fund for Women United States Agency for International Development Urivi Vikram Charitable Trust Village Education Committee World Bank West Bengal Voluntary Health Association World Health Organisation World Health Organisation South-East Asia Regional Office Working Womens Hostel Zila Saksharta Samiti

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