At 1.8 billion adolescents and youth form a significant part of the world’s population; the numbers are expected to grow even faster in the developing world. Which makes it critical that we invest in their education and health, and that includes sexual and reproductive health.
About 16 million adolescents in developing countries between the ages of 15-19 years give birth annually; many of them are unplanned pregnancies. One-third of girls are married before 18 years, and 12% by the age of 15. An estimated 33 million young women between 15-24 years have an unmet need for contraception.
The global consensus statement at the recently concluded International Conference on Family Planning seeking to expand contraceptive choices, even long acting reversible contraceptives, for young people acknowledges this critical gap. A significant number of adolescents and youth are sexually active and want to prevent or delay a pregnancy. But access to contraception and ability to choose from a variety of methods is limited.
“I believe the terminology “family planning” needs to be modified”, says Dr C.M Purandare, president of the International Federation of Gynecology and Obstetrics, FIGO. “Because adolescents are not family planning—they have no family. But they are looking at contraception. When the terminology was decided, maybe 20 years ago, the situation was different. Then, we were talking about population reduction”.
The statement calls for providing evidence-based information to policymakers, ministry officials, service providers, communities, family members and young people on the benefits of contraceptive options.
At its very core, it demands a rethink in how many countries, including India, approach sexuality education.
With one fourth of our population between 10-19 years, India is the youngest country in the world. We are likely to have 358 million young people in the next three decades. Young people, by accident or design, are experimenting with sex but is there enough being done to ensure that they are informed about it in an appropriate manner?
Findings from the latest National Family Health Survey findings are not very promising. Data collected from the 13 states surveyed in Phase 1 show that 82% women and 70% men lacked comprehensive information about HIV/AIDS and safe sex practices.
Sexuality education, as defined by UNESCO, “provides opportunities to… build decision-making, communication and risk reduction skills about many aspects of sexuality. The term encompasses the full range of information, skills and values to enable young people to exercise their sexual and reproductive rights and to make decisions about their health and sexuality”.
However, in India, the subject of sexuality education has been a controversial one. In 2007 when the Centre, along with the NACO, NCERT and UN agencies announced the launch of the Adolescence Education Programme in schools, 13 states announced an immediate ban who felt comprehensive sexuality education is against Indian culture. Presently there is a ban on AEP in five states across India, and there is no unformity in the way the subject is approached.
Successful sexuality education programmes start with children between the ages of 5-8 years. Children are curious about their bodies, and ideas of shame and silence are internalized at a young age. It is important, say experts, to educate children early on on the need to understand issues of consent, body image/shame, preventing abuse, establishing good communication skills and gender norms.
There is a need to adopt a “sex positive approach” and go beyond looking at sexuality education as a “means of controlling adolescent fertility because we want to reduce unwanted pregnancies or make sure families are planned better”, says Ishita Choudhry, Ashoka Fellow and Founder of The YP Foundation, a youth-led organization that has worked with adolescents and young people in India in settings, both urban and rural, on many development issues, which include sexual and reproductive health and rights.
“The fact is that adolescents are discovering their bodies and this is a joyful, exciting process for them”, says Dr V Chandramouli, scientist at the WHO Department of Health and Reproductive Research. “They need information that will help them make safe, informed choices and this is not to be always framed in the context of HIV”.
But most parents do not talk to their kids about sex and believe they will figure it out by themselves at some stage. They fear that incorporating it in the school curriculum will encourage promiscuity although innumerable studies show otherwise.
“From our experience we find that most adolescents are getting to know about sex from porn videos”, says Ramya Jawahar, Vice Chair, International Youth Alliance for Family Planning. “These videos don’t talk about safe sex or respecting boundaries so the messages going out to these adolescents is that its OK to not wear a condom or treat women in a disrespctful manner”.
Policymakers and the government, says Jawahar, have to start looking at sexuality education as a health, development and human rights issue and not through a morality prism.
“It is high time we move past our individual discomfort in acknowledging sexuality as a human desire and started considering adolescents as people with agency”, says Chaudhry. “Until then we will keep looking at ways of regulating sexuality across different health outcomes instead of empowerment.”
Shai Venkatraman is a Mumbai-journalist and blogger who writes about issues related to public health and gender equality, on her blog, Healthy Living, a part of Business Standard’s platform, Punditry.
She tweets as @shaivenkat
