Historically most policies did not recognise adolescents as diverse heterogeneous group, a perspective that neglected the particular needs of different groups of young people, especially adolescent girls. In the 2005 National Adolescent Reproductive and Sexual Health Strategy was formulated. Although policies defined the need to raise awareness about sexual and reproductive health issues, they did not recognize the need for imparting life skills for empowerment. Married girls were especially underserved and were unable to benefit from either educational or economic development programs*. Growing evidence shows that girls’ education and professional development are closely correlated with improvements in their lives, including smaller family size, more decision-making responsibility, and higher income.
Adolescent Programmes : Divided responsibilities**
The components of adolescent health are being looked after by separate ministries and departments by the Indian Government:
- The Ministry of Health and Family Welfare (MoHFW) focuses on delivering adolescent health services.
- The Adolescent Education Pro- gramme (AEP) and sex education come under the Department of Education in the Ministry of Human Resource Development (MoHRD), while its earlier version SAEP was administered by National AIDS Control Organization.
- The program on nutrition and counselling of adolescent girls—Kishori Shakti Yojana—is being looked after by the Ministry of Women and Child Development (MoWCD) under its Integrated Child Development Scheme (ICDS).
- The National Youth Policy 2003, of the Ministry of Youth Affairs and Sports (MoYaS) recognises adolescents (15 – 19 years) as distinct from the youth (20 – 35 years age), but its focus on ARSH is limited to advocacy on ARSH and life skills (MoYaS, 2008).
Thus each ministry is looking after one component of adolescent health and therefore a comprehensive ARSH policy is yet to emerge. This multi-sectoral approach limits in-depth outreaches in achieving holistic development of this group that is now universally addressed as young people between 10-24 years of age.
*Panda : Adolescent Girls in India, 2007
** Gupta, Ramani : Advances in Applied Sociology, 2012
National Youth Policy (2014)
National Youth Policy was officially declared by the Government of India on 14th January 2014
- The National Youth Policy 2012 is a step forward in the right direction as it reaffirms commitment of the Nation to the rights and comprehensive development of the young people of the country.
- The policy recognises diversity among young people. It also recognises that within the age group of 16-30 years the need of young people between the age of 16-21 years, 21-25 years and 26-30 years are different.
- The policy facilitates access to all sections of the youth for basic nutrition and health services especially related to reproductive and sexual health services; promote a healthy lifestyle, free of substance abuse and other unhealthy addictions, and dissuades them from engaging in harmful sexual practices.
- The policy also focuses on the groups that suffer from social or moral stigma transgender, gays and lesbians, those infected and affected by HIV/AIDS and Tuberculosis.
- The policy actively encourages youth engagement in monitoring and evaluation process of development work undertaken by government or non government structures including Panchayati Raj Institutes.
- The policy will provide direction and the much needed impetus to design comprehensive health programme and need for ensuring convergence among different programmes being offered by different departments and ministries
The National Adolescent Health Strategy (2014)
Adolescent Health Strategy
Launched on 7th January 2014 as the Rashtriya Kishor Swasthya Karyakram (RKSK) by the Health minister Mr Gulam Nabi Azad at New Delhi, this health programme for adolescents between 10-19 years of age aims to enhance their lives by encouraging participation and leadership.
To aid this programme, the Adolescent Health Strategy was developed by the department of Women and Child Welfare and UNFPA as a more holistic model. Prioritising concerns of young people in the development agenda, this strategy aims to improve knowledge, attitudes and behaviour regarding sexual and reproductive health among adolescents. Critical social and health concerns like age at marriage, menstrual hygiene practices, birth preparedness, appropriate spacing, teenage pregnancy and mortality and morbidity associated with it will also be addressed by working with both adolescent boys and girls, and their caregivers. This policy is inclusive of all adolescents in urban, rural and remote areas, irrespective of sex, marital status, economic condition and also those in school or out of school. Its main focus areas are mental health , nutrition, substance misuse, gender based violence and non-communicable diseases. This is expected to positively impact workforce, parents, and leaders of tomorrow, and break the inter-generational cycle of poor health and future prospects. It introduces community-based interventions through peer educators implemented through inter-sectoral convergence between other ministries and state governments.
National Policy for Children (2013)
On April 18th, 2013 the Union Cabinet approved the National Policy for Children to promote programmes and schemes for children all over the country.This policy recognizes every child below the age of 18 as a child where survival, nutrition, health, development, education, protection and participation are undeniable rights of every child. The National Commission for Protection of Child Rights and State Commissions for Protection of Child Rights are made responsible to ensure that the principles of the policy are respected in all sectors at all levels. The Government has also created a provision of reviewing the Policy after every five years. The Ministry of Women and Child Development will be the nodal ministry for overseeing and coordinating the implementation of the policy and will lead the review process.
A Strategic Approach to (RMNCH+A) in India
In January 2013, Government of India decided to focus in an integrated approach to achieve the Millennium Development Goals- 4 and 5. As a result the Ministry of Health and Family Welfare, Government of India has brought out an approach document “A Strategic Approach to Reproductive, Maternal Newborn, Child and Adolescent Health in India “ which clearly recognizes the need to address reproductive and sexual health needs of adolescent girls.
The Reproductive, Maternal, Child and Adolescent Health programme is at the heart of Government of India’s flagship programme National Rural Health Mission (NRHM). Central tenets guiding this programme have been equity, universal care, entitlement and accountability. It aims to protect the lives and safeguard the health of women, adolescents and children and this has been the driving force for reaching out to the maximum numbers, in the remotest corners of the country through constant innovation and calibration of interventions. The strategies have yielded rich and quick dividends, evident in improved IMR and MMR.
The Ministry of Health & Family Welfare has brought out an integrated approach document for reproductive, maternal, new born, child and adolescent health (RMNCH+A) in India. RMNCH+A approach essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilising health care and services. The RMNCH+A strategic approach document has been developed to provide an understanding of ‘continuum of care’ to ensure equal focus on various life stages.
National Adolescent Reproductive & Sexual Health Strategy (2006)
Health is one of the key technical programmes under the National Rural Health Mission (RCH-II) of the existing public health system. This is a two-pronged strategy where firstly, it falls in the coverage and scope of the RCH-II programme. The Department of Health and Family Welfare (DOH&FW)will incorporate adolescent issues in all RCH training programmes and all RCH materials for communication and behaviour change. This will include interventions for addressing unmet need for contraception and pregnancy care, prevention of STIs including HIV/AIDS. Secondly, this strategy will be implemented in select districts and will require the DOH&FW to reorganize services at PHCs and dedicate special days and timings for service delivery to adolescents. The district RCH society will be responsible for implementation and regular monitoring of the programme while the district RCH officer will be the focal point. Medical and healthcare needs will be met through the existing network of CHCs, PHCs and sub-centers. Also, the revised MIS suggested in RCH II will analyze data on adolescents as a separate client group, especially with focus on teenage pregnancy rates, institutional delivery and prevalence of STIs.
The National Adolescent Health Strategy 2014 is launched.
Domestic Violence Act, 2005
To prevent violence against women and to protect the rights of aggrieved women, the Indian parliament passed ‘The Protection of Women from Domestic Violence Act’. According to this act every woman who have been deprived of their right to life by the act of husband or relatives of the husband, can file a complaint to the protection officer, police officer or magistrate in the form of ‘Domestic Incident Report’ (Similar to FIR). Complaint can be filed by the victim /aggrieved person or relatives, it will be considered as the prima-facie evidence of the offence. Every ‘Domestic Incident Report’ has to be prepared by the Protection Officer which will assist in the further investigation of the incidence. The protection officer will pass certain orders i.e. protection of the women, custody of respondent and order of monetary relief to the victim.
In 1993, The United Nations General Assembly adopted a declaration which for the first time offers an official UN definition of gender-based abuse.
“An act of gender-based violence that results in, or is likely to result in physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life.”
The Government of India has signed and ratified numerous international human rights instruments and has also adopted numerous progressive laws and policies at the Union and State levels. These include:
- The Indian Penal Code which broadly includes crimes against women. This law includes the crimes of rape, kidnapping and abduction for specified purposes, homicide for dowry, torture, molestation, eve teasing, and the importation of girls, among others.
- The Criminal Law Amendment Act 2013
- The Sexual Harassment of Women at Workplace (Prohibition, Prevention and Redressal) Act 2013
- The Indecent Representation of Women (Prohibition) Act 1986
- The Scheduled Castes and the Scheduled Tribes (Prevention of Atrocities) Act 1989
- The Dowry Prohibition Act 1961
- The Commission of Sati Prevention Act 1961
- The Immoral Traffic (Prevention) Act 1956
Furthermore, the following Bills are currently under discussion: the Indecent Representation of Women (Prohibition) Amendment Bill 2012, the Readjustment of Representation of Scheduled Castes and Scheduled Tribes in Parliamentary and Assembly Constituencies Bill 2013, the Removal of Homelessness Bill 2013, the Prevention of Female Infanticide Bill 2013, the Abolition of Child Labour Bill 2013, the Child Welfare Bill 2013, the Indecent or Surrogate Advertisements and Remix Songs (Prohibition) Bill 2013.
National Health Policy (2002)
The National Health Policy (2002), does not identify adolescents separately. Adolescents are grouped with children and pregnant women, which results in a misrepresentation of their concerns. The policy expresses concerns for the health care of special groups, under this it includes adolescent girls, however it is limited to nutritional needs. The age specific health needs of the adolescents and young people are not focussed upon. It touches upon the areas of awareness building among the school & college going children.
National Policy for Empowerment (2001)
The policy clearly recognizes the gender discrimination in different stages of women’s life with a specific mention of adolescents. It also focuses on the nutritional needs of women at all stages of her life. Gender based violence is recognised as a problem requiring legal action. The issue of violence has been given its due recognition but it emphasizes violence against women and girls as a critical issue hindering their well-being. Specific concern of adolescents and violence is not clearly articulated; however early marriage in the light of maternal mortality has been given its due recognition.
National Population Policy (2000)
The National Population Policy (2000) has given importance to adolescents in terms of early marriage, teenage pregnancy and use of contraceptives for spacing. It strongly recommends action for enforcing the Child Marriage Restraint Act in the light of reducing teenage pregnancies.
Since the policy aims to reduce the fertility level to the replacement level by 2010, there is a recurring mention of adolescents in the light of population stabilization. The policy further recommends a health package for adolescents which encompasses counselling, population education, contraceptive services etc. The policy recommends strengthening of Primary Health Center and sub centers to provide contraceptive counselling to newly married young couples. It ignores the reproductive and sexual health service need of the unmarried adolescents to a great extent.
National AIDS Prevention and Control Policy (2000)
In India, the number of people living with HIV/AIDS is approaching five million. Of this youths aged between 15-24 years are the fastest growing segment in the newly infected population, with one youth infected every 15 seconds. Young people between the ages of 10 and 25 years make up to 50% of all new infections, with a shift of this epidemic towards women and young people (PFI 2003).About 75 per cent of the infections spread through the sexual route (both heterosexual and homosexual), about 8 per cent through blood transfusion, another 8per cent through injecting drug use. About 89% of the reported cases occur in the sexually active and economically productive age group of 18-40 years. One in every 4 cases reported is a woman (National AIDS Policy – 2000) .
Expanding HIV/AIDS policy and programmes in the world of work is a key component under the mainstreaming strategy in the National AIDS Control Programme phase-III (2007-2012). The National AIDS Control Organization(NACO), realizes the threat of HIV to the Indian working population where nearly 90% of the reported HIV infections are from the most productive age group of 15-49 years. To address HIV/AIDS prevention in a sustained manner, it has established a dedicated mainstreaming cell which would be responsible for initiating and facilitating mainstreaming efforts with government, civil society organizations and businesses/industries
National Education Policy (1992)
The Education system plays a vital role in overall personality development of adolescent groups. The National Policy on Education does not target the specific educational needs of the adolescent population. Retaining children and adolescents in schools is not an area of concern, as only enrolment seems to be the focus in the policy, which reflects that it does not recognise education as a right and a tool to ensure equity in society. The National Education Policy reflects commitments to the eradication of illiteracy, particularly in the age group of 15-35 years. It has commitments of universalisation of the primary education, however it does not mention adolescents and young people as a separate category. It mentions need based vocational courses and non-formal education. The policy does not mention the explicit concerns of the 15-35 age group. It talks about population education as a means to motivate youth about family planning and responsible parenthood in the light of population stabilization.
Quality higher education is necessary to ensure development at par with the needs of the day. Although the ‘Common Minimum programme ’aims to equip adolescents with economic and social empowerment, certain core issues are neglected. While only 7% of the relevant age group (17-23 years) undergoes higher/professional education in India, the comparative figures in developed countries like England, France, America and Canada are 52%, 50%, 81% and 100% respectively. The position of many developing countries is better compared to India. It is 11% in Indonesia, 12% in Brazil, 14% in Mexico and 19% in Thailand. Various programmes under this policy include – Sarva Shiksha Abhiyan, National Programme for Education of Girls at Elementary Level, Rashtriya Madhyamik Shiksha Abhiyan , Inclusive Education for the Disabled at Secondary Stage and Saakshar Bharat for adult education.
The Indecent Representation of Women (Prohibition) ACT, 1986 (NO. 60 OF 1986)
This is an act to prohibit indecent representation of women through advertisements or in publications, writings, paintings, figures or in any other manner. It extends to the whole of India, except the State of Jammu and Kashmir.
National Nutrition Policy (1983)
The National Nutrition Policy recognises several aspects of gender discrimination. It identifies adolescent girls as a special vulnerable group. However the concern of vulnerability is articulated in terms of motherhood. It does not target adolescent boys and girls as individuals. In the strategies to implement the policy, importance is given to health and nutrition education to address the concerns of malnutrition and under nutrition.
The 12th Five Year Plan
The 12th plan emphasizes the need to address the health, nutrition and development needs of adolescents. It recognizes the diversity among adolescents and the challenges especially faced by adolescent girls, which include early marriage, poor access to reproductive and sexual health, under nutrition, gender inequality, violence etc. It further recommends addressing the issues of adolescents from a perspective of survival, protection, care, participation and development and informed inclusion in the society. It also recognizes and emphasizes addressing the gender dimension in any plan/programme for adolescents