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Adolescents and Young People

Integrated Management and Promotion of Adolescent Concerns in Totality (IMPACT)

An Overview
SANKALP has been promoting population and reproductive health, particularly among adolescents and young people. SANKALP’S programmes on Integrated Management and Promotion of Adolescent Concerns in Totality (IMPACT) seek to address the critical information needs of adolescents on sexuality and reproduction to enable them to make healthier choices, resist negative pressures and avoid risk behaviour. The programmes also strive to impart life and livelihood skills to the adolescents, particularly adolescent girls to realise their full potential.

Project Goal
The goal of the project is to address the critical information needs of the in-school adolescent population of India on reproduction, sexuality and HIV/AIDS in conformity with the relevant international agreements and conventions as well as to initiate a broad-based consultation on adolescent reproductive and sexual health concerns at national and regional levels to enable the adolescents to attend the highest standards on their own health and for the future.

Objectives

  • to provide comprehensive education and information to the in-school adolescents about reproductive health and sexuality to enable them to make healthier choices, resist negative pressures and avoid risk behaviour
  • to create a safe and supportive environment for the in-school adolescents so that they may enjoy their rights to information, education and services that will allow them to reach their full potentials
  • to organise a Consultation at National/Regional level to strengthen the existing strategies and to evolve new approaches to promote adolescent reproductive and sexual health and rights

Background and Justification
Although, the Programme of Action of the International Conference on Population and Development (ICPD), 1994 and its Operational Review and Appraisal in ICPD+5, 1999 have recommended a set of independent goals on adolescent reproductive and sexual health and rights as part of international population and development agenda; in most countries, including in India, the adolescents as a distinct population with particular needs and capacities, continue to be neglected in health and family welfare programmes.

Adolescents are poorly informed about sexuality and reproduction. Most often parents, public opinion leaders and policy makers believe that withholding information about sexuality and reproduction from adolescent will dissuade them from becoming sexually active. Adolescents without adequate and accurate information find increasingly difficult to deal with the physical, emotional and social changes affecting them. They are pushed to risks of unwanted pregnancy, unsafe abortion, sexually transmitted diseases, HIV/AIDS and sexual abuse. Ignoring the needs of adolescents, therefore, incurs a high cost in lost development opportunities, social disruption, and ill health. And, it means failing to fully support our next generation of parents and leaders.

Education and awareness about reproductive health and sexuality is critical to adolescents’ development. Relevant information that helps adolescents understand sexual changes as positive and natural aspects of their development and promotes safer sexual practices, including delayed sexual initiation, abstinence, access to methods for pregnancy prevention and STD and HIV/AIDS prevention are absolutely essential for them both in and outside of formal education systems.

Studies show that good quality sexuality education for adolescents and young people does not increase their sexual activity and instead it promotes safe sexual practices. For instance, a review commissioned by UNAIDS and reported in October 1997, was based on the analysis of 68 research reports on sexual health education from diverse countries. The main conclusions were:

  • education about sexual health and/or HIV does not encourage increased sexual activity.
  • quality sexual health education either delayed the onset of sexual activity reduced the number of sexual partners or reduced unplanned pregnancy and STD rates.
  • responsible and safe behaviour can be learned.
  • sexual health education is best started before the onset of sexual activity.

Information and knowledge about reproductive and sexual health issues, combined with services, are key to empowerment and well-being of adolescents, particularly adolescent girls. Adolescent girls' access to information is particularly limited for many reasons, including customary attitudes, early marriages, and absence of basic literacy, lack of adequate support system in school, economic dependence and gender inequalities in families and in society at large. Because of such discrimination, adolescent girls often lack the knowledge and skills they need to advance their status in society. Gender-based violence and sexual reproductive health are closely linked. Adolescent girls, both in-school and out-of-school, therefore, may require special support to acquire the skills they need to protect themselves.

In India, more than one-fifth of the population (22.1%) belongs to adolescent group (age-group of 10-19) and around one-third (31.3%) belong to young people category (age-group of 10-24). 17.8% of females, in India get married before 18 years of age and 69.5% get married before 20 years of age.

The age-specific fertility rate and age-specific marital fertility rates in India among adolescent population were quite high with 54.0 and 220.2 respectively. The corresponding figures for the age-group 20-24 were even higher with 220.3% and 300.2%.

While the available facts underline the importance of adolescent reproductive health and sexuality in India, the research findings also highlight the fact that the unique developmental, sexual and reproductive health needs of adolescents of the country are poorly understood and under-served.

Effective interventions that replicate and adapt the key United Nations and other international declarations and agreements on adolescent sexuality, reproductive health and HIV/AIDS; have to be implemented to empower the adolescent population in India. In-school adolescent girls and boys are one of the important segments of adolescent population and they could be provided with education and information, with effective involvement of trained teachers and peer educators.

The ongoing adolescent reproductive and sexual health programmes at the national-regional-international levels need to be critically assessed for evolving measures for their further augmentation through a broad-based consultation process involving health experts, government representative and adolescent advocates.

Strategies and Activities
The broad strategy of the project is to guide and empower the in-school adolescent population of the country to enable them to enjoy their rights to information and education on reproduction, sexuality and HIV/AIDS prevention as well as to promote consultation on critical aspects of adolescent reproductive health and rights.

Three integrated, interactive, participatory and gender-sensitive activities, namely
I. Teachers’ Training on Adolescent Reproductive and Sexual Health and HIV/AIDS,
II. Reproductive and Sexual Health and HIV/AIDS Education for Adolescent Students and
III. Consultation on Promoting Adolescent Reproductive and Sexual Health and Rights are implemented under the project.

The activities in details are stated below:
i. Teachers’ Training on Adolescent Reproductive and Sexual Health and HIV/AIDS:
The training, based on the adaptation of materials and modules developed by UNFPA, WHO, UNAIDS and other international/national agencies; imparts skills to the teachers to effectively respond to adolescent’s changing needs and sexuality, HIV/AIDS prevention methods and women’s human rights.

The training underscore the crucial roles of the teachers in shaping the perceptions, beliefs and behaviour of adolescents.

The trained teachers, with effective knowledge and capabilities, get equipped to guide and empower adolescent girls and boys with comprehensive and non-judgmental information on their special reproductive and sexual health needs and rights.

The trained teachers also identify and involve adolescent students as peer educators, counsellors and spokespersons for adolescent concerns, and build up a support network of adolescents in the school system.

ii. Reproductive and Sexual Health and HIV/AIDS Education for Adolescent Students:
Workshops for the adolescent girls and boys are organised in those schools which are covered under teachers’ training programmes.

The workshops comprise of orientation and sensitization programmes (thematic lectures by experts on adolescent reproductive and sexual health and rights, HIV/AIDS and women’s human rights as well as group discussions, forums, readings, dialogues and popular contests) and creative art performances (covering one or more forms of performing, visual and literary arts).

The thematic lectures are delivered by representatives from Union and State Governments, nodal governmental autonomous agencies, non-governmental organisations and prominent medical science institutes/research bodies. The creative art performances are choreographed, directed and staged by exponents of performing arts and persons of letters, with the involvement of the dramatic and literary societies/forums and fine arts, dance and drama teachers of the schools.

The workshops are of interactive and participatory in nature. The dialogues cover a range of taboo topics, including conception, contraception, abortion, STDs and HIV/AIDS. Participants are encouraged to share information, explore prevailing attitudes, discuss their values, and express their doubts, anxieties and questions about sexuality and reproduction. In each workshop two doctor-coordinators (one female and the other male), alongwith the peer counsellors (who are trained for the purpose by the doctor-coordinators facilitate the discussions. Questions are noted and answered immediately or on the following day by the doctor-coordinators, who if need arises could take the help of psychologists.

The workshops, particularly that of adolescent boys, stress on male involvement and responsibility for safe and healthy sexual behaviour, the need for the man to respect the reproductive choices of the woman, and the shared responsibility in case of pregnancy and childbirth. However, male adolescent needs and attitudes are also be underlined.

The workshops also discuss the linkage between gender-based violence and reproductive health, emphasise violence against girls and women as a major health and human rights issue and highlight the adverse consequences of such violence. The workshops underscore new positive role for females based on their contribution to the family and society.

The workshops adopt life skills education approach to enable the adolescents to effectively deal with increasingly complex social and peer pressures of their transition to adulthood. There are many such skills, but core life skills include the ability to:

  • make decisions, solve problems, and think critically and creatively
  • clarify and analyse values
  • communicate, including listen, build empathy, be assertive, and negotiate
  • cope with emotions and stress
  • feel empathy with others and be self-aware

The workshops are designed and conducted with full involvement and participation of the targeted adolescent population in the schools

Peer education is an essential element of adolescent students’ workshops and sensitizations. The trained teachers orient and train peers educators.

Effective interpersonal communication based on participation of peer educators and nodal teachers are integrated in adolescent education for internalisation of responsible and healthy behaviour pattern among the adolescents.

Outputs
The implementation of the project has a concrete impact on the quality of life of the in-school adolescent population in India and for the future generation. The integrated and participatory nature of the outlined activities help in the progression of the human resource index of the targeted adolescents and educate and empower them to take positive decisions on their health and development.

The expected outcomes of the project include:

  • enhance adolescent’s ability to take responsibility for making healthier choices, resisting negative pressures and avoiding risk behaviours;
  • develop a human right-based perspective to reproductive and sexual health of adolescent girls;
  • enable adolescents to make responsible and informed choices and decisions regarding their sexual and health needs;
  • contribute to prevention and elimination of all forms of abuse, including sexual abuse and incest;
  • promote positive portrayals of adolescents;
  • enhance gender equality, equity and empowerment of adolescent girls; and
  • strengthen the policy framework and response towards adolescent health and development.

Replicability & Sustainability
The project will definitely serve as a positive replica to the governmental and non-governmental agencies on promotion of adolescent sexuality, gender and reproductive health education. It has adopted innovative, interactive, gender-sensitive and participative set of programmes of actions based on the key international agreements and declarations on adolescents and youth.

The project objectives are universal in character and particularly suit the in-school adolescents. The programmes provide appropriate, specific and user-friendly education and information to address effectively the reproductive and sexual health needs of adolescents with their full involvement in the design and implementation of the proposed programmes. The project could be exactly emulated for any school-based adolescent reproductive and sexual health and rights education project in India or in any part of the world.

The outcome or impacts of the project will be sustained. The project will impart responsible and healthy reproductive and sexual behaviour and promote gender equality among the adolescents. The acquired skills will enable the adolescents to attain the highest standards in their own health and for the future.

The trained teachers will provide necessary support and skills to create a sustainable base of peer education among the adolescent students for further dissemination of education and information on adolescent sexuality and reproduction.

The peer educators and the nodal teachers will sustain the project activities after its completion. The Organisation will continuously remain in contact with the trained teachers and peer communicators to arrange follow-up programmes and initiate new activities.