Adolescents and youth represent almost one-third of the population of India. Adolescent pregnancy, excess risk of maternal and infant mortality, sexually transmitted infections and reproductive tract infections in adolescence, and rapidly rising incidence of HIV in this age group, are some of the public health challenges that characterise this group. Matters are made worse by the fact that discussion on these issues is taboo in society so that the youth fall prey to quacks. In this respect Samarthan has been implementing a programme that targets youth by providing them education on reproductive health through lifeskills. Initially the programme was spread over 120 Panchayats but it has been increased to 205 Panchayats in the three blocks of Sehore, Ichchawar and Budni. In the current year the programme covered over 15000 youth.
Under this project youth facilitators functioning as peer educators have been trained on issues relating to reproductive health and lifeskills. These facilitators return back to their villages where they form three groups – a group of adolescent boys, a group of adolescent girls and a group of newly married couples. Not only do they educate members of these groups about reproductive health but also engage in monitoring of service delivery by Anganwadis and ANMs/MPWs to ensure better services for pregnant mothers and infants. The VHSC has also been mobilized and has received funds for improving sanitation in the village. Further Panchayat representatives as well as health service providers have been oriented about the project and their role in this regard.
The project has led to:
• Cooperative attitude of ANM, ASHA and AWW with the community
• 24 VHSC opened bank accounts and reformed old committees
• PRI members taking active part in Community Monitoring
• Youth groups raising issues and concerns on community hygiene and sanitation in gram panchayat meetings
• Increase in usage of family planning products
• Engagement with block and district level officials through sharing workshops
• Engagement with the media as a better monitoring tool
Meetings were organised with the district administration to provide the youth facilitators and the youth group members a district level platform where they could bring up their issues with the district level administration. In this respect three big youth melas were organised along with three special events in the blocks. Further, two district level sharing workshop were organised in Sehore. The purpose of the workshops was to share with the district administration the challenges related to access of health services by the adolescent and the youth in rural areas. The forum was also used to share the experiences of the youth facilitators in working with the adolescent groups in the villages. A large part of the discussion revolved around the usage of the untied funds by the SHC and the village health and sanitation committee since they received funds in instalments of Rs 2000 each which limited the activities that the committee could plan. The CMHO took note of the issue of providing more autonomy to the village health and sanitation committee in planning for and utilising the untied funds.
There were several positive impacts in the villages. These were: be
- The engagement with the health service providers like ANM, MPW and Anganwari workers on the issue of adolescent health has helped the service providers pay attention towards the health needs of the adolescents which was till now not a priority
- The pregnant women and lactating mothers have started putting pressure on the ANMs and the Anganwari workers for their timely vaccinations, the IFA tablets and the nutritional supplements in several villages.
- Adolescent youth taking action on school and anganwadi on supply of MDM and its quality in schools and anganwadi.
- It was found that in some of the villages the IFA tablets were not distributed as the SHC did not receive it for a long time. The findings are regularly shared with the block and district administration and this helped in ensuring that the villages received the medicines timely and in sufficient quantity.