By Stella Paul
NEW DELHI (IDN) – For three years, 13-year-old migrant Manasa spent nine hours a day picking chilli on a neighbour’s farm in southern India’s Guntur district.
But when a team of local health activists conducting a door-to-door survey in her village in the summer of 2015 found that students had stopped attending school, the finding was shared with a senior official in the provincial government who ordered the village heads to crack down on those employing children on their farms.
Along with 20 others, Manasa was rescued and sent back to school where she is now in her fifth year and dreams of becoming a teacher some day.
Across India and the world, credible data and evidence gathered by the governments and NGOs have been helping improve the lives and health of thousands of adolescents like Manasa. ITALIAN | JAPANESE | TURKISH
This was emphasised by numerous experts at the 11th World Congress on Adolescent Health held here from October 27-29, who agreed that more data, better maps and evidence are crucial for better addressing the crimes and health challenges faced by adolescents across the world.
Speaking to IDN on the sidelines of the event, Dr. Sunil Mehra, Executive Director of the MAMTA Health Institute for Mother and Child (MAMTA-HIMC) – one of the organisers of the congress – said that the world has been slow in taking adolescent health seriously. But, barely 10 years after the first Congress was held, much progress had been made thanks to an “evidence-based approach”.
Evidence-based approach
Across the world there are 1.2 billion adolescents, and India alone is home to 21 percent or 253 million of them. With every fifth adolescent in the world an Indian, the country had a population too big to ignore and so in 2014, India became the world’s first country to launch a specific programme – Rashtriya Kishore Swasthya Karyakram (RKSK) – for improving adolescent health and nutrition, and protect them from violence.
So far, 7,000 health clinics have been opened under the programme to serve adolescents and about 30,000 adolescents have been trained to counsel and educate others in their communities.
According to Mehra, data has been crucial in implementation of RKSK, which runs across 230 (of 707) districts. “We now have more evidence to say that if our adolescents do not get married before 18, it will bring significant effects on the economic output of the country, on addressing poverty, addressing under nutrition, anaemia and repeated pregnancies. This is possible because we have collected enough evidence, including from lower and middle income countries,” Mehra says.
But producing data and evidence needs money. Mehra shares an example: it took him about 25-30 rupees (about.5 dollars) to produce data for a study he recently conducted on the status and progress of Indian adolescents. “Multiply this 253 million times and that is the number we are looking at,” he said before pointing out that few in the non-profit sectors could afford to spend, so there has to be a greater government, NGO and private sector partnership on data.
Cross-sectoral collaboration
At the same time, because the issues of adolescents are multiple – including education, economic, health and security, to name a few – a cross- sector approach is needed in conducting research and gathering data.
The best way to go, suggested Mehra, is with holistic ‘adolescent budgeting’, so that every department within the government has enough money allocated for data and evidence on adolescents. The skills of the workforce employed in the job also need to be strictly monitored and improved, he added.
Citing figures from a study he presented at the congress, Mehra said that the road accidents kill 22,000 adolescents each year. To prevent this, there needs to be a seamless collaboration among different agencies regulating traffic laws, policies and safety and risk mitigation programmes.
However, health ministry officials say that the current budget for adolescents – 3,500 million Indian rupees – is quite adequate. “The money that we spend now is enough to implement RKSK and achieve the [Sustainable Development Goals] (SDGs) as well, said Sushma Dureja, Deputy Commissioner at the ministry. She also asserts that the current workforce is both adequately skilled and sensitised on adolescent issues.
India is currently running Digital India – an ambitious campaign that aims to connect the country’s entire population to Internet. According to Dureja, programmes like RKSK will benefit from such campaigns by using more digital tools to contact more adolescents, delivering relevant information and educating them in relevant issues.
Currently, the programme is using a mobile application called ‘Sathiya’, social media and a digital database. “The digital India campaign will give our work a boost as we can get data from newer places,” she noted.
However, Dureja admitted that the size of the adolescent population in India is a huge challenge. The size adds complexities to the problems, she pointed out, and that is one reason why action is slower than expected,
“Take the cases of school drop-outs. Adolescent girls drop out, and by the time it’s noticed, they are already married away. So we have cases like this in millions, spread across urban and rural areas, in mainstream and marginalised communities … all of this makes it complicated, she said.
Action now
Mehra has a solution: do not wait for all the data to be on the table, but start taking action even as the data starts to trickle in. “That’s the approach we took in the MDG era and we lost a few initial years to take action. This time, we need to have data and action run parallel,” he told IDN.
Mehra’s suggestion received a huge cheer from Gogontlejang Phaladi (Gigi) – an adolescent participant activist from Botswana. “We need four things right now: action, action, action and action”, said the young activist to huge roars of applause from the audience.
“We need political will and intent, policies, we need data, innovations but above all, we need urgent action on adolescents.” [IDN-InDepthNews – 30 October 2017]
Photo (top): A panel of experts discussing mental health challenges faced by adolescents at the 11th World Congress on Adolescent Health in New Delhi. Credit: Stella Paul – IDN | INPS
Photo (centre): Manasa, an adolescent rescued from child labor in India’s Guntur. Her rescue was made possible by a survey conducted by the district administration on school dropouts. Credit: Stella Paul – IDN | INPS