In India even today hundreds of women, especially young girls are reluctant to talk about their reproductive health issues and do not like to visit the doctors or health care providers with their concerns. It is often only when the situation becomes dire or even life threatening and they are left with no other options, they approach health practitioners for their various issues.
Despite the fact that adolescents represent nearly 1/4 of the Indian population their reproductive needs are poorly understood and ill served. One serious limitation is the lack of attention in almost every dimension of the reproductive health including sexuality, reproductive morbidity, abortion seeking and reproductive choices.
Adolescent girls are likely to face a range of health and social challenges. For instance initiation of sexual activity while they lack adequate knowledge places. Adolescents at a higher risk of unwanted pregnancy unsafe abortions and sexually transmitted diseases including HIV aids. Prevalence of early marriage and childbearing in Indian communities is associated with higher maternal mortality and morbidity as well as increased rate of neonatal and infant mortality. Moreover adolescents themselves are too immature and lack adequate childbearing skills to effectively care for any child that may be born to them. It is sad to see that child marriages are still prevalent in many parts of Southern Asia. Young mothers often do not get the chance to pursue and complete their education leading to inadequate knowledge regarding their own health and their child's health. The cycle continues when they get their young daughters married off at an early age as they do not know any better.
Being a young mother not only places a strength on the physical well being but also causes a great deal of emotional and mental distress. Even today in India many girls have to fight their families and patriarchal notions of simply having the right to be educated. We as a society need to stress upon the importance of our young women being educated and making sure they can stand up on their own feet during difficult times. We have often seen a woman trapped in a bad or abusive relationship or marriage simply because she has never been educated enough to fight her own battles and she has no other options but to bear the trauma until the day she dies.
Most adolescents in India need need sexual and reproductive health services such as appropriate information contraception and option and treatment of STDs. Yet these are either not available or provided in such a way that makes an adolescent feel embarrassed and reluctant. Health services need to be sensitive to the needs and requirements of such adolescents.
Various studies have shown that school based reproductive health education is linked with better health and reproductive health outcomes. This requires training of teachers and education providers themselves to sensitize students in an appropriate manner about the various sexual and reproductive health issues in young children, particularly young girls. Incorrect information has the potential to create misunderstandings in the youth making them less likely to adopt healthy practices and attitudes towards their reproductive health.
Public discussions of topics of a sexual nature are largely considered as taboo in the Indian community.It acts as a barrier to delivery of adequate and effective sexual education to Indian adolescence. Sex education at school's level has attracted strong objection and apprehension from all areas of the society including from parents teachers and politicians; it has even been banned in a few states .
Legislators contend that it corrupts Indian youth and offense Indian values, leading to promiscuity, experimentation and irresponsible sexual behavior. Others argue that sex education has no place in a country like India with its rich cultural values and traditions. They argue that we may be providing the youth with something which they have no knowledge of. But it's time for us to understand and accept that things have changed within the last 20 years.
Nowadays we have a lot of youth open to closer relationships with the opposite sexes . In the largest cities, young people have been quite openly found to be dating. It's not like how things were 20 or 30 years back,when children were unaware of such things. It is the age of computers and the Internet. We should endeavor to provide our youth with correct and accurate information and choices. As children and young adults are naturally curious they may resort to seeking information from their friends or from the internet which is often found to be misinterpreted and incorrect. It is time to change our views and realize the importance of impacting such correct information and knowledge to our young ones.
Prevalence of sexual abuse and physical abuse is increasing along with substance abuse. A study on child abuse in India showed that 47% of girls had faced some sort of sexual abuse most of which went unreported and untold.
So,what is reproductive health and adolescence?
Reproductive health is defined by the World Health Organization (WHO) as the total well-being in all aspects of reproduction i.e., in behavioral, emotional, physical, and social. For a healthy society or population, it is necessary to maintain reproductive health. Adolescence is the stage of growth and sexual maturity. Thus, it is essential to practice good hygiene habits at this stage itself. For being healthy, one has to keep hygiene at a personal level (personal hygiene) as well as at the community level (social hygiene).
Below are the different ways to maintain reproductive health during adolescence:
Balanced diet: The balanced diet is important for all age groups. Adolescents must have a well-balanced diet as growth depends on the dietary intake. A well-balanced diet comprises all types of nutrients like proteins, fats, carbohydrates, vitamins, and minerals in an adequate amount. Fruits, rice, roti, green vegetables, meat, milk, eggs, etc. are certain foods with high nutritional values. However, nowadays fast food, junk foods, and other bakery products have gained enormous popularity among adolescents. The daily consumption of fast food has invited many diseases including obesity, vitamin deficiency diseases, and also affecting reproductive health both physically and emotionally.
Personal Hygiene: Personal level hygiene includes cleanliness, physical exercise, proper rest, and sleep, etc. Since adolescence is the onset of puberty, many pubertal changes take place in us. Sweat glands are more active during this stage, this causes more sweating, in addition to this, the hair growth in public regions and armpit make it even worse. Hence, maintaining cleanliness by proper hand washing. regular bathing, washing, and ironing of clothes has to be followed. Girls need to keep themselves clean especially during menstruation. Regular walk, outdoor games, and workouts help adolescents remain physically fit and healthy.
Adolescent Pregnancy: As per the Marriage Act, the permitted age of marriage for the girl is 18 years and for the boy is 21. Early marriage before 18 years is not allowed as the girl is too small and not well matured and is not prepared mentally or physically for motherhood, which results in mental agony and other health problems both in the mother and the child.
No to Drugs: As we know, during puberty the hormonal fluctuations level will be high, which has a great impact on our intellectual and emotional maturity, sometimes leading to poor decision making. During this period, adolescents become more vulnerable to bad habits like drinking, smoking, taking drugs, etc. Once they get addicted to these habits, it becomes very difficult for them to recover easily. These drugs also affect reproductive health, causes delayed puberty and both physical and social consequences.
Good sexual and reproductive health is important for women’s general health and wellbeing. It is central to their ability to make choices and decisions about their lives, including when, or whether, to consider having children.
Sexual and reproductive health is not only about physical wellbeing – it includes the right to healthy and respectful relationships, health services that are inclusive, safe and appropriate, access to accurate information, effective and affordable methods of contraception and access to timely support and services in relation to unplanned pregnancy.
Different life stages are associated with specific women’s sexual and reproductive health issues, including menstruation, fertility, cervical screening, contraception, pregnancy, sexually transmissible infections, chronic health problems (such as endometriosis and polycystic ovary syndrome) and menopause.
Safe sex practices are important for the sexual and reproductive health of sexually active women of all ages. Access to accurate, impartial and up-to-date sexual and reproductive health information, and services such as human papilloma virus vaccination, cervical screening tests and screening for sexually transmissible infections, is also essential.
Having access to sexual and reproductive health services, quality information about maintaining a healthy lifestyle, and physical and mental health services can all help women achieve optimal health and wellbeing.