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World Population Day: Invest in ensuring women’s sexual, reproductive rights

We have failed the youth in helping them exercise their right to make informed choices on reproductive matters

analysis Updated: Jul 11, 2019 08:29 IST
Shireen Jejeebhoy
Shireen Jejeebhoy
Many newly married young people want to delay their first pregnancy, but are unable to act on their desires because of objection from family members(Shutterstock)

India’s population has reached 1.37 billion, according to the recently released United Nations World Population Prospects. Every fifth Indian, 248 million in all, is a young person aged 15-24. As we celebrate World Population Day today, we must recognise that it is these young people whose development trajectories will determine the extent to which India can reap its demographic dividend, meet its commitments to the Sustainable Development Goal (SDGs), achieve population stabilisation, and contribute to its national aspirations of becoming a $5 trillion economy by 2024.

A critical domain where we continue to fail our youth, however, is in helping them exercise their right to make free, informed and responsible choices, especially in sexual and reproductive matters. Evidence highlights that we in India continue to neglect and violate the sexual and reproductive rights of the youth. For example, not only do more than one in four girls marry in their childhood (below 18) but also, as a recent state-wide survey in Bihar and Uttar Pradesh (UDAYA) by the Population Council shows, 65% married girls meet their husbands for the very first time on the wedding day.

Studies have repeatedly shown that many young people enter sexual life before marriage, and irrespective of whether they enter this before or within marriage, many are uninformed about options for preventing pregnancies, HIV and sexually transmitted infections, and where to access the means for doing so. Despite this, very few adolescents receive education that would equip them with knowledge about gender relations, safety and consent in reproductive matters. The UDAYA study in Bihar and Uttar Pradesh shows that just 19% of unmarried girls and 8% of unmarried boys had ever received sex education.

Many newly married young people, both male and female, want to delay their first pregnancy, but are unable to act on their desires because of objection from family members, lack of knowledge or the means to do so. The recent National Family Health Survey shows that as many as 22% of married young women aged 15-24 have wanted to delay their next pregnancy or wanted no more children, but were not using a contraceptive.

Sexual violence against girls is an extreme manifestation of the violation of their sexual and reproductive rights and remains far too common, inflicted by their husband, boyfriend, family members, neighbours and strangers. Sexual violence within marriage is even more common.

What is the way forward? Engaging girls and, equally, boys, in gender transformative life skills education is critical. The health journal, The Lancet, has noted that this is a highly effective method through which to ensure the wellbeing of, and exercise of rights, by the young. At the same time, parents must be approached, their inhibitions about communicating with their children, and their fears about delaying their daughter’s marriage must be allayed. Moreover, the health system must be reoriented; providers must be re-trained and sensitised into offering non-judgmental services to the young. Efforts have no doubt been made through the Rashtriya Kishor Swasthya Karyakram that envisions providing avenues so that adolescents can make informed decisions about their health and overall wellbeing. But more needs to be done.

Documenting neglect and violation of sexual and reproductive rights of the youth is equally important, and it is unfortunate that the NITI Aayog’s recently established Health Index excludes youth-focused indicators. After all, what gets measured is likely to be acted upon.

Without a minimum of these strategies, India will fall short of meeting a host of commitments we have made to achieve, by 2030, including, to “Ensure universal access to sexual and reproductive healthcare services, including family planning, information and education” (SDG3, Target 3.7) and “Ensure universal access to sexual and reproductive health and reproductive rights” (SDG5, Target 5.6).

Of course, India has made impressive gains in many indicators affecting youth sexual and reproductive health, but far more investment is needed to ensure their sexual and reproductive rights.

Shireen Jejeebhoy is director, Aksha Centre for Equity and Wellbeing. She is a demographer and
social scientist whose work has focused on young people’s health and development
The views expressed are personal

First Published: Jul 11, 2019 08:27 IST