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Globally, the largest share of adolescents and young people is and will continue to be in Asia (UNFPA 1998). India has an adolescent population of 200 million and overall youth (10-24 years) of around 300million and this age group is rapidly expanding in India and many countries. At 1.05 billion globally, today it is the largest ever generation of young people between 15 and 24 years. Worldwide statistics reveal that 11 percent of young women (about 29 million) aged 15-19 are sexually active, and are not using any form of contraceptive (the Alan Guttmacher Institute, 1998). It has been estimated that there has been an increase of 20-60 percent in unplanned pregnancies in young women under 20 years in developing countries (WHO , 1997).

Even if these pregnancies were planned, the risk of maternal mortality among adolescents is two to four times greater than for pregnant women aged over 20 years. Global trends also indicate that the age of menarche and that of onset of sexual activity is declining, while the age of marriage is rising. Although this is true for some countries of the Asia-Pacific region, the fertility rates of young women aged 15-19 years are still high for countries like India, where early marriage is prevalent.

Other major consequences associated with unwanted pregnancies and unprotected sexual activities among young women are unsafe abortions and the increase in HIV/AIDS and STD cases. More than 2 million adolescent girls in developing countries resort to unsafe abortions, a leading cause of death for young women. As regards HIV/AIDS, in many developing countries, over 60 percent of new HIV infections are found among those in the 15-24 age group. Yet, there are no special prevention programmes that cover these groups with their special needs. The outreach of the government health and family welfare programmes starts after an individual is married and practically ends by the time the offspring is five years old. Despite adolescence and youth being crucial phases of life, very little data is available to explain their special biological, psychological and emotional needs.

Lack of information about their needs means that service providers are ill equipped to deal with these groups. There is some information about the married adolescents/young people in India, but very little is known about the unmarried ones. Researchers in the country have only recently begun investigating adolescent/youth sexuality in depth.

Community failure to acknowledge and address the youth related issues further complicates the situation in certain countries. Various barriers may hinder the provision of health and information services to youth as well as their utilisation of available facilities. The socio-cultural milieu influences this situation significantly. Also, there is very little ground experience for such activities and programmes. Since the ICPD and the Beijing Conference on Women, there have been initiatives from the government to bring to the fore young people's reproductive health and to some extent sexual health as an issue, but a clear policy has not yet been formulated.

Equally important are issues related to education, employment and the gender biases in these areas. It is a major challenge to overcome social biases and prejudices against girls and women, and to meet young peoples' growing needs for education, information and care related to RSH, and to provide them with optimum social and economic opportunities. Therefore Reproductive and Sexual health needs of young people should be viewed from a holistic developmental and integrated programme approach, rather than from a narrow bio-medical approach, in order to address the multifarious needs of young people.



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