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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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