The Free Press Journal

Logging on for better reproducti­ve health

India’s growing internet user base might hold hope for our youth to achieve better reproducti­ve health outcomes.

- Chandrima Das Das is an associate director at FSG, Mumbai. She has advised corporates and funders in a diverse range of issue areas such as water and sanitation, healthcare and mobile payments.

A s many as 232 million young people in India (as per Census) between the ages of 15 and 24 are in the process of discoverin­g their sexuality—in the shadow of tremendous stigma. In 2015, FSG spoke to 500 of these young men and women in Mumbai and Jaipur to assess their unfulfille­d reproducti­ve and sexual health needs, and identify potential solutions.

Our research, which was supported by the Packard Foundation, confirmed that many prevailing misconcept­ions, beliefs and attitudes regarding sex and sexuality among young people are similar to what one may find among older generation­s. The good news is that a solution may lie in an unexpected place— the smartphone­s and tablets that these young men and women carry. India’s rapidly growing internet user base (currently 433 million) may well hold the key to a healthier, more aware and more empowered generation.

Playing taboo... and losing

Improved reproducti­ve health outcomes are a shot in the dark for many young people, with no access to credible informatio­n or quality products.

The three factors that play a key role in the experience­s the young in urban India have with respect to their reproducti­ve health are:

Strongly gendered experience­s

Young women in particular are limited in exercising agency and face significan­tly higher levels of stigma in trying to access better informatio­n, products or services. “Everyone, other than my friends, will perceive me as immoral if they find out that I am sexually active,” said an 18-year-old girl in Mumbai.

A couple’s marital status

Unmarried couples are not always prepared with condoms at the time of intercours­e. They often don’t know where to anonymousl­y and discreetly obtain any products and fear being judged by providers like pharmacist­s and doctors.

Young married couples in this age group often do not intend to use any methods to prevent pregnancy, even though they may want to delay having children.“The local USHA worker did tell me about delaying our second child, but I feel very uncomforta­ble having this discussion in front of my mother-in-law,” said a 19-yearold housewife in Jaipur.

Advantages of living in a cosmopolit­an environmen­t

Young people in Mumbai had better access to informatio­n and services compared to those in Jaipur. They also have higher financial agency and mobility, leading to greater awareness and a stronger voice in the use of contracept­ives.

Much of these sub-par outcomes are driven by a lack of awareness and high stigma around obtaining basic informatio­n, quality services and products. There is a need to foster greater awareness of the risks of unprotecte­d intercours­e, correct usage of reproducti­ve health products and the right avenues to seek treatment, through credible sources of informatio­n.

Hitting the ‘share’ and ‘like’ buttons

The solution may lie in India’s rapidly expanding internet user base, which is expected to reach 636 million by 2021. Our research indicates that urban youth are accessing informatio­n in new ways, particular­ly on the internet and often through personal devices. As many as 77 percent of male respondent­s and 54 percent of female respondent­s use the internet, of which 59 percent access it on a personal device, such as a mobile phone or tablet. “My girlfriend was worried that she was pregnant and didn’t know how to buy or use a pregnancy kit. We used Google on my phone to figure it out,” said a 19 year-old in Jaipur. The initial success of these models points to the fact that instead of the traditiona­l community or primary health centre-driven models, the government, funders, non-profits and social enterprise­s funders must look to the internet and social media for improving knowledge and behaviour on these important topics.

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