‘there is no sinGle Blue-print for pArentinG AdolesCents’
Susan Sawyer, president, International Association for Adolescent Health, says that lack of sexual, mental health education is affecting adolescents.
The world is home to 1.2 billion adolescents, and at 253 million, India has the largest population of adolescents in the world, with every fifth adolescent in the world being an Indian and every second adolescent being an Asian. For the first time, India hosted the largest event on adolescent health this week. On the sidelines of the 11th International Congress on Adolescent Health, Professor Susan Sawyer, President, International Association for Adolescent Health (IAAH), told The Sunday Guardian about changes in the Indian adolescent health policy and consequences of the lack of academic sex and mental health education. Excerpts: Q. How has the adolescent world changed and how has that led to modern challenges? A. The ways of upbringing an adolescent have changed drastically. They had no access to social media and even television used to be accessible to a limited number of people. The social circle was small and kids used to do what they were told to do. Their years of exploration were limited before they would settle down to get married and have children. However, globalisation, urbanisation, the advent of internet, bigger career aspirations and more years in education have all given way to different kinds of jobs for young men and women, while changing our ways of social communication and outreach. The adolescent world has changed drastically. Q. What are the key challenges that adolescents in India and the world are facing? A. In a country like India, where 30 years ago most young people used to get married while they were still adolescents, the changing dynamics of the present world have most rightly given way to a huge concern about sexual and reproductive health of adolescents. Present day adolescents are more active sexually and want to experiment too with their sexuality, but most of them do not have the right guidance. In the Western world, sexual awareness is high, so adolescents are well-informed. However, among the major challenges in the West are adolescent mental and emotional well-being, bullying in schools and on the internet, prevention of poverty and clinical facilities for adolescents. In India, statistics also show that the highest number of adolescents die due to road accidents. Q. How is the lack of sexual and mental health education affecting the present day adult? A. Every country in the world faces taboos about sexual, reproductive and mental health discussions. I do not think there is any society in the adult world that is straight forward about discussions on sex. Parents obviously find it an uncomfortable subject, but that is why we need to have trained teachers who can address questions academically. Today’s adolescent has social media. They can access pornography at a click, which is why we have all the more reason to hold discourse about healthy sexual relationships and healthy friendships. Teenage pregnancies, self-harm and suicide among adolescents have been on the rise globally. Q. In a society like India’s, where people take a lot of pride in strong family systems, cases of self-harm among adolescents have been seen time and again. How do you explain this? A. In the present day world, after a certain age, there is a disconnect that starts between the child and parent. Around the age of 12 years, this disconnect starts to build up, while relationships with peers get stronger. However, this should not necessarily be seen as a failure of parenting. The conflict between a parent and child starts due to biological and evolutionary need of humans that pushes adolescents to move out of their immediate family. Q. How should parents take care of their adolescent children? A. Parenting adolescents is not straightforward. The challenge of parenting adolescents is that parents need to empower their children, but also protect them. It is a constant juggling between power and protection. There is no single blue-print for parenting adolescents. Parents must ensure that children follow the law, that they do not violate traffic rules, take responsibility for their choices and encourage their adolescents towards academic discourse of otherwise taboo issues. Q. How is policy making in India faring with regard to adolescent health? A. The government of India has been realising the importance of adolescent health and has invested in it too. We hope to energise the discourse in India and encourage policies that are made along with the participation of the youth. Lack of data on adolescent health is a major hurdle hampering efficient policy-making to improve the deteriorating health of adolescents in the contemporary world. Adolescent health experts have highlighted the need for accurate data if the challenges of tomorrow’s adults are to be addressed.
Speaking at the 11th World Congress on Adolescent Health, Sunil Mehra, MAMTA Health Institute for Mother and Child, said, “We have all the intention in the world to address the problems that today’s adolescents face, as they will become adults and run the world. But in order to make policies that benefit the adolescents, we need the required data.”
Out of the 1.2 billion world adolescent population, over 21% live in India. According to the 2011 census, between 19602011, India’s adolescent population has increased from 85 million to 253 million. According to statistics of the Ministry of Health and Family Welfare (MoHFW), the Indian adolescent population is expected to reach 297 million by 2050.
According to data available with the National Family Health Survey 2015-16, between the age of 13-17 years, the prevalence of mental disorders is around 8%, while tobacco use among minors is 7.3%, among the age group of 15-17. While 22% of adolescent girls between the age of 15-19 years experienced physical or sexual violence, around 22,000 deaths among adolescents is caused by road accidents in India. Current use of contraception among married adolescent (15-19 years) women is only 13%. In terms of nutrition, 56% girls and 30% boys are anaemic in India, while among the adolescent population in the age group 8-18 years, 5.3% is obese.
Listing the reasons for concern about adolescent health, Manoj Jhalani of the MoHFW, giving a presentation at the Health Congress, said, “Nearly 35% of the global burden of disease has roots in adolescence. Globally, an estimated 3,000 adolescents die every day due to preventable diseases. The burden of shifting pattern of diseases among adolescents indicates non-communicable diseases as a leading contributor to DALYs (Disability-Adjusted Life Years), which has seen an approximate 50% rise from 1990.” DALYs is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death.
According to MoHFW, the leading issues among Indian adolescents are tobacco and alcohol consumption, junk food, and physical inactivity. Injuries, including self-harm and transport injuries, are the newer challenges. On account of mental and substance abuse, DALYs are on the rise and contributes to 11% of total DALYs. Nutritional deficiencies are a leading cause of morbidity burden among young adolescents.
Jhalani added, “Convergence between the education department, women and child development ministry, youth affairs etc. is easier said than done. However, without mutual co-operation of all these stakeholders, we will not be able to achieve our desirable goals.”
Emphasising on the role of states, Sunil Mehra said, “States need to become proactive. The Centre cannot do the ground work alone. India needs to address the issue of adolescent health proactively in order to ensure a healthy future of the nation.”