Nineteen-year-old Gomti knew very little about menstruation, pregnancy and contraception until three years ago. Today, she and 54 others like her work as peer educators under Mamta Taruni programme, run by a voluntary organisation based in Ahmedabad, which is working with adolescent girls in 53 villages in tribal dominated Sabarkantha district of Gujarat.
Three years after the Centre for Health Education Training and Awareness (CHETNA) started the awareness programme in collaboration with the State government’s Mamta Taruni scheme, awareness about HIV/AIDS, condoms and reproductive and sexual infections has doubled among out-of-school adolescent girls between 10-19 years.
After the CHETNA training, the peer educators now know the importance of menstrual hygiene as well as the perils of early marriage. This had helped Gomti and other peer educators to persuade many of the out-of-school adolescent girls in her village to stand up against early marriage.
A study by CHETNA found the percentage of adolescent girls who were aware about the use of condoms increased from 46 per cent to 90 per cent and the numbers who were aware of HIV/AIDS more than doubled from 48 per cent to 98 per cent over the last three years.
With 40 per cent adolescents in Gujarat married before the age of 20 years, poor access to reproductive and sexual health services, morbidity related to risky behaviour and poor nutrition increases their health risks. “Health challenges can be overcome if adolescents are able to access information and services,” said Pallavi Patel, Deputy Director, CHETNA.
Sharing the findings of the study, Ms. Patel said that information about reproductive tract infections increased from 50 to 90 per cent and knowledge of anaemia increased from 73 to almost 100 per cent among adolescent girls after a sustained awareness campaign.
The peer educators were supposed to be paid a meagre Rs. 25 per month under the programme but Gomti received the money only once in the past two years while others, not even once. “I continue to work even without money because I have myself realised the difference health and sanitation education has made in my life ever since I joined this programme,” she said.
CHETNA’s endline survey in 2012 showed that compared to pre-intervention phase, 81 per cent adolescent girls had accessed treatment for reproductive health infections from the primary health centre after receiving relevant information at the end of intervention. Further, the percentage of girls who reported receiving general health services from the PHC increased from 36 per cent in 2009 to 92 per cent in 2012.
“It is a tough job to talk about condoms and even tougher to convince men to use it,” said Nandi, another peer educator. The peer educators only talk to adolescent girls but often girls complain that their partners (pre-marital sex is accepted in most tribal communities) or husbands do not pay heed, in which cases girls themselves have to opt for contraceptives.
Similarly, awareness about the importance of improving nutrition and health prompted 99 per cent of the girls to access iron folic acid tablets and supplementary food given on Mamta Taruni Divas compared to the initial 21 per cent and 97 per cent of girls had their height and weight measured.
“The 240 million young people in our country are a demographic dividend only if they are healthy and educated. Such interventions help in empowering the young people with knowledge and converting them into an asset,” demographer Leela Visaria said.
Even as over 2,000 out-of-school adolescent girls in Prantij and Khedbrahma block of Sabarkantha district were benefitted from the programme, lack of communication about the various services available under State or Central health programmes like the National Rural Health Mission (NRHM), has weakened its implementation. It was to bridge this gap that the Participatory Communication Initiative was launched in 2008 in 40 districts in seven States by Communication for Health India Network, a group of organisations including CHETNA, working on health.
Five blocks in five districts of Gujarat and the same number in Rajasthan were chosen for the initiative that was aimed to enhance the community’s access to quality public health services as guaranteed under the NRHM.