Objective="To improve understanding about relationships, sexual and reproductive health, raising self-esteem and reducing incidence of STIs and HIV/AIDS among out-of school adolescents."
Details for Reform Option "Kishor Mitra Pariyojana: Life Skills Education Programme for Out-of-School Adolescents, Madhya Pradesh"
Over 35% of all reported HIV infections in India occur among young people in the age group of 15-24 years. Out of these, the estimate number of young women living with HIV/AIDS was almost twice that of young men. Majority are infected through unprotected sex. Age specific fertility rate in the age group of 15-19 years contribute to 19% of the total fertility rate and only 7.4% of married girls use contraception.
The adolescent population in Madhya Pradesh consists of 34.6%. The literacy level is 63.7% out of which male literacy is 76.1% and female literacy is 50.5% Thus many of the adolescents are inaccessible to the sexual and reproductive health, education and services that leads them to early marriage, misperceptions about sex, sexuality and relationship, STIs and HIV; and teenage pregnancies.
This initiative is one of the results of the fifth country programme (1997-2002) of the UNFPA-India. It has been implemented by the Department of Health & Family Welfare, Government of Madhya Pradesh in support with the UNFPA as a pilot programme in five districts (under Integrated Population Development Project– IPDP). This initiative has also received support from the Bhartiya Gramin Mahila Sangh, Indore. It was implemented in the year 2002 in the selected villages of each IPD districts and was completed in the September, 2004.
The initiative studied the information and counselling needs of the out-of-school adolescents, developed a training curriculum, collaborated with local interested NGOs for capacity building and implemented the life skills education which sensitised adolescents for the following:
(i) Awareness of physical changes during adolescence (10-19 years age)
(ii) Awareness of emotional changes during adolescence
(iii) Awareness of the relationship issues, sexual and reproductive health
(iv) Developing understanding about STIs and HIV/AIDS
(v) Vocational training such as in stitching, embroidery, soft toy making, agarbatti making,
to enhance earning resources and orientation to public service offices like Bank and
(vi) Building up negotiations skills and raising self-esteem
(vii) Enhancing the skills of peer educators like leadership quality and communication skills
Kishor Mitra Centres also observes special days or weeks like World Population Day and Feeding Week.
How was it organised?
The programme was implemented in 2002 in the selected blocks of the IPD Project districts. A need assessment was done in the Sidhi district. The Directorate of Health & Family in support with UNFPA prepared a concept note on Life Skills Education Program for out of school adolescents on the line of the IPD Project Output 7 (Knowledge on sexual and reproductive health and life skills of in and out of school adolescent boys and girls improved). The process of organizing this endeavour has been step wise.
Clients: Boys and girls of the age 10-19 years.
Results:The programme reached a total of 3807 adolescent girls and 2253 adolescent boys. The assessment of the programme was conducted by the Preventive and Social Medicine Department of Rewa Medical College, Madhya Pradesh in the year 2005. The programme had better impact in Satna comparing to Rewa districts in terms of the knowledge of the animators and the adolescents girls especially on the sexual and the reproductive health aspects and the type of methodology adopted was quite encouraging.
Information not available.
Five IPD districts: Rewa, Satna and Sidhi of Rewa division, Panna and Chhatarpur districts of Sagar division.
A period of 14 months starting from September, 2003 to December, 2004.
Access and coverage: it met the much sought needs of the out-of-school adolescents and promoted positive sexual health.
Building up self-esteem: it enhanced the self-esteem of children through transferring knowledge and skills to lead an economically productive life.
Socio-cultural barriers: traditional social barriers about being open to adolescents on sexual and reproductive health issues and the usual tussle among moralists, conservatives and experimentalists school of thoughts.
Involvement of females: selection of female animators difficult in a male dominant society as men may not allow women for this activity and for attending any residential training, responsibility of siblings on girls, less interest of females if the project duration is too short (as if 3-6 months).
Baseline data need assessment, supportive environment, Development of training curriculum as per local needs and its pre-testing, trained staff, infrastructure to be used as a place where transferring knowledge, skills and attitudes can occur. Budget allocation as per project area and physical distance from the department head quarter.
Who needs to be consulted
Key people in the community: adolescents, parents and teachers.
Local Government bodies, NGOs, health professionals providing STI treatment and counselling services, women welfare organisations, UNFPA field Programme Coordinator and State Government of Madhya Pradesh.
Fair, it needs persistent advocacy efforts to maintain a supportive environment and to dilute the social barriers on adolescent sexuality and reproduction which have been existing in the community across generations.
Its sustainability can be further enhanced by linking it to the resources available under the national Rural Health Mission.
Chances of Replication
The initiatives on adolescent reproductive and sexual health and on life skills are already being practised in different states as per the local circumstances such as Multi-purpose Youth Centres and Telephone Help-Line in Maharashtra, Better Life Option Programme being run by CEDPA in Delhi, an international non-profit organization for females between the age 12-20 years.
Hence, chances of replication are good.
Considering the deprived conditions of the out-of-school adolescents, their lower literacy level and accumulated life experiences, sensitivity and reluctant acceptance of adolescent sexuality by the society, the training material has to be designed keeping in mind the local epidemiology, culture and social values.
There is also a need to conduct ‘Training of Trainers’ refreshing courses time-to-time to meet the upcoming needs as the programme evolve and develop.
Need for involvement of Integrated Child Development Scheme (ICDS) Health Department Need for adolescents friendly health centres in the districts having Kishor Mitra Pariyojana to accelerate the positive impact.
Sensitisation of media people to gain maximum support from them.
Dr. Anil Bhola, Research Consultant, National Institute of Medical Statistics, New Delhi November, 2006