Young people (10-24 years) represent about one third of India’s total population. Though this segment has been recognized as a potential demographic dividend in India, the burden of disease in young is rising leading to great amount of health and sexual right violations in this group. The vulnerabilities to poor sexual and reproductive health are high, especially among girls, young women and poor. Yet, young people are the most neglected segment in the public health system in India.
MAMTA-HIMC has been a leading contributor in improving sexual and reproductive health of these groups, through the life cycle approach keeping gender, sexuality and rights as the guiding principles of the interventions. MAMTA primarily works under four intersecting domains, namely, Comprehensive Sexuality Education; Adolescent Friendly Health Services; Addressing Harmful Traditional Practices like Early Child Forced Marriage; Changing Inequitable Gender Norms.
Over two decades of promoting community empowerment as well as action along with informing national policy and programming, MAMTA has demonstrated how multi-sectoral interventions can contribute to essential sexual and reproductive rights realization. The youth friendly health services, a concept of NHS (the flagship program of Government of India) is being supported by MAMTA through story advocacy at various levels and by providing technical inputs. MAMTA has been instrumental in designing and developing the Adolescent Friendly Health Centers.
As a part of 1994 United Nations International Conference on Population and Development (ICPD) agenda the government of India is obliged to provide free and comprehensive sexuality education for adolescents and young people. Even though the government has taken intensive steps towards addressing young people’s sexual and reproductive health and rights in India by activating adolescent focus health facilities, functionaries and services, there is an urgent need for realizing comprehensive sexuality education at the grassroots. Young people in India bear a significant burden of poor sexual and reproductive health outcomes, including unmet need for family planning, early marriage and childbearing, maternal death, gender-based violence and sexually transmitted diseases including HIV. MAMTA promotes comprehensive sexuality education through negotiation with community and focused involvement of men and boys. By engraining these adolescents through informing , training adolescents, help foster greater equitable and healthier attitudes and behaviors. MAMTA has been a key promoter for mainstreaming comprehensive education across policy frameworks by implementing programmes focused on creating positive attitudes among young people about sexuality and gender issues by clearing the cobwebs of myths and confusions.
Adolescence is a period of transition to adulthood and it is well known that the adolescents undergo various psycho-social changes during this period. As sexual maturation is a major physiological development during this period, it is required that the health care services should give attention to respond to the special needs while adopting various youth friendly health services. Young people have the right to quality health care services, but there is poor awareness especially amoung unmarried adolescents. Therefore, it is extremely essential that the adolescent health care services are friendly and cater to their immediate and special needs without judgmental attitude. The YRSHR implementation programmes of MAMTA are based on enhancing young people accessibility to this service, as well as strengthening of the services. MAMTA has played a catalyst role in establishment of safe space model for the young and adolescents by formation of Youth Information Centers (YIC) and Gender Resource Centres. These are platforms which act as assets for vulnerable adolescent girls and boys to address issues of sexual and reproductive health and rights in gender appropriate manner. MAMTA has advocated within the health system establishment and strengthening of these services.
Women and girls in India, especially from the marginalized communities experience discrimination, abuse and violation of their basic human rights. Traditional practices including forced early marriage, early pregnancy, female feticide and dowry (to mention a few) continue to be practiced in India. Practices such as these underscore violence and discrimination against them. Consequentially, women and girls experience hindrance in physical, emotional and psychological development.
MAMTA continues to address these violations and advances girl centered and community based intervention models to empower individual, community and government by creating opportunities for dialogue on such discriminatory and culturally unequal gender norms and practices.
While MAMTA addresses a gamut of issues and violations of health, sexual and reproductive rights of the marginalized communities, emphasis is laid on strengthening administrative systems for enforcement of law and policies, community mobilization and empowerment of young people, networking and strengthening capacities of NGOs/CBOs on early marriage and early pregnancy and improving quality and access to basic health care services of pregnant and lactating mothers and young couples. To achieve these overall impact in better health outcomes of women and girls through addressing traditional harmful cultural practices, building public opinion on the need for prevention of such practices has been a key role that MAMTA has played nationally and internationally.
While working with young people MAMTA understood the significant concerns which relate to sexual and reproductive health issues, and are unarticulated and un-addressed due to lack of information and services, parental/community support and understanding. Inequitable gender norms elevate the risk associated to adolescent health and this necessitated the initiation of a broad based integrated approach to address these norms within the rights paradigm. MAMTA’s interventions successfully promote more equitable norms, and lead to significant reductions in HIV and STI risks among the marginalized and vulnerable adolescent communities in India. In our experience talking about inequitable gender norms in rural settings, especially which define masculinity is crucial as a prevention strategy. Group education interventions which MAMTA promotes, through its interventions successfully influence young men’s and community gatekeepers’ attitudes towards progressive gender roles, lead to healthier relationships and finally to empowerment of adolescent girls.