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No. 19, 2007 Santhya, K.G. and Shireen J. Jejeebhoy. "Young people’s sexual and reproductive health in India: Policies, programmes and realities," South and East Asia Regional Working Paper no. 19. New Delhi: Population Council. (PDF) Abstract This paper presents an overview of key policies and government programs intended to reduce HIV vulnerability and improve sexual and reproductive health among young people in India, and identifies the extent to which these policies and programs have addressed the gamut of unique sexual and reproductive needs of young women and men. It also explores the extent to which programs have been adapted to accommodate state-level differences in the sexual and reproductive vulnerability of youth; the review takes the examples of two states, namely, Andhra Pradesh, characterized by both early marriage and high HIV prevalence, and Madhya Pradesh, characterized by early marriage and low rates of HIV. The review focuses on four program dimensions: awareness building, service provision, reducing gender disparities, and developing a supportive environment. Findings suggest that significant strides have been made in articulating a commitment to addressing many of the sexual and reproductive health needs of adolescents and youth. However, there remains a considerable schism between the commitments made in policies and programs, the implementation of these commitments, and the reality of young people’s lives in India. At the state level too, the implementation of programs to meet these commitments varies considerably. While several national and state-specific programs have been implemented to raise awareness about sexual and reproductive health among young people, our review suggests that on balance, communication programs appear to stress HIV and safe sex over other aspects of sexual and reproductive health. Moreover, the focus of awareness raising programs has been somewhat skewed in terms of subpopulations covered; married young women, for example, are least likely to be reached. With regard to the provision of services, although policies and programs have underscored the right of adolescents and youth to sexual and reproductive health counseling and services, service delivery has not been youth-friendly or responsive to their unique needs, and there is considerable ambiguity in the extent of service delivery; the unmarried for example, remain underserved. Programs intended to reduce gender disparities and enhance the status of girls and young women tend to be limited in their reach and variable in their content; efforts thus far have focused more on improving the nutritional status of adolescent girls than on changing gender inegalitarian attitudes, sensitizing youth and their gatekeepers about the sexual and reproductive rights of women and men, or changing the perceptions of young men. Similarly, efforts to build a supportive environment to meet young people’s needs have yet to be undertaken in a sustained way and among all gatekeepers, particularly parents. Evaluations of programs that have been implemented have not always been systematic or rigorous. Policies and programs have recognized the importance of improving sexual and reproductive health and choice among young people and the importance of healthy youth in shaping India’s future. Efforts have been initiated to translate this commitment into practice; what is needed is a similar level of commitment to ensuring that programs do indeed reach young people, that the scope and content of programs are expanded, and promising lessons are assimilated and scaled up.
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