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A Researcher’s Diary: Is There Healthcare For Adolescents On The Margins?

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By S. Ram Aravind:

Note: Placing adolescent health at the heart of urban planning, PRIA, University of Glasgow (UoG), and Gurugram University have come together to undertake Participatory Action Research with communities residing in urban informal settlements in Gurugram. In this six-part series that explores the relationship between cities and health, Ram Aravind, from PRIA, will take the readers through the process of conducting participatory research with adolescents and how collective action with stakeholders makes for an effective strategy for effecting change at the grassroots.
Research fieldwork in Gurugram.

On the first day of fieldwork, I encountered a young girl who had migrated from Jharkhand to Gurugram, after the pandemic-induced lockdown restrictions were lifted. I observed her from a distance. She was engrossed in serious business on her mobile phone, unconcerned by the ‘gaze of research’.

The digital revolution had made owning a mobile phone affordable. Adolescents, in Gurugram, had access to mobile phones, and information from around the world was just a click away. The irony lay in the fact that their access to information about their health needs in itself was limited.

The Challenges For The Youngest Generation

One in five adolescents in Southern Asia is out of school, according to a paper by the UNESCO Institute of Statistics (UIS). Mere access to information on the internet was not empowering adolescents when it comes to their health. They remain powerless, voiceless, and neglected in a city and in its planning to provide health services.

Reaping the benefits of India’s demographic dividend will be central to India’s economic development, but the largest generation of young people in human history face enormous challenges towards realizing their potential to contribute to the growth story. The Lancet Commission report titled, ‘Our Future’ had identified ‘adolescence’ as a “critical phase in life for achieving human potential” and concluded by recommending that only substantial investments in improving adolescent health and well-being would aid in India’s progress towards achieving the UN Sustainable Development Goals.

But how do we generate evidence into priority areas of public policy that would ensure the holistic development of adolescents, especially those belonging to marginalized communities? Drawing upon PRIA’s prior experience of engaging with youth, the study titled ‘Our Health, Our Voice’ seeks to advance the use of participatory research methodology into the thematic area of adolescent health. Through the active participation of adolescent boys and girls living in urban informal settlements in Gurugram, the evidence is expected to generate fresh insights into their lives from the perspective of urban migration.

For many, the name Gurugram (erstwhile Gurgaon) is synonymous with the entrepreneurial boom that has now gripped India. However, Gurugram is home not only for the well-heeled but also people fighting it out in the fringes, hoping to eke out bare minimum sustenance. In a pattern that is typical of rapid urbanization, a vertical expansion of Gurugram to accommodate the deluge of migrant workers had followed. Construction workers, drivers, domestic workers, gardeners, gate-keepers, and the ones labeled as ‘criminals’ and ‘delinquents’; you will find possibly all of them here. Otherwise known as ‘urban informal settlements’, the term has its genesis in the economics of the city.

The Dearth in Adolescent Health Studies

The development economists are guided by the philosophy ‘what gets measured gets done’. The existing literature on adolescent health is populated with studies that evaluate gaps in adolescent health service delivery or awareness among adolescents on various health issues. Studies that explored the phenomenon were few. There appears to be a dearth of studies on adolescent health that combines theory, practice, and advocacy.

As a methodological and thematic novice, I look forward to combining the three, to innovate on techniques and methods of action research and deepen our presence in working with India’s youth.

The practice of converting the numbers into tangible results on the ground distinguishes the participatory research methodology from the more traditional methods of research. Further, the respondent or participant in the study is not kept distant from the research. In fact, their stakes are much higher in Participatory Action Research. To engage in a process of research that gives agency to the community to have control over the factors that affect their lives! How exciting is that?

That would include sharing the results of a study with the respondents, interviewing the multiple stakeholders involved in health service delivery, working with local elected representatives, gaining perspectives on existing practices from parents, all the way extending into behaviour change communication with the community that they live in.

Over the coming months, as the adolescents in the community transition from being respondents of questionnaires to owning their stake in the process that seeks to transform health service delivery through policy advocacy, the journey seems long and arduous, but transformative. For me as a researcher and hopefully, for them as active participants. Their experiences, their stories—those will contribute to the discourse.

And, beyond all the literature that I had reviewed, read, and built my understanding of the research topic, it is an opportunity for me to learn how to research not for people, but with them.

Read more about ‘Our Health, Our Voice’ here. Learn more about Participatory Research Methodology here.
The featured image is for representational purposes only.
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