India has made a significant progress in improving women’s and young people’s sexual and reproductive health. These advancements include the National Family Planning Programme’s expansion of the contraceptive method mix, efforts to strengthen the contraceptive supply chain, and the 2014 launch of the Rashtriya Kishor Swasthya Karyakram (National Adolescent Health Programme), which prioritises healthy development during adolescence.
Still there are significant gaps in meeting adolescent sexual and reproductive health needs. Many adolescents have limited agency to protect and foster their sexual and reproductive health due to a lack of accurate information, provider bias, and other barriers; and obtaining comprehensive abortion care can be especially difficult. In addition, adolescents who are marginalised because of their sexuality, gender expression, or marital status face additional challenges in getting information and services. Access to comprehensive sexual and reproductive health care for all adolescents must be addressed to exercise their bodily autonomy and live healthy lives.
Some facts and figures to take note of:
- In India, 2 million adolescent women do not have access to modern contraception.
- Fifty-two per cent of adolescent mothers have the recommended four antenatal care visits.
- Seventy-eight per cent of teenage abortions is unsafe, posing an increased risk of complications.
- Following an unsafe abortion, 190,000 adolescents do not receive necessary care.
If all adolescent women in India who wanted to avoid pregnancy used modern contraception and were given the full range of contraceptive options, counselling, and information, and if all maternal, newborn, and abortion-related health care needs were met, there would be:
The annual cost to provide contraception, maternal and newborn health care, and abortion-related care to all adolescent women in India who require these services would be around Rs. 11.42 (US$0.16) per capita. This includes both direct care and indirect costs associated with programmes and systems.
Between 15 and 19, many Indian women become sexually active, marry, and begin childbearing. Many adolescent women (3.4 million) want to avoid pregnancy. There are 3.2 million married women and 195,000 sexually active unmarried women in this group. Only about one million (29%) adolescent women who want to avoid pregnancy use modern contraceptive methods.
Need to address issues related to maternal and newborn health care
Although adolescent women giving birth in a health facility (85%) and with a skilled birth attendant (86%) are relatively common, there are still many adolescents whose needs for pregnancy-related health care are not being met, and these gaps vary according to women’s characteristics.
48% of adolescent women who experience major medical complications during pregnancy or delivery do not receive the necessary treatment. Only 52% of adolescent mothers who give birth receive the recommended four antenatal care visits. This proportion is much lower among adolescent women giving birth who have no education (30%) than among those with more than a secondary education (56%), and it is lower among rural adolescent women (48%) than among those in urban areas (64%). In addition, the proportion of adolescent mothers giving birth in a health facility is lower for women from the poorest households (72%) than for those from the wealthiest families (96%).
Targeted investment in adolescents’ sexual and reproductive health in India is critical for reducing unintended pregnancies, unsafe abortions, unplanned births, maternal deaths, and ensuring the country’s young people’s bodily autonomy and well-being. However, in addition to the full investment, a rights-based policy framework is required to prevent reproductive coercion and ensure equity in access to services.