Union Budget 2022: Centre must invest more on adolescents, says Population Foundation of India

To actualise India’s much-talked-about demographic dividend, the forthcoming Union budget 2022-23 must include sufficient budgetary allocations specifically pertaining to the health and well-being of the adolescent population (aged between 10 and 19 years). India’s large young population presents a huge opportunity for the country. But to capitalise on it, it is imperative that we acknowledge distinctions within this heterogenous segment of the population. For instance, the needs of adolescents are distinct from those of youth (aged between 15 and 24 years), whose concerns often centre around employment and economic stability. Adolescents, on the other hand, are in their formative years and are far more impressionable and vulnerable. At 253 million, India has the largest adolescent population in the world, with one in every five Indians belonging to this category. By 2024, around 127 million adolescents would have turned 18, and will begin contributing to nation-building as consumers, members of the workforce, and future leaders. Investments in the health and education of this group is crucial to the future development of our country. Adolescents, especially from marginalised communities, face numerous challenges to their physical and mental health due to a lack of access to information, guidance and services. The COVID-19 pandemic has exacerbated these challenges. School closures, absence of interactions with peers, mobility restrictions, loss of parents and social networks, growing household responsibilities and violence experienced by adolescents may have lifelong effects. With delayed educational and employment opportunities, many are feeling helplessness, anxiety and fear. The National Family Health Survey (NFHS 5) 2019-21 reveals that anaemia is a major health concern among adolescents and is more prominent among girls. Anaemia levels among girls aged 15-19 years increased from 54% in 2015-16 to 59% in 2019-21 and in the case of adolescent boys, they increased from 29% to 31% between the same period. While evidence from the NFHS-5 largely pertains to the pre-pandemic period, the health and nutrition scenario in the country continues to be threatened with disruptions in essential services due to the impact of the pandemic. A study conducted in three states (Rajasthan, UP and Bihar) during the COVID-19 pandemic period by the Population Foundation of India finds that school closures have impacted access to mid-day meals, Iron and Folic Acid tablets and sanitary napkins for adolescent girls. There was an increase in their domestic workload. An increase in domestic violence or fights at home were reported by one-fourth of adolescents. In addition, there were also reports of an increase in incidences of child marriages across the country during the pandemic period. While India has implemented several measures to improve reproductive and child health, interventions to address the health needs of adolescents have been limited, with the exception of the Rashtriya Kishor Swastya Karyakram (RKSK). Availability of family planning services helps adolescents avert teenage pregnancies arising out of early marriage, prevent unsafe abortions and sexually transmitted infections from unsafe sexual practices and delay pregnancies. Health services for adolescents are key to addressing reproductive, maternal and new-born care as early pregnancies endanger the health of both the mother and the child. The RKSK program needs to be strengthened because it is the only comprehensive program that is designed to address the health needs of adolescents. Going forward, reproductive health and family planning services need to be further integrated with nutrition programming. This would reduce rates of adolescent pregnancy, increase awareness for birth spacing which will provide a critical window for mothers to rebuild their depleted nutritional status and have healthier, safer pregnancies. Thus, Population Foundation of India looks forward to a substantial increase in budget allocations for health, nutrition and education and skill building of adolescents in the forthcoming Union budget 2022-23. Specifically, the budget should focus on: • Strengthening Mission Poshan 2.0 in order to address the nutrition requirements of adolescent girls. • Increasing allocations for the RKSK scheme so that adolescent girls have access to sexual and reproductive health services, including menstrual hygiene products. • Increasing the budget for family welfare to ensure adequate supply of contraceptives methods for spacing births and Long-Acting Reversible Contraceptives (LARCs) to meet reproductive health needs. • Allocating more towards Samagra Shiksha Abhiyan to help bridge the digital divide in education for adolescent girls and create equal opportunities for schooling and equitable learning outcomes. • Investing in promoting health education in schools and colleges to enable adolescents to take charge of their own health needs. • Greater budgetary investments in social and behaviour change communication strategies and gender equality initiatives which address social determinants of health. • Strengthen response to gender-based violence, a growing public health concern. 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