With this year’s World Population Day’s theme being reproductive health and gender equality essential for achieving sustainable development, the focus has once again shifted towards the need for women’s reproductive health. Surveys have shown that how women having lack of knowledge on sex, contraception, pregnancy and abortion has been affecting their reproductive health orientation.

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A reproductive health orientation means that people have the ability to reproduce as well as to regulate their fertility; women are able to undergo pregnancy and childbirth safely and that the outcome of pregnancy is successful, in terms of both, maternal and child health and well-being. Reproductive health is affected by a variety of socio-cultural and biological factors and the quality of the delivery system. A woman-based approach to reproductive health is one which responds to the needs of adult women and adolescent girls.

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Current Scenario

Even after four decades of the inception of the family planning program, nothing much has been observed in terms of the population growth rate, which continues to grow at over 2% per year. Currently, almost 18 million people are added to India’s population annually, from which 40% of the population comprises children under the age of 14 years.

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Life expectancy has now reached 61 years, up from about 44 in 1960; and the crude death rate has fallen dramatically from 27 per 1000 population at the time of Independence in 1947 to 9.8 per 1000 (1991). In Kerala, which reports the longest life expectancy, there is 67.2 years for males and 72.4 for females Whereas, in Uttar Pradesh, which reports among the lowest life expectancies in the nation, there is a reversal of the gender pattern: while males can expect to live a total of 57.1 years, female life expectancy is only 52.8.

Gender Disparity the biggest roadblock in Unequal Access to Healthcare

Women’s unequal access to resources be it healthcare, education is a reality. Even economically, despite being majority of rural Indian women are active, their work goes largely unrecognized and poorly remunerated. Where women work, they earn lower wages including lower cash to kind ratio than that awarded to men. When it comes to household level, women have little decision-making authority and freedom of movement. Many behavioral norms further reinforce women’s lack of freedom of movement, self-confidence and acceptance of self-denial including in matters relating to health seeking and food intake. Violence against women and rape are all part of women’s lives. Women’s poor reproductive health in India can be attributed to various sociocultural and biological factors. Thus, efforts to improve women’s education are fundamental, be it raising enrollment and attendance rates of girls in school, reducing the drop-out rate on the one hand or enhancing women’s income autonomy on the other.

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Loopholes in the Women Reproductive Program

India’s Family Welfare Program are basically focused on achieving demographic targets by increasing contraceptive prevalence and notably female sterilization. However, the Indian family planning program also evolved through a number of stages. It has changed its focus. In the early years, the program was laid with loads of caution and its impact was hardly felt. Then during 1965-75, the program was strengthened by integrating family planning with maternal and duringthe period child health services were introduced. It was also during that decade, abortion was legalized. Despite all these, India’s maternal mortality ratio is estimated at 555 per 100,000 live births, about fifty times higher than that of many industrialized nations and six times as high as that of neighboring Sri Lanka.

The following sub-sections highlight major concerns in the area of reproductive health:
a) Focus to be laid on reproductive morbidity and maternal health
b) Improving access to safe abortion
c) Information on sexually transmitted diseases
d) Improved quality of reproductive systemViolence

India is home to 253 million adolescents which is largest in the world in terms of absolute numbers and when Reproductive, Maternal, Newbond and Child Health (RMNCH) programs were launched globally, India was the first country to add the ‘+A’ i.e. adolescent component to the RMNCH, making it today’s RMNCH+A program.

Under the Rashtriya Kishore Swasthya Karyakaram(RKSK) (2014) the Secretary, Health and Family Welfare recently launched the SAATHIYA Resource Kit including ‘SAATHIYA SALAH’ Mobile App for adolescents. RKSK identifies six strategic priorities for adolescents i.e. nutrition, sexual and reproductive health (SRH), non-communicable diseases (NCDs), substance misuse, injuries and violence (including gender-based violence) and mental health.

The most important component and driving force of RKSK program are its Peer Educators and this resource kit has been launched to enable them to communicate with the adolescents of their community.

The Peer Educators (Saathiyas) act as a catalyst for generating demand for the adolescent health services and imparting age appropriate knowledge on key adolescent health issues to their peer groups. In order to equip the Saathiyas in doing so Saathiya Resource Kits (including ‘Saathiya Salah’ Mobile App) have been launched. The kit will enable the 1.6 lakhs Peer Educators towards taking their job forward and answering all the queries in the minds of an adolescent in-spite of the plethora of media like Magazines, TV, internet etc.available.

The Resource Kit comprises
i) An Activity Book
ii) Bhranti-Kranti Game
iii) Question-Answer Book and
iv) Peer Educator Diary

Also the mobile app ‘Saathiya Salah’ (downloadable from Google play-store) acts as a ready information source for the adolescents in case they are unable to interact with the Peer Educators.

The mobile app is also linked to another important piece of costeffective information platform of a toll-free SAATHIYA HELPLINE (1800-233-1250) which will act as an e-counselor. While the short films will be played by the Peer Educators at their group meetings, the activity book and games will bring about discussion and resolve adolescent queries.

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