Presentation made at an IFPRI event on "What Lies Beneath: Women’s and Girls’ Wellbeing as a Critical Underpinning of India’s Nutritional Challenge" on December 10, 2018, in New Delhi

1. Study supported by
Ensuring the wellbeing of adolescents in Bihar and Uttar Pradesh
Successes, challenges and pathways
K G Santhya and Sachin Shinde
1

2. The potential of adolescents in Bihar and Uttar Pradesh
WORLD
1198,714,752
INDIA
253,160,473
BIHAR & UP
72,302,838
Every 5thadolescent in the world lives in India
Every 16th adolescent in the world and 4thadolescent in India lives in Bihar & UP2

3. UDAYA – Objectives and design
Objectives Design Sample size, 2016
Assess the quality of transitions
from adolescence to adulthood
Profile the situation of
adolescents & change in their
situation over time
Planned follow-up survey of
2015-16 cohort of adolescents
Longitudinal survey of
adolescents first interviewed in
Bihar in 2007, as part ofYouth in
India: Situation & Needs study,
in 2016
Cross-sectional survey of
adolescents in Bihar & UP, 2015-
16
Cross-sectional
20000+ adolescents in ages 10-
19 (boys & girls, unmarried &
married, rural & urban)
Longitudinal
3000+ young adults in ages 23–
27
Cross-sectional survey of youth
(15–24) in 2007
3

4. Adolescent well-being: Successes
Photo courtesy: http://amrutsanitationforcommunities.blogspot.in, theTimes of India,Youth kiAwaaz4

5. School-to-work transitions over time: Bihar, 2007 & 2016
Boys (15–19) Unmarried girls (15–19) Married girls (15–19)
Ever enrolled Completed
Class 8
Completed
Class 10*
Currently
enrolled in
school
100
80
60
40
20
0
100
80
60
40
20
0
88
97
57
79
38
60 62
80
Ever engaged in
paid work
Engaged in
child labour
42
26
12
4
2007 2016
Ever enrolled Completed
Class 8
Completed
Class 10*
Currently
enrolled in
school
100
80
60
40
20
0
100
80
60
40
20
0
70
91
35
73
40
64
45
72
Ever engaged in
paid work
Engaged in
child labour
24
17 14
7
2007 2016
Ever enrolled Completed
Class 8
Completed
Class 10*
Currently
enrolled in
school
100
80
60
40
20
0
30
71
10
46
7
27
6
18
Ever engaged in
paid work
Engaged in
child labour
30
11
31
10
2007 2016
100
80
60
40
20
0
* Of those in ages 18–19
5

6. Gender equality in schooling experiences: Bihar & UP, 2015-16
100
80
60
40
20
0
Ever
enrolled
Regular
attendance*
Completed
Class 8
Completion of
Class 10**
97 93
77 74
59 57 59 62
Boys (15–19)
* Of those currently enrolled in school; ** of those in ages 18-19
Unmarried girls
(15–19)
6

7. 100
80
60
40
20
0
Agency and attitudes of adolescents over time: Bihar 2007 & 2016
Boys (15–19) Unmarried girls (15–19) Married girls (15–19)
Owned a
savings account
Independently
operated the
account*
Allowed to visit
selected locations
unescorted
100
80
60
40
20
0
100
80
60
40
20
0
88
96
61
72
8
52
Prosocial
attitudes**
Voted in the
last elections
62 65
30
34
2007 2016
100
80
60
40
20
0
100
80
60
40
20
0
5
50
21
66
16
47
42
65
10
20
2007 2016
2
34
48
64
13
21
30
57
23
31
2007 2016
100
80
60
40
20
0
Owned a
savings account
Independently
operated the
account*
Allowed to visit
selected locations
unescorted
Prosocial
attitudes**
Voted in the
last elections
Owned a
savings account
Independently
operated the
account*
Allowed to visit
selected locations
unescorted
Prosocial
attitudes
Voted in the
last elections
* Of those who had an account, **refer to attitudes toward mixing freely with people of different castes/ religions
7

8. Immediate future plans, older adolescents, Bihar & Uttar Pradesh, 2015-16
59
65
2
56
50
1512
45
51
0
20
40
60
80
100
Continues studies or
return to school
Work for pay or acquire a
vocational skill
Assume the role of a spouse,
parent or homemaker
Boys (15–19)
Unmarried girls
(15–19)
Married girls
(15–19)
8

9. Transition to marriage and motherhood over time
Bihar, 2007 & 2016 and Uttar Pradesh, 2005-06* & 2015-16
Marriage before 18
All girls (18–19)
100
80
60
40
20
0
66
44
Bihar, 2007 Bihar, 2016
44
21
All girls (18–19)
UP, 2005-06 UP, 2015-16
* National Family Health Survey 2005-06
Adolescent pregnancy
All girls (18–19)
100
80
60
40
20
0
Bihar, 2007 Bihar, 2016
All girls (18–19)
UP, 2005-06 UP, 2015-16
23
13 14
7
9

10. Adolescent well-being:
persisting and new challenges
Learning outcomes Unmet need for skill
building
Reproductive
choices
Continuum of care Violence Mental health
Systemic issues Inequities Early warning signs
Awareness of
health matters
Infant mortality
10

11. 1-4years
5-7years
8-9years
10-14 15-19
1-4years
5-7years
8-9years
10-14 15-19
33%
10-14 15-19
10-14 15-19
10-14 15-19
10-14 15-19
18%
64%
44%
82%
72%
23%
3%
52%
26%
70%
48%
Literacy & numeracy skills, younger & older boys, Bihar & Uttar Pradesh, 2016
Boys who can
read class 2 text fluently*
Boys who can
solve a simple division problem*
* Of those who were ever enrolled in school
Girls performed
worse than boys
At 8-9 years of
schooling,
adolescents in
Bihar performed
better than those
in UP
11

12. Unmet need for vocational skills training,
older adolescents, Bihar and Uttar Pradesh, 2015-16
100
80
60
40
20
0
Boys (15–19)
Unmarried girls
(15–19)
Married girls
(15–19)
100
80
60
40
20
0
78
11
Interested in
acquiring
vocational skills
100
80
60
40
20
0
88
31
78
36
6
12
16
Wanted at some time
to attend a course but
could not do so
Attended
a course
Boys preferred
Girls preferred
12

13. Limited awareness of sexual and reproductive matters, older adolescents
Bihar and Uttar Pradesh, 2016
25
8
24
28
24
8
30
33
53
22
30
42
0
20
40
60
80
100
Knew that a women can get
pregnant at first sex
Knew that oral pills should be
taken daily/weekly
Knew that a women should have
at least 4 antenatal check-ups
Knew that a newborn should be
breastfed within an hour of birth
Boys (15–19)
Unmarried girls
(15–19)
Married girls
(15–19)
13

14. Missed opportunity to promote continuum of maternal health
care, married girls, Bihar and Uttar Pradesh, 2016
Pregnant girls, 100
Got antenatal care, 96
Got delivery care, 81
Got postnatal care, 37
-4
-15
-44
14

15. Missed opportunity to provide comprehensive health information by
frontline workers, married girls, Bihar & Uttar Pradesh, 2015-16
35% of married girls
had interacted with ASHAs
in the year preceding the interview
Information on
safe pregnancy
20%
Escort to health
facility
17%
Information on
immunization &
infant care
55%
IFA tablets,
20% Information on
general health
and hygiene
14%
15

16. Violence witnessed, experienced or perpetrated, younger & older adolescents,
Bihar and Uttar Pradesh, 2016
Range refers to min and max among younger & older boys and younger & older girls
*of those who had engaged in sex
Community Family
Intimate
partner
Witnessed parental violence
Experienced physical violence
20-22% 26-31%
54-71% 31-50%
Perpetrated (boys*)/
experienced (girls*) forced sex
within pre-marital relationships
Experienced (married girls who
had cohabited) marital violence
Physical
Sexual
Emotional
25%
33%
25%
Bullied someone
Involved in physical fights
Experienced mobile
phone/internet based
harassment
Verbally harassed a girl with a
sexual tone
Familiarity with marriage-
related markers of trafficking
17-27% 3-26%
26-46% 3-30%
(15-19) 20%
<3% 1-6%
2-3% 3-12% 29% 54-62% 16

17. Symptoms of mild
depression
8% 12% 19%
Seriously contemplated
committing suicide
2% 4% 8%
Symptoms of moderate to
severe depression
2% 5% 8%
Inflicted self-harm
4% 3% 4%
Mental health concerns, older adolescents, Bihar and Uttar Pradesh, 2016
17

18. Irregular school attendance
Can't read fluently or solve a simple
division problem
Engaged in paid work
Did not have any role models
Any anemia
Symptoms of mild/moderate/severe
depression
Injured in a road accident
Consumed tobacco products
Never received information on puberty
Exposure to substance use at home
Witnessed parental violence
No interaction with frontline workers
Girls (10-14) Boys (10-14)
Early warning signs: situation of younger adolescents, Bihar & Uttar Pradesh, 2016
18

19. Make maximal use of old and new platforms, Bihar & Uttar Pradesh, 2015-16
% in school
% regularly exposed
to mass media
% having access to
mobile (own or family)
% exposed to social
media or internet*
92
88
68
56
8
76
60
86
62
50
15
3
40
10
6
79
68
93
86
94
% aware of frontline
workers
88 9194 96 95
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20. Ideas. Evidence. Impact.
The Population Council conducts research and delivers
solutions that improve lives around the world. Big ideas
supported by evidence: It’s our model for global change.
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