This document discusses India's large adolescent population and their unique needs and vulnerabilities. It notes that India has over 250 million 10-19 year olds, the largest in the world. Data shows adolescents face health risks like injury, violence, early pregnancy, and mental health issues. Their brains and identities are also still developing. The document argues that adolescents need quality education, healthcare, gender equality initiatives, and opportunities to develop leadership skills. It proposes that schools are well-placed to address these needs through adolescent health programs that provide information, screening and support.

1. Why Focus on Adolescents
Realities, Needs and Responses

2. • The big deal about working with Adolescents, NOW
• Adolescent Health and Well being: Data Speak
• Unique Characteristics and Needs of Adolescence
• Potential Responses
Presentation Outline

3. • In absolute numbers, India has the largest adolescent population in the world:
• Almost double the total population of Mexico
Source: World Population Prospects: The 2012 Revision, Census of India, 2011
17%
INDIA’s
CONTRIBUTION
20%
INDIA’s
CONTRIBUTION
253 million
Adolescent Population (10-19 years)

4. 2050
80.6
124.2
186.0
236.6
262.0
297.0
Millions
20302010199019701950
Source: World Population Prospects 2012
India’s Adolescent Population

5. MALE FEMALE
Age
Population %
1970
Demographic Transition in India

6. MALE FEMALE
Age
Population %
1990
Demographic Transition in India

7. MALE FEMALE
Population %
Age
 Base of the
population pyramid
has started to shrink,
number of working
people has increased
in relation to children
and elderly
 Demographic
Window:
proportionally large
working populations
and relatively light
dependency burdens
- Potential for high
economic growth
 Capturing this
potential depends on
factors such as
governance,
education, health,
skilling and labour
2010
Window of opportunityDemographic Transition in India

8. Window closesDemographic Transition in India
2010 2030 2050

9. Adolescent Health and Well being: Data Speak

10. 0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
5-9 0-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+
Age (in years)
Intimate partner violence
Self-harm
PercentoftotalDALYs
Source: Global Burden of Disease, IHME, 2010 released 2013
Vulnerability: Intentional Injuries

11. 0%
3%
6%
9%
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+
PercentoftotalDALYs
Age (in years) Source: Global Burden of Disease, IHME, 2010 released 2013
Vulnerability: Sexual Abuse and Violence

12. 1 in 5 girls 15-19 yrs who
experienced sex before
marriage was forced
2 in 5 girls who were
commercially sexually exploited
were minors
1 in 3 married girls 15-19 yrs
experienced violence
at hands of their husbands
IIPS, 2006-07; NFHS-3, 2005–06; India Country Report, 2008
Vulnerability: Gender-based Violence

13. Approximately 56% adolescent girls and 30% adolescent boys in
India suffer from anaemia
Globally, More than 33% of the disease burden, and
almost 60% of premature deaths among adults
can be associated with behaviour or conditions that began or
occurred during adolescence

14. of aged 15 and over
are insufficiently
active
31%
Physical inactivity-
6% of deaths , main cause
for 21–25% of breast
and colon cancers, 27%
of diabetes, 30% of
ischaemic heart disease
adolescent boys
use tobacco
18%
50%
continue
to smoke
7% deaths
30% NCDs due
tobacco use
adolescent are obese
11%
Overweight & obesity -
44% of diabetes, 23%
of ischaemic heart disease
and 7-41% of certain
cancers
of adolescents
experience a mental
health problem
20%
Antisocial personality
disorder- greater than
50% of first diagnoses
across the life course are
ONLY by age 25 years
47%
experience
alcohol
dependence
of adolescent girls and
14%
of boys reported use alcohol.
18%
9% of all deaths in 15
and 29 age group due to
alcohol-related causes
Source: WHO 2008; WHO 2009; WHO 2011
Morbidity Across Life Can be Traced Back to Adolescence

15. 10 – 14 years 15-19 years 20 – 24 years
1. Road Injuries Road Injuries Road Injuries
2. HIV/AIDS Inter-personal violence Self Harm
3. Drowning Self Harm Inter-personal violence
4. Intestinal Infectious Diseases Drowning Tuberculosis
5. Lower Respiratory Infections HIV/AIDS Drowning
6. Diarrheal Diseases Intestinal Infectious Diseases Ischemic Heart Disease
7. Malaria Tuberculosis HIV/AIDS
8. Haemoglobinopathies and
Haemolytic Anemia
Lower Respiratory Infections Exposure to mechanical forces
9. Congenital Anomalies Ischemic Heart Disease Lower Respiratory Infections
10. Meningitis Exposure to mechanical forces Falls
Top 10 risks for death in India
Top 10 Causes of Death in Males (2013)

16. 10 – 14 years 15-19 years 20 – 24 years
1. HIV/AIDS Self Harm Self Harm
2. Intestinal Infectious Diseases Road Injuries Road Injuries
3. Road Injuries HIV/AIDS Tuberculosis
4. Lower Respiratory Infections Tuberculosis HIV/AIDS
5. Malaria Fire, heat & hot substances Fire, heat & hot substances
6. Diarrheal Diseases Intestinal Infectious Diseases Other maternal disorders
7. Drowning Diarrheal Diseases Diarrheal Diseases
8. Haemoglobinopathies and
Haemolytic Anemias
Malaria Lower Respiratory Infections
9. Congenital Anomalies Lower Respiratory Infections Malaria
10. Meningitis Drowning Complications of abortions
Top 10 risks for death in India
Top 10 Causes of Death in Females (2013)

17. • Physiologically: adolescent brain is still developing, more likely to act on impulse,
not able to accurately assess consequences of actions
• Developmentally: identity formation, forming close relationships outside family
(PEERS), responding to social realities as independent individuals
• Willing to experiment with new ideas, better connected and exposed to global
influences through media and technology
• Vital stage to inculcate healthy lifestyle, positive and progressive attitudes
especially related to gender based discrimination and violence
Unique Characteristics of Adolescence

18. Overall,
• Balance between autonomy and support
• Recognition, Respect, Trust and Support from informed and
empathetic group: peer group, parents, teachers, counsellors,
doctors
• Opportunities for collectivization and access to safe, inclusive and
non-judgmental spaces
Needs of Adolescents

19. Specifically,
• Need quality education that is relevant to their needs and equips them to live fulfilling lives
and access productive employment/ careers with scope for advancement
• Youth friendly health services with an understanding that :
• All adolescents need information and health education
• A substantive proportion need psychological support
• 10-30% have behaviours that put them at risk of ill-health or injury in the present or will
cause ill health in the future (Indian Journal of Medical Research Aug. 2014)
• Smaller proportion suffer from conditions that need curative care
• Initiatives that uphold gender equality, actively engage them and nurture their leadership
• Accountable and responsive governance structures
Resonated by 425,000 young people in the ages 16-30 in My World Survey, 2015
Needs of Adolescents

20. Where could Adolescents be Reached?
• Substantive proportion of adolescents in India are in schools
o In the age group of 10-14, 19% girls and 17% boys have completed middle school
(grades 6-8) education (Census, 2011)
• Schools are trusted institutions for learning
• Provide opportunities for efficient and effective outreach
• Excellent avenues to provide information and psychological support to all adolescents
and screen for specific health and behvioral issues
• An initiative institutionalized (resource materials, capacities, monitoring protocols,
finances) in school education has high scope for sustainability
• Likely to be dynamic and responsive to evolving needs of young people

21. Optimal Time to Initiate Adolescence Education
• Secular trend towards earlier attainment of puberty
• Increased and early exposure to diverse and oftentimes unreliable sources of information
• Less academic pressure in upper primary grades
• Both students and teachers would like to start in upper primary grades
• Better school attendance and less drop out in upper primary than secondary