NEW DELHI:  A survey of young adolescents in Bihar and Uttar Pradesh has indicated that close to 2.4 million adolescents in these two States inflicted self-harm, 1.9 million showed symptoms of depression and 0.4 million had even considered suicide though many had worrying mental health condition.
The survey on `Understanding the Lives of Adolescents and Young Adults (UDAYA) done by The Population Council on young adolescents (10-14 years) in Uttar Pradesh (1,961 boys and girls) and Bihar (1,776 boys and girls) suggests that only 1% of boys and girls knew about Rashtriya Kishore Swasthya Karyakram, only one-third of the girls knew about sanitary napkins programme though only 10% received benefits. Only 22-24 % of boys and girls received health services/information at school but almost all knew about anganwadi worker and 56-66% knew about ASHA. Only 4-7% of boys and girls received health services provided by ASHA and anganwadi.
Most girls reported using pieces of cloth during menstruation, while half of those who did not use sanitary napkins could not afford and a quarter was not aware of sanitary napkins.
A significant minority reported sexual and reproductive health problems with more boys than girls reporting a problem  one in 6 vs one in 10. Boys are three times likely compared to girls to seek treatment with private facility being the preferred choice for seeking treatment.
The burden of nutrition is heavy in these two States with about 6.6 and 12.0 million very young boys and girls being anemic and 1.2 million and 2.8 million being severely anemic respectively in these two States.
Injury was reported by a large number of early adolescents  one-third boys and one-fifth girls. Half of the boys and slightly less proportion of girls were beaten by their parents. Similar proportion was involved in physical fight with another boy/girl. Substance use was high among boys than girls.
Meanwhile, with a view to strengthen adolescent health in the country, the Ministry of Health and Family Welfare is all set to bring about changes in its ambitious Rashtriya Kishore Swasthya Karyakram (RKSK) to focus on anemia control and prevention of diseases.
These decisions were taken following a review of the RKSK programme which showed that the anemia prevention strategy had not shown much success with the burden of anemia being very high across the country. Keeping this in mind, the Ministry decided to launch an intensive demand generation campaign to create awareness among people on anemia, particularly the adolescents. 
Speaking on the sidelines of the third day of the 11th World Congress on Adolescent Health being organized by the International Association for Adolescent Health (IAAH) here, Dr Ajay Khera, Deputy Commissioner (Adolescent Health), Ministry of Health and Family Welfare said one reason identified for less-than expected outcome of the anemia strategy was that this programme was not being monitored,ÂÂ he said.
The Ministry will now monitor its Weekly Iron Folic Supplementation (WIFS) programme on IT-platforms to see how successful it was. Importantly, the Ministry will soon launch a big demand generation programme to help create awareness among the people which not only adversely impacts their physical growth but their cognitive growth as well.
Also, the focus of the Intensified School Health Activity (ISHA) under the RKSK programme will now be on prevention and promotion rather than clinical treatment at present. These decisions were taken during a review meeting on RKSK, where it was decided that schools should be made the platforms for implementing adolescent health programmes since 60% of the adolescents in the country were now in schools and the percentage was increasing, Dr Khera said.
The RKSK is implemented at the facility, school and community level. At the facility level, Adolescent Friendly Health Clinics (AFHCs), Resource Centres at the district levels and Adolescent Health Counselors at the Block level are the core components.At the school level, Intensified School Health Programme (ISHA), WIFS, health screening and menstrual hygiene are focused while Peer Education Programme, Adolescent Health Days, Adolescent Friendly Clubs and WIFS and MHS (for out of school beneficiaries) are being implemented.