New Delhi : Home to 253 million adolescents at present, India is expected to have 297 million adolescents by 2050 presenting an opportunity to reap the benefits of demographic dividend. However, nutritional deficiencies and injuries, including self-harm are emerging as major challenges, as are mental and substance abuse.

While there has been a 50% decline in early marriages and teenage pregnancies, more than 26% girls are still married before 18-years of age and teenage pregnancy continues to be 7.9% with a high unmet need for contraception among married adolescents. One-third of young women experience physical/emotional/social violence and 20% experience mental health problems. Over 12% tobacco users in the country are in the age group 15-24 years and one-fourth in this age group use alcohol. 

Additionally there are more issues associated with adolescents. Inadequate data on adolescent behavior and health risk particularly for young adolescents, lack of perceived benefit of adolescent health among programme implementers, says Mr Manoj Jhalani, Additional Secretary and Mission Director, National Health Mission, Ministry of Health and Family Welfare. 

Adolescent health has linkages with various sectors and multi-sector actions are required to achieve desired outcomes.

From a one-day orientation programme for teachers at district levels under the 8^th Five-Year-Plan in 1992-1997, to the ambitious Rashtriya Kishore Swasthya Karyakram (RKSK) which is being implemented currently, India has achieved many milestones in adolescent health. 

The RKSK was launched in 2014 to address the health and development needs of the adolescents in India. Based on continuum of care for adolescent health and development needs through the three-tier public health system with a multi-component intervention targeting both determinants of health problems and their consequences, RKSK adopts a facility-based approach, school-based approach and community-based approach for expected outcomes by including immunization and iron Âfolic acid tablets programmes to improve health and deal with anemia.  

India now has more than 7,000 Adolescent Friendly Health Clinics with a case load of 73 people each month, 11.2 crore children have been administered Weekly Iron-Folic Acids tablets and 22205 Health Days held so far. The Menstrual Hygiene Scheme has been launched across the districts. Under the Peer Education Programme 1.96 lakh Peer educators have already been selected of which 28% have been trained. 

Pointing out that investing in adolescent health would pay dividends, Dr Sunil Mehra, Executive Director MamtaÂHealth Institute for Mother and Child said there is a need to enhance core competencies in health care functionaries to deliver on adolescent health (both in clinical and public health) in addition to increased financial and human resource allocation to adolescent health.

ÂWe need age (and sex) disaggregated data and rigorous and transparent evaluations of our adolescent programmes. It is important to intervene early and continue with age-specific programming and importantly it is time to question ourselves that Âare we reaching high risk adolescents through our existing programming, Dr Mehra said.

On the National Health Policy released earlier this year, Dr Mehra said it envisages engagement of private sector for creating awareness about adolescent health, commitment to pre-emptive care to achieve optimum levels of adolescent health and making school health programmes as a major focus area as well as making health and hygiene as part of the school curriculum targeting adolescents.