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Title: Understanding Adolescence: Knowledge, Attitude and Practices of Reproductive and Sexual Health Among School Going Adolescent Girls (a study among girls of government schools of Delhi)
Authors: Singh, Kaavya
Keywords: Adolescent Girls
Reproductive Health
School of Health Systems Studies
Anil Kumar, K.
Issue Date: 2015
Publisher: TISS
Abstract: Background: Adolescence is the crucial phase of life for an individual that brings a transi tion not only physically but also mentally, emotionally and in all social spheres and interactions. The reproductive and sexual health of the adolescent needs special attention because during this phase the vulnerability to adopting health risking behaviou r is higher. The lack of knowledge and awareness or exposure to incorrect half knowledge raises the risk even more. Therefore, it is necessary to address the health needs of adolescents. In the culturally rich society that Indian girls grow up in, differen t norms, myths and taboos surround them and more than often prevent them to take care of their health needs. Many previous studies have explored the adolescent reproductive health issues, but a very few have focused upon the awareness level of the school g oing girls who have gained adolescent health knowledge as a part of their curriculum and are expected to be following good reproductive health practices. Policies, programmes and schemes developed keeping the adolescent girls in frame are how far able to m eet their need also requires attention especially at school level. Objectives: This study attempts to present the information about the level of knowledge, perception and the practices that the young school going adolescent girls in government schools of Delhi follow with respect to their reproductive and sexual health. It proposed to study the perception of the girls regarding some of the sensitive issues such as eve - teasing, physical intimacy, pregnancy and contraception. The present study also aimed to study the knowledge and perception of the adolescent girls with respect to Kishori scheme and provision of free sanitary napkins and also tries to identify the suggestions from the girls about their need of knowledge about RSH. Methodology: A quantitative study using a pre - tested structured questionnaire having a few open ended questions to know the perception of the girls in their own words. This study was carried out among 180 school going girls who were studying between VI - VIII classes of 3 Delhi govern ment (only girls) schools selected by multi - staged random sampling from three different zones of Delhi. the girls were selected by stratified random sampling, XI class girls were not available during the time of study, therefore only six classes were selec ted to do the sampling from. The data for the study was collected from April 2014 to May 2014. The data was analysed using the statistical software (SPSS). Results : Major findings from the study pointed out that the school going adolescent girls were parti ally aware about certain important core issues of reproductive health such as puberty and pubertal changes, knowledge about HIV/AIDS and STIs.The knowledge about the very crucial phase in the life of adolescents is puberty and the changes that happen physi cally can be intriguing, the situation of half or incorrect knowledge is as harmful as having no knowledge at all. Not much girls were able to enumerate more than two primary and more than three secondary sexual characteristics changes that occur during pu berty. The awareness was proportionately higher among the older age group adolescent girls. Of the total 137 girls who had their menarche 67 percent used sanitary pads as absorbent while 20 percent were using both cloth as well as sanitary pads . While near ly 20 percent girls were not aware about how frequently pads should be changed almost 40 percent of the girls using cloth as the absorbent dried it in closed places like a bathroom or inside their rooms. Sixty two out of the 180 respondents have had experi enced some form of eve - teasing. A large majority (87.2%) of the older adolescent girls were aware about it and were using the services more than the younger adolescent girls. This may be due to the lack of awareness amongst the girls who have not yet atta ined menarche. Although more than 80 percent girls found the provision of free sanitary napkin very beneficial, but a larger proportion of older adolescent girls found it useful. The young girls had slightly different perception about this, where the girls who had not attained puberty and have not started menstruating do not understand the use of the pads even though they are provided to them. The suggestions that they mentioned broadly maintained a similar requirement of imparting them with the knowledge a bout the process of menstruation and the related issues. Due to hesitation about 28 percent, reported that they did not discuss their reproductive health issues with anyone. In such a scenario, it is essential to communicate with the girls, which after a m other only a teacher can better convey. The girls had very little knowledge about contraceptives. The most common contraceptive according to them of which they know about is Oral Contraceptive Pills. More than half of them mentioned about I - Pill (brand na me of an OCP) as the contraceptive that they know of. Similar was the case with the knowledge about HIV/AIDS, 88 percent had some idea about the syndrome and a very high percentage of the ones aware were from the age group of older adolescents. T he modes o f transmission of infection as per them were blood (80), from mother to child (48), unsafe sex (74), and food (28), mosquito bite (43). A few knew about the mode of transmission of HIV/AIDS. About STIs, only one fourth of the total girls had heard about i t. Pain in abdomen, pain while urination, discharge from the genitalia, itching were some of the common symptoms that they were able to mention . While almost sixty percent girls in older age group were aware about physical intimacy or sexual contact. Whe n questioned about the age at first sexual contact more than 60 percent replied it to be after marriage . More than 86 percent girls said that it is very important to be thought in schools along with the regular curriculum, while only 13 percent felt that it was irrelevant. On finding the statistical association between knowledge of the respondents and their background characteristics, the major findings that were observed were that the knowledge scores of the adolescent girls who had attained menarche were comparatively higher than the one who hadn’t. The attainment of menarche and the knowledge about various reproductive health issues were observed (chi square, p value 0.003). But other factors such as education of parents, their occupation and the living s tatus with parents or with others, did not depict much significant association. Conclusion: This study was done to assess the knowledge levels of the school going adolescent girls in the government schools of Delhi. The purpose for only selecting governme nt school was due to two main reasons, one as the adolescent education programme which is implemented in all the schools of India, it is upon the discretion of the private schools,to implement such a programme in their curriculum. But for government school s it is mandatory to include this aspect into the curriculum. Also the Kishori scheme which was a Delhi government initiative to supply free of cost sanitary napkins was only restricted to schools of Delhi Government and private aided schools. So in order to assess both knowledge and utilisation of the services of Kishori scheme, schools run by Delhi were selected. As a result of this study, it was learnt that there is a gap in the knowledge of the adolescent girls. These girls are not fully aware about the problems of Reproductive and sexual Health. The incorrect and incomplete knowledge of these girls is not only harmful for them but the vulnerability will be carried on for generations together. So specific interventions that are designed in a more adolesc ent friendly manner for disseminating proper information and counselling to cater too the unmet needs of these young girls is the need of the hour.
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