Adolescent girls battle several developmental hurdles stacked against them such as, gender based violence, under-nutrition, threat to safety, early marriage, myths and misconceptions around menstruation, and the list is unending. Less than half of those who experience health problems identify it as being a problem and seek help for it.
Meena (name changed), lives with her family in Mohammadpur village. Although spread across a small radius of just 7 kms, the actual number of people living in Mohammadpur could possibly be higher than 50,000, making it extremely congested. Mohammadpur struggles with accessing basic amenities and families like Meena’s are barely able to keep up with their health needs. Saroj, a frontline health worker working with Swasti frequented her neighbourhood and while undertaking a risk assessment exercise on Anemia suspected that Meena needed to undergo hemoglobin screening. Coaxed by Saroj, Meena shared that she experienced frequent bouts of tiredness, headaches and general fatigue to the extent where daily life chores were becoming difficult.
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“Undiagnosed and untreated Anemia has far reaching consequences and may cause irreversible damage to the human body. Many of the girls don’t disclose when they have symptoms. Or don’t see it as a problem,” says Saroj. Upon Saroj’s gentle insistence, Meena got her hemoglobin screened by the Nurse, Sonia at the Wellness Centre. There, it was found to be 8gm, well below the normal range for hemoglobin for women, which is 12.0 to 15.5 grams per deciliter.
Sonia and Saroj sat with Meena and worked out solutions with her to arrive at what would work for Meena to recover and sustain. Saroj continued counseling Meena and actively partnered with her towards reaching hemoglobin levels that were critical for her well-being.
Educating about, creating awareness, and protecting the health of adolescent girls is essential for her entire life cycle. The most common cause of anaemia, that Meena struggled with silently, for instance, is nutritional deficiencies, particularly iron deficiency and others such as folate, vitamins B12 and vitamin A. In turn Anaemia has far reaching, intergenerational consequences and can lead to maternal and infant mortality in some cases, arrest the physical, cognitive and psychological development in others and lead to a host of illness and psychological issues overall. More than 3 out of 10 women aged between 20 to 24 die during childbirth in India. Anemia is a major cause.
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An adolescent girl empowered with knowledge and skills in nutrition not only protects her health but also pave the way towards reducing further health inequity for herself and therefore experience everyday well-being - a critical factor towards her making healthy and positive life choices. This, when achieved in meaningful numbers can effectively break cycles of ill health and poverty for entire communities and is still wishful thinking.
Dipankar Bhattacharya, Researcher and Knowledge Catalyst, Swasti shares 3 learnings that NFHS-4 throws up for India, “1. More than half of the adult women are anaemic in India. Though, the poor are more likely to be anaemic, rural/urban differences within the respective state is not significant 2.Children hailing from poor family status are worst affected by wasting and underweight irrespective of their residence location 3. For certain nutrition indicators, urban poor are worse off than rural poor.”
“The answer actually lies in partnering with adolescent girls to protect their well-being, going beyond health.” , adds Shama Karkal, CEO Swasti, “The covid-19 situation also gives us a never before presented opportunity to work with entire families who are now disconnected from their daily schedules, and enable them to turn their focus on reflection on critical aspects of behaviour change, especially when it comes to adolescent girls. With adolescent girls, we need to universally recognize that she needs to be a key member of the decision making around her own life. The idea is to put in place programs and interventions that not only cater to or offer services for the adolescent girl, but actually listen and partner with her in meeting constructive life goals that help her development. Frontline health workers like Saroj and nurses like Sonia who hail from the same community and are familiar figures play a crucial role in building education, awareness and empowerment among adolescent girls on protecting their health. The covid-19 focus on preventive behaviours can go a long way in nutrition protection with entire families focusing on adopting better health and behavioural pathways.”
The need to educate and create awareness among adolescent girls to protect their health is real. This period of physical distancing, self isolation and reduced everyday distractions could be a once in a lifetime opportunity for all partners in development to invest time, energy and resources in contributing towards the same, through evidence based sustained community based mechanisms that adolescent girls are part of and can lean into as they traverse this growth period in their life.
(The author is an Associate Director of Swasti - The Health Catalyst, a global public health not-for-profit headquartered in Bangalore, India)
