How India can take care of its marginalised adolescents during Covid crisis
The Covid-19 pandemic started as a public health crisis, calling for extreme mitigation measures ranging from social distancing to complete lockdowns. This led to a cascading effect that has impacted various aspects of our lives, ranging from the ability to earn, access to education and basic necessities and services, etc. The impact of this pandemic is further exacerbated on the lives of vulnerable groups like adolescents, who traditionally have a limited say in their future when it comes to completing their education and subsequent livelihood, the age at which to get married, and the choice of motherhood. Adolescents from marginalised communities and those in far-flung rural areas are further disadvantaged, as they are disconnected from the reach of mainstream media, and cannot make their voices heard.
With 253 million adolescents, it is critical for India to take stock of the unique challenges that the pandemic presents to a demographic that holds the key to the country’s future.
With this background, the 10 to19 Community of Practice has brought together various critical stakeholders – ranging from funders, Civil Society Organisations (CSOs), technical experts and the government – to initiate a series of webinars that aim to shed some light on the issues affecting vulnerable adolescents during the ongoing crisis. Titled ‘Voices from the Ground’, the first webinar brought together field-level program functionaries, government officials and adolescent girl champions, to understand the impact of Covid-19 crisis on adolescents and their families.
The discussion focused on gauging the ground realities, unpacking the critical role played by frontline workers and understanding from the government officials the initiatives currently underway or being planned with a focus on adolescents and potential areas of collaboration with CSOs.
Some of the common concerns were:
1. Vulnerable adolescents, who were re-enrolled in schools as part of the outreach program run by communities and CSOs, are once again at risk of permanently dropping out of school. Many will be unlikely to continue attending school once the national lockdown ends due to economic stress. With UNESCO emphasising that as many as 111 million girls in developing countries may not return to schools in 2021, stakeholders from across the sector are echoing these concerns. Sushant Mihir Pathak from Quest Alliance — an NGO working on education — acknowledged that the staggered unwinding of the lockdown may result in educational institutions bearing the brunt of the crisis, with social distancing being a challenge in schools and colleges.
Girl champion Priyanka Kumari from Deoghar district in Jharkhand asserted that other peer educators and girl champions like herself are uncertain about continuing their education given the present scenario. She further added, “Most of us are concerned about our ongoing and future education needs. We would like to continue the progress we’ve made and not drop out of school, or even worse fall prey to early marriage.”
2. Due to the closure of schools and primary health centres, the last mile delivery of basic health care services and products like sanitary napkins, iron-folic acid (IFA) supplements have been adversely affected.
3. Accounts from all stakeholders indicate that adolescents are dealing with increased incidences of domestic abuse to due to extended periods of being stuck at home and the inability to get away from perpetrators or reach out to their support network of friends or trusted adult supporters (teachers, principals, community leaders and frontline workers). While CSOs are working to bridge this gap, they are struggling to remain connected to communities in remote geographies.
4. An environment of fear and uncertainty concerning their future is leading to high levels of stress and anxiety among adolescents. Furthermore, lack of physical activities such as outdoor sports, and reduced social interactions are also affecting their mental health, exacerbating often-untreated cases of depression or anxiety.
While many unmet needs were articulated, speakers also showcased encouraging signs of the resilience of the young and described innovative actions being taken despite lockdown. Girl champions or adolescent peer educators are accompanying frontline workers in some areas, delivering information on how to stay safe and allaying fears. These peer educators have taken the initiative to prepare face masks for family and neighbours. Girls also have WhatsApp groups through which health and safety-related information are being disseminated, concerns can be raised and cases of domestic violence can be reported.
Responding to the Covid-19 crisis, the Ministry of Health and Family Welfare and civil society organisations are working on a variety of initiatives to address adolescents’ needs holistically. This includes ensuring last-mile delivery of contraceptives, sanitary napkins, IFA supplements; establishing helpline or counsellor services to address mental health and domestic violence; engaging families through social media, television, and digital interactions to promote information sharing and alleviate their concerns with respect to the lockdown.
Dr Zoya Ali Rizvi, Deputy Commissioner of Adolescents Health, Ministry of Health and Family Welfare emphasised that adolescent nutrition, health (including mental health), and domestic abuse are important areas for the government's adolescent health program. “During these times, frontline health workers have two supporting roles for adolescents. First, ensure three month’s supply of IFA and sanitary napkins is provided. Second, report any kind of violence or domestic abuse faced by adolescents to helplines. Any kind of mental distress amongst them should also be reported on helplines like 104, 1098 or to NGOs with child protection programs. However, we do acknowledge that owing to Covid-19, pandemic-centric activities being carried out by ASHA workers, the adolescent health-focused activities are hindered. Here, CSOs can step in to create a system for distribution of basic services like sanitary pads, IFA and contraceptives.”
All the participants stressed on the importance of sustaining the advances made so far in accelerating education, delaying the age of marriage for adolescents and addressing their reproductive health needs, and ensuring that these priorities do not get sidetracked amidst this crisis. Some encouraging initiatives brought forth by CSOs and government representatives were:
1. Adapting government programs, by redirecting procurement and distribution to the household/ village level instead of school/public health centres/Anganwadi centres
2. Leveraging technology to establish a direct connect with adolescents through helplines/ social media
3. Streamlining resources and improving service delivery through partnerships between civil society and government
4. Engaging parents, caregivers and other members of the family to ensure equitable distribution of roles and maintain a positive environment at home
Covid-19 has presented a unique and unprecedented challenge that is further exacerbated in the case of adolescents. Therefore, the common consensus among the group was to prioritise adolescent-specific issues during and beyond the lockdown, to ensure the continuity of services and resources for them. Other measures that were recommended are:
1. Designing and implementing effective virtual or distance teaching and learning for adolescents to continue their education despite shuttered schools and colleges
2. Mediating the impact of job erosion on adolescents who are transitioning into work by creating strong linkages with the private sector for job creation, including effective assessment of skill gaps.
3. Supporting young migrant workers stranded away from their hometowns, and those back in their homes to transition back safely to work and ensure their job security.
4. Ensuring that essential health services – such as sanitary napkins, contraceptives, pre- and ante-natal care – are provided by piggy-backing on private supply networks.
5. Continuing and amplifying mental health services via phone-counselling services or e-mental health platforms
6. Issuing clear directives to emergency support services for women and children, such as the 1098 Childline, the 181 Women’s Helpline, and One-Stop Centres on prioritising and handling cases through/despite measures such as lockdown, restricted mobility etc.
7. Mediate the impact of job erosion on adolescents transitioning into work by creating strong linkages with the private sector for job creation, including effective assessment of skill gaps.
8. Support young migrant workers stranded away from their hometowns, and those back in their homes to transition back safely to work and ensure their job security.
These recommendations will require a concerted and collaborative effort, as stated by Dr Rizvi. Solving for this crisis will hinge on multi-stakeholder action, which will bring together the entire ecosystem around adolescents, ranging from policymakers, CSOs, local government functionaries, and most importantly, the families of the adolescents’ themselves, without whom we will not be able to tackle this crisis.
Also read: Why teenagers should make their own health care decisions