Recently, I toured a health clinic in India and met a girl named Anju. Anju's family is poor. They live far away in a remote village that has no running water or health care. Although Anju is only 14, her parents expect her to marry and start having children soon. But she confided that she is not ready to get married. She doesn't even want a boyfriend. What she wants more than anything is to go to school.
Anju dreams of becoming a teacher or even a doctor, something that will give her a chance to make life better for her family and the people in her village. To do this, she will need to complete her education, delay marriage and pregnancy, and stay healthy. Most importantly, she will need the ability to decide whether and when to have children, and how many to have.
Discussing sexual and reproductive health for a girl as young as Anju may seem premature. Yet, each year, millions of girls in India and in more than 20 other developing countries where EngenderHealth works are married too early--as young as 15--and begin having children.
What will happen to Anju's dreams if she has children before she is ready? What does the future hold for any teenage girl who has no say in contraceptive use, cannot protect herself against HIV or other sexually transmitted infections, and cannot stay healthy?
This is the life for many women and adolescent girls in India's poorest villages, where high-quality reproductive health care--or health care of any kind--can be a day's walk away. For example, in Jharkhand and Bihar, two states in Eastern India, 25% of teenage girls have already had a baby, and nearly half of those who are married want, but lack access to, contraception.
We are changing this reality. In places like India, doctors and nurses who are trained by EngenderHealth understand the special needs of adolescents, including how to counsel effectively so that they make informed decisions about contraception and nutrition. We also engage communities about the risks of early marriage and pregnancy, anemia, unprotected sex, and unsafe abortion, to help create a supportive environment in which adolescents can seek and access health care.
And we're seeing results. Last year, in Jharkhand and Bihar, we saw a steady increase in the number of adolescents who accessed health services.
We're hoping for similarly encouraging results in Texas, where we're piloting a program to reduce teenage pregnancy. This program, which is based on one that EngenderHealth has run in more than 15 developing countries, teaches teenage girls and boys to challenge harmful gender stereotypes that drive unhealthy behavior. The program encourages boys and girls to think and discuss issues together--like how to decide if and when to have sex, and to use contraceptives--using a mix of workshops, social media strategies, and youth-generated video messages. Hear what these young men and women have learned.
By seeking ways to protect and improve their own health, a 14-year-old girl in an Indian health clinic, teenage mothers in impoverished villages, and adolescents in Texas are on their way to improving their health and the health of others in their communities.
Access to health care and the ability for adolescents to make choices about their own sexual and reproductive health aren't limited to adolescents in India or even developing countries--this is a global health issue. In fact, more than 1 billion young people are entering their reproductive years, and they need high-quality sexual and reproductive health care to fulfill their potential and to thrive. Our responsibility is to work together to drive change and create opportunity for adolescents around the world.
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