India turns spotlight on adolescent health


Dr. Flavia Bustreo. – Photo: R. Prasad

“India has demonstrated very strong leadership in positioning adolescent health as part of continuum of care. India has taken the lead to present to the rest of the States why it is important to have a discussion on adolescent health,” said Dr. Flavia Bustreo, Assistant Director-General of Family, Women’s and Children’s Health, WHO, Geneva. She was recently in New Delhi to attend the Global Expert Consultation meeting.

Last year, India had requested a discussion on adolescent health at the equity board of the WHO. There were discussions at the equity board this year as well. “We will have a development of framework on adolescent health which will be discussed by all health ministers at the UN General Assembly in May this year,” she added.

In February 2013, at the Summit on the Call to Action for Child Survival, India launched its ambitious new Reproductive, Maternal, Newborn, Child and Adolescent Health strategy, now known as RMNCH+A, to accelerate mortality reduction amongst the country’s most vulnerable women and children.

India has every reason to take the lead — it has a huge adolescent population of 243 million, constituting over 21 per cent of the country’s population. India is yet to meet the Millennium Development Goal 4 (under-5 mortality rate) and MDG 5 (maternal mortality rate).

Overlooking the health of the adolescents has been one of the main reasons why it has failed to reach these goals till now. The adolescent period provides a second chance to improve the health and wellbeing of a child in the second decade of his life.

While what happens during the early years of life impacts adolescents’ health and development, what takes place during the adolescent period affects health during the adult years and even influences the health and wellbeing of the next generation.

Unfortunately, programmes targeted at adolescents are not as advanced as in the case of child health and survival. “We have decades of knowledge, in say, oral rehydration salts (ORS). But in the case of adolescent health, we have only a couple of decades’ knowledge,” she said. “Programmes targeted at adolescents are not so well established. And knowledge and capacity to drive those programmes are not well established.”

Besides health and wellbeing issues like teenage pregnancy, nutrition, alcohol and tobacco consumption, mental health, suicides and road accidents, there are certain interventions which if not applied during the adolescent period can be missed forever. Immunisation of adolescent girls using human papillomavirus (HPV) vaccine can cut deaths from cervical cancer.

As per 2013 data, maternal mortality has been reduced to 2,80,000 across the world. But there are roughly 5,00,000 new cervical cancer cases a year causing nearly 3,00,000 deaths. The HPV vaccine can prevent the onset of cervical cancer if given to girls between 10 and 13 years.

“We are having a discussion on whether the Indian government and society require any other evidence.” Dr. Bustreo said. “But governments have to put in place certain systems.” Since the HPV vaccine serves as primary prevention, governments must also have in place cervical cancer screening, which is secondary prevention. “If you screen and detect cervical cancer, countries should have the ability to treat women, because it is unethical to screen a patient and communicate the news and say we are not able to treat you,” she warned.

Published in The Hindu on March 5, 2015