Diego Palacios, country representative (India), United Nations Fund for Population Activities, talks about the new programme called Sathiya – a part of the centre’s Rashtriya Kishor Swasthya Karyakram
In a bid to educate the adolescent population of India – the largest in the world, the health ministry, in partnership with United Nations Population Fund (UNFPA), rolled out a nationwide programme in February, under which around 1.6 lakh boys and girls will work as peer educators in the country. The programme called Sathiya – a part of the centre’s Rashtriya Kishor Swasthya Karyakram (RKSK) – will enable educators to work with their peers on the community level and educate them about a number of topics including reproductive health, sexual health, hygiene and nutrition. The attempt by the government has been commended, especially, for its mature approach towards same-sex attraction, emphasis on the concept of consent, and a stand against gender stereotyping in the resource material for peer educators. UNFPA’s country representative Diego Palacios talks to Pranita Kulkarni about the programme and the issues related to the well-being of the adolescents.
What is the importance of a programme like RKSK in India?
It is a very important programme – a strategic decision for the country. India has the biggest adolescent population in the world, and if the country realises the full potential of these adolescents, in addition to empowering them, India will have the possibility of reaching sustainable development in the coming decades. The aim for India is to grow steadily. The need for human capital is immense, and the country would be on the right track if its demographic dividend is realised.
However, realising the demographic dividend is not automatic; investment in health, education, skilling is a must. Young people can utilise their full potential only if they’re healthy, educated and able to work. They need to have information about their reproductive health, sexual health, mental health, nutrition and several other important issues, when they’re growing up. With RKSK, we can use the leadership of young people at the community level to provoke social change.
Adolescents are exposed to a lot of information. The penetration of the internet, even in rural communities, is amazing. But sometimes, the information that they are getting from the internet is not the best information. It may not be scientific and evidence-based. It may not have the necessary sensibility and clarity. The RKSK kit, launched by the ministry of health, aims to bring that balance in, in terms of quality of information, that they’re anyway already getting.
Education of adolescents and young people will help them fight several social issues that are obstructing their empowerment. There is a need to intervene at different points to be able to break the cycle of social harms. And that’s where young people can help. When they’ve gone through a programme which gives them scientific and comprehensive information about all the relevant issues, and teaches them how to deal with them in a compassionate manner, they will be able to grow healthier and to interact with their parents and family with enhanced capacities.
How has the programme been conceptualised and designed?
The design of the RKSK’s peer educators strategy is very comprehensive. It has drawn attention from the global community, including a very recent publication of the WHO. Two crucial aspects of this programme are the peer educators and the community’s positive response. The peer educator strategy is being rolled out at community centres in phases. The plan is to have one counsellor at the sub-district level. This is the most important feature, which you will not see in other countries. There is an adolescent-friendly health centre (AFHC) in each community health centre. The RKSK programme has a provision to hire a counsellor for each AFHC who is trained systematically. And the peer educators – who’ll be working with fellow adolescents and young people – will be supported by the counsellor. Peer educators are also supposed to encourage peers to visit the counsellor, whenever necessary. You can’t expect a peer educator to have all the knowledge, and so to support their knowledge, the counsellors will play an important role. The community’s positive response is imperative for the success of the programme.
Can you tell us about the process of developing the resource material for peer educators? What constitutes it?
Many NGOs, academia, UN agencies have been working together on the programme for some time now. Development of the Sathiya kit goes back to 2015. What’s really interesting is that the information materials being presented now have not been an invention of public officials in the ministry of health or the UNFPA experts. Its content has come from a process of analysis of what questions adolescents are asking, of what is in their minds. When the first material was produced in 2015, it was prepared by a group of national experts – coming from different sectors, many of them were working with adolescents. The research for these documents has been handled by prominent NGOs working in this field. The research compiled FAQs by the adolescents and young people. These NGOs are interacting with young people in big cities, small cities and at grassroots level on a daily basis and they are quite aware about the issues that need to be included in the materials. These NGOs were commissioned by the government, and they are acknowledged in the material.
Although the attitude towards discussion on sex and sexuality is undergoing a gradual change in the Indian society, a large portion of it still remains conservative. In this context, how does UNFPA anticipate response to the resource material for the peer educators?
The situation in India is changing rapidly. The issues of sexuality are being discussed frequently. But the interesting thing about this material is that it goes beyond sexuality, it covers many issues that are important for adolescents’ development. The intention is to give a clear response to many issues that young people are confronted with in a sensitive way, to ensure they have valid information and to be able to act on it. The package includes comprehensive health-related information, from nutrition to mental health to the issues of non-communicable diseases like obesity and growing-up issues, reproductive health – based on the framework of age-appropriate materials. This is a programme for the age group of 10-19. And the information needed for the age group of 10-14 is different from the information needed for 15-19. We know that in rural areas, the age of marriage is as low as 18-19 years. That group also needs to be covered. These are, basically, the seeds of change that the governments are planting at the community level. It’ll take some time, but we’ll reach there.
With legality of homosexuality still in question in India (section 377 of IPC criminalises homosexuality), the material talks about one’s attraction towards the opposite sex as well as the same sex. How do you explain it?
The fact remains that the young people are asking questions about this topic. One option is to say that this is not happening or the other option is to say that it is wrong, and this shouldn’t happen. If you take either of these two positions, you will not be addressing their questions – the real issues that young people are enquiring about. You need to have a response, and the response is neither to promote nor to condemn. You have to treat these issues with clarity and a sense of responsibility and compassion. If you don’t dispel these taboos – like the one associated with masturbation, you are not addressing the young people’s needs for balanced information. On the contrary, you might be provoking more distress and guilt. That’s why I applaud that the health ministry has taken an important decision to consider addressing sensitive issues in a natural way, with a sense of reality. In Indian culture and philosophy, compassion is a crucial principle.
What is UNFPA’s stand on the demand for equal rights for LGBTI in India?
UNFPA works within the framework of national legislation and laws of India. We know that in India, like in any other countries, people could have different sexual orientations. Together with the national institutions, we are supporting the rights of all people to ensure they have access to services and information so they can live a rewarding human life, regardless of their sexual orientation. Look at agencies that are working in the prevention of HIV/AIDS. They are working with the LGBTI community to make people safe. By doing so, they are not legitimising homosexuality. Their work is oriented to support and protect their human rights and needs for health services and information.
What role should parents play in the discussion on adolescents’ reproductive health? Is there a need to counsel the parents as well?
As a part of this programme a day has to be observed once in every three months as an Adolescent Health Day. UNFPA is helping the RKSK to design and implement the health day. Peers are encouraged to bring the parents to these occasions. The parents will know that their children are being taught about diverse topics – right from nutrition and sanitation to mental health. Let the parents come and see what are the risks that their children can be exposed to, so that they can promote and encourage young people to participate in the programme, and also support them to become peer educators. Parents’ support is important for developing their personality wholesomely. Also, the peer educators are going to be communicating with the whole community – be it parents, be it teachers or be it the panchayat members. This will also help them develop their leadership skills.
What qualities or qualification an ideal peer educator should possess?
First of all, they should be good communicators and, in many cases, they are natural leaders in that community. They should belong to the older side of this age group – towards 18-19, so that they will be able to communicate not only with the young peers, but also with their parents, teachers and other senior community members. It’s not like one size fits all. He or she could be young, but can still be an effective communicator. The important detail here is that the peer educator will be selected by the community. The government’s health staff has been told to discuss the programme at the community level to get them involved in the nomination of peer educators, according to the guidelines. They are mandated to be trained for six days over a period, which is to be decided by the state governments.
How can the RKSK reach adolescent mothers or young married women, who are outside any formal settings like schools – trapped in the patriarchal setups?
The peer educators belong to their communities. They will not only be boys, they will also be girls – both school-going and not school-going. Through this mechanism, a wider portion of the community including young married women and girls will be involved in the peer educators’ activities at the community level. We need to realise that to change the situation of lack of information and decision-making, we need more than this. There are other government programmes like ‘Beti Bachao, Beti Padhao’, which are also working at the community level to empower young women. This will combine efforts at the community level to give young people more information and empower them. The prime minister has been emphasising empowerment of women and girls. Decisions that the government is adopting are very relevant. It’s much more complex than just health. It aims at changing mindsets that keep young people, particularly women, in a secondary role. We need to work from multiple sectors and from different standpoints – from the school system, from the health sector, from the community in terms of women’s empowerment programmes. Programmes like skilling should also come together to increase livelihood opportunities, which will also provoke social change. I have worked in about 20 developing countries, and what I am seeing in India is very interesting. There are right policies that will bring positive social change, keeping the Indian cultural values intact, but will also shift some ideas that are keeping women and young people in a situation where they cannot develop and contribute fully. I expect that in the next five-ten years, India will achieve very important social development outcomes out of the seeds that the government is planting.
Has UNFPA implemented a similar programme in any of the other socially backward country? What are the lessons drawn from these countries?
Developing countries look at UNFPA as a valuable organisation that can help them advance the young people’s agenda. By virtue of the mandate that these countries give us, we’re working closely with national institutions to support youth development, particularly of girls. We’re mindful that in every country action has to be contextualised to suit its cultural values, historical development and so on. There’s no single recipe for all the countries. We’re inspired by basic principles of human rights, in this case the rights of young people – right to information, education and health. Programmes in other developing countries have successfully addressed issues and problems of adolescents and young people. I’m sure it’ll happen in India as well.
(The interview appears in the April 16-30, 2017 issue of Governance Now)