Empowerment of 200000 Adolescent Girls in India

Ashavini is from a very small village (hamlet) Malewadi, which has merely 125 households and a total population of 625. Both her parents have only 4 years of schooling and work as agricultural labourers. Her three siblings have not completed schooling either.

Ashavini attended Life Skills Education (LSE) organised by Institute of Health Management Pachod (IHMP), in her village, in 2016. She was so captivated by LSE, she continued attending subsequent courses for the next two years. She was selected as a peer leader by the other girls. Ashavini organised a Girl’s Collective in her village, which took out rallies and organized a street play on the importance of education for girls.

 Recently, when interviewed by a journalist, Ashavini said, “I learnt many things in LSE; about the rights of adolescent girls and women, importance of education in a girl’s life, importance of iron rich food. I also learnt several art and craft. I learnt about the functioning of a bank, post-office and other institutions. I am able to deal with the local bank independently. I learnt about my body, importance of menstrual hygiene, how to cope with sexual harassment, etc. I acquired communication and negotiation skills. After attending LSE I felt much more confident in myself and my abilities. The greatest change that occurred in me was an obsession to study further. I could negotiate with my parents because of improved self–esteem and communication skills, which I acquired from LSE. I convinced them to allow me to finish schooling and go to college for higher education”.

Seeing her enthusiasm, Ashavini’s school teacher gave her the job of an assistant teacher in her village school. She plans to complete her graduate studies in commerce in a nearby town.

 Ashavini says, “LSE encouraged me to dream and aspire for higher education. I have a dream of becoming an officer in a bank”.

Over the last 25 years about 100,000 girls have attended Life Skills Education organised by IHMP in their villages. Ashavini’s testimony reflects how LSE has transformed their lives.

Gangaram Tanda is a small tribal village in the project area of Institute of health Management Pachod (IHMP). The village has a Girl’s Collective (Kishori Mandal), which is named Kalpana Chawla Kishori Mandal by the adolescent girls that are members of this collective. All the members of this Girls Collective have completed Life Skills Education conducted by IHMP in their village.

Varsha who lives in Gangaram Tanda, had a dream of becoming a police officer. But the financial condition of Varsha’s family is not good. Her father is an alcoholic. She has two brothers who work as casual labourers but they are not able to support the family.

Varsha passed 10^th grade in school with very good marks but her mother asked her not to continue further studies because of the family’s financial constraints. Varsha decided to help her mother in agriculture work while continuing with her education.

Varsha discussed her dream of becoming a police officer with members of the Girls Collective. Her peers in the Girls Collective decided to discuss Varsha’s dream with her mother and all of them marched to her home. Members of the Girls Collective told Varsha’s mother about various government schemes for scheduled tribes. They requested IHMP to help Varsha get a scholarship.

Varsha succeeded in getting a scholarship and was able to continue her education. While studying for her 12th grade, Varsha started running and did vigorous physical exercises in preparation for selection into the police force. Members of the Girls Collective would cheer and encourage Varsha when she would be exercising.

After Varsha completed 12th grade there was an advertisement in the newspaper for several posts in the State Reserve Police. Varsha applied and got selected. Presently, she is posted as a police officer in Mumbai where she draws a handsome salary. She is very happy because her dream of becoming a police officer has been fulfilled and she is able to support her family.

Varsha is deeply indebted to the Girls Collective of her village who convinced her mother, arranged for a scholarship to continue her studies and supported her for selection into the police force.

Varsha said something which has altered IHMP’s strategy for empowering adolescent girls. She said “Nobody will gift us our rights, we will have to struggle for them and if girls organise themselves into collectives it becomes easier for girls to claim their rights”.

IHMP is empowering Girls Collectives by organising leadership training for their members. A pair of peer leaders are taking the responsibility of 10 neighbouring household where they prevent early marriage, motivate the parents to continue educating their daughters, ensure nutritious diet for girls and time for leisure and games.

Girls empowerment has become a movement for girls, by girls, through Girls Collectives. IHMP is privileged to be a part of this movement.

Empowering Adolescent Girls for future Leadership Roles

In Maharashtra 57.7 % girls aged 11-19 years suffer from iron deficiency anemia (National Family Health Survey - 2020). The growth spurt that occurs between the age of 11 and 19 years, associated with poor nutrition, and intake of food lacking in elemental iron, results in a high prevalence of anemia. The vulnerability of adolescent girls gets compounded when they start menstruating. Anemia results in impaired physical capabilities, reduced work productivity and maternal deaths.

IHMP has been empowering adolescent girls through Life Skills Education since 1998, which resulted in a significant improvement in their self-esteem, educational status and in delaying age at marriage. These empowered girls have established Girls Collectives and are providing effective Peer Leadership to girls in their communities. They are ready to take up more leadership roles.

In consultation with Peer Leaders, IHMP has come up with an audacious plan for further empowerment of adolescent girls.

A pair of adolescent girls will adopt 20 households in their village. They will make monthly household visits to provide nutrition education and iron and folic acid supplementation to unmarried adolescent girls in these households. Parents of adolescent girls will be engaged during household visits. A book on nutrition recipes will be distributed to the peer educators for dissemination to adolescent girls in their peer group. Peer Leaders will also mobilize the community for events such as nutrition workshops, iron rich recipe demonstrations, recipe and nutrition essay competitions, etc. Each unmarried adolescent girl will be given a diary in which she will record the quantity and variety of food she eats. Peer Leaders will facilitate and monitor regular entries in the diary.

Hemoglobin levels will be measured among adolescent girls prior to and after the intervention.

Your support has facilitated this intervention that can bring about a transformative change in the agency of adolescent girls and preparedness for future leadership roles.

Pushpa lives in Bhaygaon, which is her natal village. In 2018, Pushpa regularly attended Life Skills Education classes conducted by Institute of Health Management, Pachod (IHMP).

When Pushpa was 16 years old her parents decided to marry her. She told them that she does not want to marry till she her 19^th birthday. She was in love with a boy living in her neighbourhood. She told her parents that if they insist on marrying her she will marry her boyfriend and nobody else. The boy belongs to same village so the parents agreed. Pushpa got married after completing 10 years of schooling. She lives in a joint family with in laws, and husband’s siblings.

In IHMP’s Life Skill Education, Pushpa had learnt about the adverse consequences of early pregnancy before 19 years of age and the possible risks for both mother and baby.

After getting married Pushpa told her husband that she wants to continue her education and does not want to become a mother until she turns at least 19 years old. Her husband shared Pushpa’s decision with his parents. They appreciated her straight forward opinion and agreed.

Pushpa had learnt about contraceptives during Life Skills Education. After marriage, she and her husband decided to use condoms to delay first pregnancy till her 20^th birthday.

Pushpa missed her periods after she was 20 years old. When a urine test report confirmed her pregnancy, she registered herself with IHMP’s nurse for antenatal care. During monthly household visits the ASHA and IHMP’s nurse gave her information about importance of care during pregnancy, diet, and complications that can occur during pregnancy.

The baby was in a breech position so when she went into labour, IHMP’s nurse advised to get admitted in a nearby city hospital. She had a cesarean section and a male baby, weighing 2.9 kilos, was born. Both mother and baby are doing well.

Following the advice of IHMP’s frontline workers, Pushpa planned her first pregnancy and took good care of herself during her pregnancy, as a result she gave birth to a healthy baby.

Over 200,000 thousand adolescent girls have benefitted from IHMP’s Life Skills Education and Sexual and Reproductive health services.

Due to the Covid 19 pandemic, large scale migration is taking place in the slums where Institute of Health Management Pachod (IHMP) is working. The result is that the slums continue to have new sets of families every month.

One such family migrated to Ramnagar, one of our project slums. During routine household visits to identify the health needs of married adolescent girls and young married women, the community health worker visited a family that had migrated to the slum recently.

The family members kept denying the presence of an adolescent girl in their house. After several visits, when there was no other member in the house, Komal (name changed), an adolescent girl, came running to the community health worker saying that she needs immediate help.

On inquiring, it turned out that the girl was not allowed to step out of the house, not to speak to anyone, and the family also denied her presence to the community health worker. Komal is only 18 years old, is married and has a baby. Within 2 months of the first delivery, Komal conceived again and is currently pregnant with her second child. She said that she is very weak, scared that she is not receiving any support from her family and is also not taken to a hospital for care during her second pregnancy.

Komal and her family members were counselled by the community health worker, and she was visited by IHMP’s front line worker. The health worker identified symptoms of severe anaemia.

Komal had continuous nausea and vomiting, swelling of the body and weakness. The community health worker referred her to IHMP’s pathology laboratory. Her haemoglobin level was found to be 4.0 g/dl which is dangerously low. The report was explained to her husband and mother-in-law by IHMP’s front line worker including the consequences which Komal and her child might face if proper care is not taken at this stage.

Komal was then immediately admitted to a hospital for treatment. Her haemoglobin level rose to 9.1 g/dL, and she feels better with no more weakness. She is also taking an iron rich diet as guided by IHMP’s front line worker.

Early identification of such health issues combined with interpersonal communication and counselling, and laboratory services in the community, are overcoming risks and complications that may affect these young mothers and their children.

IHMP is monitoring haemoglobin levels for all adolescent girls in the community and providing them with iron supplements and nutrition education to prevent anaemia and its consequences.