‘Next what, condoms?’ was the response of IAS officer Harjot Kaur Bamhrah to a query by a Bihar student on affordable sanitary napkins. In the widely reported incident, Bamhrah, an additional chief secretary-rank officer, who also heads Bihar’s women and child development commission, mocked a school student for requesting the government to also consider providing free sanitary napkins apart from doles such as free bicycles and school uniform.

“There is no limit to such freebies. The government is already giving a lot. Today, you want a packet of napkins for free. Tomorrow, you may want jeans and shoes and, later, when the stage comes for family planning, you may demand free condoms as well,” Bamhrah was quoted as saying in a viral video taken during a state-level workshop organised in collaboration with UNICEF in Patna.

While the incident triggered a massive response, including that from the National Commission for Protection of Child Rights (NCPCR) and chief minister Nitish Kumar, the IAS officer’s remark on “free condoms” under the Centre’s family planning initiative actually rings true.

The condom brand ‘Nirodh’ is available free of cost at government health facilities and supplied at the doorstep by ASHAs for a minimal cost. Even oral contraceptive pill (OCP) brand ‘MALA-N’ is available for free at all
public healthcare facilities and at the doorstep of beneficiaries by ASHA on a minimal charge.

India was the first country to have launched a National Programme for Family Planning in 1952. Since then, the government has expanded its focus from population stabilisation goals to include promotion of sexual reproductive health rights (SRHR) and reducing maternal, infant and child mortality and morbidity.

The central government describes young people aged between 10 and 19 as ‘adolescents’. These adolescents, both married and unmarried, are also included in family planning strategies. According to National Family Health Survey (NFHS-5) conducted during 2019-21, 23.3 per cent girls get married below the age of 18 and out of total deliveries 6.8 per cent are adolescents, ie, 15 to 19 years. The situation regarding age of girls at marriage is more alarming in states like Bihar (40.8%), Rajasthan (25.4%), Jharkhand (32.2%), Uttar Pradesh (15.8%), and Madhya Pradesh (23.1%).

In a landmark verdict and a win for activists advocating safe access to reproductive health services for adolescents, Supreme Court has extended the benefits of the Medical Termination of Pregnancy (MTP) Act to minors who engage in consensual sexual activity by exempting doctors from disclosing their identity to local police. The top court included unmarried women for abortion between 20 to 24 weeks of pregnancy under the MTP Act, saying limiting the provision to cover only married women will render it discriminatory and violative of Article 14.

In 2014, ministry of health and family welfare launched the Rashtriya Kishor Swasthya Karayakram (RKSK) or the National Adolescent Health Programme. The government developed the National Adolescent Health Strategy in collaboration with the United Nations Population Fund. The RKSK aimed at increasing adolescent participation and leadership, equity and inclusion, and strategic partnership to enable them to make informed and responsible decisions related to health and well-being.

The objectives of the national adolescent health strategy included improving nutrition, sexual and reproductive health, enhancing mental health and preventing sexual violence and substance abuse. The core package of the services under RKSK included preventive, curative and counselling sessions, routine check-ups at primary, secondary and tertiary health care for adolescents, married and unmarried boys and girls. It aimed to address the health needs of adolescents via community-based interventions through peer educators and other collaborations by the ministries and state governments.

Under the government’s Ayushman Bharat programme, school-based health promotion activities were incorporated as a part of its health and wellness component. Launched in 2020, the School Health and Wellness Programme was implemented in government and government-aided schools in which two school teachers are designated as ‘Health and Wellness Ambassadors’ and are responsible for interacting with school children.

Adolescent Friendly Health Services

First initiated in 2006 under the Adolescent Reproductive Sexual Health (ARSH) clinics to counsel on sexual, and reproductive health issues, under the RKSK, Adolescent Friendly Health Clinics (AFHC) now give services on reproductive health, nutrition, substance abuse, injuries and include violence that addressed gender-based violence, non-communicable diseases and menstrual health.

Adolescent Friendly Health Services (AFHS) are availed from trained service providers, medical officers, ANMs, and counsellors at AFHCs in primary and secondary health clinics, district hospitals and medical colleges. Counsellors inform, educate and counsel clients on adolescent health issues and can refer them to health facilities or other service delivery points: Integrated Counselling Testing Centre, de-addiction centres and non-communicable disease clinics.

According to the programme, counsellors are required to undertake outreach exercises twice a week at schools, colleges, youth clubs and communities to influence adolescents, caregivers and influencers on health issues and awareness about AFHS.

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