The vast majority of adolescents (88 per cent) live in developing countries. India has the largest national population of adolescents (243 million) comprising one fourth of the population. 1 Significant proportion of adolescents has poor level of life-skills and they are not sufficient to deal with the demands of modern society.2 With advanced & complex life style, traditional mechanisms to incorporate life skills may no longer be adequate. Life skills hitherto should be included to curriculum. What are life skills? Life skills are problem solving behaviors used appropriately and responsibly in the management of personal affairs. UNICEF lists 10 life skills as most important under the domain of psychosocial and interpersonal skills. These are problem solving skills, critical thinking skills, effective communication skills, decision making, creative thinking, interpersonal relationship skills, self-awareness building skills, empathy and coping with stress and emotions.

Introduction: The anemia management program for adolescent girls (15–19 years) was part of Eastern Uttar Pradesh Health Initiative implemented by Tata Trusts in 9 districts and 19 blocks in partnership with block level community-based organizations. Objective of the Health Initiative was to build community-based platform (In the form of Village Health and Nutrition Day – VHND) to provide primary healthcare services for basic maternal, child and adolescent health. The anemia management component in the program was based on the National Iron Plus Initiative guideline. Objectives: To ascertain prevalence of anemia in adolescent girls registered in the program; to demonstrate a community-based model for anemia management with the help of adolescent collectivization facilitated by trained front line health workers. Materials and Methods: Total 26,982 girls were screened in first phase of the program from April 2014; followed by second and third screenings with average duration of 3–6 months between each screening. Total 18,428 girls participated in second screening and total 13,979 girls were part of all three screenings till September 2015. WHO recommended Hemoglobin (Hb) Color Scale Method was used as a screening tool, implemented by auxiliary nurse midwives and lab technicians. Girls’ collectivization was facilitated by the trained frontline health workers to spread awareness, mobilize girls for screening and conduct health education sessions. Data is from the project MIS and was analyzed with the help of Microsoft Excel and SPSS. Results: Project implementation level data across 19 sites for 3 checkups with mean interval between each checkup as 3–6 months, shows prevalence of anemia in adolescent girls was 86.80%. Mean rise of hemoglobin from checkup 1 to checkup 3 is 0.6 gm. Drastic reduction in severe anemia from 5.66% to less than 1% is seen in the program. In case of non-school-going girls, reduction in severe anemia was from 17% to 1.5%. Conclusion: Overall burden of anemia in adolescent girls (15–19 years) is very high in girls in late adolescence stage. As age increases, prevalence increases, non-school-going girls are worst affected with severe anemia. It is promising to implement anemia management program through a platform led by a trained frontline health worker facilitated adolescent girls’ collectivization. Community-based strategies and individual follow up is significant to reduce burden of severe anemia.

Objective: The purpose of the study was to assess the risk behavior and its effect on involvement in sex among school-going adolescents as a part of assessing implementation of Adolescent Reproductive and Sexual Health Scheme (ARSH) in a state of India. Methods: The sample covered 3069 randomly selected adolescents (students) from 9th to 12th standard in various government, private and missionary-run schools from two districts, namely, Aizawl and Champhai in the state of Mizoram. Results: It was found that more than one-third of adolescents (37%) accepted taking alcohol and 72% of adolescents accepted seeing pornographic movies. Nearly 23% respondents were aware about premarital pregnancy among friends and 7.5% were aware about complication due to unsafe abortion among them. About 10% accepted involvement in premarital sex and majority of them (70%) had premarital sex between age group 15 and 19 years and 54% never used condom. Influence of peer group who were taking alcohol, tobacco and drug and exposure to erotic materials was found to be the major risk factors for indulgence in unsafe sex practices among adolescents. Conclusion: Better awareness and counseling against tobacco, alcohol and drug abuse, and pornographic literature among adolescents is needed through school health education.

Background and Aims: Peer-led intervention is one of the beneficial approaches for preventing adolescents from health risk behavior. So, peer-led intervention may help to prevent adolescents from smoking cigarettes but impact of such intervention has not been studied well. Therefore, this study was conducted to investigate the effect of peer-led intervention to prevent adolescents from smoking behavior. Methods: Pub Med, PschyINFO, EMBASE, Google Scholar and Cochrane Library were searched from March to June, 2016, with set criteria in review protocol and only randomized control trials were included. Screening and data extraction were conducted and data from eligible studies were pooled. Results: The number of studies included after full text review were three. Three eligible studies’ data were extracted and further analyzed for risk of bias in Revman.5 Three studies targeting smoking behavior were pooled which represent 25,864 adolescents. Meta-analysis revealed that odd ratio of smoking was lower in those receiving peer-led intervention compared to those not receiving peerled intervention. Conclusions: Peer-led intervention may be effective in prevention of cigarette smoking among adolescents but the studies included in the study are less in number.

Background and Objective: Reproductive health is a crucial component of general health during adolescence and adulthood as the severity of problems faced during the time of puberty decides the health of next generation as well as the health of both males and females beyond reproductive years. A majority of young teenagers are still far from access of education on sexual and reproductive health and rights. This study attempts to understand the knowledge and perceptions of school-going adolescents regarding pubertal changes, pregnancy, abortion, menstruation (girls only), masturbation (boys only) and problems of reproductive health. Materials and Methods: A cross-sectional study was conducted in the urban area of Varanasi city of Uttar Pradesh, India. It consists of 650 boys and 1022 girls of 9th and 11th standard of both Hindi and English medium schools. Both boys and girls are interviewed by a self-administered structured questionnaire maintaining high level of confidentiality. Results: Adolescents of Hindi medium schools are more ignorant regarding sexual health than those of English medium schools. The majority of boys (65.8 percent) gather information on sex from internet websites and also by watching blue movies. Over two-third girls discuss their personal problems with their parents. Around one-fourth of boys have ever involved in sexual intercourse. Mean age at first intercourse is found to be 15.43 years and 14.95 years for boys and girls respectively, who were ever involved in sexual intercourse. Only 16.4 percent Hindi medium school boys know that father is responsible for the determination of gender of the child. Merely 60 percent girls have the knowledge about menstruation before it started and in most cases mothers give this information to their daughters. Conclusions: The knowledge of school-going adolescents, both boys and girls, is poor about pubertal changes and reproductive health issues. There is a great need for sexual and health education programs to be implemented among adolescents.

Objective: To assess and compare the prevalence and risk for eating disorders (ED) among middle and late adolescents in India. Materials and Methods: A prospective study conducted among 1855 adolescents of age group 14 years to 19 years from four schools and three colleges in Mangalore city. A standardized structured questionnaire was used to evaluate the subjects’ attitude toward and preoccupation with food, dieting, eating, physical appearance, and personal control over eating. Eating Attitudes Test questionnaire (EAT-26), consisting of 26 questions that assess the symptoms and concerns that are characteristic of eating disorders and four additional questions to asses weight control behavior patterns adapted. Participants who scored 20 and above on EAT were considered to have eating disorder that would require professional attention. Results: 1855 students participated in the study and completed the self-report EAT-26. Among the study participants, 47.3% were in mid-adolescence and 52.7% in late-adolescent age group respectively. 26.7% of participants scored 20 and above; scores attained were correlated with the behavioral patterns adapted which was found to be statistically significant, indicating a high risk for development of eating disorders among adolescents. Higher prevalence of eating disorder was noted in those with increased BMI (p-value <0.0001) but age and gender did not have a significant influence. Conclusion: Eating disorders and subthreshold eating conditions are prevalent in sample of Indian adolescents and were strongly associated with psychological, behavioral and socioenvironmental domains, which show the necessity of initiating routine screening programs and intervention programs to control eating disorders among Indian adolescents. Further evaluation, counseling and follow-up with a qualified professional is essential to rule out any underlying cause for eating disorder.

Background and Objectives: “Adolescent Reproductive and Sexual Health (ARSH)” has been included in the existing public health system in Gujarat from 2006 for addressing issues of adolescents. This study was done to identify the operational gaps and service utilization of ARSH clinic in one of the urban health centers (UHC) in Surat city. Methodology: Mixed approach having in-depth interviews and observation and record-based analysis was done to assess operational efficiency of ARSH clinic. In-depth interviews were carried out among four service providers and secondary data of 157 adolescents were analyzed from the UHC records. The ARSH assessment check list was developed using national guidelines. Quantitative data analysis was done by MS excel 2007. Interviews were transcribed, translated and content analysis was done. The problem analysis was done using Fish-bone diagram and SWOC analysis. Action plan was prepared by developing the critical pathway method. Results: Only 1.9% beneficiaries were boys. Service utilization was done mainly for STI/ RTI counseling (96.83%), IFA tablets (59.23%) and Immunization (81.53%). Inadequacy of infrastructure, materials, human resources, referral linkages, monitoring and supervision was observed. SWOC analysis revealed that the staff was empathetic towards the needs of adolescents but lack of IEC was identified as a major challenge to prepare an action plan. Demand generation was identified as the critical pathway. Conclusion: Service utilization was comparatively very low among boys and only for few services even among girls. Demand generation in schools and community and strengthening of weaknesses in operational aspects of ARSH may improve service utilization

Introduction: Adolescent pregnancy is pregnancy by a female, aged 13 to 19 years. Despite decline in birth rate from 98.6 in 2000-2005 to 86.3 in 2005-2010 per 1000 babies born to adolescent girls aged 15-19 years, India topped the chart of 10 countries with the greatest numbers of women aged between 20 and 24 who gave birth before their age was eighteen. Material & Methods: Under the Planning Commission, Government of India, a one-year clinical prospective study was carried out at the district hospitals. The comparison was made between 200 adolescent mothers (15 to 19 years) and 200 adult women to know the different inputs regarding adolescent pregnancy. Observations: The outcome of pregnancy was 15.50%, 21% and 63.50% in adolescent group while 6%, 54.50% and 39.50% in adult group of miscarriage/abortion, normal vaginal delivery and caesarean, respectively. High incidence of low birth weight, neonatal problems and maternal complications were identified in the adolescent age group. Discussion and Conclusion: The high incidence of caesarean section may be due to the maternal age which hinders the way of normal vaginal delivery. High incidence of low birth weight, neonatal deaths and maternal complications in adolescent group also attribute to the maternal age. Maternal complications during delivery were 42% and 17%, incidence of maternal mortality, morbidity and under nutrition 69.60% and 30.30% respectively in adolescent and adult group respectively. As per Sample Registration System (SRS), the Registrar General of India (RGI-SRS), the state of UP is far behind in IMR [57 (2011) 53 (2012)] and MMR [359 (2007-09) 292 (2010-12)]. Our study reflects the high incidence of maternal mortality, morbidity and under nutrition (69.60%) and maternal mental health problems (63.80%) in adolescent group which shadows the MMR targets for MDG-5. Apart from blocking the road of MDG-4, the adolescent pregnancies also stop the development of female children who have the right to avail all the facilities and opportunities offered by the nature and society.