We have close to 236.5 million adolescents in India today. This young generation, aged between 10 and 19 years, is the future of this country. They will drive our economic growth and social development in the decades to come and take us down the road to prosperity, provided we ensure that their health and wellbeing becomes and remains a top national priority.
Adolescence is a critical stage in life during which the foundation for adulthood and future health is set. This is the time when young people are seeking autonomy and greater control over their lives. Undoubtedly, it is a unique opportunity for us to encourage and reinforce positive health-seeking behaviours in this demographic.
The diverse nature of adolescent health needs, issues and concerns calls for a holistic approach to ensure prevention of non-communicable diseases.
Adolescence is characterised by one of the most significant changes in an individual's life: puberty. This has biological, physiological and emotional implications. We need to show young adults how to manage these changes and guide them to ensure that they are protected against a number of diseases and can build a strong foundation for future health. The latest addition to this list are non-communicable diseases (NCDs).
Many Indians are genetically predisposed to non-communicable diseases, so they pose an even bigger threat. NCDs include cardiovascular disease, cancer, chronic respiratory diseases and diabetes. Every year, approximately 5.8 million Indians die from NCDs. A large number of these deaths can be prevented altogether, if the foundation for a healthy lifestyle is laid during adolescence.
Adolescents need to understand that the root cause of most NCDs are poor lifestyle choices such as an unhealthy diet, alcohol and tobacco consumption and inadequate physical activity. These habits can, later in life, lead to four key metabolic and physiological changes in the body: increase in blood pressure, accumulation of fatty tissue in the body, and high levels of sugar and fat in the blood. As a consequence of these changes, obesity-related NCDs such as insulin resistance, Type 2 diabetes mellitus and metabolic syndrome are far more prevalent today. Moreover, overweight adolescents are twice as likely to develop cardiovascular disease when they become adults.
It is clear that NCDs impose a significant economic burden on us by increasing healthcare expenditure and undermining productivity. The diverse nature of adolescent health needs, issues and concerns therefore calls for a holistic approach to ensure prevention of NCDs.
The government continues to try and curb the risks for NCDs in India. In 2014, the first national adolescent health programme, Rashtriya Kishor Swasthya Karyakram (RKSK) was launched. With inputs from civil society organizations and national public health experts, RKSK was built around nutrition, sexual and reproductive health, mental health, prevention of injuries and violence, substance abuse and NCDs as key focus areas. However, it is a matter of concern that barring a few states, most have not been able to put in place systems to implement this programme.
For Indian adolescents in the age group of 13 to 15 years, 19% of boys and 8% of girls consume tobacco products on a regular basis.
Another major health concern is the growing use of tobacco amongst the young. The PRB report revealed that for Indian adolescents in the age group of 13 to 15 years, 19% of boys and 8% of girls consume tobacco products on a regular basis. This addiction claims over 6 million lives globally every year through illnesses such as cancer, chronic respiratory disease and heart disease. This year on World No Tobacco Day, the Health Ministry announced that anti-tobacco pictorial warnings will now be a part of the curriculum for schoolchildren. This is a good move, but we need to do more to increase awareness through local community efforts to target a wider group of adolescents across India. We need to ensure that tobacco products are not sold near schools and colleges.
We also need to consider the issue of alcohol and drug use. A large number of young people today are addicted to these, a trend that cuts across socio-economic levels. These harmful choices significantly increase the risk of developing cancer of the mouth, breast, oesophagus, stomach, liver, kidneys and pancreas.
The Adolescent Health Division of the Ministry of Health and Family Welfare currently implements three programmes: Adolescent Reproductive and Sexual Health Programme (ARSH), Menstrual Hygiene Scheme (MHS) and Weekly Iron Supplementation Programme (WIFS), across 107 districts in the country. In 2014, the government developed a national adolescent health strategy in consultation with UNFPA. Known as the Rashtriya Kishor Swasthya Karyakram, the program aims to address the various health needs of 25.3 crore adolescents aged 10–19 years.
We need to adopt a comprehensive approach where the government, corporates, private health sector, civil society organisations and NGOs come together and pool their resources and expertise.
Last year, the government passed the Juvenile Justice Act penalising anyone intoxicating a child with liquor, narcotic drugs, tobacco products or any psychotropic substance, making it punishable with rigorous imprisonment which may extend to seven years and a fine which may extend up to ₹1 lakh. Additionally, on this year's World Health Day, Health Minister Shri J P Nadda emphasised the need to focus on adolescents and youth for prevention of lifestyle diseases.
These are examples of health interventions that are making a meaningful difference in the health and well-being of marginalised and disadvantaged adolescent boys and girls, by encouraging them to make informed health choices. Such well-tested and successful models for NCD prevention and control in adolescents, we believe, can be scaled for wider implementation.
To fully protect our adolescents from the risk of NCDs, we require a combination of policy changes and social and behavioural interventions. We need to adopt a comprehensive approach where the government, corporates, private health sector, civil society organisations and NGOs come together and pool their resources and expertise. Many lifelong health behaviours are initiated in adolescence, making investment in adolescent health absolutely critical.