PUB - Publikationen an der Universität Bielefeld

The study intended to explore the magnitude and characteristics of sexual and reproductive health risks of young people in Gujarat, India. In particular, the study examined the fit between sexual and reproductive health needs and the existing programming responses in terms of policies, programs and access to health care services. The study is based on empirical research and Social Cognitive Theory framework. The investigation was conceived in the context following the International Conference on Population and Development (ICPD, 1994) declaration that young people should be given access to sexual and reproductive health information and services. Though India has taken a lead in translating the ICPD declaration initiatives, the task seems to be largely unaccomplished. Against such a background, the study hypothesised that there is a poor fit between young people's sexual and reproductive health needs and the existing programming in India. The state of Gujarat in India was chosen as the study site. The study population comprised of planners and policy makers in the concerned ministries, program managers of governmental as well as non governmental organisations working for young people, United Nations agency representatives (categorised as Inter-Governmental Organisations), health service providers, young people and key informants like parents, teachers and media representatives. The respondents were identified through combinations of convenience and purposive sampling, the use of key informants and programme and service reports and records. The data were collected using qualitative methods consisting primarily of in-depth semi-structured individual interviews, supplemented with observations and analysis of policy documents. The results indicated that while young people in Gujarat tend to engage in significant risky sexual behaviour both in early marital and premarital sexual relations, the existing programs are ill-equipped to meet their needs. The risk behaviour involving early initiation of sexual activity which tends to be mostly unsafe and hazardous seems to be arising from a number of factors. Significant levels of hazardous consequences like too early pregnancy, sexually transmitted infections and unsafe abortions were also perceived by the respondents. The perspectives regarding the existing policies, programs and responses from the health care systems in terms of meeting the sexual and reproductive needs of young people were also elicited. Analysis based on Social Cognitive Theory showed that there is a poor fit between programs and needs. Young people tend to face many barriers in accessing health services too. The findings are discussed based on previous research and recommendations for future programming are evolved.