Adolescence may be defined as a transition from childhood to adulthood, a time when structural, functional, and psychosocial developments occur. Consequently, pregnancy during teenage can adversely affect the health as the adolescent female concerned is yet to attain her full growth potential. Moreover, reports show, adolescent pregnancies also impact social development and the national economy.
According to UN report, India bears economic losses of $7.7 billion a year due to teenage pregnancies. An earlier estimate by health ministry suggested economic losses of teenage pregnancies at 12% of the gross domestic product (GDP).
Teenage pregnancy is almost double in rural areas, 9.2%, as compared to urban, 5%, in India. Here’s where the problem lies – these pregnancies not only make adolescent girls extremely vulnerable, both physically and mentally but also place them and their babies at risk. Such pregnancies are associated with an increased risk of miscarriages, abortion and other adverse outcomes.
In India, more than 50 per cent adolescents who are married have already given birth to children. As is evident from statistical data, the prevalence of teenage pregnancies is inversely proportional to their levels of education. At least twenty per cent of the women who got pregnant as teenagers had no schooling. There is also a higher prevalence of teenage pregnancies at 10.6% in the poorest wealth quintile and tends to lower at 2.5% in the highest quintile. Similarly, teenage pregnancies tend to be higher in scheduled tribe communities as compared to other castes.
Although the trend of early marriages is on the decline, at least 27 percent of women are married before the legal age of 18 years. The trend is higher in West Bengal (44%), Bihar (42%), Jharkhand (39%), and Andhra Pradesh (36%) and lowest in Lakshadweep (5%), Jammu & Kashmir and Kerala (9%). This shows the correlation between high rates of adolescent marriages with low levels of education.
What’s alarming is the increasing rate of maternal and infant deaths caused by anaemia. About 54.1% adolescent girls, aged 15-19, are anaemic with a slightly higher incidence in rural as compared to urban areas. And this is because only 28.1% of adolescent expectant mothers consumed iron and folic acid tablets, which are crucial in curbing anaemia during pregnancy.
Similarly, at least 42 per cent adolescent girls in India are undernourished with a BMI less than 18.5. As a direct consequence, pregnancy in such a fragile state perpetuates the malnutrition cycle and triggers neonatal, and infant deaths. A recent study has found higher stunting and underweight in children born to adolescent mothers. The low education, poor nutritional status, high rates of anaemia further contribute to the vicious cycle. Low dietary intake with a diet deficient in fruits and milk and wide variation across states in consumption of foods from required food groups adds to the poor nutritional status in women.
Sadly, not much has changed in India with regards to child marriage, teenage pregnancies, and associated malnutrition for adolescents. It is disturbing, given that India is expected to have the biggest national adolescent girl population by 2030 at 95 million; and that is exactly why it is imperative to undertake measures which can reduce child marriages and teenage pregnancies in order to check maternal and infant mortality rate.
The national program on adolescent health “Rashtriya Kishor Swasthya Karyakram” (RKSK), was launched in 2014. RKSK provides an impetus to the adolescent health interventions by a renewed focus on community-based health promotion and prevention combined with clinical-based preventive and curative services.
Yet, that’s just on paper. Challenges of early marriage, teenage pregnancy, anaemia and high incidence of maternal mortality continues to persist. Poor implementation of the program is probably to blame here. The need of the hour is a comprehensive and convergence among various departments to address all the needs of adolescents. Robust measures and policies to end teenage marriages and consequent pregnancies are exactly what India needs at present.
The author is a Senior Fellow at Observer Research Foundation.