Beyond Remorse to Reflection: Curating a Strategy for Research and Response for Adolescents in India post COVID-19

Mallika Tharakan (mallikab@khpt.org) is a Research Scholar at the Institute of Development Studies (IDS), University of Mysore, Mysuru, INDIA and Lead, Knowledge Management at KHPT (www.khpt.org). Mundayat Meera (drmmeera1@gmail.com) teaches at the Institute of Development Studies (IDS), University of Mysore, Mysuru, INDIA. Mohan HL (mohan@khpt.org) works at Karnataka Health Promotion Trust (KHPT), Bangalore, India.
12 May 2023

Global data on the impact of the COVID-19 pandemic on adolescents show that >150 million children and adolescents in 165 countries have been affected by the pandemic-induced closures (Xiang et al 2020). This article presents experiences and conversations around the pandemic’s effect on the adolescent population and the need for spotlighting and vulnerabilities of adolescent girls, specifically, in India. The article tries to establish the need for deeper introspection on “successes and learnings” of responses across development programmes designed to address the impact of the pandemic with this population group of Koppal district, Karnataka. 

“I had just about managed to convince my parents to keep me in school, but with the pandemic starting and schools closing down, my parents had a perfect situation to take away from me my hopes and aspirations. No more school for me”—Rani (name changed), Koppal district, Northern Karnataka.

 

Global data on the impact of the COVID-19 pandemic on adolescents show that >150 million children and adolescents in 165 countries have been affected by the pandemic-induced closures (Xiang et al 2020). This article presents experiences and conversations around the pandemic’s effect on the adolescent population and the need for spotlighting and vulnerabilities of adolescent girls, specifically, in India. The article tries to establish the need for deeper introspection on “successes and learnings” of responses across development programmes designed to address the impact of the pandemic with this population group.

 

The Indian Council of Research on Women (ICRW) explains adolescence as the formative change from childhood to adulthood, a time when numerous significant social, economic, biological, and demographic events set the stage for adult life. This is a “vital period of conjecture (Jeffrey 2010) crucial to develop knowledge and skills, learn to manage emotions and relationships, and acquire attributes and abilities” (Nanda 2020). The United Nations International Children's Emergency Fund (UNICEF) reports that adolescents aged 10–19 years constitute about one-fourth of India’s population.

 

As a phase of gradual development towards autonomy and individual adult decision-making, adolescents are often faced with situations for which they may not be prepared, may not have adequately sensitised socio-cultural contexts, and many are likely to be involved in risk-taking behaviours (Alderman et al 2019). In developing their identity and independence, they also face growing pressure to be responsible and trustworthy while grappling with issues like sexuality, negative gender norms, and peer relationships (Youel 2020). The American Academy of Paediatrics explains that adolescence is a season of fast-paced development in five key areas: moral, social, physical, cognitive, and emotional. Hence, adolescents require distinct services considering their developmental status and the ways in which they experience the structural changes around them, which in turn give rise to certain unique forms of adolescent vulnerabilities. This places them at higher risks of malnutrition, child labour, child sexual and physical abuse, discontinuation of education, poor access to healthcare, poor understanding of their sexual and reproductive health needs, poor mental health outcomes, substance use, and abuse.[1] Even under “normal” circumstances, adolescent girls face a wide range of health needs and social challenges that largely remain unaddressed because of underlying barriers at individual, familial, community, and ecosystem levels. Some of these include discriminatory gender norms, poor opportunities for participation, limited agency, and decision-making power (Mmari and Sabherwal 2013; Sommer and Mmari 2015; Salam 2016). The sustainable development goal (SDG) of “ensuring equal social, health, educational, and economic opportunities for the well-being of girls” calls for deeper (Gates 2014) efforts to modify the social norms that drive gender inequalities among adolescent girls[2] (Kabeer 1999).

 

2.         The Shift Triggered by the Pandemic

The onset of the COVID-19 pandemic has compounded the existing vulnerabilities of adolescents, placing several developments efforts with this population group, towards accelerating education, delaying child marriage, addressing sexual and reproductive health needs, and building agency, at the risk of being dissipated (Jejeebhoy 2021). Research studies globally reveal the multi-layered impact of the pandemic on adolescents and their well-being.

 

The psychological impact of the COVID-19 pandemic on adolescents is far greater than that on adults because they are more vulnerable to the negative effects of stress (Zhang et al 2020). Organisations working with adolescents and youth have asserted concern about the effect of the pandemic on mental well-being, friendships and familial relationships as well as access to reliable information (Jejeebhoy 2021). Research studies have shown that the major consequences faced by adolescents following exposure to disaster or conflict are externalising behaviour problems, physical health, post-traumatic stress, and vocational or educational disruption (Grasso et al 2013). The alarming educational disparities along socioeconomic lines were already present, but the pandemic has aggravated them. It has highlighted many existing societal divides and the way it has disproportionately impacted lower income communities as well as the exacerbated gender inequalities (Grasso et al 2013).      

 

The lockdowns invited the closure of schools and social distancing that haveposed challenges for adolescents, including educational disruptions and interruptions in daily activities and has increased the levels of domestic violence, stress, and mental health issues (Shah et al 2020). Adolescents in these circumstances have major barriers in respect to receiving support, access to the internet, lack of equipment, lack of income, lack of space at home or food, access to healthcare and emotional support, violence, and so on. An International Labour Organization (ILO 2021) report indicated that 70 per cent of the group has been negatively affected by the closure of schools, universities, and training centres, especially since schools and educational institutes are not only a place for delivering educational content but also social and emotional growth (ILO 2021). According to the report, 38 per cent of the group are uncertain of their future career prospects, with the crisis that has anticipated to create more barriers in the labour market and lengthen the transition from school to work.

 

Additionally, adolescents have been faced with a serious nutrition deficit owing to the disruption of mid-day meals in schools, which form the primary source of nutrition for many. A study conducted by Dasra (2020) reveals that more than one quarter (28%) of the responding organisations were aware of instances in which students reported going hungry because their mid-day meal had stopped being served, and no take-home ration facility was available.

 

The time girls spent in schools has been diverted to household tasks. Many girls have been married off during the lockdown, and many of the adolescents were forced into the labour market. According to a survey of adolescent girls in the backward district of Koppal (Northern Karnataka) conducted by the Karnataka Health Promotion Trust (KHPT), 93 percent of the girls expressed anxiety about discontinuing their education due to the increasing financial constraints on their families. Six out of 10 girls reported sexual violence, and 9% of the girls reported physical violence during the lockdown.[3] The Dasra study (2020) also revealed adolescents’ anxieties regarding the possibility of death in their families, with some of them also reporting suicidal tendencies. The impact the pandemic on adolescents is multifaceted, ranging from a lack of essential services and adequate nutrition to psychological distress.

 

3. Revisiting the Efforts and Their Impact

In order to reduce the complex ramifications of the pandemic on the adolescents, many youth-led organisations and movements in India and across the globe are acting on an unprecedented scale to provide support for adolescents in their respective communities. Open deliberations and critical review of these efforts among the community of stakeholders who work on adolescent issues will help strengthen and sustain these responses.

 

Some of the stated challenges seen within programmes and projects engaging with the issue of adolescents from a perspective standpoint are that the responses often homogenise the population, adopting a “one-size-fits-all” approach. Also, adolescence is viewed as a stage of development by itself; however, there is a need to understand that there are several stages within adolescence (early, middle, and late adolescence) with varying needs, which require different approaches. Programmes often address only adolescents in the 15–19 age group, leaving out early adolescence, a stage at which many developments such as identity and moral values are shaped. Most programmes and interventions are centred around girls, leaving out adolescent boys who are also at a crucial stage of development, have unique needs, and are integral to shaping the gender equity narrative within families and communities. Many programmes are indifferent to the geography and culture of the adolescents and fail to be sensitive to the changing contexts of adolescent groups. For instance, the pilot of a Hindi tool developed by Young Lives India (YLI) showed that the tool worked in one district of Rajasthan but not in another (KHPT2021). A telephonic survey conducted by YLI (Young Lives is a collaborative research project coordinated by a team based at the University of Oxford operating in India since 2002) between June and December 2020 revealed that more boys than girls interviewed were forced to leave school and pushed into the workplace.

 

From a response strategy and access standpoint, internet-based education as a response to the pandemic has been imposed on all sections of the adolescent population. While well-off urban schools have transitioned to online classes, this facility is not always available to the rural population. Students have faced a myriad challenges from internet connectivity issues to poor access to devices and gadgets, leading to widening the already existing digital divide. Adolescents with disabilities, more specifically, have been disproportionally affected in accessing education online. Another gap in adolescent development programmes was largely around the access to critical services. Due to frontline workers being diverted to COVID-19-related work, adolescents’ access to services especially seen in the deficiencies in addressing sexual and reproductive health (SRH) during the pandemic have reduced. The lack of adequate guidance for girls regarding reproductive health and contraception, particularly for those not married has only accentuated due to the bottlenecks in outreach posed by the pandemic. In India, girls were hesitant to access SRH services due to the fear of contracting COVID-19. KHPT’s study in Koppal revealed that 51 percent of the girls surveyed lacked access to sanitary pads and six out of 10 girls who wished to avoid pregnancy were unable to do so, owing to the lack of access to contraception during the lockdown.

 

Against the background of these challenges both in terms of perspective and strategy, below highlighted are some of the expert recommendations on addressing these gaps. A key thought process includes moving away from a project-centred approach to a programme approach that considers the need to scale and sustain initiatives with adolescents across geographies. Also needed is the shift from the “one–size-fits-all” approach to a prioritised approach that focuses on adolescents from marginalised and socially excluded community groups, which also includes adolescents with disabilities. Also, multisectoral collaboration to ensure that government agencies do not function in silos and encourage a unified effort towards adolescent welfare is critical to the sustainability of efforts. A key to ensuring equitable growth and development across adolescent populations are gender-transformative programmes that promote equal access to SRH and health services, technology, information, and opportunities.

 

Strengthening some of the Government of India initiatives like the flagship programme for adolescents, the Rashtriya Kishor Swasthya Karyakram ), by adopting empowerment and peer support approaches that view adolescents not just as passive recipients of support but as active participants in the change process will help shape the narrative of gender equity and adolescent empowerment across geographies. Also, in the context of the challenges posed specifically by the pandemic, access to and use of technology to reach the last mile with adolescents with information on health and SRH services would help bridge an important service disconnect.

 

Also, adopting a socio-ecological approach to addressing adolescent issues that emphasises on the need to create an enabling, non-judgemental, and gender-sensitive environment through involving families, community leaders, and community structures like the panchayat and health workers will help adolescents gain confidence to express their opinions, seek support as well as participate in social platforms. Programmes with adolescents must involve their parents  to help sustain behavioural change and promote parent–child communication to support their aspirations. Lastly, challenging regressive norms that curb every adolescent’s freedom to voice their opinions fearlessly should be a foundational philosophy-guiding programme. Empowering and equipping adolescents to advocate for their rights is the cornerstone of long-lasting change.

 

In addition to strengthening programmes, without the generation of evidence and robust research, groups and individuals will lose out on the opportunity to understand the changing contexts and emerging needs of adolescents. Hence, research models that respond to the context of the adolescents are needed.

 

Bringing to the forefront the segments of the adolescent population that require the extra attention and accelerated support is the need of the hour. This knowledge should guide resource allocation and policy frameworks on adolescent development. Both researchers and practitioners should reflect and lay down the next course of action for the post-pandemic era, which might see many of us in this sector faced with the same challenges that we once thought we had overcome. The pandemic has brought increased attention to adolescents, not only to the risks and negative outcomes they face but also to how they have negotiated these challenges and shown resilience, through sound family and peer support systems, which in itself is an interesting exploration for practitioners in adolescent programmes.

 

Conclusions

Research on the impact of the pandemic on adolescents world over reveals several overwhelming challenges in terms of the widening gap between the reality and the SDG of gender equity. However, social workers and development practitioners opine that the challenges are not new but only magnified in the pandemic context with access to service affected and spaces of participation denied to the adolescents. The solution lies in continuous research to understand the individualised experiences of deprivation and discrimination in the current contexts as well as the creation of opportunities for adolescent boys and girls to participate, deliberate, and introspect these experiences and devise solutions that can help them navigate the barriers in their own unique settings. Empowerment, therefore, is not just the end result but a process that allows for this participation to be realised. As described by Kabeer (1999), empowerment of adolescents is enhancing their agency and their ability to define goals and act on them in order to cope well with the various inequalities that undermine their self-worth (KHPT 2021). The pandemic has compounded their vulnerabilities, but as long as programmes for adolescents will systematically foster their self-esteem and self-worth through individualised and social empowerment models, the country’s adolescent population can hope for a fair chance to freely express, aspire, and flourish as those t will shape the destiny of future India.

This article includes excerpts from deliberations with the adolescent programme and research experts like Dr Renu Singh, Country Director, Young Lives India; Dr Priya Nanda, Senior Program Officer, The Gates Foundation; Ms Manasa Priya Vasudevan, Adolescent and Youth Development Specialist, UNICEF India; and Dr Venkatraman Chandra-Mouli, Adolescent Sexual and Reproductive Health (ASRH), WHO. I acknowledge the support of Dr Maithreyi Ravikumar, Strategic Lead, Adolescent Health, KHPT, in offering time and assistance to shape this article.

Mallika Tharakan (mallikab@khpt.org) is a Research Scholar at the Institute of Development Studies (IDS), University of Mysore, Mysuru, INDIA and Lead, Knowledge Management at KHPT (www.khpt.org). Mundayat Meera (drmmeera1@gmail.com) teaches at the Institute of Development Studies (IDS), University of Mysore, Mysuru, INDIA. Mohan HL (mohan@khpt.org) works at Karnataka Health Promotion Trust (KHPT), Bangalore, India.
12 May 2023