Don’t curb sexual knowledge

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Leaving young people to fathom things for themselves can result in unsafe sex, spread of diseases, and encourage wanton use of emergency contraception pills. Helplines are a good alternative to educate teenagers and young adults about ‘birds and bees’, but we need other options if schools are to be debarred from talking about sex

Ever since the Committee on Petitions of Parliament said “no” to sex education in schools, two views have emerged. The first that the panel is right. Most Indian homes never allude to the facts of life and teachers find classroom sex talk loathsome, whatever they might proclaim before zealous superiors.

The second view point is that if sex education is not undertaken on a massive scale it would have disastrous fallout in terms of unwanted pregnancies, unsafe abortions, and the suppression of curable diseases. Most scary of all, ignorance and inhibitions could fan the spread of HIV transmission.

The parliamentary panel has also directed withdrawal of adolescent education literature from all state-run or CBSE-affiliated schools in the country. It is unlikely that any future conclave of Chief Ministers would negate the Committee’s recommendations. Some States had earlier rejected sex education in schools (and some decided to restore it.)

India is not alone in grappling with this impasse. Other countries have faced and are still confronting this dilemma. Despite the extraordinary achievements ascribed to Mr Mechai Viravaidya who led a successful safe sex campaign in Thailand and won accolades for averting an HIV epidemic, the one-time Cabinet Minister actually lost his patience with the Government and had to undertake his pro-condom campaign as a lone show.

In the US the ‘abstinence only’ programme has been accused of causing the highest teen pregnancies in any developed country. The Economist recently referred to research conducted at the University of Washington suggesting that teenagers that received comprehensive sex education showed a 50 per cent lower risk of becoming pregnant. Recently, two Bills seeking funding for sex education and parental independence to decide whether they want sex education or abstinence education (or nothing) in schools have been introduced.

Two years ago the Jansankhya Sthirata Kosh or the National Population Stabilisation Fund requested gynaecologists and community health doctors to recommend useful strategies in the context of ongoing population stabilisation efforts. Without exception the doctors recounted the appalling levels of ignorance that persisted, cutting across urban and rural clients and equally between children from posh colonies and neighbouring slums. The doctors recommended that a call centre service should give authentic information anonymously in a matter-of-fact way. Examples of professionally-manned call centres were cited, along with the lack of sustainability of helplines.

It took NPSF more than a year to prepare the question bank, convert it into software and establish a BPO-run service manned by life science graduates. They were trained by Delhi’s Maulana Azad Medical College. Today the call centre receives around 500 calls a day, even from the most conservative districts of Uttar Pradesh and Bihar. District’s like Balrampur and Kishanganj falling in the lowest development quintile of the country, where women on an average have five or more children, where the age of marriage is between 15 and 17 for girls and long before 21 for boys, and where contraceptive use is abysmally low, have started telephoning the call centre. Most of the calls relate to contraception and within that, information on the use of condoms and natural methods dominates. In decreasing proportion come questions on the use of pills, intrauterine devices, emergency contraceptives and sterilisation. Male sexual health is a huge preoccupation among male callers of all ages. An experienced doctor handles specialised information needs and supervises the agents.

The moot point is whether Governments have a responsibility to impart sex education for adolescents at risk. Leaving young people to fathom things for themselves can result in unsafe sex, spread of infection, and encourage wanton use of emergency contraception pills — as often as six times a month. A perilous abortion is also hardly an option. The call centre service has managed to penetrate into a few homes of every district in Uttar Pradesh and Bihar and since responses are provided only to specific questions posed by the caller, it does not upset or repulse the uninitiated. But no call centre can become a panacea and alternatives must be found if schools are debarred from fielding the subject.

The most arresting recommendation of the parliamentary panel is to build awareness that child marriage is illegal and is injurious to the health of the girl child. This is an insightful recommendation as it highlights the most important factor that determines the quality of future generations. Once the fact that under-age marriages are illegal is dinned into school children, the message would percolate into the community much faster than any Government propaganda can hope to achieve. The Committee deserves to be complimented for this perceptive recommendation which can augur a turnaround in levels of maternal and infant mortality that have challenged us for decades.

To ensure that the message permeates and sticks, it is critical to make registration of marriage compulsory and set up systems that insist on registration before wedding celebrations can be held. The registration process could itself mandate an audio-visual session on contraception and safe sex followed by optional counselling. The possibilities are enormous and there is unlimited scope to use the opportunities the 135th Report has opened up — but differently.

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