An attempt has been made to assess the Youth Friendly Health Services (YFHS) from the clients’ perspectives and the role of outreach community-based approach (Youth Information Center, YIC) in improving access to services. A cross- sectional study was undertaken in Arajiline and Hoskote blocks in Varanasi and Bangalore districts respectively using primarily a quantitative technique. A consecutive sample of 120 clients from 4 selected clinics was interviewed after seeking services from YFHS. Additionally, facility assessment of clinics and 8 FGDs were conducted among community members and the young people in the community. Majority of the clients (90.8%) are aware that YFHS provide services to young males and females separately on specific day and time. Nearly 66% clients visited YFHS to sought treatment for three key health problems i.e. menstruation problems (25.4%) followed by general illness (22.8%) and swelling/itching of private parts (21.1%). In Hos- akote privacy was maintained during the con- sultation with the doctor, however, situation was relatively not better in Arajiline. Out of those clients who had visited YIC atleast once, 49 out of 53 in Arajiline and 51 out of 60 in Hasokote reported that the YIC staff/activities had motivated them to sought services at YFHS. Study concludes that while majority of the clients were satisfied with the services at YFHS, there is a need for strengthening the existing “package” of the services. At facility level, reassurance about the privacy and confidentially and alternative ways to promote access and utilization of services by active involvement of young people is recommended. On the other hand, at outreach level, new technologies should be introduced to generate demand, intensive focus on adults in the community and integration of YIC with local governance and school environment is suggested so as to protect young people against poor health outcomes.

BackgroundSocial inequities in early child bearing persist among young married people, especially among tribal populations in India. Rural women belonging to tribal groups and those coming from poor households are more likely to give birth before age 18. This paper explores the connection between ethnicity, gender and early fertility intention among young married people in rural India.MethodsThe data is drawn from a cross sectional baseline evaluation of an intervention programme in rural India. A sample of 273 married young people was taken. Respondents were selected using systematic random sampling. Logistic Regression was used to assess the effect of being a tribal on early fertility intention and also to determine if covariates associated with early fertility intention differed by tribal status. Qualitative data was analysed using deductive content analysis approach.ResultsBivariate and logistic regression results indicated that young married people from tribal communities had higher odds of planning a child within one year of marriage than non-tribals (OR = 1.47, p-value-0.079). Findings further suggest that early fertility intention among tribals is driven by gender factors and higher education and among non-tribals, higher education and awareness on contraception are key predictors. Among tribals, the odds of planning a child within one year of marriage was strongly associated with inequitable gender norms (OR = 1.94, p-value-0.002). Higher education showed significant positive association with non-tribals (OR = 0.19, p-value-0.014) and positive association with tribals (OR = 0.56, p-value-0.416). Qualitative investigation confirms that fertility desires of young married people are strongly influenced by gender norms especially among tribal populations.ConclusionEarly child bearing was underpinned by complex ethnic factors and gender norms. Preference for early child bearing was seen most among tribal communities. Gender attitudes were a cause of concern especially among tribal groups. These results suggest that efforts to improve early child birth will require changing gender norms related to fertility among tribals as well as social equity issues including higher education among non-tribals and tribals.

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Neighbourhoods and families are key social institutions instilled with development of early life course of adolescents. Limited research in India has examined exposure to community along with socioeconomic conditions for school-dropouts of girls. Multidimensional benefits of female education are increasingly recognized in recent years; hence, it becomes imperative to study the community components of school discontinuation particularly in rural area. This study aims to analyse effect of mother’s education, community poverty, and gender equitable attitudes associated with a girl’s school dropout. This study uses baseline survey data from an intervention program from poor-performing districts of India. Collinearity among individual predictors validated by variance inflation factor proceeded step-wise binary-logistic regression. Result suggests that communities with high concentrations of poverty and mother illiteracy are disadvantages with low gender perception and high levels of dropouts. Result suggests that girls living in poor communities are three times more likely to dropout and 70% more if belonged to communities with lower mother literacy. Girls who scored low on Gender Equitable Scale had less probability to dropout. The study concludes that girls from poor communities with low levels of mother literacy and non-egalitarian gender attitudes are at higher risk of school dropout.

The intervention had positive results for the public health system and the services are being scaled up to different blocks of the districts, under a public-private partnership.