Understanding and Delivering to Address Adolescent Needs - UDAAN

A Baseline Survey for Adolescent Health Initiative, Uttarakhand

MARCH 2010 This publication was produced for review by the United States Agency for

International Development.

It was prepared by Futures Group International, New Delhi

For further information, contact:

Futures Group International

DLF Building No. 10 – B, 5th Floor, DLF Cyber City

Phase – II, Gurgaon – 122002 (Haryana)

Understanding and Delivering to Address Adolescent Needs - UDAAN

A Baseline Survey for Adolescent Health Initiative, Uttarakhand

March 2010

The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government.

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Contents

LIST OF TABLES ....................................................................................................... v

LIST OF ACRONYMS ................................................................................................ vi EXECUTIVE SUMMARY ........................................................................................... vii

1.1 Background ........................................................................................................... 1 1.2 Socio-Demographic Features of Uttarakhand ........................................................ 2 1.3 Study District Snapshots ........................................................................................ 3 1.4 Objectives of the Survey ........................................................................................ 4 1.5 Study Tool ............................................................................................................. 5 1.6 Survey and Sample Design ................................................................................... 5 1.7 Recruitment, Training and Fieldwork ..................................................................... 5 1.8 Data Collection ...................................................................................................... 6 1.9 Quality Control Mechanisms .................................................................................. 6 1.10 Ethical consideration.............................................................................................. 6 1.11 Data Processing .................................................................................................... 7

CHAPTER 2 HOUSEHOLD CHARACTERISTICS ..................................................... 8 2.1 Household Population ................................................................................................. 8 2.2 Household Characteristics ....................................................................................... 10 2.3 Households Possessing BPL and Health Card .......................................................... 11 2.4 Summary ................................................................................................................... 12

CHAPTER 3 BACKGROUND DETAILS OF ADOLESCENTS ................................. 14 3.1 Age and Education ................................................................................................... 14 3.2 Occupation of Parents ............................................................................................... 14 3.3 Reasons for Never Attending/Dropping Out of School ............................................ 16 3.4 Employment Status of Non-School Going Adolescents ............................................. 16 3.5 Informal Education and Vocational Training .............................................................. 17 3.6 Adolescents’ Perspective of Their Future .................................................................. 18 3.7 Extracurricular Activities and Recreation ................................................................... 19 3.8 Summary ................................................................................................................... 21

CHAPTER 4 PERSONAL HYGIENE, HEALTH AND HEALTH -SEEKING BEHAVIOUR OF ADOLESCENTS........................................................................... 22

4.1 Personal Hygiene ...................................................................................................... 22 4.2 Awareness, Source of Information and Health Status ................................................ 24 4.3 Health-Seeking Behaviour ......................................................................................... 26 4.4 Anthropometric Interpretations .................................................................................. 28 4.5 Mental Health ............................................................................................................ 28 4.6 Suggestions on Improving Health Services ............................................................... 31 4.7 Summary ................................................................................................................... 32

CHAPTER 5 AWARENESS ON ISSUES RELATED TO ADOLESCENCE ............. 34 5.1 Puberty ...................................................................................................................... 34 5.2 Knowledge and Myths about Menstruation ................................................................ 35 5.3 Sexual Concerns of Adolescent Boys ........................................................................ 38 5.4 Awareness on and Misconceptions about Balanced Diet........................................... 39 5.5 Opinion on Marriage, Pregnancy and Sex of Baby .................................................... 40 5.6 Opinion about Family Size ......................................................................................... 43 5.7 Knowledge about Family Planning ............................................................................ 43 5.8 Knowledge of RTI and STI ........................................................................................ 44 5.9 Knowledge about HIV and AIDS................................................................................ 46 5.10 Substance Abuse .................................................................................................... 48 5.11 Summary ................................................................................................................. 49

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LIST OF TABLES Table 1 Total Number of Adolescents Contacted During Field Survey .................................. 7

Table 2.1 Household Population by Age and Sex ................................................................. 8

Table 2.2 Characteristics of Household Population ............................................................... 9

Table 2.3 Characteristics of Adolescents ............................................................................ 10

Table 2.4 Household Characteristics ................................................................................... 11

Table 2.5 Households Possessing BPL and Health Cards .................................................. 12

Table 3.1 Age and Education .............................................................................................. 14

Table 3.2 Parents’ Occupation ............................................................................................ 15

Table 3.3 Reasons for Adolescents’ Never Attending/Discontinuing Studies ....................... 16

Table 3.4 Employment Status of Non-School Going Adolescents ....................................... 17

Table 3.5 Informal Education, Vocational Training and Future Plans .................................. 18

Table 3.6 Factors Necessary to Attain Career ..................................................................... 18

Table 3.7 Preferred Profession ........................................................................................... 19 Table 3.8 Hobbies/Extracurricular Activities ........................................................................ 20 Table 3.9 Type of Intertainment and Means of Recreation Facilities Available/allowed to Family ................................................................................................................................. 20 Table 4.1 Daily Hygiene Routine ......................................................................................... 23

Table 4.2 Observations on Personal Hygiene and Living Conditions of Adolescents .......... 23

Table 4.3 Knowledge Levels of Adolescents and Information Sources ................................ 24

Table 4.4 IFA Tablets/Syrup ................................................................................................ 25

Table 4.5 Status of TT Vaccine ........................................................................................... 26

Table 4.6 Contact with Health Workers ............................................................................... 26

Table 4.7 Advice on Treatment for Illness ........................................................................... 27

Table 4.8 Body Mass Index of the Adolescents ................................................................... 28

Table 4.9 Adolescents’ Mental State ................................................................................... 29

Table 4.10 Issues that Bother Adolescents ......................................................................... 30

Table 4.11 Advice Seeking by Adolescents ......................................................................... 30 Table 4.12 Suggestions on Improving Health Services ....................................................... 30 Table 5.1 Awareness of Puberty ......................................................................................... 34

Table 5.2 Changes After Puberty ........................................................................................ 35

Table 5.3 Awareness of Menstruation ................................................................................. 36

Table 5.4 Understanding of Menstruation and the Reasons for its Occurrence ................... 36

Table 5.5 Common Practices and Cloth Used During Menstruation .................................... 37

Table 5.6 Common Problems Faced During Menstruation and Action Taken ...................... 38 Table 5.7 Sexual Concern Among Male Adolescents .......................................................... 38 Table 5.8 Awareness on and Misconceptions about Balanced Diet..................................... 39

Table 5.9 Opinion on Marriage ............................................................................................ 41

Table 5.10 Consequences of Early Marriage of Girls .......................................................... 41

Table 5.11 Perceptions about Pregnancy and Sex and Baby .............................................. 43

Table 5.12 Perceptions about Ideal Family Size .................................................................. 43

Table 5.13 Knowledge of Family Planning .......................................................................... 44

Table 5.14 Knowledge of RTI and STI ................................................................................ 44

Table 5.15 Symptoms and Treatment-Seeking Behaviour with Regard to RTI and STI ....... 45

Table 5.16 Awareness of HIV/AIDS .................................................................................... 46

Table 5.17 Ways to Avoid Being Infected by HIV/AIDS ....................................................... 47

Table 5.18 Perception of HIV/AIDS ..................................................................................... 47

Table 5.19 Substance Abuse .............................................................................................. 48

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LIST OF ACRONYMS

AIDS

ANC

ANM

APL

ARSH

ASHA

AWC

AWW

AYUSH

BCC

BPL

CHC

CMO

DH

DHAP

DLHS

GP

HC

HIV

IEC

LHV

MMU

MOIC

NGO

NRHM

PHC

PRI

RCH

RNTCP

RTI

SC

SHG

SNP

ST

STI

TB

VHC

VHSC

Acquired Immuno Deficiency Syndrome

Antenatal Care

Auxiliary Nurse Midwife

Above Poverty Line

Adolescent Reproductive and Sexual Health

Accredited Social Health Activist

Anganwadi Centre

Anganwadi Worker

Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy

Behaviour Change Communication

Below Poverty Line

Community Health Centre

Chief Medical Officer

District Hospital

District Health Action Plan

District Level Household Survey

Gram Panchayat

Health Card

Human Immunodeficiency Virus

Information Education and Communication

Lady Health Visitor

Medical Mobile Unit

Medical Officer In-Charge

Non Governmental Organization

National Rural Health Mission

Primary Health Centre

Panchayati Raj Institution

Reproductive And Child Health

Revised National Tuberculosis Control Programme

Reproductive Tract Infection

Scheduled Caste

Self Help Group

Supplementary Nutrition Programme

Scheduled Tribe

Sexually Transmitted Infection

Tuberculosis

Village Health Committee

Village Health and Sanitation Committee

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EXECUTIVE SUMMARY

Adolescence, the second decade of life, is a period of transition from childhood to adulthood. It is one of the most crucial periods in the life of an individual, since between the ages of 10-19 years, rapid physical, physiological, and psychosocial changes occur. The Government of Uttarakhand has launched Understanding and Delivering to Address Adolescent Needs (UDAAN), an adolescent health initiative on a pilot basis, with technical assistance from the Innovations in Family Planning Services Technical Assistance Project (ITAP), funded by United States Agency for International Development (USAID) and implemented by Futures Group International. In this context, a baseline survey was conducted by Indian Institute of Health Management Research (IIHMR), Jaipur to assess the health needs of adolescents in Dehradun, Haridwar, Nainital and Udham Singh Nagar districts. The key objective of this survey was to assess the healthcare needs of school going and non school going adolescents, to understand adolescents’ knowledge and perception of healthcare and personal hygiene, and to study the accessibility and acceptability of health care services to adolescents in Uttarakhand, especially in Dehradun, Hardwar, Nainital and Udham Singh Nagar districts. Education and Career It was found that the population of adolescents was about one-fifth of the total in each of the 10-14 and 15-19 age groups. The number of adolescents who had completed 10th grade and above was the highest at about 23 percent male adolescents in Nainital, while the lowest was 13 percent of the male adolescents in Hardwar. Most of the adolescents reported that their fathers were farmers. In Dehradun, about 37 percent of the fathers of school going adolescents were farmers, as compared to 41 percent of non-school going adolescents. The main reason for adolescents’ discontinuing studies were financial problems, lack of interest in studies, and disapproval from family and relatives. Most of the non-school -going adolescents were reported to be working; a majority were helping in the family business, farming their own land and doing private work. Most of the adolescents were not interested in and had not undergone vocational training. Almost all the adolescents reported that they give importance to their career/job. According to them, to have a successful career, the prerequisites are further education, family’s support, financial support and hard work. In terms of professional aspirations, most adolescents in the study area want to join military service, become a teacher, doctor or engineer. Interestingly, they did not want to become farmers, like most of their parents. In terms of extracurricular activities, it was reported that more males than female adolescents love to play outdoor games. The other pastimes were playing indoor games, watching television and singing/listening to music. The common means of entertainment and recreation available to most of the adolescents were television,

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radio and magazines and newspapers. It was reported that the tape recorder was out of fashion. The issues that mostly bothered the adolescents were money, studies, physical looks, having to work at home, career aspirations and unemployment. They reportedly seek the advice of and discuss their concerns mainly with their parents, friends and siblings. Nutrition and Health Most of the adolescents (69-90%) were aware what a balanced diet constitutes. More than 90 percent stated having different kinds of vegetables and fruits as a balanced diet. The response of adolescents regarding routine health and hygiene practices were satisfying. Although there was some difference in the health and hygiene practices followed by the school going and non-school going adolescents, these were not very significant, barring a few exceptions. Most of the adolescents reported that they brush their teeth regularly in the morning, but only a few brush their teeth at night before going to bed. A majority bathe regularly, but not all use soap while bathing. Cutting and keeping nails clean was not a common practice among the target group. Most of them reported that they wear clean clothes and wash hands before eating. A majority of the adolescents also reported that they wash hands with soap after defecation. The school going adolescents were more knowledgeable about de-worming and prophylaxis as compared to non-school going adolescents. Only a few of the female adolescents reportedly received IFA tablets, and according to them, the key sources for obtaining IFA tablets were sub-centre, private doctor/clinic, ASHA and CHC/PHC, which varied from one district to the other. About one-third of the adolescents had received the TT vaccine at the age of 10 years. A majority had not met with health workers in the last six months (at the time of the study), and those who had met health workers, did so at a health facility. 34 to 55 percent of the adolescents reported that they had been unwell in the last three months. The common complaints were fever, cough, cold and headache. When unwell, most of them seek the advice of their parents. It was good to note that a majority seek treatment at private health facilities, government/municipal hospital, CHC/PHC/FP centre and sub-centre. The key criteria for choosing a health facility were acquaintances frequenting the facility, accessibility and convenience of location. Most of the adolescents were reportedly satisfied with the health services they had availed. Some of the suggestions of the respondents to make the health services more convenient and friendly were:

the timings could be morning and evening

a doctor of the same sex should be made available

enough privacy should be ensured

the location of the facility has to be at a convenient place

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the services should be provided at home (according to a few adolescents) The respondents wanted information on health issues, treatment of menstrual problems, treatment of anaemia, delivery care services and family planning services to be made available. A majority of the adolescents were satisfied with their health. In this context, there was not much difference in the responses received from those who were going to school and those who were not going to school. About their mental health, a majority of them reported that they were able to concentrate on what they were doing, have not lost sleep, and were capable of making decisions. Most of them were not under any strain, felt that they will overcome their difficulties, and were enjoying their normal daily routine. Substance use among adolescents was not very significant. Puberty and Menstruation Most of the adolescents were aware of puberty. On changes which occur in girls with the onset of puberty, three-fourth of the adolescents reported a rapid increase in weight and height and enlargement of breasts. Half of the male adolescents mentioned hoarseness in voice, while one-fourth mentioned that hair grows in armpits. Incidentally, non-school going adolescents were more aware about menstruation than their school going counterparts. More male adolescents compared to female adolescents knew about how menstruation prepares the body for childbirth. Many said that it involved the body expelling impure blood. A significant percent of the adolescents stated that while menstruating, they avoid/are not allowed to visit religious places, attend religious ceremonies or work in the kitchen. About one-third said that they maintain personal hygiene during their periods. About one-fifth of the adolescents use sanitary pads, and about half of them use old cloth pieces. During menstruation, 58 to 78 percent of the female adolescents experience excessive abdominal pain/cramp. Back pain was mentioned by 20-39 percent of the adolescents, while mood swings were reported by 17 percent of the females in Dehradun. Sexual Health Not just female, but male adolescents too had many sexual concerns. Due to social taboo, they cannot voice their concerns to their elders and discuss such topics openly. Hence, whatever information they have is what they obtain from their peers, who have rather limited and unscientific information themselves. The main sexual concern among male adolescents was nightfall, which was reported by 14 percent in Dehradun, 13 percent in Nainital, 9 percent in Haridwar and 8 percent in Udham Singh Nagar. Masturbation was reported by a very low percent of male adolescents - about 4 percent in Dehradun and Haridwar each, 2 percent in Nainital, and a negligible percent in Udham Singh Nagar. It was surprising to note that only a few knew about reproductive tract infections (RTI) or sexually transmitted infections (STI). When prompted on the symptoms of RTI/STI, a significant percent of adolescents reported fever, abdominal pain and

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urethral/vaginal discharge. A significant percent of adolescents consulted a private doctor, and only a tiny percent visited government allopathic doctors. The adolescents who were aware of HIV/AIDS range between 54 to76 percent. Most of the adolescents knew the routes of HIV infection - multiple sexual partners (81-93%), unprotected sex (68-95%), unsterilized syringes (86-99%), blood contact (41-73%). 72-94 percent of the adolescents knew how HIV/AIDS can be avoided. Marriage, Family Planning and Pregnancy Asked for their opinion on marriage, a majority of the male adolescents said that they would get married after getting a job. The female adolescents were more concerned about their education; a significant percent of female adolescents stated that they would marry only after completing their studies. According to most of the adolescents, the right age of marriage of girls in mean years is 21 to 24 years, and for boys, it is 23 to 27 years. The consequences of early marriage to girls per the respondents were harm to girl’s health, possibility of giving birth to sick and weak offspring, possibility of maternal death, and inability to manage home and family. A majority of adolescents knew about family planning and were aware about oral pills and condoms. Most of the adolescents know that a girl can become pregnant after sexual intercourse with a boy. In response to the question on factors which determine the sex of a baby, most of the adolescents answered that the father determines the gender of the baby. According to 11 to 43 percent of the adolescents, both the mother and the father determine the sex. Most adolescents reported that the ideal number of children a couple should have is two. In response to the question about ideal gender of the first child, male adolescents stated male and female adolescents chose girl child. Overall, from the study findings, what emerges is the fact that although adolescents in the study area are aware of the health services available and want to avail them too, the services are not tailor-made per their requirements. It is critically important to have an open discussion on their concerns. The survey revealed that there were quite a few myths and misconceptions on a variety of topics among school going and non-school going adolescents, both girls and boys. This finding highlights the lacunae in the education system, which has not contributed in increasing the adolescents’ information level. The cause of concern is that who will initiate the discussion, when and how? Do we have the adequate and appropriate health education services in place within the existing system to respond to the emerging needs of these adolescents? If yes, are these equipped to cater to the requirements of adolescents? If no, what are the plans to respond effectively and efficiently to these emerging needs?

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CHAPTER 1 INTRODUCTION

1.1 Background

A nation’s adolescents are a supremely important asset. Programmes created around adolescents should be a prominent part of our national plans for the development of human resources. Adolescence is one of the most crucial periods in the life of an individual, since between the ages of 10-19 years, several biological, social, economical, demographic and cultural events occur that set the stage for adult life. Changes occurring in adolescence are often divided into five general domains: physical (onset of puberty etc.), cognitive (development of formal operational thought processes), moral (exploration of internal and external values and rules), identity-related (transitions from identity confusion to identity integration), and sexual (discovering sexuality, developing intimacy and relationships). Policy interest in adolescents began to grow after the ICPD (International Conference on Population and Development) held in Cairo in 1994, which called for specific efforts by governments and civic society to understand and meet the particular reproductive and sexual health needs of adolescents. It also observed that the number of adolescents across the world is increasing rapidly (however, their proportion in total population is declining due to declining fertility levels). Against the backdrop of a relatively early maturation of adolescents than ever due to greater exposure to information, growing complexities of modern life style, tendency to live freely, etc., the problem has grown in scale, and needs urgent attention of all concerned. The National Population Policy 2000 identified adolescents as an under-served group for which health needs, and specifically reproductive and sexual health interventions, are to be designed. The National Youth Policy 2003 recognizes 13 to 19 years as a distinct age group, which has to be covered by special programmes in all sectors, including health. The Government of India has launched the Adolescent Reproductive and Sexual Health (ARSH) programme under the National Rural Health Mission (NRHM), as a part of the Reproductive and Child Health (RCH) programme. The focus on ARSH and special interventions for adolescents aimed to achieve the following outcomes:

Delay the age of marriage

Reduce incidence of teenage pregnancies

Meet unmet contraceptive needs

Reduce the number of maternal deaths

Reduce the incidence of sexually transmitted diseases

Reduce the proportion of HIV-positive cases in the 10-19 age group. The Government of Uttarakhand has launched Understanding and Delivering to Address Adolescent Needs (UDAAN), an adolescent health initiative on a pilot basis with technical assistance from the Innovations in Family Planning Services Technical Assistance Project (ITAP), funded by United States Agency for International Development (USAID) and implemented by Futures Group

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International. In this context, a baseline survey was conducted to assess the health needs of adolescents in Dehradun, Haridwar, Nainital and Udham Singh Nagar districts of the state.

1.2 Socio-Demographic Features of Uttarakhand The state of Uttarakhand was created by combining the hilly districts of Uttarkashi, Chamoli, Rudraprayag, Tehri Garhwal, Dehradun, Garhwal, Pithorgarh, Bageshwar, Almora, Champawat, and Nainital with Udham Singh Nagar district in the Tarai region and Haridwar in the foothills of the erstwhile Uttar Pradesh. According to Census 2001, the state has 13 districts, 49 tehsils, 95 blocks, and 16,414 villages. With a total area of 53,483 per square kilometer, the state ranks 18th in terms of area, and its share in the total area of India is 1.69 percent. Uttarakhand has a population of approximately 8.49 million (Census 2001). A population exceeding 10 million is expected by the next census of 2011. The state contributes 0.83 percent to the total population of the country and is placed 20th among the states and union territories in terms of population size. The population growth rate was 19.2 percent in 1991-2001, which is much lower than the growth rate for Uttar Pradesh (25.8 percent) as well as the growth rate for the country as a whole (21.3 percent). The growth rate of Uttarakhand in 1991-2001 was lower than the growth rate of 24.2 percent for the earlier decade. The population density per square kilometer is 159, which is less than one-fourth of the population density of Uttar Pradesh (689). The population density in Uttarakhand increased from 133 in 1991 to 159 in 2001. The population sex ratio of 962 females per 1,000 males is not only higher than both the all-India sex ratio (933) and the Uttar Pradesh sex ratio (898), but it is also much higher than the state sex ratio in 1991 (936). The literacy rate for the population aged seven and above in the state is 84 percent for males, 60 percent for females, and 72 percent for the total population (Director of Census Operations, Uttarakhand, 2001). Infant mortality has decreased from 50 to 43 (per 1000 live births) over the period, 2000-2006. Further, data from the Sample Registration System (SRS) indicated a marginal, statistically insignificant, increase in the levels of infant mortality and fertility in the state during the recent period, 2003-2006. The two rounds of the National Family Health Survey (NFHS-2 and NFHS-3) also show marginal increase (38 to 42) in the rate of infant mortality. However, the fertility estimates give no indication of any increase; the total fertility rate (TFR) is 2.6, the average number of children to a woman in her childbearing years. However, the state’s maternal mortality ratio (MMR) is 440 (SRS 2004-06), which is higher than the national average (254). The state has shown progress in the area of reproductive health and family planning. NFHS-3 data shows that 45 percent of the women receive at least three antenatal care visits. This rapid increase is almost double that of NFHS-2 (20 percent) and 60 percent more from the result of the second round of the District Level Household Survey (DLHS-2) at 28 percent. Institutional births have also increased from 21 percent (NFHS-2) to 36 percent (NFHS-3), which is also supported by DLHS-2 (24 percent) conducted in 2002-04.

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As expected, current use of any family planning method in the state is 59 percent, showing an increase from 43 percent in NFHS-2. According to NFHS-3, contraceptive use at last sex as reported by men is lower (52 percent) than women’s reported usage (59 percent). Female sterilisation accounts for more than half (54 percent) of family planning use, which is down from 63 percent in NFHS-2. Unmet need for family planning has decreased from 21 percent (NFHS-2) to 11 percent (NFHS-3). Currently, 85 percent of the demand for family planning is being met, up from 67 percent in NFHS-2. Six out of 10 children, aged 12-23 months, are fully immunised against six major childhood illness according to NFHS-3 - an increase from NFHS-2 (four out of 10). Between the first and third doses, the dropout rate is more in DPT (18 percent) compared to polio drops (10 percent). However, most children are at least partially vaccinated; only 9 percent have not received any vaccination at all. Although breastfeeding is nearly universal in the state, only three out of 10 children under six months are exclusively breastfed (NFHS-3), as per WHO recommendations. Among children aged 9-59 months, the majority are anaemic (61 percent), with 2 percent suffering from severe anaemia (NFHS-3). Per NFHS-3, more than two-thirds of the women have heard of HIV/AIDS, a significant increase from NFHS-2, when only one-third of the women were aware of HIV/AIDS. Almost all (nine out of 10) men are aware of HIV/AIDS as reported in NFHS-3.

1.3 Study District Snapshots Dehradun Dehradun, with a population of 1.3 million, which accounts for 15 percent of the state’s population, is the second-most populous district in the state (RGI, 2001). The population growth rate was 24.7 percent during 1991-2001, higher than the state growth rate of 19.2 percent. The population density per square kilometer has increased from 332 in 1991 to 414 in 2001 - third highest in the state. 47 percent of the population lives in rural areas and 22 percent of the population is engaged in agricultural sector. The proportion of scheduled caste (SC) population is 14 percent, lower than the state figure of 17.9 percent, while the proportion of scheduled tribe (ST) population is 8 percent, higher than the state figure of 3 percent. The sex ratio (females per 1000 males) in the district has increased from 843 in 1991 to 893 in 2001. The child sex ratio of the district is 903. The overall literacy rate for the population aged seven and above has increased from 70 percent in 1991 to 79 percent in 2001; for males, from 78 percent to 86 percent, and for females, from 59 percent to 71 percent. Nainital Nainital, the fourth-most populous district in the state (with a population of 0.8 million), comprises 9 percent of the state’s population (RGI, 2001). The population growth rate was 32.9 percent during 1991-2001, much higher than the state growth rate of 19.2 percent. The population density per square kilometer has increased from

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149 in 1991 to 198 in 2001. 65 percent of the population lives in rural areas and 46 percent of the population is engaged in agricultural activities. The proportion of SC population (19 percent) is higher compared to the state figure (17.9 percent), while the proportion of ST population (0.7 percent) is lower than the state figure (3 percent). The sex ratio in the district has increased from 881 in 1991 to 906 in 2001. The child sex ratio of the district is 908. The overall literacy rate for the population aged seven and above has increased from 68 percent in 1991 to 80 percent in 2001; for males, from 80 percent to 88 percent, and for females, from 55 percent to 71 percent. Udham Singh Nagar Udham Singh Nagar, with a population of 1.2 million (15 percent of the state’s population), is the third-most populous district in the state (RGI, 2001). The population growth rate was 27.8 percent during 1991-2001 as against the state growth rate of 19.2 percent. The population density per square kilometer has increased from 332 in 1991 to 424 in 2001 - second highest in the state. 67 percent of the population lives in rural areas and 51 percent of the population is engaged in agricultural activities. The proportion of SC population is 13 percent, lower than the state figure of 17.9 percent, while the proportion of ST population is 9 percent, higher than the state figure of 3 percent. The sex ratio in the district has increased from 863 in 1991 to 902 in 2001. The child sex ratio of the district is 912. The overall literacy rate for the population aged seven and above has increased from 49 percent in 1991 to 66 percent in 2001; for males from 61 percent to 76 percent and for females from 36 percent to 54 percent. Haridwar Haridwar, with a population of 1.4 million that accounts for 17 percent of the state’s population, is the most populous district in Uttarakhand (RGI, 2001). The population growth rate was 26.3 percent during 1991-2001, higher than the state growth rate of 19.2 percent. The population density per square kilometer in district has increased from 485 in 1991 to 612 in 2001, highest in the state. 69 percent of the population lives in rural areas and 40 percent is engaged in agricultural activities. The proportion of SC population is 22 percent, higher than the state figure of 17.9 percent, while the proportion of ST population (0.2 percent) is lower than the state figure of 3 percent. The sex ratio (females per 1000 males) in the district has increased from 846 in 1991 to 868 in 2001. The child sex ratio of the district is 852. The overall literacy rate for the population aged seven and above has increased from 48 percent in 1991 to 65 percent in 2001; for males, from 59 percent to 75 percent, and for females, from 34 percent to 53 percent. 1.4 Objectives of the Survey

The key objectives of this survey were to:

assess the healthcare needs of school going and non-school going adolescents

gauge the adolescents’ knowledge and perception of healthcare and personal hygiene

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study the accessibility and acceptability of healthcare services to adolescents in the state, especially in Dehradun, Hardwar, Nainital and Udham Singh Nagar districts.

1.5 Study Tool A structured questionnaire was used to gather information from adolescent girls and boys aged 10-19 years, who were usual residents of the sample household or visitors who stayed in the sample household the night before the interview. In addition to household and parental characteristics, the questionnaire addressed the details of the adolescent’s personal health, hygiene and health-seeking behaviour. The questionnaire is broadly divided into six sections. The first section deals with household characteristics and the second section has questions related to background of adolescent boys and girls. The third section tackles personal health, hygiene and health-seeking behaviour of adolescents, while mental health of the adolescents is gauged in section four. Section five deals with the issues of puberty, emotional changes, menstruation period, sexual concerns, balanced diet, right age of marriage, implications of early marriage, preference of sex of a child, knowledge about contraceptive etc. Section five has questions on RTI/STI and HIV/AIDS. The sixth section deals with the reproductive health of married adolescents, where information was gathered on age of marriage, family planning methods, pregnancy, etc.

1.6 Survey and Sample Design The baseline survey was carried out in Dehradun, Haridwar, Nainital and Udham Singh Nagar. From each district, two blocks were selected – one with the highest percentage of school going adolescents and another with the lowest percentage of school going adolescents. In each block, 10 villages were selected as primary sampling units (PSUs), using simple random sampling. In each PSU, house-listing was conducted to identify households with adolescent boys and girls aged 10-19 years. 32 adolescents were selected using systematic random sampling. A total of 2,560 adolescents were selected from 80 PSUs, spread across the four districts. PSU with more than 300 residential households were segmented, and two segments were selected for detailed enquiry.

1.7 Recruitment, Training and Fieldwork The recruitment of field staff (supervisors, editors and field investigators) was done by the Indian Institute of Health Management Research (IIHMR). Well-qualified (minimum qualification set as graduation) investigators experienced in conducting reproductive health surveys were recruited. Most of the field investigators were recruited from Uttarakhand and Uttar Pradesh, so that they could communicate easily and establish a good rapport with the respondents.

An intensive training was conducted for all the field staff (supervisors, editors and investigators) by IIHMR at its campus in Jaipur. The training course consisted of instructions for interviewing techniques, detailed discussion on schedules, field

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procedure for conducting survey, series of simulation exercise by each participant and quality control. During the training programme, special attention was paid to missing information, sensitive questions, skips, filter questions, etc. All corrections and rectifications were communicated to ITAP staff, who incorporated the same and provided the final questionnaire to IIHMR.

For quality data collection by field staff, various techniques were used during the training programme. Mock interviews among the participants in the classroom, and practice interviews in the field were arranged during the training sessions. On the basis of the performance of each participant during the training programme, the final team for the fieldwork was selected.

1.8 Data Collection Both female and male investigators were recruited for the fieldwork. Female investigators interviewed the adolescent girls in the households, while the male investigators interviewed the selected boys. Separate teams of male investigators were constituted for carrying out mapping and listing operations.

The mapping-listing team consisted of two members, a ‘mapper’ and a ‘lister’. The teams completed the entire mapping-listing operation within the given time limit.

Each survey team consisted of two female investigators, two male investigators, one female editor and one male supervisor (total six members). Four teams were deployed to complete the survey, which included one extra team member to conduct revisits. Detailed field movement plans were prepared for mapping-listing operations and main survey, indicating dates of the field visits to each PSU.

1.9 Quality Control Mechanisms The following measures were taken by IIHMR during the survey to maintain quality of the data:

Ensured that all the households of a PSU were listed for sampling.

Completed mapping and listing operation of households seven days prior to the main survey date.

Deputed senior research officers/research officers (SRO/RO) from IIHMR during fieldwork to monitor the data collection process. Regular monitoring and spot-checks/back-checks were conducted by the SROs/ROs while supervising the survey in the field.

On-site field editing done by female field editors. The office editing of each filled-in schedule was carried out by the office editors.

Followed practice of regular feedback on mistakes to each team in order to improve the quality and reliability of information collected.

Visit by project coordinator to all field areas to ensure the quality of work and to support the SROs/ROs

1.10 Ethical consideration

7

The consent of each head of the sample households were first taken before interviewing the adolescents. In the survey team, the IIHMR representative briefed the head of the household that the data generated from the study will not be used by anyone except the Government of Uttarakhand, and that the information will not be used against them or for any other purpose. It was made clear that individual data of any adolescent or family will not be misused in any way. For the field survey, the team composition was ensured to have an equal representation from each gender, so that females could interact and fill questionnaires for female respondents and a similar routine for the male respondents. The investigators were trained to not force the adolescent respondents to answer the questions. The respondents would be given the option of not participating in the survey or not answering a question they do not want to answer. 1.11 Data Processing

The final processing of data, including office editing, coding, data entry and data cleaning was done at IIHMR, Jaipur. An IT professional from the institute was deputed exclusively for managing the data-processing under the supervision of the project coordinator. This IT person was trained by the ITAP staff in the computer programme developed by ITAP. The IIHMR team analyzed the final data per ITAP requirement and the programme needs of the government of Uttarakhand.

Sample coverage

Table 1 Total Number of Adolescents Contacted During Field Survey

District/ Block School Going Non-School Going All Total

10-14 years 15-19 years 10-14 years 15-19 years 10-14 years 15-19 years

M F M F M F M F M F M F

Dehradun

Chakrata 43 39 38 41 48 49 46 41 91 88 84 82 345

Doiwala 39 43 43 41 15 7 40 37 54 50 83 78 265

Nainital

Okhal Khanda 41 42 39 38 15 39 41 42 56 81 80 80 297

Haldwani 39 40 36 42 16 26 42 39 55 66 78 81 280

Udham Singh Nagar

Gadarpur 44 39 40 38 35 40 46 38 79 79 86 76 320

Khatima 33 41 40 42 40 40 35 40 73 81 75 82 311

Haridwar

Bhadrabad 44 41 39 40 38 38 37 43 82 79 76 83 320

Khanpur 39 42 40 37 34 40 43 42 73 82 83 79 317

Total 322 327 315 319 241 279 330 322 563 606 645 641 2455

M- Male F- Female

8

CHAPTER 2 HOUSEHOLD CHARACTERISTICS

This chapter presents the household characteristics of the four districts of Uttarakhand identified for the survey.

2.1 Household Population The adolescent population was about one-fifth of the total population in each of the 10-14 and 15-19 age groups. The variation in the 10-14 age group among the male population was from 19 to 21 percent, while in the female population, it was from 19 to 23 percent. In the 15-19 age group, variation in male population was from 20 to 23 percent and among females, it was from 18-22 percent. 19 and 20 percent of the male adolescents in Dehradun were in the age group of 10-14 and 15-19, respectively. In Udham Singh Nagar, 23 percent and 20 percent of the female adolescents were in the age group of 10-14 and 15-19, respectively (Table 2.1).

Table 2.1 Household Population by Age and Sex

Percent distribution of the household population by age and sex, Uttarakhand, 2009

Block/District Dehradun Nainital Udham Singh Nagar

Haridwar

Age group M F M F M F M F

0-4 6.7 6.6 4.8 5.8 3.7 4.0 6.0 5.3

5-9 10.1 10.3 9.1 7.4 8.9 8.3 11.5 10.7

10-14 18.9 19.0 18.5 21.7 21.1 22.8 20.9 20.8

15-19 19.9 18.3 21.9 21.1 22.5 20.3 20.6 22.2

20-24 7.0 7.1 9.3 5.0 8.2 6.2 8.7 5.6

25-29 4.9 4.6 3.2 2.4 2.6 2.4 2.1 2.2

30-34 2.8 5.3 2.1 5.0 2.5 5.5 1.7 5.9

35-39 5.1 8.9 5.8 9.5 5.6 9.7 6.6 8.4

40-44 6.6 6.8 7.0 8.6 8.2 9.0 6.5 7.4

44-49 6.4 4.1 8.1 5.5 7.4 3.8 6.5 3.8

50-55 3.3 2.3 3.8 2.2 2.6 1.8 2.9 2.1

55-59 2.1 2.5 1.6 1.3 1.6 2.3 1.6 1.4

60-64 2.5 1.8 2.4 1.3 2.5 1.6 1.6 1.8

65-69 1.3 1.1 1.0 1.1 1.4 0.6 0.8 1.0

70-74 1.2 0.5 0.4 0.8 0.3 0.4 1.1 0.7

75-79 0.3 0.4 0.4 0.6 0.1 0.5 0.3 0.2

80+ 0.8 0.7 0.5 0.5 0.7 0.7 0.6 0.5

Total (%) 100 100 100 100 100 100 100 100

N 2169 2000 4169 1811 1718 3529 2102 1893

M- Male, F- Female, T- Total

9

The mean number of persons were highest in Dehradun (7.2) and lowest in Nainital (5.9). In other two districts, the mean number of persons were 6.2 in Udham Singh Nagar and 6.6 in Haridwar. Dehradun and Nainital have maximum population of Hindus, 94 and 97 percent, respectively. The Muslim population in these two districts was very less, 5 and 3 percent, respectively. In Udham Singh Nagar and Haridwar, there is a sizeable Muslim population, approximately 22 and 26 percent, respectively. Other population groups which include Christians and Sikhs were insignificant in the surveyed districts, except Udham Singh Nagar where it was around 8 percent. The caste-wise distribution shows that the percent of other backward classes (OBC) is higher in Haridwar and Udham Singh Nagar, at 50 percent and 31 percent, respectively. OBCs were least in Dehradun and Nainital at about 14 percent each. The SC population was higher in Dehradun, Haridwar and Nainital at 30, 28 and 26 percent, respectively. The percent of STs was highest in Udham Singh Nagar at about 27 percent. In Dehradun, STs were at about 22 percent and only about 3 percent in Nainital. 57 percent of the population in Nainital, 34 percent in Dehradun, 22 percent in Udham Singh Nagar and 19 percent in Haridwar belonged to the general category (Table 2.2).

Table 32.2 Characteristics of Household Population

Percent distribution of household by mean, religion and caste in Uttarakhand, 2009

Districts Dehradun Nainital Udham Singh Nagar Haridwar

Mean household size 7.2 5.9 6.2 6.6

Religion

Hindu 94.4 96.6 70.7 75.4

Muslim 5.2 2.8 21.9 24.5

Others (Christian & Sikh) 0.3 0.7 7.5 0.2

Caste

SC 29.8 26.2 21.2 27.5

ST 22.1 2.6 26.5 4.1

OBC 14.4 14.1 30.8 49.6

General 33.6 57.1 21.5 18.8

Total 100.0 100.0 100.0 100.0

Of the eight identified blocks of Uttarakhand, the distribution of adolescents in the age group of 10-19 years was about 40 percent males in Chakrata and 43 percent females. In Doiwala, it was 55 percent males and 56 percent females. In Okhalkhanda, 43 percent were males and 56 percent were females. In Haldwani, 47 percent were males and 59 percent females. If we look at the sex ratio of the adolescent population, it was 1210 in Haldwani and 1209 in Okhalkhanda. The lowest was in Doiwala, at 941. The overall sex ratio was lowest in Bhadrabad at 845 and highest in Chakrata and Doiwala at 922 each (Table 2.3).

10

Table 2.3 Characteristics of Adolescents

Percent distribution of Adolescent in 10-19 years of age and sex ratio

Block

Adolescent age Sex ratio*

(adolescent) Sex ratio* (overall) Male Female

Chakrata 39.7 42.5 988 922

Doiwala 55.2 56.4 941 922

Okhalkhanda 43.2 56.3 1209 928

Haldwani 47.4 58.9 1210 974

Gadarpur 51.1 54.5 946 888

Khatima 46.1 57.2 1133 915

Bhadrabad 47.5 59.2 1054 845

Khanpur 48.6 54.4 1002 896

Note: *Females per 1000 males.

2.2 Household Characteristics Out of the four districts, the maximum pucca houses were in Dehradun (44%). The maximum semi-pucca houses were in Udham Singh Nagar at 47 percent. The maximum kaccha houses were found in Nainital (18%) and Haridwar had the least at 6 percent. The source of drinking water was mainly taps and hand pumps. In about 84 percent of the households in Dehradun, tap water was the main source of drinking water, while in Udham Singh Nagar, the hand pump served as the key source of drinking water for 79 percent of the households. Spring water/gadera/other was the main source of drinking water in Nainital (43%). Most of the households do not have a flush in their toilets - only 29 percent of the homes have flush toilets in Haridwar and about 43 percent do so in Dehradun. In Haridwar, about 66 percent of the households still defecate in the fields/behind bushes. The practice of defecating in the open was significantly high among the households in the other districts too - 55 percent in Dehradun, 53 percent in Nainital and 43 percent in Udham Singh Nagar. The key source of lighting was electricity in all the districts, from 92 percent in Dehradun to about 82 percent in Nainital. The use of gas/oil/other sources for lighting was negligible in all the districts. Kerosene was used for the purpose in 15 percent of the households in Nainital (Table 2.4).

11

Table 2.4 Household Characteristics

Percent distribution by own house, source of drinking water, toilet facility and main source of lighting in Uttarakhand, 2009

Characteristics

Dehradun Nainital Udham Singh Nagar Haridwar

Type of House

Pucca 43.9 42.7 37.0 41.6

Semi-Pucca 44.6 39.2 46.7 52.3

Kaccha 11.5 18.1 16.3 6.1

Drinking Water Source

Tap-Residence/Public 83.6 47.0 20.1 22.9

Hand Pump 13.1 9.8 79.3 73.2

Well 1.0 0.5 0.0 1.4

Spring/Gadera/Other 2.3 42.7 0.6 2.5

Toilet Facility

Flush 43.3 36.3 39.9 28.9

Pit 1.3 10.5 16.7 5.5

Field/Bush 55.4 53.2 43.4 65.6

Source of Lighting

Electricity 92.6 81.6 91.2 90.6

Kerosene 6.7 14.8 8.6 6.0

Gas/Oil/Other 0.7 3.6 0.2 3.5

Total 100.0 100.0 100.0 100.0

2.3 Households Possessing BPL and Health Card In Dehradun and Nainital, 47 percent each of the households possessed below poverty line (BPL) cards. The highest percent of BPL card possessing households were in the Chakrata block of Dehradun and Okhalkhanda block of Nainital, at about 60 and 61 percent, respectively. The least (20%) number of households possessing BPL cards were in Gadarpur block of Udham Singh Nagar. In Okhalkhanda, 2 percent of the households were not aware of BPL card. Again, most households in Chakrata had health cards (36%). In Bhadrabad block of Haridwar, only 8 percent of the households possessed health cards. In three districts, except Haridwar, 1-2 percent of the households were not aware of health card.

72 percent each of the households in Chakrata and Okalkhanda blocks belonged to the low standard of living index (SLI). Both the blocks are located in hilly areas with difficult topography. 49 percent (the highest) of the households in Doiwala block belonged to the high SLI. Both the blocks of Udham Singh Nagar had a high number of households (averaging 52 percent each) in the medium SLI. The SLI was used as the proxy for the economic status calculated based on the household amenities and possession of select household items (Table 2.5).

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Table 2.5 Households Possessing BPL and Health Cards

Percent distribution of the households by BPL, health card and SLI in Uttarakhand, 2009

Characteristics Dehradun Nainital Udham Singh Nagar Haridwar

Chak-rata

Doi-wala Total

Okhal-khanda

Hald-wani Total

Gadar-pur

Kha-tima Total

Bhadrabad

Khanpur Total

Possess BPL Card

Yes 60.6 25.0 46.9 61.2 26.2 46.7 20.1 32.8 26.3 26.4 28.7 27.6

No 39.1 75.0 52.9 36.7 73.1 51.8 78.4 66.2 72.4 73.6 71.3 72.4

Don't know 0.3 0.0 0.2 2.0 0.7 1.5 1.6 1.0 1.3 0.0 0.0 0.0

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Possess Health Card

Yes 35.6 18.2 28.9 31.6 31.2 31.4 21.6 21.5 21.6 8.2 14.2 11.2

No 63.1 81.1 70.0 65.6 68.5 66.8 77.4 76.5 77.0 91.5 85.8 88.7

Don't know 1.3 0.8 1.1 2.7 0.4 1.7 0.9 1.9 1.4 0.3 0.0 0.2

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Standard of Living Index

Low 72.2 9.5 48.0 71.8 26.5 53.0 28.2 27.0 27.6 22.6 40.7 31.7

Medium 26.9 41.3 32.4 26.5 44.1 33.8 52.7 51.1 51.9 59.4 48.6 54.0

High 0.9 49.2 19.6 1.7 29.4 13.2 19.1 21.9 20.5 17.9 10.7 14.3

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

N 320 264 684 294 279 673 319 311 630 318 317 635

2.4 Summary The population of adolescents was about one-fifth of the total in each of the age groups of 10-14 and 15-19. The variation in the age group of 10-14 among the male population was from 19 to 21 percent, and in the female population, it was from 19 to 23 percent. In the 15-19 age group, the variation in male population was from 20 to 23 percent, and among females, it was from 18-22 percent. The mean number of persons in the households varied from 7.2 to 5.9 in Dehradun and Nainital, respectively. There were 97 percent Hindu families in Nainital, 95 percent in Nainital, 71 percent in Udham Singh Nagar and 75 percent in Haridwar. In Haridwar, Muslim population was highest as compared to other districts at 25 percent. There was negligible Christian and Sikh population in Nainital, Dehradun and Haridwar. If we look at the caste-wise distribution of households, we find that the percentage of SCs was highest in Dehradun at 30 percent. The percentage of ST population was highest in Udham Singh Nagar at 26 percent. The OBC percentage was highest in Haridwar (50%). The sex ratio of adolescents was 941 in Doiwala block, the lowest, and the highest was reported in Haldwani (1210). The overall sex ratio varied from 974 in Haldwani to 922 each in Doiwala and Chakrata. Pucca households were most found (44%) in Dehradun and least (37%) in Udham Singh Nagar. 18 percent of the houses in Nainital were kaccha, the highest among all the blocks, while only 7 percent in Haridwar were kachha. The source of drinking

13

water was piped in about 84 percent of the households in Dehradun. Piped drinking water was reported to be lowest (20%) in Udham Singh Nagar, where hand pumps were the key source of drinking water (73%). In Nainital, gadera was the main source of drinking water in 43 percent of the households. In Dehradun and Nainital districts, around 47 percent each of the households possessed BPL cards. Households with BPL cards were highest in Chakrata block of Dehradun and Okhalkhanda block of Nainital, at about 60 and 61 percent respectively. Both these blocks are located in hilly areas with difficult terrain. The least percentage (20%) of households possessing BPL cards were found in Gadarpur block of Udham Singh Nagar. The percentage of households having health cards was highest (36%) in Chakrata. In Bhadrabad block of Haridwar, only 8 percent (the least among all the blocks) of the households had health cards. The lowest standard of living was found in 72 percent of the households in Chakrata and Okhalkhanda blocks. Almost half of the households in Doiwala block of Dehradun belonged to the high SLI. Both the blocks of Udham Singh Nagar had a high number of households belonging to the medium SLI (averaging at 52 percent each). .

14

CHAPTER 3 BACKGROUND DETAILS OF ADOLESCENTS

This chapter gives the details of the background of the adolescents in the eight study blocks.

3.1 Age and Education

In Haridwar, 49 percent of the male adolescents were in the age group of 10-14 years, while 51 percent were in the 15-19 age group. In Dehradun, male and female adolescents in the age group of 10-14 were about 47 and 46 percent, respectively. 54 percent each of the male and female adolescents in Dehradun were in the age group of 15-19 years. In Nainital, 42 and 58 percent of the male adolescents were in the age group of 10-14 and 15-19, respectively, and female adolescents in the two age groups were 48 and 52 percent, respectively. 23 percent (the highest among all the blocks) of the male adolescents in Nainital had studied 10th grade and above, while only 13 percent (lowest percentage) of the male adolescents in Haridwar had completed 10th grade and more. Nainital had the least number of adolescents who had no schooling experience (3.7 percent of the males and 4.5 percent of the females) (Table 3.1).

Table 3.1 Age and Education

Percent distribution of the adolescents by age at the time of survey and educational status, according to sex of adolescents

Characteristics

Dehradun Nainital Udham Singh Nagar

Haridwar

M F M F M F M F

Age

10-14 46.5 46.3 42.1 47.7 47.9 50.3 49.4 49.8

15-19 53.5 53.7 57.9 52.3 52.1 49.7 50.6 50.2

Education

No schooling 7.1 8.1 3.7 4.5 3.9 7.2 8.9 10.2

1-9th

standard 75.3 70.1 72.9 75.6 79.0 73.3 78.0 75.2

10th

and above 17.6 21.8 23.4 19.8 17.2 19.5 13.1 14.6

Total Number 312 298 273 308 309 318 314 323

M: Male, F: Female

3.2 Occupation of Parents

Most of the adolescents reported that their fathers were farmers. The fathers of non school going adolescents were reported to be farmers, 43 percent in Nainital and 27 in percent in Haridwar. In Dehradun, about 37 percent of the fathers of school going adolescents were farmers as compared to 41 percent of non school going adolescents. In Nainital, 44 percent and 43 percent of the fathers of school going and non school going adolescents were famers. In Udham Singh Nagar, 45 percent the fathers of school going adolescents were farmer as compared to 29 percent of non school going.

15

20 percent of the fathers of non school going adolescents in Nainital and about 10 percent of the fathers of school going adolescents in Dehradun were agricultural labourers. In Udham Singh Nagar, there was a significant difference in the percent distribution of adolescents whose fathers were unskilled workers - school going (15%) and non school going adolescents (31%). Most of the adolescents reported that their mothers were housewives. The percent varied from 51 percent in Nainital for non school going adolescents to 78 percent in Haridwar for school going adolescents. Almost 23 percent of the mothers of non school going adolescents in Nainital were farmers, the highest across the districts (Table 3.2).

Table 3.2 Parents’ Occupation

Percent distribution of the adolescents by parent’s occupation, according to school going and non school going adolescents

Occupational Status

Dehradun Nainital Udham Singh Nagar

Haridwar

SG NSG SG NSG SG NSG SG NSG

Father

Agricultural labourer 9.5 15.5 11.3 19.9 15.3 16.3 12.7 17.8

Farmer 37.3 41.3 43.8 42.9 44.6 29.1 34.8 27.3

Artisan 2.8 1.8 2.5 1.9 0.0 .3 2.8 2.5

Petty trader/shop owner 4.3 2.5 0.9 0.0 2.5 1.9 6.5 4.1

Business/industrialist 0.9 0.0 0.3 0.0 0.6 0.0 0.3 0.3

Unskilled worker 12.5 19.1 10.0 8.4 14.6 31.0 18.3 21.6

Skilled worker 6.7 3.9 5.0 5.4 3.8 9.3 8.7 5.1

Self employed 4.3 3.5 3.4 2.3 2.5 1.9 4.0 2.9

Clerical/supervisory/sales person 12.2 2.5 7.5 1.9 2.9 0.3 2.8 1.3

Officer/Executive 1.8 0.0 5.9 2.3 4.1 1.3 1.6 0.0

Not working 1.8 2.5 1.6 1.5 2.5 2.9 2.2 5.7

Father not alive 4.6 7.4 5.3 13.0 5.1 5.4 5.3 10.8

Others 1.2 0.0 2.5 0.4 1.3 0.3 0.0 0.6

Mother

Agricultural labourer 7.0 8.8 6.9 16.1 10.5 13.4 5.9 9.5

Farmer 21.1 21.9 17.5 22.6 12.1 11.8 8.4 6.3

Artisan 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Petty trader/shop owner 1.2 0.0 0.0 0.0 0.6 0.0 0.3 0.3

Business/industrialist 2.8 0.7 1.9 6.5 2.9 5.8 2.5 4.4

Unskilled worker 0.0 0.4 0.0 0.8 0.6 1.3 1.2 0.0

Skilled worker 2.1 0.0 0.3 0.4 0.0 0.3 0.3 0.3

Self employed 2.1 1.4 0.6 0.0 0.3 0.0 0.3 0.6

Clerical/supervisory/sales person 0.0 0.0 0.3 0.0 0.6 0.0 0.3 0.0

Housewife 61.5 63.7 68.8 50.9 68.8 60.7 78.3 68.0

Mother not alive 0.9 3.2 2.5 2.3 2.2 5.4 1.9 10.5

Others 0.9 0.0 1.3 0.4 1.3 1.3 0.6 0.0

Total Number 327 283 320 261 314 313 322 315

SG: School going, NSG: Non school going

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3.3 Reasons for Never Attending/Dropping Out of School

The key reason for never attending school/discontinuation of studies among adolescents was financial, varying from 59 percent in Nainital to 74 percent in Dehradun for male adolescents and from 44 percent in Udham Singh Nagar to 64 percent in Dehradun for female adolescents. Among the female respondents across the four districts, 16 to 35 percent were not interested in studies. In Nainital 52 percent of the male adolescents and 29 percent of the females never attended or discontinued their education out of disinterest. The percentage of adolescents who reported that their family members did not approve of their education varied from 13 percent male adolescents in Hardwar to 38 percent female adolescents in Dehradun. In Dehradun, again, the highest percentage of female adolescents across the study area discontinued their schooling because there were no schools near their homes (Table 3.3).

Table 3.3 Reasons for Adolescents’ Never Attending/Discontinuing Studies

Percentage of the non-school going adolescents by reasons for never attending/discontinuing studies, according to sex of adolescents

Reasons

Dehradun Nainital U S Nagar Haridwar

M F M F M F M F

Not interested in study 35.1 17.2 52.3 29.4 64.3 35.0 48.4 15.5

Family/relative did not approve 34.5 38.1 20.2 28.0 21.4 37.6 13.1 32.9

Financial reason 74.3 64.2 58.7 51.0 72.1 43.9 64.1 53.4

Involvement in housework 16.9 11.2 10.1 2.8 13.0 9.6 4.6 19.3

Involvement in farming 12.8 14.2 17.4 4.9 9.1 4.5 12.4 3.7

Got married 0.7 3.0 1.8 4.9 0.0 1.9 1.3 0.6

Looking after sibling 2.7 3.7 3.7 2.8 0.6 5.7 2.0 3.1

No nearby school 8.1 16.4 12.8 11.9 5.2 6.4 3.3 5.0

No transport 4.1 3.0 5.5 3.5 0.6 0.6 2.6 1.2

Other 6.8 6.7 12.8 11.9 9.1 10.2 19.6 21.1

Total Number 149 134 115 146 155 158 152 163

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

3.4 Employment Status of Non-School Going Adolescents

Most of the female non-school going adolescents were currently employed, varying from 100 percent in Dehradun to 82 percent in Nainital. Employment of male-non school going adolescents varied from 72 percent in Haridwar to 89 percent in Dehradun. The adolescents in the four districts were mostly involved in helping in their family business, farming their own land and doing private work. However, a few also reported being employed to farm others’ land. In Udham Singh Nagar, 89 percent of the non-school going adolescent females reported that they were helping in their family business as compared to 25 percent of their male counterparts (Table 3.4).

17

Table 3.4 Employment Status of Non-School Going Adolescents

Percent distribution of non-school going adolescents by employment status, according to sex of adolescents

Work Status

Dehradun Nainital US Nagar Hardwar

M F M F M F M F

Currently Employed

Yes 88.6 100.0 73.9 81.5 74.8 89.2 71.7 92.6

No 11.4 0.0 26.1 18.5 25.2 10.8 28.3 7.4

Type of Work

Farming own land 29.5 20.9 25.9 17.6 19.8 5.7 28.4 5.3

Farming someone else land 6.1 1.5 20.0 4.2 18.1 1.4 13.8 13.9

Doing private work 22.0 9.0 34.1 5.0 23.3 1.4 24.8 10.6

Helping in family business 40.2 62.7 7.1 71.4 25.0 89.4 24.8 70.2

In service 2.3 2.2 2.4 0.8 4.3 0.7 0.9 0.0

Student 0.0 2.2 7.1 0.0 4.3 0.7 3.7 0.0

No occupation 0.0 1.5 3.5 0.8 5.2 0.7 3.7 0.0

Total Number 132 134 85 119 116 141 109 151

M: Male, F: Female

3.5 Informal Education and Vocational Training

It was reported by most of the adolescents in the study area that they had never been to any informal education centre. The percent varied from 72 percent in Haridwar to 99 percent in Nainital among females, and among males, the percent varied from 78 percent in Dehradun to 97 percent each in Nainital and Udham Singh Nagar. Only a few among the adolescents reported that they had undergone any vocational training, varying from 1 to 7 percent. The percent of adolescents who wished to pursue further education or training was significant. 76 percent each of the male adolescents in Nainital and Udham Singh Nagar wanted to pursue higher education, while the same was true of 67 percent of the female adolescents in Haridwar. In response to the question on what their future plans were, most of the adolescents reported that they would like to continue their studies. The percent of female adolescents who reported this varied from 85 percent in Udham Singh Nagar to 71 percent in Dehradun. Those respondents who preferred to learn at work varied from 10 percent females in Udham Singh Nagar to 56 percent of the male adolescents in Nainital. Most of the respondents felt it was important to have a career, from 99 percent of the female adolescents in Haridwar to 94 percent of the males in Nainital (Table 3.5).

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Table 3.5 Informal Education, Vocational Training and Future Plans

Percent distribution of non-school going adolescents by informal education, vocational training, and future plans, according to sex of adolescents

Educational Activity

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Been to any informal education centre

Yes 22.3 23.3 2.8 0.7 2.6 1.9 11.9 28.0

No 77.7 76.7 97.2 99.3 97.4 98.1 88.1 72.0

Taken any vocational training

Yes 0.7 5.3 0.9 2.1 3.9 4.5 7.3 3.1

No 99.3 94.7 99.1 97.9 96.1 95.5 92.7 96.9

Wish to go for further education or training

Yes 66.9 65.4 75.9 65.7 75.8 63.9 66.9 66.5

No 31.8 29.3 22.2 29.4 22.2 31.0 31.8 30.4

Don’t know 1.4 5.3 1.9 4.9 2.0 5.2 1.3 3.1

Future plans

Higher education 54.5 71.3 43.9 73.4 59.5 84.8 61.4 72.9

Vocational training 3.0 2.3 0.0 3.2 2.6 1.0 5.0 1.9

Learn at work 42.4 26.4 56.1 22.3 37.9 10.1 33.7 25.2

Important to have a career/job

Yes 94.6 95.5 93.9 94.5 97.4 98.1 98.0 98.8

No 0.7 0.7 3.5 1.4 1.9 0.0 0.7 0.6

Don’t know 4.7 3.7 2.6 4.1 0.6 1.9 1.3 0.6

Total Number 149 134 115 146 155 158 152 163

M: Male, F: Female

3.6 Adolescents’ Perspective of Their Future

Most of the adolescents felt that they would need to study further to establish a career. 10 percent of the female adolescents in Nainital to 35 percent of the females in Haridwar felt that they would need their family’s support to get a job. 41 percent of the males in Dehradun and 63 percent of the adolescent males in Haridwar felt that hard work is vital for getting a job. Another key requirement cited by the adolescents was financial assistance; nearly 27 percent of the males in Udham Singh Nagar felt so (Table 3.6).

Table 3.6 Factors Necessary to Attain Career

Percent distribution of adolescents by felt need to attain career, according to sex of adolescents

Needs

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Further education 76.9 66.1 94.9 91.9 95.8 95.3 84.4 70.6

Technical/vocational guidance 16.3 16.4 6.6 1.3 13.9 1.9 17.2 7.4

More family support 28.2 32.2 31.9 10.4 23.6 18.6 30.3 34.7

More community support 2.6 2.3 1.1 0.3 1.9 2.2 6.1 2.5

More financial assistance 23.4 22.5 10.6 5.2 26.9 16.4 20.4 16.4

Self-motivation 11.5 9.1 11.7 3.2 17.8 4.1 25.8 15.8

Hardworking 40.7 43.6 42.5 33.8 48.5 42.1 63.4 45.5

Sincerity 13.1 6.0 7.3 4.2 5.8 6.9 10.5 11.5

Other 0.3 1.3 2.6 2.6 2.3 2.2 0.3 0.6

None of the above 0.0 0.0 0.4 1.3 0.0 0.0 0.3 0.0

Total Number 312 298 273 308 309 318 314 323

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

19

Most of the male adolescents (32 percent in Haridwar to 39 percent in Udham Singh Nagar) reported that they want to become military personnel. Interestingly, a few female adolescents (from 4 percent in Nainital to 10 percent in Dehradun) also wanted to join the armed forces. About 34 percent of the male adolescents in Udham Singh Nagar reported that they want to become doctors. Again, the highest percent of male adolescents (22%) who wanted to become engineers belonged to Udham Singh Nagar.

About half of the female adolescents reported that they want to become teachers, from 40 percent in Haridwar to 59 percent in Udham Singh Nagar (Table 3.7).

Table 3.7 Preferred Profession

Percent distribution of adolescents by future aspiration in life, according to sex of adolescents

Future Aspiration

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Farmer 7.4 1.0 6.2 0.0 4.5 1.6 3.5 0.0

Teacher 26.9 48.7 25.3 51.9 16.5 59.4 24.8 39.9

Nurse 0.3 8.1 0.7 8.8 1.6 8.8 0.6 2.8

Doctor 18.6 22.8 32.6 28.9 33.7 27.0 21.0 22.9

Engineer 15.4 4.4 19.0 5.5 21.7 5.7 16.2 3.1

Computer specialist 3.2 0.3 8.8 1.6 7.8 2.5 4.5 0.3

Manager 7.7 3.0 2.6 0.6 3.2 1.6 1.3 0.3

Lawyer 4.5 1.0 4.8 1.0 3.2 1.3 3.5 4.0

Business person 5.1 0.3 2.6 0.0 3.2 0.9 1.9 0.3

Sports person 5.8 0.7 5.9 0.3 5.8 0.9 3.2 0.3

Military personnel 34.0 9.7 37.0 3.9 39.2 9.1 31.8 8.0

Driver 1.6 0.0 8.8 0.0 9.4 0.0 2.9 0.6

Carpenter 1.0 0.0 2.9 0.0 4.5 0.0 1.6 0.3

Artist/writer/singer/Musician 1.6 4.0 2.2 2.6 1.6 2.5 2.5 1.5

Other 8.0 10.7 7.3 10.7 7.4 20.4 10.8 14.6

Don’t know 3.8 4.7 2.9 5.5 0.6 2.8 6.7 8.0

Total Number 312 298 273 308 309 318 314 323

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

3.7 Extracurricular Activities and Recreation

Most of the male adolescents reported that their key interests were playing outdoor games and watching television or going to the cinema. The male adolescents who reported that their interest was outdoor games varied from 73 percent in Nainital to 84 percent in Haridwar. The female adolescents who expressed an interest in outdoor games varied from 31 percent in Haridwar to 44 percent in Dehradun. The male adolescents who preferred watching television or going to the cinema to any other activity varied from 35 percent each in Dehradun and Nainital to 53 percent in Udham Singh Nagar. The male adolescent who told that their interest was in singing and listening to music varied from 29 per cent in Nainital to 35 per cent in Hardwar. Reading emerged as a key hobby of the female adolescents, from 43 percent in Dehradun to 45 percent in Haridwar (Table 3.8).

20

Table 3.8: Hobbies/Extracurricular Activities

Percentage of adolescents by hobbies/extracurricular activities, according to sex of adolescents

Hobby/Extracurricular Interest

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Playing indoor game 31.4 26.8 17.2 23.4 19.4 13.8 23.2 20.4

Playing outdoor games 82.7 44.3 72.5 34.1 76.1 36.8 83.8 31.0

Reading 29.8 42.6 42.1 33.1 35.6 31.4 35.4 45.2

Writing/painting etc 6.1 17.4 7.3 12.3 3.9 12.9 7.3 15.5

Singing/listening music 33.3 43.0 29.3 28.6 31.7 26.1 35.4 36.8

Watching TV/cinema 34.6 43.3 35.2 23.7 52.8 45.9 50.3 47.1

Technical work 4.5 2.7 4.0 2.3 2.6 1.6 3.5 9.0

Other 3.5 18.8 7.7 22.4 10.4 30.8 5.7 22.9

Total Number 312 298 273 308 309 318 314 323

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

Most of the adolescents reported that they had access to television were allowed to watch television by family. Radio did not emerge as a very popular means of entertainment among the adolescents. A sizeable number of male and female adolescents in Haridwar and Dehradun displayed an inclination towards attending fairs/melas, but not so much by the youngsters in the other two districts. A huge majority of the adolescents across the four districts visited friends and neighbours. The tape recorder was rarely used as a means of entertainment by the adolescents (Table 3.9).

Table 3.9: Type of entertainment and means of recreation facilities available/allowed in family

Percent distribution of adolescents by Type of entertainment and means of recreation facilities available/allowed in family, according to sex of adolescents

Available Means of Recreation

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Television 50.3 61.4 48.0 50.3 68.0 71.4 51.3 56.0

Radio/Transistor 11.5 12.1 24.2 19.2 12.6 9.4 2.9 1.9

Tape recorder 3.2 2.0 2.6 5.8 1.9 4.1 6.4 0.6

Magazine/Newspaper 11.9 15.8 16.1 14.9 17.2 18.6 7.6 8.0

Watched movie in last one month 11.5 0.3 5.1 0.3 2.6 0.0 7.0 0.6

Went to fairs/melas in last one month 40.4 43.3 10.6 3.2 6.1 1.3 68.8 61.6

Visited friends/neighbours

in last one week

96.2 93.6 94.5 79.5 99.7 94.7 97.5 96.3

Total Number 312 298 273 308 309 318 314 323

M: Male, F: Female

21

3.8 Summary In Haridwar, male adolescents in the age group of 10-14 years were about 49 percent and about 51 percent were in the 15-19 age group. In Dehradun, male and female adolescents in the age group of 10-14 were about 47 and 46 percent, respectively. In the age group of 15-19, both male and female adolescents were about 54 percent in Dehradun. In Nainital, male adolescents in the age group of 10-14 and 15-19 were 42 and 58 percent, respectively, and female adolescents in the two age groups were 48 and 52 percent, respectively. Male adolescents who had studied 10th grade and above were highest (23%) in Nainital and lowest (13%) in Haridwar. Most of the adolescents reported that their fathers were farmers. Fathers of non school going adolescents were reported to be farmers, with the highest percent (43%) in Nainital and lowest (27%) in Haridwar. In Dehradun, it was reported that about 37 percent of the fathers of school going adolescents were farmers as compared to 41 percent of the fathers of non school going adolescents. The main reasons for discontinuation of studies were financial problems, disinterest in studies, and disapproval of family and relatives. Most of the non school going adolescents were employed; a majority were helping in their family business, farming their own land or doing other private work. Vocational training was not a subject of great interest among the adolescents. About two-thirds of the adolescents wished to pursue further education and training. Most of them felt that they would like to continue their studies and about one fourth to one third reported that they would like to learn at work. Almost all the adolescents felt having a career/job is extremely important. According to most of the adolescents, the key requirements to attaining a career were higher education, family’s support, financial support and hard work. Regarding future aspirations, most adolescents wanted to join the armed forces, become teachers, doctors and engineers. Interestingly, the respondents did not want to take up farming, though the parents of most of them were farmers. In terms of extracurricular activities, more males than female adolescents love to play outdoor games. The other hobbies included playing indoor games, watching television and singing/listening to music.

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CHAPTER 4 PERSONAL HYGIENE, HEALTH AND HEALTH -SEEKING BEHAVIOUR OF ADOLESCENTS

This chapter describes the current status of personal hygiene, health and health-seeking behaviour of school going and non school going male and female adolescents in the four identified districts of Uttarakhand. This chapter also highlights the level of satisfaction of adolescents with current health services. An attempt has been made to gauge the status of mental health of these adolescents. This chapter also analyzes the suggestions received from the adolescents regarding how the current health services can be improved.

4.1 Personal Hygiene About 90 percent of the adolescents, school going and non school going, reported that they brush their teeth early morning. Only in Haridwar, about one-fifth of the non school going adolescents admitted that they do not brush their teeth daily. About 60-89 percent of the adolescents bathe regularly - as low as 59 percent in Dehradun (non-school going) and as high as 89 percent (school going) in Haridwar. In this regard, a difference of almost 10 percent was observed between school going and non school going respondents. Almost half of the adolescents were regular in cutting and cleaning their nails across the four districts, irrespective of their school going status - as low as one-third of the non school going and a little less than 50 percent of the school going adolescents. More than 80 percent adolescents across the entire study area reported that they wear washed and clean clothes. Only a quarter of the adolescents reported that they brush their teeth at night before sleeping, which implies that a majority do not do so. Nearly 90 percent of the respondents comb their hair regularly and frequently. About three-fourth wash their hands before meals. About 60 percent of non-school going and nearly 75 percent of school going adolescents reportedly wash their hands with soap before meals. Nearly 60 percent and 50 percent of the non-school going adolescents in Haridwar and Dehradun, respectively, wash their hands before cooking. A majority of the adolescents in all the districts reported that they wash their hands with soap after defecation (Table 4.1).

23

Table 4.1 Daily Hygiene Routine

Percent of the adolescents by daily routine of hygiene practices, according to school going and non school going adolescents

Daily Routine

Dehradun Nainital US Nagar Haridwar

SG NSG SG NSG SG NSG SG NSG

Brush teeth early morning 92.0 86.2 98.8 92.3 96.8 93.0 91.9 76.2

Take bath regularly 69.1 59.0 76.9 68.2 87.3 79.6 88.5 71.1

Take bath regularly with soap 65.4 45.9 70.9 52.9 81.5 70.0 82.3 66.3

Cut and clean nails 48.0 32.5 56.3 39.5 48.4 35.1 54.0 38.7

Wear washed and clean cloths 91.4 81.6 94.4 81.6 98.4 89.5 96.9 83.8

Brush teeth at night before sleep 26.9 20.1 28.4 14.2 26.8 14.7 28.3 23.8

Comb hair regularly and frequently 93.6 89.4 96.9 91.2 98.4 96.5 96.3 90.8

Wash hands with soap before meals 75.8 66.4 73.1 62.1 74.2 62.6 82.6 69.5

Wash hands before cooking 53.5 49.5 35.9 37.2 36.9 39.3 56.5 60.0

Wash hands with soap after defecation 93.3 90.8 95.9 93.5 98.1 96.2 98.1 96.2

Total Number 327 283 320 261 314 313 322 315

SG: School going NSG: Non school going

Table 4.2 Observations on Personal Hygiene and Living Conditions of Adolescents

Percent distribution of the adolescents by personal hygiene and living condition through observation, according to school going and non school going adolescents

Observation

Dehradun Nainital US Nagar Haridwar

SG NSG SG NSG SG NSG SG NSG

Hygiene

Nails

Clean 67.0 53.4 61.6 43.3 62.4 45.0 68.9 44.4

Not so clean 31.5 36.7 33.4 50.2 35.7 52.4 28.9 49.5

Dirty 1.5 9.9 5.0 6.5 1.9 2.6 2.2 6.0

Hair

Clean 78.3 64.3 81.9 64.0 90.1 82.7 83.5 58.4

Not so clean 20.2 27.9 17.8 35.2 9.9 17.3 14.3 35.2

Dirty 1.5 7.8 .3 .8 0 0 2.2 6.3

Clothing

Clean 75.8 61.8 73.1 54.4 84.4 66.1 84.8 57.8

Not so clean 19.3 25.4 22.5 37.5 14.6 31.6 13.7 33.3

Dirty 4.9 12.7 4.4 8.0 1.0 2.2 1.6 8.9

Teeth

Clean 74.3 63.3 73.8 58.6 88.5 74.8 80.7 53.3

Not so clean 22.0 28.3 25.6 38.3 11.1 24.9 17.1 37.5

Dirty 3.7 8.5 .6 3.1 .3 .3 2.2 9.2

Living Conditions

House

Clean 74.0 62.5 67.5 57.1 83.1 68.7 77.3 58.1

Not so clean 21.4 29.3 31.9 39.1 16.9 31.0 18.9 34.0

Dirty 4.6 8.1 .6 3.8 .3 3.7 7.9

Surroundings

Clean 61.2 52.7 45.6 36.8 50.6 37.7 59.3 37.5

Not so clean 26.3 27.6 46.6 55.2 46.8 56.5 31.1 44.4

Dirty 12.5 19.8 7.8 8.0 2.5 5.8 9.6 18.1

Total Number 327 283 320 261 314 313 322 315

SG: School going, NSG: Non school going

24

More than 43 percent of all the adolescents had clean nails, one-third had slightly unclean and about 2 percent had dirty nails. The hairs of nearly all the school going respondents were clean, as compared to non school going. The adolescents in Udham Singh Nagar had either clean or slightly unclean hair, but none had dirty/ filthy hair. The clothes of more than half of all the adolescents were clean. The teeth of about three fourth of the adolescent were clean and 18 percent had slightly unclean teeth. The condition of the houses of 76 percent of the respondents were clean, while about one-fourth were not so clean. The immediate surroundings of about 40 percent of the respondents were clean, 40 percent were not so clean and 20 percent were dirty (Table 4.2).

4.2 Awareness, Source of Information and Health Status About 90 percent of the adolescents, irrespective of their school going status, reported that they had been taught about personal hygiene. There was not much variation in the percentage of school going and non school going adolescents who knew about de-worming. Similarly, awareness of prophylaxis against anaemia, goitre and vitamin A deficiency was as low as 30 percent among both school going and non school going respondents. Table 4.3 Knowledge Levels of Adolescents and Information Sources

Percent of the adolescents by knowledge and source of information, according to school going and non school going adolescents

Awareness on

Dehradun Nainital US Nagar Haridwar

SG NSG SG NSG SG NSG SG NSG

Personal hygiene 94.8 85.9 96.6 93.1 94.9 95.8 92.5 86.3

De-worming 27.8 14.8 46.6 30.7 28.3 25.2 21.7 17.1

Prophylaxis against anaemia 36.1 24.7 35.6 25.7 35.7 26.8 29.5 19.4

Prophylaxis against goitre 36.4 18.7 35.9 28.7 43.0 30.0 33.2 22.9

Prophylaxis against vitamin-A 33.0 17.0 45.3 30.3 43.9 34.5 32.3 15.6

Prophylaxis against tetanus 62.1 51.6 63.8 51.7 73.2 58.8 58.4 48.9

Prophylaxis against diphtheria 32.1 19.4 29.4 17.6 28.7 21.1 38.2 32.1

Prophylaxis against measles 32.1 35.0 33.1 18.4 29.0 20.1 41.0 32.4

Source of Information1

Parents 78.0 86.2 83.8 84.7 84.4 86.9 75.2 79.7

Friends 28.1 41.3 15.6 13.0 12.4 22.4 27.6 27.9

Teachers 67.6 19.8 71.6 30.3 72.3 26.8 67.7 24.8

Radio 2.8 3.5 7.2 8.0 4.1 3.5 4.0 3.5

Television 27.8 13.8 27.2 16.9 38.2 33.2 25.8 18.7

Newspaper/magazine 11.3 4.2 11.9 6.1 13.4 6.7 5.3 3.5

ASHA 1.8 2.8 .9 1.9 1.3 .3 1.2 3.8

AWW 1.8 1.4 1.9 2.7 1.0 .3 3.1 5.1

Government doctor 8.6 3.5 11.9 13.0 5.1 4.2 11.2 7.9

Private doctor (qualified) 6.4 5.3 6.3 7.7 7.6 7.0 6.5 7.3

Private doctor (un-qualified) 3.7 1.4 .3 1.9 1.6 3.5

Other 8.3 8.1 5.9 6.5 3.5 2.6 15.2 10.5

Total Number 327 283 320 261 314 313 322 315

1Percent may add to more than 100 due to multiple responses

SG: School going, NSG: Non school going

The percentage of adolescents who reported to have been taught about the prophylaxis against tetanus was high across the four districts, but there is a 10

25

percent difference between school going and non school going adolescents. Again, awareness of prophylaxes against diphtheria and measles was low among all the adolescents, ranging from 18 percent of the non school going adolescents in Nainital to 41 percent of school going adolescents in Haridwar. Parents were the main source of information for school going and non school going adolescents in all four districts. For school going adolescents, teachers were an additional source of information. Television was key in spreading awareness among both school going and non school going adolescents. Among the medical practitioners, government doctors were the most significant source of information (Table 4.3). The percentage of adolescents who had ever received iron and folic acid (IFA) tablets/syrup was very low, ranging from 3 percent to 10 percent. About 62 percent and 63 percent of school going and non school going adolescents, respectively, in Dehradun had received IFA tablets in the last six months, whereas as low as 21 and 4 percent of school going and non school going respondents, respectively, in Udham Singh Nagar had received IFA tablets in the last six months at the time of the study. The key source of IFA tablets in Dehradun were government health facilities, while in Haridwar, private health facilities dispensed the same. Nearly one-third of the respondents in Nainital had received IFA tablets from accredited social health activists (ASHAs) (Table 4.4). Table 4.4 IFA Tablets/Syrup

Percent of the adolescents by status of IFA tablets/syrup, according to school going and non school going adolescents

Status of IFA Tablets/Syrup

Dehradun Nainital US Nagar Haridwar

SG NSG SG NSG SG NSG SG NSG

Ever Received

Yes 9.8 6.7 7.5 6.9 8.9 3.2 4.7 3.5

No 90.2 93.3 92.5 93.1 91.1 96.8 95.3 96.5

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number 327 283 320 261 314 313 322 315

Received in Last Six Months

Yes 62.5 63.2 29.2 44.4 21.4 10.0 46.7 36.4

No 37.5 36.8 70.8 55.6 78.6 90.0 53.3 63.6

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number 32 19 24 18 28 10 15 11

Source

Government 60.0 33.3 42.9 37.5 16.7 * 28.6 *

Private 20.0 50.0 14.3 25.0 50.0 * 57.1 *

ASHA 20.0 16.7 28.6 12.5 16.7 * 0.0 *

Other 0.0 0.0 14.3 25.0 16.7 * 14.3 *

Total Number 20 12 7 8 6 1 7 4

SG: School going, NSG: Non school going

* Figures not shown due to few cases

Nearly 40 percent of the school going adolescents in Dehradun, Nainital and Udham Singh Nagar had ever received tetanus toxoid (TT) injections. Only one-fourth of non school going respondents across the four districts had ever received TT injections. About one-fifth of both school going and non school going adolescents were

26

unaware whether they had ever received the TT vaccine. The percentage of adolescents who received the TT vaccine at the age of 16 was very low, the highest being 22 percent each of the school going respondents in Nainital and non school going respondents in Haridwar (Table 4.5).

Table 4.5 Status of TT Vaccine

Percent of the adolescents by status of TT injection, according to school going and non school going adolescents

Status of TT

Dehradun Nainital US Nagar Haridwar

SG NSG SG NSG SG NSG SG NSG

Ever Received

Yes 40.4 24.0 40.9 23.8 41.1 26.2 32.0 26.0

No 31.8 54.1 40.6 55.9 42.0 53.4 41.0 45.1

Don’t know 27.8 21.9 18.4 20.3 16.9 20.4 27.0 28.9

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number 327 283 320 261 314 313 322 315

Received at the Age of 16

Yes 17.8 14.7 21.8 7.3 18.7 15.1 19.6 21.6

No 73.7 75.6 70.6 85.3 78.5 80.8 72.0 66.2

Don’t know 8.5 9.6 7.6 7.3 2.8 4.1 8.4 12.2

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number (aged 16 and above) 118 156 119 150 107 146 107 139

SG: School going children, NSG: Non school going adolescents

4.3 Health-Seeking Behaviour Except in Nainital and Haridwar, more female adolescents than males met health workers in health facilities. Only 1 percent of the males in Dehradun and 4 to 5 percent of the females in Nainital and Udham Singh Nagar met health workers at home. The figures for the number of adolescents who had never met a health work are quite shocking, from 52 percent of the females in Dehradun to 76 percent of the female respondents in Nainital and nearly 60 percent of the males in Haridwar to 73 percent of the males in Udham Singh Nagar. Of the respondents who had met health workers, most had met doctors and auxiliary nurse midwives (ANMs) (Table 4.6).

Table 4.6 Contact with Health Workers

Percent of the adolescents by meeting with health worker in last six months, according to sex of adolescents

Met Health Workers

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

At health facility 34.6 46.3 28.9 16.6 20.7 23.0 37.9 49.8

At home 1.0 0.7 2.9 3.9 5.8 4.7 2.2 3.1

At home and health facility 1.0 0.7 0.4 2.9 0.3 3.5 0.0 0.3

Never met 63.5 52.3 67.8 76.0 73.1 68.9 59.6 46.7

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number 312 298 273 308 309 318 314 323

Met with:

ASHA 7.0 2.8 8.0 10.8 12.0 9.1 3.9 1.7

AWW 5.3 1.4 5.7 16.2 7.2 15.2 3.1 1.2

NGO worker 9.6 1.4 10.2 5.4 4.8 2.0 7.1 0.0

ANM 11.4 9.2 20.5 17.6 19.3 19.2 7.9 4.1

Other (dominated by doctor) 76.3 88.7 67.0 56.8 66.3 62.6 85.0 96.5

Total Number 114 142 88 74 83 99 127 172

M: Male, F: Female

27

Of the adolescents who had been unwell in the last three months at the time of the study, 64 to 83 percent suffered from fever. Cases of abdominal pain were largely higher among males than females. Headache was also more common among the male respondents.

In terms of seeking advice for illness, a majority of the respondents relied on their parents. Friends were the other significant source of advice on treatment. More male respondents preferred to turn to their teachers for advice (18 percent in Dehradun, 8 percent in Nainital, 4 percent in Udham Singh Nagar, and 21 percent in Haridwar).

Majority of the respondents had sought treatment during their last illness (Table 4.7).

Table 4.7 Advice on Treatment for Illness

Percent of the adolescents by illness and seeking advice, according to sex of adolescents

Characteristics

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Fallen Sick in Last Three Months

Yes 34.3 41.6 50.5 48.1 49.8 55.3 43.3 50.2

No 65.7 58.4 49.5 51.9 50.2 44.7 56.7 49.8

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number 312 298 273 308 309 318 314 323

Suffered From

Fever 72.9 64.5 82.6 80.4 77.9 79.5 78.7 75.3

Cough 24.3 30.6 30.4 29.7 29.2 29.0 22.1 24.7

Cold 15.9 18.5 49.3 39.2 55.8 31.3 14.0 22.2

Diarrhoea 3.7 4.8 4.3 2.7 3.2 2.3 2.9 9.3

Abdominal pain 22.4 20.2 21.0 21.6 15.6 18.8 16.9 10.5

Depression 2.8 0.0 1.4 3.4 1.9 1.1 0.7 0.6

Headache 28.0 16.1 25.4 14.9 30.5 18.8 19.1 14.2

Loss of appetite 1.9 1.6 1.4 1.4 1.3 0.6 3.7 0.6

Other 17.8 32.3 10.9 13.5 11.0 13.1 19.1 28.4

Advice on Treatment Received From1

Parents 88.8 85.5 83.3 85.8 90.9 93.2 92.6 90.7

Grandparents 4.7 7.3 8.0 6.8 5.8 4.5 6.6 4.9

Friends 32.7 4.0 8.0 3.4 3.9 3.4 20.6 4.3

Teachers 17.8 0.8 13.8 0.0 7.1 0.0 5.9 0.6

ASHA 3.7 1.6 4.3 1.4 1.3 1.7 0.7 1.2

AWW 2.8 0.0 2.9 1.4 0.6 0.0 2.2 0.6

Relatives 0.9 1.6 2.2 2.7 0.0 2.3 0.7 0.0

Sister-in-law 0.9 4.0 2.2 2.7 1.9 2.8 2.9 8.6

Self 12.1 8.1 15.9 0.7 25.3 5.1 15.4 16.0

ANM 5.6 2.4 4.3 0.0 1.9 1.7 3.7 1.9

NGO worker 3.7 0.0 0.7 0.7 1.3 0.6 3.7 0.0

Other 14.0 18.5 20.3 16.9 5.2 9.1 15.4 15.4

Sought Treatment

Yes 91.6 96.8 93.5 89.2 100.0 96.6 95.6 98.1

No 8.4 3.2 6.5 10.8 3.4 4.4 1.9

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number 107 124 138 148 154 176 136 162

1Percent may add to more than 100 due to multiple responses

M: Male, F: Female

28

4.4 Anthropometric Interpretations

To measure the body mass index (BMI) of the adolescents, the investigators used

height and weight measuring instruments. The ICMR standard was used to measure

the BMI. Table 21 shows the BMI of the adolescents in the four study districts.

Around 74 percent of the male adolescents in Dehradun were underweight, while

only one-fourth were of normal weight. Only about 35 percent of the female

adolescents in Dehradun were of normal weight. The same trend was observed in

the other study districts too, and among both younger and older adolescents too.

Interestingly, in all four districts, more school going adolescents were underweight

compared to non school going respondents (Table 4.8).

Table 4.8 Body Mass Index of the Adolescents

Percent of the adolescents by body mass index, according to age, sex and school going/non-going adolescents

Background Characteristics

Body Mass Index (BMI) in Kg/M2

Dehradun Nainital US Nagar Haridwar

Below 18.5

18.5 & above

Below 18.5

18.5 & above

Below 18.5

18.5 & above

Below 18.5

18.5 & above

Sex

Male 74.4 25.6 60.8 39.2 55.3 44.7 80.3 19.7

Female 65.5 34.5 61.0 39.0 59.6 40.4 74.1 25.9

Age

Early adolescent 74.1 25.9 67.2 32.8 62.4 37.6 80.9 19.1

Late adolescent 65.5 34.5 53.1 46.9 52.6 47.4 73.2 26.8

Education

School going 90.6 9.4 83.5 16.5 83.1 16.9 88.9 11.1

School not going 52.3 47.7 42.3 57.7 32.7 67.3 65.3 34.7

All 70.0 30.0 60.9 39.1 57.5 42.5 77.1 22.9

Total Number 421 180 352 226 360 266 485 144

4.5 Mental Health 70 percent of the males in Dehradun felt that they could concentrate on the task at hand, a feeling echoed by 79 percent of the females in the district. In case of losing sleep over worry, 10 percent of the male adolescents in Udham Singh Nagar males and as many as 40 percent of the females in Haridwar fell in the category. Males were more confident than females with 26 percent of the female adolescents in Dehradun, 33 percent in Nainital, 23 percent in Udham Singh Nagar and 28 percent in Hardwar reporting a loss of confidence. More than 70 percent of the respondents felt they were capable of taking decisions when required.

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A majority of the adolescents, males and females, reported themselves as happy, all things considered (Table 4.9).

Table 4.9 Adolescents’ Mental State

Percent of the adolescents by mental state in past one month, according to sex of adolescents

Mental State

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Able to concentrate on whatever doing

69.9 79.2 84.2 79.9 84.1 88.7 66.2 64.7

Losing sleep over worry 18.9 37.2 19.4 27.6 10.4 28.6 17.2 40.6

Feel that they are playing a useful role

63.1 62.4 71.4 55.2 71.2 66.7 63.1 65.0

Feel capable of making decisions about things

72.8 56.7 77.7 68.2 77.0 70.4 62.7 45.2

Feel constantly under strain 9.6 23.8 17.9 24.0 15.2 27.4 9.9 22.9

Feel they can overcome difficulties 71.2 76.5 83.2 73.7 86.7 75.8 69.1 72.8

Able to enjoy normal day to day activities

70.8 85.2 92.7 96.1 95.1 95.9 70.1 88.9

Able to face up to problems 71.5 70.5 79.9 76.3 84.1 75.5 65.9 69.7

Feel unhappy and depressed 15.4 27.5 19.8 32.5 14.2 30.8 15.0 25.7

Lost confidence 15.1 26.2 25.6 32.8 16.8 23.3 15.0 27.9

Have thoughts of worthlessness 4.2 13.4 9.2 8.1 2.3 7.2 4.8 11.5

Feel responsible and happy 83.0 82.9 91.2 97.1 96.4 94.7 93.3 78.6

Total Number 312 298 273 308 309 318 314 323

M: Male, F: Female

Fifty-four percent and 29 percent of the male adolescents in Dehradun and Nainital, respectively, were bothered most by sexual problems. Twenty-eight percent of the females in Dehradun were unhappy with their relationship with their parents. Twenty-two percent of the male adolescents in Haridwar were anxious due to their unemployed status. Not surprisingly, more male adolescents in all four district brooded over their not having a job than their female counterparts. More than a quarter of the males in Udham Singh Nagar were most bothered about their career. Twenty-nine percent each of the female respondents in Haridwar and Dehradun were reportedly upset about drug abuse. More than half of the males in Dehradun and nearly 30 percent of the males in Nainital were most occupied with sexual problems. Sexual issues did not seem to be much on the minds of the female adolescents, except for 8 percent in Nainital and 4 percent in Haridwar. Nearly 39 percent of the males and 35 percent of the females in Dehradun were bothered about nutritional status and menstrual problems, respectively (Table 4.10).

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Table 4.10 Issues that Bother Adolescents

Percent of the adolescents by issues that bother, according to sex of adolescents

Issues

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Studies 10.1 16.4 12.6 8.4 13.3 11.1 12.1 16.0

Body image 16.7 21.9 7.6 4.3 8.1 6.2 16.7 18.6

Illness 10.0 6.3 17.9 12.9 23.0 10.3 9.8 9.8

Unemployment 22.8 2.5 15.4 6.8 18.2 8.3 22.2 3.7

Career 25.6 6.0 13.2 2.3 27.0 6.0 17.8 2.0

Marriage 26.9 25.2 2.5 11.8 5.9 10.9 5.0 11.8

Work at home 19.1 19.9 6.3 10.9 6.6 10.4 14.8 12.0

Relationship with parents 5.1 28.3 14.1 12.1 6.1 10.1 4.0 20.2

Relationship with friends 20.2 16.3 3.8 12.5 5.8 14.4 17.3 9.6

Nutritional status 38.5 7.7 7.7 3.8 9.6 3.8 21.2 7.7

Sexual problem 54.2 0.0 29.2 8.3 0.0 0.0 4.2 4.2

Menstrual problem 15.0 35.0 0.0 25.0 0.0 5.0 5.0 15.0

Lack of money 12.8 13.3 8.6 9.3 12.9 12.3 17.3 13.5

Alcohol abuse 4.3 25.5 4.3 14.9 2.1 25.5 0.0 23.4

Drug abuse 14.3 28.6 14.3 0.0 0.0 14.3 0.0 28.6

Other 3.1 13.2 12.1 14.4 10.1 21.4 10.5 15.2

Don’t Know 14.0 1.9 18.7 20.6 7.5 16.8 15.9 4.7

Total Number 312 298 273 308 309 318 314 323

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

Across the four districts, a majority of the females sought their father’s advice on issues. Except for 44 percent in Dehradun, most female adolescents did not discuss vital issues with or take advice from their mothers. While, on the other hand, more male adolescents were comfortable with discussing issues with and taking their mother’s counsel (the highest being nearly 82 percent in Udham Singh Nagar).

Table 4.11 Advice Seeking by Adolescents

Percent of the adolescents by advice sought from and concern discussed with, according to sex of adolescents

Advice Sought From

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Father 84.6 77.9 75.8 80.2 79.6 85.5 84.7 70.9

Mother 80.4 44.0 72.9 27.3 81.9 31.8 75.8 26.6

Friends 31.1 29.2 35.2 22.7 40.1 24.2 26.4 30.0

Teacher 13.5 6.4 31.1 7.5 21.7 5.3 14.0 8.7

AWW 0.0 0.0 0.7 0.6 1.0 0.0 0.3 0.3

ASHA 1.0 0.3 1.1 0.6 0.0 0.3 0.3 0.0

ANM 0.3 0.3 1.8 0.0 0.3 0.0 0.6 0.3

Sibling 20.8 26.5 22.0 16.9 19.4 18.2 37.6 23.8

Sister-in-law 1.3 2.7 2.9 2.3 1.6 4.1 5.1 1.5

Other 4.5 6.4 7.3 8.8 1.9 5.3 10.8 16.1

Total Number 312 298 273 308 309 318 314 323

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

Friends and teachers were the other figures whose advice was sought most by the adolescents. Nearly one-fourth of the adolescents shared their concerns with their

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siblings (21 and 27 percent in Dehradun, 22 and 17 percent in Nainital, 19 and 18 percent in Udham Singh Nagar, 38 and 24 percent in Haridwar) (Table 4.11).

4.6 Suggestions on Improving Health Services Except for Nainital and Udham Singh Nagar, most male and female adolescents in the other two districts felt that morning timings were ideal for making health facilities available. Again, lesser percent of adolescents in Nainital and Udham Singh Nagar preferred evening timings compared to adolescents in the other two districts. 22 percent of the male respondents in Dehradun wanted the sub-centre (SC) to be located in close vicinity, while 46 percent of the males in Udham Singh Nagar wanted the primary health centre (PHC) to be conveniently located. Most of the female adolescents were not very particular about the location of the health facilities, except for 20 percent and 11 percent in Udham Singh Nagar and Nainital, respectively, who wanted the PHC to be located at a convenient distance from their homes.

Table 4.12: Suggestions on Improving Health Services

Percent of the adolescents by suggestions on health services, according to sex of adolescents

Health Facility

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Convenient timing - Morning 55.1 39.9 16.5 5.8 11.0 3.1 55.4 36.5

Convenient timing - Evening 35.9 31.2 17.6 5.8 11.0 8.5 35.4 28.2

Convenient location - SC 22.1 3.7 30.4 2.9 24.9 7.2 25.5 1.2

Convenient location - PHC 12.5 1.7 20.9 11.4 46.0 20.4 20.4 1.2

Convenient location - CHC 2.2 2.7 9.9 14.6 25.2 31.4 2.2 0.0

Outside health facility 7.4 2.3 11.7 8.4 18.4 13.2 12.1 0.3

Doctor of same sex 27.6 28.9 27.8 20.1 35.0 16.4 43.6 20.7

Privacy 23.7 15.8 5.9 3.6 15.5 4.4 30.3 11.5

Confidentiality of information 8.3 4.4 1.1 1.3 1.6 0.9 9.2 9.6

Providing services at home 22.1 27.9 14.3 20.8 23.3 23.3 15.9 19.8

Other 3.5 15.1 3.7 16.2 3.9 17.0 5.4 12.1

Don’t know/can’t say 7.7 11.7 29.7 19.8 11.3 11.6 7.3 25.4

Services on

Information on health issue 71.8 73.5 64.5 64.3 79.6 73.3 84.7 61.9

Delivery care services 28.5 10.1 4.8 4.9 7.4 6.3 29.9 5.3

Family planning services 3.5 6.4 1.8 0.6 0.3 0.0 1.0 2.5

Anaemia treatment 3.5 6.4 0.0 1.9 0.3 0.6 6.1 3.1

Treatment for menstrual problem 6.4 4.0 2.9 1.6 2.9 2.5 7.0 2.2

Treatment for RTI/STI 0.3 0.0 0.0 0.3 0.0 0.0 0.0 0.0

Other 7.1 19.8 15.4 19.2 15.5 32.4 3.8 13.9

Don’t know 20.5 15.4 26.0 20.8 13.6 12.3 11.8 29.1

Total Number 312 298 273 308 309 318 314 323

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

More than three-fourth of all the male and female adolescents wanted health-related information to be made available in the health facility - 72 and 74 percent in Dehradun, 65 and 64 percent in Nainital, 80 and 73 percent in US Nagar, and 85 and 62 percent in Haridwar, respectively.

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That the doctor should be of the same sex was suggested by almost 44 percent of the male respondents in Haridwar and 29 percent of the females in Dehradun. Interestingly, more males than females in Dehradun and Haridwar wanted delivery care services to be made available at the health facilities (Table 4.12).

4.7 Summary The response of the target group on routine health and hygiene practices were satisfying. Although there was some difference in the health and hygiene practice of school going and non school going adolescents, the variation was not very significant, barring a few exceptions. Most of the adolescents reported that they brush their teeth regularly in the morning, but only a few reportedly brush their teeth at night before going to bed. A majority of the adolescents bathe regularly, but not all used soap to do so. Cutting and cleaning of nails was not a common practice among the respondents. Most of them reportedly wear washed and clean clothes. It was good to note that most of them wash their hands before eating. A majority of the adolescents also reported that they wash their hands with soap after defecation. Major differences were observed between the awareness levels of school going and non school going adolescents regarding de-worming and prophylaxis. The school going adolescents were more knowledgeable as compared to the non school going adolescents. Only a few of the females had received IFA tablets and the major sources of IFA tablets as reported by them were SC, private doctor/clinic, ASHA and CHC/PHC, which varied from one district to the other. About one-third of them had received the TT vaccine at the age of 10. A majority of them had not met with health workers in the previous six months, and those who did, reportedly met the health worker at a health facility. 34 to 55 percent of the adolescents reported that they had been unwell in the last three months. The common illnesses were fever, cough, cold and headache. Most of the respondents sought the advice of their parents for treating their illness. A positive sign was that a majority of them sought treatment at private health facilities, government/municipal hospital, CHC/PHC/FP centre and SC/ANM. The key reasons for preference for a health facility were known acquaintance, easily accessible and convenient location. Most of the adolescents reported that they were satisfied with the available health services. Most of the adolescents, school going and non school going, were satisfied with their health About their mental health status, a majority of them reported that they were able to concentrate on what they were doing, had not lost sleep over worry and were capable of making decisions. Most of them were not under strain, felt that they will overcome their difficulties, and were enjoying their normal daily activities. A few adolescents did report that they were unhappy and depressed, were losing confidence and had feelings of worthlessness. The issues bothered the adolescents the most were related to money, studies, body image, their work load at home, career and unemployment. The

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adolescents mostly seek advice and discuss their concerns with their parents, friends and siblings. Some of their suggestions on improving health services were ensuring that the health facility is located conveniently, timings could be morning and evening, same sex doctor should be made available; enough privacy should be ensured, while some also felt that health services should be provided at their homes. The adolescents wanted that services like information on all health issues, treatment of menstrual problems, treatment of anaemia, delivery care services and family planning services should be made available.

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CHAPTER 5 AWARENESS ON ISSUES RELATED TO ADOLESCENCE

This chapter highlights the knowledge level of adolescents on issues related to adolescence. The adolescents were questioned on acceptable issues like puberty, legal age of marriage, indulgence in tobacco and alcohol, and balanced diet to gauge how informed they are on these issues which have an impact on their daily lives. The less acceptable and less talked about issues like sexual concerns, sexually transmitted infections, contraceptives, menstruation etc. were also handled.

5.1 Puberty In all four districts, more female adolescents were aware of puberty as compared to their male counterparts; the most prominent difference was seen in Nainital, where only 57 percent of the males were aware as compared to 82 percent of the females. Not much difference was seen between the awareness levels of school going and non school going adolescents. In most of the districts, about three-fourth of the adolescents were found to be aware of puberty (Table 5.1).

Table 5.1 Awareness of Puberty

Percent of the adolescents by awareness of puberty, according to sex and school going/non-going status

Background Characteristics

Dehradun Nainital US Nagar Haridwar

Aware Not aware

Aware Not aware

Aware Not aware

Aware Not aware

Sex

Male 69.6 30.4 56.8 43.2 62.1 37.9 68.8 31.2

Female 79.5 20.5 81.5 18.5 79.2 20.8 85.1 14.9

Education

School going 73.1 26.9 67.8 32.2 67.8 32.2 77.6 22.4

Non school going 76.0 24.0 72.4 27.6 73.8 26.2 76.5 23.5

All 74.4 25.6 69.9 30.1 70.8 29.2 77.1 22.9

Total Number 421 180 352 226 360 266 485 144

About 88 percent of the male adolescents in Udham Singh Nagar, the change that takes place in girls after puberty is a rapid increase in height and weight. Per nearly 71 percent of the adolescents, girls experience enlargement of breast after puberty. Onset of menstruation was reported by about three-fourth of the female adolescents in all four districts. Awareness of broadening of hips as a puberty-related change in girls was low (1-8 percent). More than three-fourth of the males in Dehradun stated that, with puberty, boys experience a rapid increase in height and weight, a view echoed by 88 percent of the females in Udham Singh Nagar. Growth of facial hair (moustache and beard) was familiar to most of the male respondents (86-97 percent), while more than 80 percent of the females were also aware of this development in boys. Attraction towards the opposite sex was reported by few adolescents, males or females – the highest being

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a quarter of the males in Udham Singh Nagar. Increase in the size of male internal genitals was reported by less than 5 percent of the males only (Table 5.2).

Table 5.2 Changes After Puberty

Percent of the adolescents by changes after puberty, according to sex of adolescents

Characteristics

Dehradun Nainital US Nagar Hardwar

M F M F M F M F

Body changes in girls1

Rapid increase in weight and height 74.4 60.4 77.3 80.5 87.4 87.7 78.3 80.8

Enlargement of breast 70.8 70.5 70.3 68.8 71.5 77.0 78.7 67.2

Hair in arm pits 30.8 27.9 27.5 41.2 20.7 43.7 32.2 8.4

Development of pubic hair around 32.4 11.1 21.6 11.7 11.7 22.6 29.9 4.6

Onset of menstruation 34.3 70.8 19.4 64.9 25.2 68.6 31.2 74.6

Pimples on face 29.2 30.5 27.5 14.9 23.9 14.8 32.5 23.2

Broadening of hips 8.0 4.0 5.9 1.6 2.9 0.6 6.7 5.3

Start taking care of self 29.8 20.8 17.2 8.4 14.6 10.7 45.2 27.6

Attraction towards opposite sex 8.7 4.0 18.7 4.9 20.1 2.8 11.8 5.0

Body changes in boys1

Rapid increase in weight

and height

75.3 56.0 83.9 78.6 90.0 88.1 84.4 73.7

Development of moustache 90.4 84.6 90.1 84.4 86.1 89.0 96.8 89.5

Development of

hoarse/heaviness in voice

44.2 51.0 62.3 43.5 66.0 52.2 57.0 61.6

Development of hair

around genitals

39.4 11.4 36.3 6.8 15.5 6.3 35.7 2.2

Hair in armpits 24.4 11.1 36.6 16.2 26.9 24.2 28.7 4.0

Broadening of shoulders 17.6 18.5 11.7 6.2 8.7 3.8 10.8 15.8

Pimples on face 29.5 18.5 15.8 5.8 15.5 9.4 33.8 9.6

Change in thinking 30.1 16.8 22.7 5.5 28.2 8.2 40.4 23.5

Attraction towards opposite sex 7.4 3.7 20.1 6.2 24.9 4.4 15.6 7.1

Increase in size of

internal genitals

4.5 0.3 5.9 0.0 5.2 0.0 4.5 0.0

Number 312 298 273 308 309 318 314 323 1

Percent may add to more than 100 due to multiple responses M: Male, F: Female

5.2 Knowledge and Myths about Menstruation

Talking openly on issues related to menstruation was not socially acceptable in the target group. About 82-87 percent of the females and 34-44 percent of the males had heard about menstruation in all the surveyed districts. Non school going adolescents were more aware of menstruation than their school going counterparts (Table 5.3). As many as 42 percent of the male adolescents in Haridwar felt that menstruation was caused by the release of sperms from the body. More male adolescents than female adolescents thought menstruation was the process whereby the female body gets prepared for child birth. A significant percent of male and female adolescents opined that menstruation was the process of impure blood being expelled from the body - 49 and 65 percent in Dehradun, 44 and 61 percent in Nainital, 76 and 74 percent in Udham Singh Nagar and 33 and 52 percent in Haridwar, respectively.

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Table 5.3 Awareness of Menstruation

Percent of the adolescents who had heard of menstruation, according to sex and school going/non-going adolescents

Background Characteristics

Dehradun Nainital US Nagar Haridwar

Heard Not heard

Heard Not heard

Heard Not heard

Heard Not heard

Sex

Male 43.6 56.4 33.7 66.3 43.7 56.3 38.2 61.8

Female 83.2 16.8 81.8 18.2 86.5 13.5 83.3 16.7

Education

School going 55.7 44.3 55.0 45.0 62.4 37.6 54.7 45.3

Non school going 71.4 28.6 64.4 35.6 68.4 31.6 67.6 32.4

All 63.0 37.0 59.2 40.8 65.4 34.6 61.1 38.9

Total Number 384 226 344 237 410 217 389 248

Nearly half of the male adolescents felt that menstruation was a natural process. Nearly 40-73 percent of the males and 23-55 percent of the female adolescents felt it signified that the girl was ready for motherhood.

Table 5.4 Understanding of Menstruation and the Reasons for its Occurrence

Percentage of the adolescents by understanding about menstruation and reasons for its occurrence, according to sex of adolescents

Understanding of Menstruation

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Release of sperm 24.3 0.4 13.0 1.2 2.2 1.1 42.5 0.4

The egg leaving the ovary 8.1 2.4 27.2 5.2 17.0 5.5 29.2 3.7

Periodic scheduling of blood 14.0 0.8 16.3 3.2 10.4 2.5 5.0 0.4

Sperm being produced

in the testes

9.6 0.8 6.5 3.6 6.7 1.5 21.7 0.4

Impure blood leaving the body 48.5 64.9 43.5 61.1 76.3 73.8 33.3 51.7

A symptom of ill health

and disorder

2.2 4.0 12.0 3.6 11.9 1.5 1.7 3.0

Body getting prepared for

child birth

70.6 35.1 50.0 9.9 42.2 11.6 75.8 46.5

Other 0.7 0.0 0.0 0.8 2.2 1.1 0.0 0.0

Don’t know 4.4 10.9 16.3 29.4 9.6 20.7 6.7 10.4

Menstruation Occurs Due to

Natural process 54.4 32.3 62.0 23.0 55.6 25.8 44.2 22.7

God's curse 0.7 0.4 1.1 0.8 0.0 1.5 5.0 1.5

Up to God 5.9 10.9 4.3 13.1 16.3 9.1 12.5 4.5

Girl ready for motherhood 50.0 51.2 56.5 23.0 40.0 29.1 72.5 55.0

Don’t know 14.0 12.5 7.6 42.9 16.3 37.5 14.2 18.6

Total Number 136 248 92 252 135 275 120 269

Percent may add to more than 100 due to multiple responses M: Male, F: Female

In Dehradun, about 58 percent of the female adolescents avoid going to kitchen while menstruating. Most female adolescents across the four districts do not visit religious places during their periods. 32 to 46 percent claimed to be particular about their personal hygiene during menstruation (Table 5.4).

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Regarding the type of cloth/pads used during menstruation, most female adolescents reportedly used old cloth pieces (70 percent in Udham Singh Nagar, 58 percent in Nainital and 50 per cent in Haridwar). Almost 40 percent of the female respondents in Dehradun use sanitary pads (the highest percent of users in all four districts), while 39 percent use clean washed cloth (Table 5.5).

Table 5.5 Common Practices and Cloth Used During Menstruation

Percentage of the adolescents by practices followed and type of cloth used during menstruation and its occurrence, according to female adolescents

Dehradun Nainital US Nagar

Haridwar

Practices

Avoid eating oily, spicy and sour food 19.5 4.3 7.0 13.5

Avoid going to kitchen 57.9 20.8 30.6 39.6

Avoid going to religious place 59.3 89.9 94.8 48.7

Avoid religious ceremonies/rituals 24.4 28.5 24.9 25.7

Mostly stay in separate room/not share bad 8.1 2.4 4.4 2.2

Maintain personal hygiene,

particularly in those days

41.6 31.9 33.2 45.7

Take rest 20.4 8.7 5.7 20.4

Do normal/mild exercise 4.1 1.0 .4 16.1

Avoid any physical exercise/stress 16.7 0.5 .4 25.2

Do not take bath during menstruation 9.5 9.7 5.2 4.3

Other 6.3 1.0 3.5 7.8

Type of Cloth Used

Sanitary pads 39.4 25.1 25.8 21.7

Any old cloth 33.9 57.5 69.9 49.6

Clean washed cloth 38.9 34.3 27.1 40.0

Use of cottons 0.5 2.9 2.2 0.0

Other 0.5 0.5 0.0 0.0

Total Number 221 207 229 230

Percent may add to more than 100 due to multiple responses

58 to 78 percent of the female adolescents faced the problem of excessive abdominal pain/cramp. Back pain was mentioned by 20-39 percent of the adolescents. Mood swings were reported by nearly 17 percent of the females in Dehradun. 30 percent in Haridwar, 23 percent in Udham Singh Nagar, 12 percent in Nainital and 16 percent in Dehradun did not report any menstruation-related complaints. When asked about how they react when faced with any of the listed problems, nearly 60 percent in Udham Singh Nagar, 71 percent in Haridwar, 53 percent in Dehradun and 41 percent in Nainital said that they did nothing. 33 percent of the females in Dehradun, 47 percent in Nainital, 28 percent in Udham Singh Nagar and 22 percent in Haridwar said that they took rest. Only 7-13 percent sought treatment for menstruation-related problems (Table 5.6).

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Table 5.6 Common Problems Faced During Menstruation and Action Taken

Percentage of the adolescents by problem faced during menstruation and action taken, according to female adolescents

Problem Dehradun Nainital US Nagar Haridwar

Regularly delayed period 3.2 1.0 0.4 6.1

Regularly early period 5.9 1.9 0.9 9.1

Irregular period 1.8 1.9 2.6 0.4

Scanty bleeding 1.8 1.4 0.9 1.3

Excessive bleeding 5.4 12.1 3.1 1.7

Persistent headache 6.8 11.1 4.8 4.3

Excessive abdominal pain/cramp 74.2 77.8 63.3 58.3

Over-eating 2.3 0.0 0.4 2.6

Loss of appetite 10.4 7.7 3.5 8.7

Vomiting/dizziness/nausea 3.6 1.0 3.9 1.3

Getting moody/temperamental 16.7 6.3 2.2 9.1

Pain in legs 13.6 7.7 17.9 11.7

Back pain 38.9 33.8 35.4 19.6

Heaviness in breasts 0.5 1.0 0.4 0.0

Body pain 10.0 10.1 7.0 3.5

None of the above 16.3 11.6 22.7 30.0

Other 1.4 0.0 2.6 0.9

Action Taken

Nothing 52.9 40.6 59.4 71.3

Ate balanced diet 5.0 1.4 0.9 1.7

Took rest 33.0 47.3 28.4 21.7

Took treatment 13.1 7.2 9.6 6.5

Took IFA tablets 0.0 5.3 2.2 0.4

Other 0.5 3.4 1.7 1.7

Total Number 221 207 229 230

Percent may add to more than 100 due to multiple responses

5.3 Sexual Concerns of Adolescent Boys

Not just girls, boys too have sexual concerns, but due to social taboo they cannot voice these with elders or discuss these openly. Hence, whatever information they collect is from their peers, who also possess very limited unscientific information. The acceptance of cause of concern in front of an unknown researcher was also difficult for the male respondents, hence the majority did not have any concerns to share. The key sexual concern of male adolescents that was reported was nightfall, by 14 percent in Dehradun, 13 percent in Nainital, 9 percent in Haridwar, and 8 percent in Udham Singh Nagar. Masturbation was reported by a very low percent of male adolescents - about 4 percent each in Dehradun and Haridwar, 2 percent in Nainital and negligible in Udham Singh Nagar (Table 5.7).

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Table 5.7: Sexual Concerns Among Male Adolescents

Percentage of the adolescents by sexual concerns among boys, according to male adolescents

Sexual Concerns Dehradun Nainital US Nagar Haridwar

Nightfall 14.4 13.2 8.4 8.9

Masturbation 4.2 1.5 0.3 4.1

Premature ejaculation 1.9 0.4 0.0 0.6

Sexual weakness 4.5 0.7 0.6 1.6

Impotency 1.0 0.0 0.0 0.0

Small penis size 3.5 0.4 0.3 1.3

Other 0.0 0.0 0.0 1.0

None 82.4 86.4 91.6 89.8

Total Number 312 273 309 314

Percent may add to more than 100 due to multiple responses

5.4 Awareness on and Misconceptions about Balanced Diet In the age group of 10-19, balanced diet plays an important role for growth and development. To assess how many respondents really understood the meaning and significance of a balanced diet, the investigators asked a few related questions. Most of the adolescents, ranging from 69-90 percent, were aware of what a balanced diet implies. There was a marginal difference between school going and non school going adolescents in this regards. According to more than 90 percent of the respondents, a balanced diet contains different kinds of vegetables and fruits. Another food that was reported to be balanced diet was food rich in ghee and oil, again with marginal differences between school going and non school going adolescents. Consuming milk products/meat/protein regularly was considered a balanced diet by about 90 percent of the adolescents (Table 5.8). Table 5.8 Awareness on and Misconceptions about Balanced Diet

Percent distribution of the adolescents by balance diet, myths and misconception, according to school going and non-school going adolescents

Diet

Dehradun Nainital US Nagar Hardwar

SG NSG SG NSG SG NSG SG NSG

Aware of Balanced Diet

Yes 86.9 72.4 88.1 71.6 83.1 69.0 90.1 74.6

No 13.1 27.6 11.9 28.4 16.9 31.0 9.9 25.4

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number 327 283 320 261 314 313 322 315

What is a Balanced Diet?

Large quantity of food 17.6 22.0 18.4 25.1 14.9 14.4 14.8 16.2

Different kinds of vegetables and fruits 95.4 91.7 90.8 93.0 95.8 98.6 96.6 98.3

Food rich in oil and ghee/fats 72.2 66.8 58.5 59.4 59.8 56.0 81.0 85.1

Tasty food of one’s own choice 61.3 63.9 79.1 78.1 82.4 85.6 74.8 75.3

Contains all essential elements of food in diet

94.0 89.8 89.0 82.9 92.3 86.6 96.2 93.6

Consuming milk/meat/proteins regularly 90.8 94.6 91.8 92.5 93.5 96.8 89.0 91.9

Total Number 284 205 282 187 261 216 290 235

SG: School going NSG: Non school going

40

5.5 Opinion on Marriage, Pregnancy and Sex of Baby The majority of male adolescents, from 60 percent in Udham Singh Nagar to 47 percent in Dehradun, stated that they would get married after getting a job. The female adolescents were more concerned about their education. The percent of female adolescents who reported that they would marry after completing their education was highest (43%) in Udham Singh Nagar and lowest in Haridwar (29%). The percent of females who stated that they would marry whenever their parents insist was highest (36%) in Haridwar and lowest in (18%) in Nainital.

According to most of the respondents, the right age of marriage of girls in mean years was 21 to 24 years, and for boys it was 23 to 27 years. The adolescents who reported the correct legal age of marriage in India range between 50 to 69 percent. In Udham Singh Nagar, 37 percent of the female adolescents did not know the legal age of marriage for girls. 30 to 60 percent of the adolescents who reported the correct legal age of marriage of boys ranged from 30 to 60 percent. The highest (60%) were in Dehradun and lowest (30%) were in Udham Singh Nagar (Table 5.9).

The adolescents’ perceived consequences of early marriage of girls were that it can harm the girl’s health, lead to the birth of sick and weak babies, lead to maternal death, and result in the girl’s inability to manage home and family. The male adolescents who reported that early marriage can be detrimental to girls’ health was highest (70%) in Haridwar and lowest in Nainital (52%). The percent of female adolescents who reported the same were highest (57%) in Haridwar and lowest (51%) in Dehradun. The male adolescents who felt that young brides can give birth to weak infants ranged from 33 percent in Udham Singh Nagar to 53 percent in Haridwar. The female adolescents who reported that maternal death can result from early marriage of girls ranged from 15 percent in Udham Singh Nagar to 33 percent in Dehradun. The female adolescents who felt that young brides will be unable to manage home and family ranged from 21 percent in Haridwar to 41 percent in Udham Singh Nagar, while the male adolescents who felt the same ranged between 11 percent in Nainital to 40 percent in Haridwar. The male adolescents who reported that they didn’t know about the consequences of early marriage of girls ranged from 27 percent in Nainital, 24 percent in Udham Singh Nagar, 13 percent in Dehradun, and 12 percent in Haridwar (Table 5.10).

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Table 5.10 Consequences of Early Marriage of Girls

Percentage of the adolescents by consequences on early marriage of girl

Consequences

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Harmful to the girls health 61.9 51.3 52.4 52.3 54.7 63.5 70.1 57.3

Possibility of birth of sick and weak baby 43.3 21.5 39.2 30.8 33.0 29.2 52.5 24.8

Possibility of maternal death 40.7 33.2 26.7 22.7 21.4 14.5 38.9 24.8

Inability to manage home and family 35.3 24.5 10.6 25.0 22.3 40.6 40.4 21.4

Possibility of adding financial burden on the family

11.2 9.1 4.0 3.2 7.1 2.2 8.3 3.7

Possibility of complication during pregnancy

16.7 11.1 9.5 8.1 9.4 14.5 10.5 9.6

Possibility of stillbirth 17.9 17.8 11.7 5.2 5.2 3.5 16.6 16.7

Failure of taking proper care of child 17.6 18.1 18.3 16.2 16.8 16.7 29.3 17.3

Inability to be economically independent 3.2 2.0 3.7 1.6 10.0 2.8 3.5 2.2

Other 2.6 2.7 6.6 1.9 6.1 1.9 5.4 1.9

Don’t know 12.5 15.4 27.1 21.1 23.6 16.4 12.4 15.2

Total Number 312 298 273 308 309 318 314 323

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

Most of the adolescents knew that girls can become pregnant during sexual intercourse with boys. The male adolescents who reported this perception ranged from about 80 percent each in Dehradun and Haridwar, and 63 and 67 percent in Nainital and Udham Singh Nagar, respectively. The female adolescents who were

Table 5.9 Opinion on Marriage

Percent of the adolescents by opinion about marriage, according to sex of adolescents

Opinion on Marriage

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

After getting into job 47.4 25.5 64.8 17.2 59.9 20.1 55.7 18.0

Whenever parents insist 19.2 21.1 13.9 18.5 15.5 17.6 28.0 35.6

After completion of education 15.4 30.9 10.6 38.0 12.6 42.8 9.6 28.5

After meeting the right person 10.3 16.1 2.2 4.9 2.9 6.0 2.9 14.9

Other 3.8 2.7 0.7 1.3 .3 2.8 1.6 1.2

Don’t know 3.8 3.7 7.7 20.1 8.7 10.7 2.2 1.9

Total Number 312 298 273 308 309 318 314 323

Perception of right age for marriage

For girl (in mean years) 21 23 23 24 23 22 22 21

For boy (in mean years) 23 25 25 27 25 25 25 23

Knowledge of minimum legal age at marriage in India

For girls

Report correctly 68.9 61.1 64.5 56.5 66.7 50.3 63.1 60.4

Report incorrectly 16.7 16.1 10.3 11.7 11.0 12.9 26.8 20.4

Don’t know 14.4 22.8 25.3 31.8 22.3 36.8 10.2 19.2

For boys

Report correctly 60.3 49.3 50.2 40.9 56.3 29.9 53.8 44.3

Report incorrectly 25.3 26.8 23.8 19.2 20.1 23.9 36.0 35.6

Don’t know 14.4 23.8 26.0 39.9 23.6 46.2 10.2 20.1

Total Number 312 298 273 308 309 318 314 323

M: Male, F: Female

42

aware that sexual intercourse between girls and boys can lead to pregnancy ranged between 46 to 72 percent, the highest being 72 percent in Haridwar. Myths and sheer ignorance about how pregnancy occurs was also observed among the target group. About 10-16 percent of the male adolescents felt that girls become pregnant when a girl and boy are in love. A few adolescents also reported that a girl gets pregnant when a boy touches or kisses a girl (1-4%), and when a boy and girl share the same toilet (1-5%). 11-27 percent of the males and 21 to 41 percent of the females professed ignorance about how a girl gets pregnant. In response to the question about the factors which determine the sex of the baby, most of the adolescents stated that the father determines the sex of the baby. The percent of female adolescents who felt that the father determines the sex of the baby ranged from 11 percent in Haridwar and 22 percent in Dehradun, while the percent of male adolescents who echoed the view ranged from 18 percent in Nainital to 34 percent in Haridwar. 19 to 32 percent of the adolescents were ignorant about what determines the sex of a baby, while the adolescents who felt that both the mother and the father are equally responsible for the baby’s gender ranged from 11-43 percent. About 38 and 37 percent of the female and male adolescents, respectively, in Udham Singh Nagar were of this opinion. The number of adolescents who professed ignorance about who determines the sex of the baby was quite significant, ranging between 20-30 percent (Table 5.11). Table 5.11: Perceptions about pregnancy and sex of baby

Percentage of the adolescents by perceptions about pregnancy and sex of baby

Perceptions

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Pregnancy Occurs1:

By nature’s intervention/God grace 4.8 5.0 5.5 6.2 2.9 7.9 1.9 3.7

When a boy touches or kisses a girl 2.2 3.7 0.4 1.3 0.3 0.9 1.6 0.9

When a boy and a girl share the same toilet

5.4 0.7 0.7 0.6 1.0 0.6 4.8 0.0

When a girl and a boy are in love 15.4 4.4 9.9 6.5 12.9 7.9 15.6 3.4

During a sexual intercourse with a boy 80.4 70.5 63.0 45.8 67.3 59.1 79.3 72.1

Other 0.0 0.7 0.4 1.9 1.3 0.3 0.6 0.0

Don’t know 13.1 20.5 27.1 40.6 23.0 26.4 11.1 22.0

Factors Determining Sex of Baby

Mother 8.7 9.1 7.7 9.4 1.9 15.1 11.5 9.9

Father 25.6 21.5 18.3 13.3 29.1 11.9 33.8 10.8

It's nature’s/God’s choice/by luck 20.5 17.8 9.2 13.3 5.8 14.8 13.4 20.4

Sin's or good deeds of last birth of parents

0.0 1.7 1.1 1.0 1.0 0.6 0.0 0.0

Both father and mother equally 17.9 25.5 43.2 30.5 36.6 37.7 11.1 30.0

Other 0.0 0.0 1.1 0.6 0.0 0.0 0.0 0.0

Don’t know 27.2 24.5 19.4 31.8 25.6 19.8 30.3 28.8

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total Number 312 298 273 308 309 318 314 323

1Percent may add to more than 100 due to multiple responses

M: Male, F: Female

43

5.6 Opinion about Family Size Most adolescents opined that the ideal number of children in a family is two - from 79 percent and 63 percent of the males in Dehradun and Nainital, respectively, to 65 percent and 78 percent of the female adolescents in Nainital and Udham Singh Nagar, respectively.

In response to the question about preference of the gender of the first child, male adolescents had a clear preference for boys, while the female adolescents preferred girls. 53 percent and 63 percent of the males in Dehradun and Nainital, respectively, wanted their first born to be a boy, while 32 percent and 39 percent of the female adolescents in Udham Singh Nagar and Nainital, respectively, desired their first born to be a girl (Table 5.12).

Table 5.12 Perceptions about Ideal Family Size

Percent distribution of the adolescents by perceptions about ideal number of children

Perceptions

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Ideal Number of Children

1 3.2 7.7 15.8 6.5 2.9 2.5 1.9 8.0

2 79.2 65.1 63.4 75.6 71.5 77.7 78.0 68.1

3 13.5 14.1 11.7 11.4 16.8 11.6 11.8 12.1

4 or more 1.9 4.4 4.8 5.2 8.4 5.0 6.1 4.0

Up to God 2.2 7.7 1.8 1.0 .3 3.1 2.2 6.5

Preference of Gender of First Child

Boy 52.9 24.8 63.4 22.7 61.2 31.8 57.6 30.7

Girl 19.2 36.9 15.8 39.0 7.8 31.8 22.0 34.4

No preference 27.9 38.3 20.9 38.3 31.1 36.5 20.4 35.0

Total Number 312 298 273 308 309 318 314 323

M: Male, F: Female

5.7 Knowledge about Family Planning The majority of adolescents reportedly knew about family planning – the highest in Udham Singh Nagar (68 percent of the males and 65 percent of the female adolescents) and the lowest percent was observed among male adolescents in Dehradun (53%) and female adolescents in Nainital (54%). Regarding the types of family planning methods, most of them were aware of oral pills and condoms. 93 percent of the female adolescents in Udham Singh Nagar knew about oral pills, while 85 percent of the male adolescents in Dehradun could claim the same. 90 percent of the males (the highest) in Haridwar knew about condoms, while only 39 percent of the females in Nainital were aware of this family planning method (Table 5.13).

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Table 5.13: Knowledge of Family Planning

Percent distribution of the adolescents by knowledge of family planning

Knowledge of Family Planning

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Yes 52.6 59.7 53.5 54.2 68.3 65.1 57.0 55.4

No 18.3 23.5 12.8 15.9 8.1 12.3 14.6 31.0

Don’t know 29.2 16.8 33.7 29.9 23.6 22.6 28.3 13.6

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number 312 298 273 308 309 318 314 323

Types of Method Known1

Oral pills 84.8 87.6 86.3 91.6 90.5 92.8 91.1 89.9

Condoms 77.4 56.2 75.3 38.9 73.0 45.9 89.9 70.4

Copper-T 37.8 15.2 13.0 9.6 3.3 3.9 40.2 14.0

Injectable 5.5 1.7 7.5 7.8 2.4 5.8 8.9 1.7

Vasectomy 35.4 38.8 30.8 6.6 44.1 12.1 28.5 31.3

Tubectomy 49.4 49.4 34.9 21.6 48.8 46.9 43.0 47.5

Withdrawal 5.5 0.0 2.1 0.0 1.4 0.0 6.1 0.0

Safe period 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.0

Other 0.0 3.4 1.4 2.4 0.5 0.5 0.6 0.6

Total Number 164 178 146 167 211 207 179 179

1Percent may add to more than 100 due to multiple responses

M: Male, F: Female

5.8 Knowledge of RTI and STI It was surprising to find that only a few of the adolescents knew about reproductive tract infection (RTI), the highest percent recorded among the male adolescents in Haridwar at 26 percent. More adolescents seemed to know sexually transmitted infection (STI) as compared to RTI, from 67 percent of the males in Udham Singh Nagar to 20 percent of the females in Haridwar. Table 5.14 Knowledge of RTI and STI

Percent of the adolescents by knowledge of RTI and STI, according to adolescents

Knowledge of RTI and STI

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Know about RTI 18.9 11.1 11.0 19.2 16.5 23.3 25.5 11.1

Know about STI 33.3 25.5 45.1 39.6 67.0 47.8 31.5 19.5

Total Number 312 298 273 308 309 318 314 323

Knowledge of Symptoms

Syphilis 1.0 2.5 7.2 12.6 10.6 12.7 2.9 1.5

Gonorrhoea 1.9 3.7 3.2 14.2 9.1 13.9 2.0 14.7

Excessive vaginal discharge 29.5 58.0 38.4 66.1 44.2 77.7 25.5 55.9

Urinary tract infections 20.0 39.5 27.2 26.8 23.6 35.5 12.7 48.5

Total Number 105 81 125 127 208 166 102 68

M: Male, F: Female

About the symptoms related to both RTIs and STIs, most of the adolescents reported two symptoms - excessive vaginal discharge and urinary tract infection. As high as 78 percent of the female adolescents in Udham Singh Nagar and as low as 26

45

percent of the males in Haridwar reported excessive vaginal discharge as a symptom. As low as 13 percent of the males and as high as 49 percent of the females in Haridwar felt urinary tract infection is a symptom related to RTIs/STIs (Table 5.14).

Experienced Symptoms and Health Seeking Behaviour A significant percent of adolescents reported that they had experienced symptoms like fever, abdominal pain and urethral/vaginal discharge – the highest in Udham Singh Nagar, where 33 and 40 percent of the male and female adolescents, respectively, reported that they had suffered from fever. Table 5.15 Symptoms and Treatment-Seeking Behaviour with Regard to RTI and STI

Percent of the adolescents by experienced symptoms of RTI and STI treatment seeking behavior, according to adolescents

Experienced Symptoms

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Urethral/vaginal discharge 2.2 3.7 11.0 19.2 1.0 15.1 3.8 1.5

Excess discharge 0.0 1.0 1.5 2.3 0.0 2.5 1.3 0.3

Foul smelling discharge 0.6 1.7 6.2 7.5 1.0 5.3 2.5 0.6

Fever 9.0 7.0 32.6 24.7 33.3 39.6 12.1 9.9

Abdominal pain 2.9 6.7 11.0 29.5 12.6 23.0 6.1 7.1

Pain while urinating 3.8 1.7 7.3 3.9 1.0 1.6 3.5 0.6

Itching/soreness in private parts 1.3 1.7 1.5 3.6 0.3 2.2 2.5 0.3

Ulcers in genitalia 0.6 0.0 0.0 0.0 0.0 0.6 1.0 0.3

Glands/swelling in groin 0.6 2.7 1.5 5.8 0.0 3.1 1.9 0.3

Action Taken1

Consulted a village doctor 20.0 11.9 17.4 9.2 22.0 31.5 12.8 2.1

Govt. doc ayurvedic 8.9 0.0 6.1 4.6 4.5 0.5 4.3 0.0

Govt. doc allopathic 15.6 38.1 18.3 6.6 15.9 6.0 8.5 12.5

Health worker/village nurse 0.0 2.4 0.9 2.0 3.8 1.1 0.0 0.0

discussed with parents relatives 22.2 4.8 26.1 9.2 34.1 10.9 8.5 8.3

Discussed with friends 13.3 0.0 13.0 0.0 4.5 1.1 0.0 4.2

Went to a pharmacist 20.0 7.1 8.7 7.9 7.6 6.5 10.6 10.4

Private doctor 33.3 16.7 23.5 17.1 48.5 22.3 59.6 62.5

Improved personal hygiene 4.4 0.0 0.9 1.3 5.3 2.7 6.4 2.1

simply ignored 15.6 33.3 23.5 43.4 3.8 24.5 17.0 14.6

Other 0.0 2.4 7.0 3.3 0.8 2.7 0.0 0.0

Total Number 312 298 273 308 309 318 314 323

Cured After Treatment

Yes 94.7 92.9 93.2 87.2 94.5 91.4 84.6 97.6

No 2.6 7.1 4.5 5.8 2.4 4.3 12.8 2.4

Partially cured 2.6 0.0 2.3 7.0 3.1 4.3 2.6 0.0

Total Number 38 28 88 86 127 139 39 41

1Percent may add to more than 100 due to multiple responses

M: Male, F: Female

Again, in Udham Singh Nagar, 13 and 23 percent of the male and female adolescents reported having suffered abdominal pain. In Nainital, fever was reported by 33 and 25 percent of the male and female adolescents, respectively, while 11 and 30 percent of the male and female adolescents, respectively, reported to have suffered from abdominal pain in the district. Urethral and vaginal discharge was

46

reported highest by 11 percent of the males and 19 percent of the female adolescents in Nainital. A significant percent of the adolescents reported that they consulted a private doctor when they suffered from the above RTI/STI related symptoms. The highest percent was in Haridwar – 63 and 60 percent of the female and male adolescents, respectively. The highest number of female adolescents (38%) in Dehradun consulted government allopathic doctor, while only lowest 6 percent of the female adolescents in Udham Singh Nagar did so. The adolescents also displayed a tendency to consult directly with the pharmacist, about one-fifth of the male adolescents in Dehradun went to the pharmacist for treatment. A significant percent of adolescents also reportedly just ignored the symptoms. A majority of the adolescents reported that they were cured by the treatment they got, the highest and the lowest percent reported from Haridwar at 98 percent of the females and 85 percent of the males, respectively (Table 5.15).

5.9 Knowledge about HIV and AIDS 54 to 76 percent of the adolescents were aware of HIV/AIDS. The awareness level of male adolescents, which ranged between 69 to 76 percent, was more than their female counterparts, which ranged between 54 to 68 percent. A majority of the adolescents knew the routes of HIV infection, and reported them to be - multiple sexual partners (81 to 93%), unprotected sex (68-95%), unsterilized syringes (86-99%), and blood contact (41-73%). Some of the adolescents also reported routes of infection which were incorrect, like touching others casually (6-27%), kissing (7-13%), and mosquito bite (13-39%) (Table 5.16).

Table 5.16 Awareness of HIV/AIDS

Percent of the adolescents by awareness of HIV/AIDS and perception about way of infection

Aware of HIV/AIDS

Dehradun Nainital US Nagar Hardwar

M F M F M F M F

Yes 73.7 68.1 71.8 53.9 76.4 56.6 68.5 57.0

No 26.3 31.9 28.2 46.1 23.6 43.4 31.5 43.0

Number

Perception of Route of Infection

Blood contact with HIV infected patient

53.5 40.9 42.3 56.6 41.9 72.8 44.2 33.2

Unprotected sex 87.8 72.4 89.8 68.1 95.3 74.4 90.2 69.6

Touching other casually 13.0 22.2 6.1 6.6 10.6 12.2 15.3 26.6

Kissing 10.4 11.8 6.6 11.4 12.7 6.7 10.7 12.5

Multiple sex partners 90.4 88.7 91.3 83.1 96.6 81.1 92.6 86.4

Un-sterilized syringes 86.5 90.1 86.2 89.2 92.4 94.4 91.2 98.9

Food or water 4.8 12.3 7.1 7.8 6.8 11.1 13.0 14.1

Mosquito/insect bite 13.5 23.2 15.8 13.3 17.4 15.6 17.7 39.1

Eating from same plate 5.2 16.3 8.2 4.8 8.9 9.4 10.2 21.2

Total Number 230 203 196 166 236 180 215 184

M: Male, F: Female

47

Adolescents who reportedly knew how to avoid acquiring HIV/AIDS ranged from 72 to 94 percent. Abstinence was stated as the key route of prevention by male adolescents ranging from 18 to 26 percent and 7-30 percent of the female adolescents. The adolescents who stated being faithful to one’s sexual partner as a route of prevention ranged from 43 to 60 percent. Using condoms during sex was reported by 40 to 89 percent of the adolescents. Avoiding blood transfusion as a means to avoid getting infected was reported by 75 to 92 percent of the adolescents. About 6 to 33 percent of the adolescents reported that avoiding blood/fluid contact with an HIV patient can help prevent infection (Table 5.17).

Table 5.17 Ways to Avoid Being Infected by HIV/AIDS

Percent of the adolescents by types of way of avoiding HIV/AIDS and perception about way of infection

Ways to avoid HIV/AIDS

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Yes 92.6 82.3 82.1 72.3 87.3 80.0 93.5 73.9

No 3.9 11.8 5.6 5.4 5.1 2.2 2.8 13.6

Don’t know 3.5 5.9 12.2 22.3 7.6 17.8 3.7 12.5

Total Number 230 203 196 166 236 180 215 184

Routes of Prevention1

Abstinence 26.3 7.8 24.2 16.7 18.4 29.9 23.9 7.4

Being faithful to one’s sexual partner

58.2 50.3 58.4 58.3 42.7 53.5 60.2 43.4

Avoiding blood transfusion 76.5 74.9 82.0 84.2 92.2 89.6 91.0 89.0

Using condom during intercourse 69.5 40.1 83.9 35.0 74.8 38.9 89.1 41.2

Avoiding blood/fluid contact with HIV patient

12.2 15.6 9.9 5.8 33.0 29.2 20.9 31.6

Other 0.5 6.0 2.5 5.8 1.9 3.5 1.5 3.7

Total Number 213 167 161 120 206 144 201 136 1

Percent may add to more than 100 due to multiple responses

M: Male, F: Female

64 to 85 percent of the male adolescents felt that it is possible for a healthy looking person to be infected with HIV, while 39 to 57 percent of the female adolescents were of the same opinion. About 22 to 54 percent of the adolescents opined that HIV/AIDS is curable. A large percent of the adolescents (21 percent of the males and 26 percent of the females) in Dehradun did not know whether HIV/AIDS is curable (Table 5.18).

Table 5.18 Perception of HIV/AIDS

Percent of the adolescents by perception about HIV/AIDS, according to adolescents

Perception of HIV/AIDS

Dehradun Nainital US Nagar Hardwar

M F M F M F M F

Can a healthy-looking person have HIV?

Yes 70.9 51.5 66.5 39.2 64.1 49.3 84.6 57.4

No 11.7 28.1 30.4 48.3 26.7 34.0 11.9 27.9

Don’t know 17.4 20.4 3.1 12.5 9.2 16.7 3.5 14.7

Is HIV/AIDS curable?

Yes 32.4 41.3 42.2 43.3 21.8 54.2 35.8 53.7

No 46.5 32.3 54.0 46.7 71.8 34.0 55.2 32.4

Don’t know 21.1 26.3 3.7 10.0 6.3 11.8 9.0 14.0

Total Number 213 167 161 120 206 144 201 136 M: Male, F: Female

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5.10 Substance Abuse Substance abuse was not very significant among the adolescents. Most adolescents were in the habit of eating betel nuts. 9 percent of the male adolescents in Haridwar and 38 percent of the males in Nainital consumed betel nuts. Of the female adolescents who consumed betel nuts, 6 percent were from Haridwar, 8 percent from Dehradun, 20 percent from Udham Singh Nagar, and 21 percent from Nainital. In Nainital, male adolescents reportedly consumed substances like paan (17%), alcohol (13%), tobacco/gutkha (11%), zarda/paan masala (5%) and cigarette/beedi (6%) (Table 5.19). Table 5.19 Substance Abuse

Percent of the adolescents by substances use, according to adolescents

Types of Substances

Dehradun Nainital US Nagar Haridwar

M F M F M F M F

Alcohol 2.9 0.3 13.2 0.3 10.7 0.3 0.6 0.0

Paan 4.8 1.0 16.5 1.9 8.7 2.2 1.6 1.5

Zarda/Paan masala 4.8 0.3 4.8 0.0 1.6 1.3 1.0 0.0

Tobacco/Gutkha 6.4 0.3 11.4 0.6 10.0 0.0 4.1 0.9

Betel nuts 16.7 7.7 38.1 20.8 25.6 19.8 8.9 6.2

Cigarette/Beedi 2.2 0.3 6.2 0.3 7.1 0.0 1.6 0.0

Bhang/Ganja 0.3 0.0 0.4 0.0 0.3 0.0 0.3 0.0

Oral medicines 0.3 0.0 0.0 0.0 0.0 0.0 0.3 0.0

Other 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Total Number 312 298 273 308 309 318 314 323

Note: M: Male, F: Female

49

5.11 Summary To have an open discussion about issues around adolescence is of critical importance. In this chapter, we saw that there were a lot of myths and misconceptions on a variety of issues among both school going and non-school going adolescents, both girls and boys. This shows that the education system does not contribute much in increasing the information level of the adolescents on these issues. The cause of concern is that who will initiate the discussion, when and how? Do we have the adequate and appropriate health services in place within the structure to respond to the needs of these adolescents? If yes, are these services catering to the requirements of adolescents? If no, then what are our plans on addressing these emerging needs? It was reported by most of the adolescents that they were aware of puberty. On the issue of changes after puberty in girls, it was reported by three-fourth of the adolescents that there is a rapid increase in weight and height, and enlargement of breasts. About one-third opined that onset of menstruation and growth of hair in armpits marks puberty. One-fifth stated that the girls start taking more care of themselves. Regarding body changes in boys, it was reported by more than two-third of the respondents that there is a rapid increase in weight and height, and facial hair growth. Half of the adolescents opined that development of hoarseness/heaviness in the voice takes place, while one-fourth stated that the hair starts growing in armpits. About 82-87 percent of the females and 34-44 percent of the males had heard about menstruation in all the surveyed districts. Interestingly, the non-school going respondents were more aware about menstruation than their school going counterparts. More male adolescents than female adolescents knew that menstruation signifies the female body getting prepared for child birth. A significant percent of adolescents said that it signified impure blood being discarded by the body. Nearly 50 percent of the male adolescents felt that it was a natural process, while nearly 40-73 percent felt it signified a girl getting ready for motherhood. Female adolescents ranging from 23-55 percent opined that menstruation implied that girls are ready for motherhood. A significant percent of adolescents said that they avoid/are not allowed to go to the kitchen or religious places, or attend religious ceremonies while menstruating. About one-third stated that they maintain personal hygiene during their periods. About one-fifth of the adolescents use sanitary pads, while about half of them use any old cloth. During menstruation, the majority (58-78%) of female adolescents suffered from excessive abdominal pain/cramp. Back pain was mentioned by 20-39 percent of the respondents. Getting moody and temperamental was reported by 17 percent of the females in Dehradun. Very few of the female adolescents reported not to have any problems during their periods. Both girls and boys had sexual concerns. The key problem was that because of social taboo, the adolescents, particularly, the males cannot voice their concern to their elders openly. Hence, whatever information they have on sexual topics is derived from their peers, who themselves are rather ignorant on the same. The acceptance of cause of concern in front of unknown researcher was also difficult for the adolescent boys. The main concern in male adolescents was of nightfall, which

50

was reported by 14 percent in Dehradun, 13 percent in Nainital, 9 percent in Haridwar and 8 percent in Udham Singh Nagar. Masturbation was reported by a very low percent of male adolescents, about 4 percent each in Dehradun and Haridwar, 2 percent in Nainital, and negligible in Udham Singh Nagar. 69-90 percent of the adolescents were aware about balanced diet. There was a marginal difference between school going and non-school going adolescents over this issue. Having different kinds of vegetables and fruits was a balanced diet per more than 90 percent of the respondents. Another food that was reported to be balanced diet was food rich in ghee and oil, with marginal differences, both school going and non-school going adolescents reported this as a balance diet. On marriage, the majority of male adolescents stated that they would get married after getting a job. The female adolescents were more concerned about their education; a significant percent of the female adolescent stated that they would marry only after completing their studies. According to most of the adolescents, the right age of marriage of girls in mean years was 21 to 24 years, while for boys, it was 23 to 27 years. On the negative impact early marriage can have on girls, the key consequences reported were harm to the girl’s health, possibility of birth of sick and weak baby, possibility of maternal death, and inability to manage home and family. The male adolescents who replied that there is a possibility of birth of sick and weak baby ranged from 33 percent in Udham Singh Nagar to 53 percent in Haridwar. The female adolescents who reported that there is a possibility of maternal death as a result of early marriage of girls ranged from 15 percent in Udham Singh Nagar to 33 percent in Dehradun. Most of the adolescents were aware that a girl can become pregnant during sexual intercourse with a boy. In response to the query on factors determining the sex of the baby, most of the adolescents stated that the father determines the sex of the baby. The adolescents who felt that both the mother and the father are equally responsible ranged between 11-43 percent. Most of the adolescents felt that the ideal number of children per family is two. In response to the question about preference of the gender of the first child, male adolescents wanted a boy, while female adolescents wanted a girl. A majority of the adolescent reportedly knew about family planning. About the different family planning methods, most of them were aware of oral pills and condoms. It was surprising to note that only a few knew about RTIs. About RTI/STI related symptoms, most reported two symptoms - excessive vaginal discharge and urinary tract infection. About the RTI/STI symptoms that they had experienced, a significant percent of the adolescents reported fever, abdominal pain and urethral/vaginal discharge. It was reported by a large percent of adolescents that they had consulted a private doctor during their ill health. Those who consulted government allopathic doctors were not significant. The adolescents who were aware of HIV/AIDS ranged between 54 to76 percent. The awareness level of male adolescents, which ranged between 69 to 76 percent, was more than that of the female adolescents, which ranged between 54 to 68

51

percent. A majority of adolescents knew the routes of HIV infection to be: multiple sexual partners (81-93%), unprotected sex (68-95%), unsterilized syringes (86-99%), and blood contact (41-73%). 72 to 94 percent of the adolescents knew how HIV/AIDS can be prevented. Substance abuse was not very significant among the respondents.

52

Annexure

Tables providing additional information

53

Table A1: Demographic, Socio-economic and Health profile of Uttarakhand State

Demographic, Socio-economic and Health profile of Uttarakhand State as compared to India figures

S. No. Item Uttarakhand India

1 Total population (Census 2001) (in millions) 8.5 1028.61

2 Decadal Growth (Census 2001) (%) NA 21.54

3 Crude Birth Rate (SRS 2008) 20.1 22.8

4 Crude Death Rate (SRS 2008) 6.4 7.4

5 Total Fertility Rate (SRS 2007) NA 2.7

6 Infant Mortality Rate (SRS 2008) 44 53

7 Maternal Mortality Ratio (SRS 2004 - 2006) 440 254

8 Sex Ratio (Census 2001) 962 933

9 Population below Poverty line (%) - 26.10

10 Schedule Caste population (in million) 1.52 166.64

11 Schedule Tribe population (in million) 0.26 84.33

12 Female Literacy Rate (Census 2001) (%) 59.6 53.7

Table A2: Health Infrastructure of Uttrakhand

Particulars Required In position Shortfall

Sub-centre 1294 1765 -

Primary Health Centre 214 239 -

Community Health Centre 53 55 -

Multipurpose worker (Female)/ANM at Sub Centers & PHCs

2004 1903 101

Health Worker (Male) MPW(M) at Sub Centers 1765 616 1149

Health Assistant (Female)/LHV at PHCs 239 340 -

Health Assistant (Male) at PHCs 239 417 -

Doctor at PHCs 239 866 -

Obstetricians & Gynecologists at CHCs 55 30 25

Physicians at CHCs 55 4 51

Pediatricians at CHCs 55 18 37

Total specialists at CHCs 220 67 153

Radiographers 55 30 25

Pharmacist 294 294 0

Laboratory Technicians 294 132 162

Nurse/Midwife 624 292 332

Source: RHS Bulletin, March 2008, M/O Health & F.W., GOI

:

54

Table A4: List of selected blocks and adolescent population covered

District Block Total Population

Adolescent Population

Total School Going

Out of school

Dehradun Chakrata 59466 13083 3073 10010

Doiwala 152047 33450 12241 21209

Hardwar Bahadrabad 243460 53561 11390 42171

Khanpur 41446 9118 1606 7512

Udham Singh Nagar

Gadarpur 104201 22924 4225 18699

Khatima 161291 35484 11678 23806

Nainital Haldwani 141661 31165 12548 18617

Okhalkand 43218 9508 3703 5805

TOTAL 946790 208294 60464 147830

Table A3: The other Health Institution in the State are detailed as under

Health Institution Number

Medical College 3

District Hospitals 18

Ayurvedic Hospitals 7

Ayurvedic Dispensaries 467

Unani Hospitals 2

Unani Dispensaries 3

Homeopathic Hospitals 1

Homeopathic Dispensary 60

55

Table A5: Household population by age and sex

Percent distribution of the household population by age and sex, Dehradun district of Uttarakhand, 2009

Block/District Chakrata Doiwala Dehradun

Age group (in years) Male Female Total Male Female Total Male Female Total

0-5 11.2 11.2 11.2 3.4 4.3 3.8 8.5 8.9 8.7

6-10 14.1 13.2 13.6 8.7 7.9 8.3 12.2 11.4 11.8

11-15 17.3 19.5 18.4 21.5 19.4 20.5 18.8 19.5 19.1

16-20 17.4 15.4 16.4 20.7 19.5 20.1 18.5 16.8 17.7

20-25 6.9 5.5 6.2 5.4 6.9 6.1 6.4 6.0 6.2

26-35 9.0 11.8 10.3 6.1 12.8 9.3 8.0 12.2 10.0

36-45 11.1 11.6 11.3 18.1 20.9 19.4 13.5 14.8 14.1

46-55 5.9 5.8 5.8 9.1 4.1 6.7 7.0 5.2 6.1

56-65 5.1 4.0 4.6 3.2 2.9 3.1 4.5 3.7 4.1

66-75 1.5 1.2 1.4 2.2 0.4 1.3 1.8 1.0 1.4

76+ 0.5 0.8 0.7 1.6 0.9 1.3 0.9 0.9 0.9

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number 1,430 1,319 2,749 739 681 1,420 2,169 2,000 4,169

Table A6: Household population by age and sex

Percent distribution of the household population by age and sex, in Nainital district of Uttarakhand, 2009

Block/District Okhalkhanda Haldwani Nainital

Age group (in years) Male Female Total Male Female Total Male Female Total

0-5 7.8 8.9 8.3 5.8 5.3 5.5 6.9 7.2 7.1

6-10 11.3 10.6 11.0 9.7 7.9 8.8 10.6 9.4 10.0

11-15 18.5 22.1 20.2 19.7 21.9 20.8 19.0 22.0 20.5

16-20 20.1 19.4 19.7 20.0 19.4 19.7 20.0 19.4 19.7

20-25 8.7 4.1 6.5 8.1 3.5 5.8 8.4 3.8 6.2

26-35 6.1 8.3 7.2 5.9 12.2 9.0 6.0 10.1 8.0

36-45 13.9 17.6 15.7 15.8 17.8 16.8 14.8 17.7 16.2

46-55 7.5 5.4 6.5 10.6 6.3 8.5 8.9 5.8 7.4

56-65 4.2 2.5 3.4 3.1 2.0 2.6 3.7 2.3 3.0

66-75 1.4 1.0 1.2 0.6 2.4 1.5 1.0 1.6 1.3

76+ 0.4 0.2 0.3 0.7 1.1 0.9 0.6 0.6 0.6

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number 997 925 1,922 814 793 1,607 1,811 1,718 3,529

56

Table A7: Household population by age and sex

Percent distribution of the household population by age and sex ,Udhamsingh Nagar district of Uttarakhand, 2009

Block/District Gadarpur Khatima Udhamsingh Nagar

Age group (in years) Male Female Total Male Female Total Male Female Total

0-5 5.2 5.1 5.2 5.6 5.6 5.6 5.4 5.4 5.4

6-10 12.2 12.4 12.3 9.9 8.8 9.4 11.1 10.6 10.9

11-15 22.4 23.6 23.0 20.9 23.3 22.1 21.7 23.5 22.5

16-20 20.9 18.2 19.7 20.8 18.9 19.9 20.9 18.5 19.8

20-25 5.9 3.8 4.9 6.6 4.9 5.8 6.2 4.3 5.3

26-35 4.8 8.7 6.6 7.1 11.1 9.0 5.9 9.8 7.8

36-45 15.0 17.3 16.1 18.4 18.7 18.5 16.6 18.0 17.2

46-55 7.2 6.4 6.8 6.2 4.6 5.4 6.7 5.5 6.1

56-65 4.7 2.3 3.5 3.4 2.6 3.0 4.0 2.4 3.3

66-75 0.6 1.3 1.0 0.7 0.9 0.8 0.7 1.1 0.9

76+ 1.1 0.9 1.0 0.4 0.8 0.6 0.8 0.8 0.8

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number 1,094 971 2,065 1,008 922 1,930 2,102 1,893 3,995

Table A8: Household population by age and sex

Percent distribution of the household population by age and sex, Hardwar district of Uttarakhand,2009

Block/District Bhadrabad Khanpur Hardwar

Age group (in years) Male Female Total Male Female Total Male Female Total

0-5 8.8 6.9 7.9 7.9 7.0 7.5 8.3 7.0 7.7

6-10 14.1 14.5 14.3 13.0 13.3 13.1 13.5 13.9 13.7

11-15 20.3 20.6 20.5 20.9 20.2 20.6 20.6 20.4 20.5

16-20 19.9 19.5 19.7 19.4 20.5 19.9 19.6 20.0 19.8

20-25 6.1 3.9 5.1 6.4 4.0 5.3 6.3 4.0 5.2

26-35 7.1 12.3 9.5 6.3 10.0 8.1 6.7 11.2 8.8

36-45 14.1 13.5 13.8 14.8 15.3 15.0 14.4 14.4 14.4

46-55 5.7 4.9 5.3 5.3 4.4 4.9 5.5 4.6 5.1

56-65 2.4 2.7 2.5 3.4 3.1 3.3 2.9 2.9 2.9

66-75 1.1 0.6 0.9 1.8 1.5 1.7 1.4 1.1 1.3

76+ 0.5 0.5 0.5 0.7 0.6 0.7 0.6 0.6 0.6

Total percent 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number 1,142 965 2,107 1,103 988 2,091 2,245 1,953 4,198

57

Table A9: Household characteristics

Percent distribution of the household population by age, sex, no. of family members, caste and religion in Uttarakhand,2009

Characteristics

Dehradun Nainital Udhamsingh Nagar Hardwar

Chakrata

Doiwala Total

Okhalkhanda

Haldwani Total

Gadarpur

Khatima Total

Bhadrabad

Khanpur Total

Head of household

Male 98.3 90.2 94.8 93.6 90.0 91.9 96.6 92.9 94.8 93.1 94.3 93.7

Female 1.7 9.8 5.2 6.4 10.0 8.1 3.4 7.1 5.2 6.9 5.7 6.3

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Age of the head of household

Less than 30 5.2 2.6 4.1 4.0 4.6 4.3 1.6 3.9 2.7 4.4 2.2 3.3

30-44 42.6 38.9 41.0 37.4 41.1 39.2 44.1 47.6 45.8 48.1 42.9 45.5

45-59 31.0 43.0 36.2 41.8 43.6 42.6 39.1 36.0 37.6 35.0 41.3 38.1

60+ 21.2 15.5 18.7 16.8 10.7 13.9 15.3 12.5 13.9 12.5 13.6 13.0

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number of usual members

1 0.0 0.0 0.0 0.0 1.8 0.9 0.0 0.0 0.0 0.3 0.0 0.1

2 0.0 1.1 0.5 1.0 5.5 3.3 1.2 0.9 1.0 0.6 0.6 0.6

3 1.4 7.7 4.2 3.6 7.0 5.3 2.6 3.4 3.0 4.0 2.9 3.4

4 8.8 21.3 14.2 11.7 17.0 14.4 12.7 18.0 15.3 7.7 7.8 7.7

5 11.6 29.8 19.5 19.1 22.4 20.8 21.1 30.5 25.7 19.9 17.4 18.7

6 13.0 21.3 16.6 23.0 23.3 23.2 20.5 18.0 19.3 21.9 24.3 23.1

7+ 65.3 18.8 45.0 41.7 23.0 32.1 41.9 29.3 35.8 45.7 47.0 46.3

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Religion

Hindu 99.7 87.5 94.4 100.0 93.2 96.7 58.8 83.0 70.7 53.8 97.2 75.4

Muslim 0.3 11.7 5.2 0.0 5.4 2.6 28.8 14.8 21.9 45.9 2.8 24.5

Christian 0.0 0.4 0.2 0.0 0.0 0.0 0.0 0.6 0.3 0.0 0.0 0.0

Sikh 0.0 0.4 0.2 0.0 1.4 0.7 12.5 1.6 7.1 0.3 0.0 0.2

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Caste

SC 40.0 16.6 29.8 28.3 24.3 26.3 26.6 15.4 21.1 22.5 32.5 27.5

ST 37.4 2.3 22.1 1.0 3.9 2.4 10.3 43.1 26.5 8.1 0.0 4.1

OBC 4.1 27.9 14.4 9.1 19.3 14.0 35.9 25.4 30.7 55.0 44.2 49.6

General 18.6 53.2 33.6 61.6 52.5 57.2 27.2 16.1 21.7 14.4 23.3 18.8

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number of Household 345 265 610 297 280 577 320 311 631 320 317 637

58

Table A10: Household characteristics

Percent distribution of the household by own house, type of house, source of drinking water, toilet facility and main source of lighting , Uttarakhand,2009

Characteristics

Dehradun Nainital

Udhamsingh Nagar

Hardwar

Chakrata Doiwala Total

Okhalkhanda

Haldwani Total

Gadarpur

Khatima Total

Bhadrabad

Khanpur Total

Own House

Yes 99.1 88.7 94.6 91.2 81.1 86.3 98.1 91.0 94.6 87.5 89.6 88.5

No 0.9 11.3 5.4 8.8 18.9 13.7 1.9 9.0 5.4 12.5 10.4 11.5

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Type of house

Pucca 15.4 81.1 43.9 27.6 58.6 42.6 33.4 40.8 37.1 59.1 24.0 41.6

Semi pucca 71.0 10.2 44.6 59.3 18.2 39.3 45.6 47.6 46.6 34.4 70.3 52.3

Kachha 13.6 8.7 11.5 13.1 23.2 18.0 20.9 11.6 16.3 6.6 5.7 6.1

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Source of drinking water

Piped water in residence 22.0 58.1 37.7 10.4 40.0 24.8 9.4 25.1 17.1 30.0 0.3 15.2

Public tap 69.9 14.7 45.9 16.8 28.6 22.5 2.5 3.2 2.9 13.4 1.9 7.7

Hand pump in residence 1.4 22.6 10.7 0.0 8.6 4.2 78.4 64.6 71.6 37.8 89.0 63.3

Public hand pump 1.4 3.8 2.5 1.0 9.3 5.0 8.8 6.8 7.8 14.1 5.7 9.9

Covered well in residence 0.3 0.4 0.3 0.0 1.1 0.5 0.0 0.0 0.0 0.9 1.6 1.3

Open well in residence 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.2

Public well 1.2 0.0 0.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Spring 0.6 0.0 0.3 33.0 2.5 18.2 0.0 0.0 0.0 0.0 0.0 0.0

Gadera 2.9 0.0 1.6 34.7 1.4 18.5 0.0 0.0 0.0 0.0 0.0 0.0

Other 0.3 0.4 0.3 4.0 8.6 6.2 0.9 0.3 0.6 3.8 1.3 2.5

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Toilet Facility

Own flush toilet 12.8 77.7 41.0 23.9 47.9 35.5 41.3 37.9 39.6 40.9 12.6 26.8

Public/shared flush toilet 1.2 3.8 2.3 0.0 1.4 0.7 0.6 0.0 0.3 2.5 1.6 2.0

Own pit toilet 0.9 1.5 1.1 7.1 7.1 7.1 18.4 11.9 15.2 6.3 2.5 4.4

Public/shared pit toilet 0.0 0.4 0.2 2.7 4.3 3.5 2.2 0.6 1.4 2.2 0.0 1.1

No facility/Bush/Field 85.2 16.6 55.4 66.3 39.3 53.2 36.9 49.2 42.9 47.2 83.0 65.0

Other 0.0 0.0 0.0 0.0 0.0 0.0 0.6 0.3 0.5 0.9 0.3 0.6

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Main source of lighting

Electricity 90.4 95.5 92.6 75.4 88.2 81.6 93.8 88.4 91.1 89.1 92.1 90.6

Kerosene 9.3 3.4 6.7 18.5 10.7 14.7 6.3 11.3 8.7 6.9 5.0 6.0

Gas 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.2 0.3 0.0 0.2

Oil 0.3 0.4 0.3 0.0 0.7 0.3 0.0 0.0 0.0 1.9 2.2 2.0

Other 0.0 0.8 0.3 6.1 0.4 3.3 0.0 0.0 0.0 1.9 0.6 1.3

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number of Household 345 265 610 297 280 577 320 311 631 320 317 637

59

Housing characteristics

Table A 11: Household characteristics

Percent distribution of the household by own kitchen, fuel used, own agricultural land and live stock, Uttarakhand, 2009

Characteristics Dehradun Nainital Udhamsingh Nagar Hardwar

Chakrata

Doiwala Total

Okhalkhanda

Haldwani Total

Gadarpur

Khatima Total

Bhadrabad

Khanpur Total

Room for kitchen

Yes 45.8 80.4 60.8 38.7 64.6 51.3 50.6 59.5 55.0 41.6 29.3 35.5

No 54.2 19.6 39.2 61.3 35.4 48.7 49.4 40.5 45.0 58.4 70.7 64.5

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Fuel used for cooking

Wood 97.7 56.2 79.7 95.3 64.6 80.4 88.4 88.1 88.3 76.9 81.1 79.0

Crop residues 0.6 0.0 0.3 4.4 2.1 3.3 0.6 0.3 0.5 1.6 1.6 1.6

Dung cakes 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.0 0.5 8.8 16.1 12.4

Coal/Charcoal 0.0 0.4 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.2

Kerosene 0.0 2.3 1.0 0.3 0.7 0.5 0.0 0.0 0.0 0.3 0.0 0.2

Electricity 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.0 0.5

LPG 1.7 31.7 14.8 0.0 25.4 12.3 9.7 10.0 9.8 10.6 0.9 5.8

Bio-Gas 0.0 9.4 4.1 0.0 7.1 3.5 0.3 1.6 1.0 0.9 0.0 0.5

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Own Agriculture land

Yes 82.9 37.0 63.0 91.6 41.8 67.4 45.6 64.6 55.0 28.4 73.8 51.0

No 17.1 63.0 37.0 8.4 58.2 32.6 54.4 35.4 45.0 71.6 26.2 49.0

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Own land

No land 17.1 63.0 37.0 8.4 58.2 32.6 54.4 35.4 45.0 71.6 26.2 49.0

up to 1 acre 7.0 28.6 12.5 16.2 14.5 15.7 17.1 25.4 21.9 12.1 7.7 8.9

1.1-3 acre 24.5 33.7 26.8 8.8 17.1 11.3 26.7 16.4 20.7 25.3 15.8 18.5

3.1-5 acre 40.9 19.4 35.4 60.3 43.6 55.3 29.5 30.3 30.0 19.8 17.9 18.5

5.1 and above acre 27.6 18.4 25.3 14.7 24.8 17.7 26.7 27.9 27.4 42.9 58.5 54.2

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Live stock

Yes 84.6 43.8 66.9 94.9 50.4 73.3 60.0 62.7 61.3 49.7 87.1 68.3

No 15.4 56.2 33.1 5.1 49.6 26.7 40.0 37.3 38.7 50.3 12.9 31.7

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Number of Household 345 265 610 297 280 577 320 311 631 320 317 637

60

Table A 12: Household items

Percent distributions of the household by household items possessed in Uttarakhand,2009

Characteristics

Dehradun Nainital Udhamsingh Nagar Hardwar

Chakrata Doiwala Okhalkhanda Haldwani Gadarpur Khatima Bhadrabad Khanpur

Household items own

Mattress 65.0 77.3 76.5 76.3 77.4 83.9 47.5 41.6

Pressure cooker 50.0 84.8 43.5 63.1 56.1 47.6 49.1 42.9

Chair 15.9 80.3 42.2 62.4 69.3 70.7 43.1 43.5

Cot/Bed 13.4 88.6 89.8 93.2 94.0 97.4 94.3 97.5

Table 15.0 68.9 27.6 51.6 40.4 50.2 39.0 30.6

Clock/Watch 68.4 90.9 81.6 82.8 77.7 85.5 76.4 80.1

Electric Fan 7.5 89.4 5.4 74.6 73.7 75.2 76.1 78.9

Bicycle 2.8 65.9 4.4 59.5 71.5 74.3 61.0 70.3

Radio/Transistor 17.2 24.2 29.6 16.1 10.0 20.3 7.9 8.2

Sewing Machine 13.1 45.8 16.0 26.9 33.9 42.8 29.2 26.5

Telephone 5.6 18.6 1.0 8.6 7.2 6.1 7.9 3.2

Mobile 53.1 78.8 65.3 71.0 68.3 70.7 54.1 60.9

Refrigerator 3.8 46.6 0.7 30.1 19.7 17.0 16.0 8.2

Television(B&W) 17.5 25.4 6.8 21.5 20.1 18.6 17.0 21.8

Color Television 20.0 64.0 12.2 48.7 46.4 41.2 35.8 37.9

Moped/Motor cycle 1.9 31.8 2.0 19.0 22.9 22.5 18.9 19.2

Car/jeep 0.6 6.1 0.7 3.6 4.1 1.9 4.1 1.3

Water Pump 0.6 7.6 0.0 4.7 13.2 14.1 7.9 14.2

Bullock cart 0.3 1.1 0.3 2.5 4.4 14.8 4.7 26.2

Tractor 0.0 0.8 0.0 3.6 10.7 11.6 3.8 16.1

Number of Household 345 265 297 280 320 311 320 317

61

Table A 13: Household characteristics

Percent distribution of the household by BPL ,Health Card and status of SLI in Uttarakhand,2009

Dehradun Nanital Udhamsing Nagar Hardwar

Characteristics Chakrata Doiwala Total Okhalkhanda Haldwani Total

Gadarpur Khatima Total

Bhadrabad

Khanpur Total

Household have BPL Card

Yes 60.6 25.0 46.9 61.2 26.2 46.7 20.1 32.8 26.3 26.4 28.7 27.6

No 39.1 75.0 52.9 36.7 73.1 51.8 78.4 66.2 72.4 73.6 71.3 72.4

Don't know 0.3 0.0 0.2 2.0 0.7 1.5 1.6 1.0 1.3 0.0 0.0 0.0

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Household have Health Card

Yes 35.6 18.2 28.9 31.6 31.2 31.4 21.6 21.5 21.6 8.2 14.2 11.2

No 63.1 81.1 70.0 65.6 68.5 66.8 77.4 76.5 77.0 91.5 85.8 88.7

Don't know 1.3 0.8 1.1 2.7 0.4 1.7 0.9 1.9 1.4 0.3 0.0 0.2

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Standard of Living Index

Low 72.2 9.5 48.0 71.8 26.5 53.0 28.2 27.0 27.6 22.6 40.7 31.7

Medium 26.9 41.3 32.4 26.5 44.1 33.8 52.7 51.1 51.9 59.4 48.6 54.0

High 0.9 49.2 19.6 1.7 29.4 13.2 19.1 21.9 20.5 17.9 10.7 14.3

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total 320 264 684 294 279 673 319 311 630 318 317 635

62

Background Details of Adolescents

Table A 14 Information about Non-school going adolescent

Percent distribution of the adolescent by age and educational status, Uttarakhand, 2009

Dehradun Nanital Udhamsing Nagar Hardwar

Characteristics

Chakrata

Doiwala Total

Okhalkhanda

Haldwani Total

Gadarpur Khatima Total

Bhadrabad

Khanpur Total

Age group

10-14 years 52.4 23.6 42.0 39.7 31.6 35.5 46.9 51.4 49.1 48.1 44.8 46.4

15-19 years 47.6 76.4 58.0 60.3 68.4 64.5 53.1 48.6 50.9 51.9 55.2 53.6

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Educational level

No schooling 23.0 12.3 19.1 10.3 32.9 22.0 18.3 21.4 19.8 35.5 24.9 30.2

1-9th

standard 71.7 59.4 67.2 77.4 55.7 66.1 73.1 64.7 69.0 61.2 69.6 65.4

10th

& above 5.3 28.3 13.7 12.3 11.4 11.8 8.6 13.9 11.2 3.3 5.5 4.4

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Total 187 106 293 146 158 304 175 173 348 183 181 364

Table A 14a: Preferred Profession

Percent distribution of the respondent adolescent by future aspiration in life, according to sex and age group, Dehradun

district of Uttarakhand, 2009.

Future aspiration

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years 15-19 years

Farmer 4.7 0.0 1.2 0.0 15.4 10.1 1.7 1.2 4.2

Teacher 18.8 22.0 50.0 50.0 46.2 22.5 51.7 39.5 36.6

Nurse 1.2 0.0 1.2 3.6 0.0 0.0 27.6 4.9 4.0

Doctor 22.4 19.5 34.1 22.6 18.5 12.4 15.5 14.8 20.1

Engineer 28.2 20.7 6.1 8.3 3.1 5.6 1.7 0.0 9.7

Computer specialist 2.4 6.1 0.0 0.0 1.5 2.2 0.0 1.2 1.8

Manager 8.2 12.2 1.2 6.0 1.5 6.7 0.0 3.7 5.3

Lawyer 3.5 4.9 0.0 0.0 3.1 5.6 5.2 0.0 2.7

Business person 4.7 2.4 0.0 1.2 7.7 5.6 0.0 0.0 2.7

Sports person 8.2 3.7 2.4 0.0 6.2 4.5 0.0 0.0 3.2

Military personnel 27.1 43.9 9.8 8.3 23.1 36.0 5.2 13.6 21.6

Driver 2.4 0.0 0.0 0.0 0.0 3.4 0.0 0.0 0.8

Carpenter 0.0 0.0 0.0 0.0 1.5 2.2 0.0 0.0 0.5

Artist/writer/singer/Musician 0.0 1.2 7.3 1.2 4.6 1.1 0.0 6.2 2.7

Percent may add to more than 100 due to multiple responses

63

Table A 14b: Preferred Profession

Percent distribution of the respondent adolescent by future aspiration in life, according to sex and age group, Nanital

district of Uttarakhand, 2009.

Future aspiration

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Farmer 2.2 2.5 0.0 0.0 8.3 9.2 0.0 0.0 2.6

Teacher 30.0 33.3 50.0 57.8 11.1 9.2 44.4 42.5 35.4

Nurse 1.1 1.2 3.5 6.0 0.0 0.0 9.7 13.8 4.5

Doctor 36.7 27.2 36.0 27.7 36.1 18.3 19.4 24.1 27.5

Engineer 16.7 27.2 8.1 7.2 2.8 11.9 0.0 4.6 10.6

Computer specialist 5.6 14.8 0.0 1.2 2.8 5.5 0.0 4.6 4.5

Manager 3.3 4.9 1.2 0.0 0.0 0.0 0.0 1.1 1.4

Lawyer 3.3 2.5 0.0 1.2 2.8 6.4 2.8 0.0 2.5

Business person 1.1 2.5 0.0 0.0 2.8 2.8 0.0 0.0 1.1

Sports person 5.6 7.4 0.0 1.2 0.0 4.6 0.0 0.0 2.6

Military personnel 32.2 39.5 3.5 7.2 30.6 25.7 0.0 3.4 17.4

Driver 4.4 1.2 0.0 0.0 8.3 14.7 0.0 0.0 3.7

Carpenter 0.0 1.2 0.0 0.0 5.6 4.6 0.0 0.0 1.2

Artist/writer/singer/Musician 3.3 0.0 3.5 2.4 2.8 1.8 1.4 2.3 2.2

Percent may add to more than 100 due to multiple responses

Table A 14c: Preferred Profession Percent distribution of the respondent adolescent by future aspiration in life, according to sex and age group, Udhamsingh Nagar district of Uttarakhand, 2009.

Future aspiration

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years 15-19 years

Farmer 0.0 1.2 1.2 1.2 5.9 8.5 0.0 3.6 2.8

Teacher 27.2 13.1 56.0 55.8 10.6 10.6 62.8 48.2 35.3

Nurse 0.0 1.2 13.1 5.8 1.2 3.2 9.3 4.8 4.8

Doctor 37.0 31.0 38.1 31.4 29.4 25.5 14.0 18.1 28.0

Engineer 23.5 32.1 10.7 8.1 10.6 13.8 0.0 2.4 12.6

Computer specialist 8.6 15.5 2.4 4.7 1.2 3.2 1.2 1.2 4.7

Manager 3.7 4.8 0.0 5.8 1.2 2.1 0.0 0.0 2.2

Lawyer 2.5 2.4 0.0 3.5 1.2 5.3 0.0 1.2 2.0

Business person 0.0 2.4 0.0 2.3 3.5 5.3 1.2 0.0 1.9

Sports person 6.2 6.0 0.0 1.2 5.9 3.2 1.2 1.2 3.1

Military personnel 28.4 34.5 10.7 15.1 37.6 40.4 5.8 2.4 22.1

Driver 0.0 1.2 0.0 0.0 16.5 14.9 0.0 0.0 4.2

Carpenter 1.2 0.0 0.0 0.0 9.4 5.3 0.0 0.0 2.0

Artist/writer/singer/Musician 0.0 0.0 0.0 3.5 2.4 3.2 2.3 3.6 1.9

Percent may add to more than 100 due to multiple responses

64

Table A 14d: Preferred Profession

Percent distribution of the respondent adolescent by future aspiration in life, according to sex and age group, Hardwar district of Uttarakhand, 2009.

Future aspiration

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years 15-19 years

Farmer 1.1 0.0 0.0 0.0 5.0 5.7 0.0 0.0 1.6

Teacher 20.7 21.2 48.8 49.7 28.8 18.1 36.0 26.7 29.7

Nurse 1.1 0.0 0.0 62.3 1.3 0.0 4.5 1.1 1.6

Doctor 34.5 21.2 22.6 31.7 8.8 10.5 18.0 21.1 20.1

Engineer 19.5 24.7 4.8 62.3 5.0 8.6 1.1 1.1 8.8

Computer specialist 5.7 4.7 0.0 15.6 2.5 2.9 0.0 0.0 2.2

Manager 1.1 1.2 0.0 15.6 0.0 1.9 0.0 0.0 0.7

Lawyer 1.1 4.7 4.8 3.5 3.8 2.9 2.2 1.1 3.4

Business person 1.1 2.4 0.0 0.0 0.0 2.9 1.1 0.0 1.0

Sports person 3.4 3.5 1.2 0.0 2.5 1.9 0.0 0.0 1.6

Military personnel 19.5 37.6 11.9 15.8 25.0 29.5 1.1 5.6 18.1

Driver 0.0 1.2 1.2 0.0 6.3 2.9 1.1 0.0 1.6

Carpenter 1.1 1.2 0.0 15.6 0.0 2.9 0.0 0.0 0.9

Artist/writer/singer/Musician 2.3 1.2 1.2 31.2 3.8 1.9 1.1 1.1 1.9

Percent may add to more than 100 due to multiple responses

65

Table A 15a: Type of entertainment and recreation facilities available/allowed in the Family

Percent distribution of adolescents by Type of entertainment and means of recreation facilities available/allowed in family, according to age, sex and educational status of adolescents, Dehradun district of Uttrakhand, 2009.

Available Means of Recreation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Television 79.7 54.8 65.0 56.3 20.3 45.2 35.0 43.7 55.7

Radio/Transistor 88.2 63.2 73.3 42.9 11.8 36.8 26.7 57.1 11.8

Tape recorder 33.3 57.1 100.0 50.0 66.7 42.9 0.0 50.0 2.6

Magazine/News paper 92.3 83.3 92.3 67.6 7.7 16.7 7.7 32.4 13.8

Frequency of watching TV

Daily 82.1 57.9 73.1 60.6 17.9 42.1 26.9 39.4 69.4

3-4 times a week 0.0 41.2 36.8 30.0 100.0 58.8 63.2 70.0 14.1

1-2 times a week 0.0 66.7 100.0 66.7 0.0 33.3 0.0 33.3 2.9

1-2 times a month 0.0 100.0 60.0 40.0 0.0 0.0 40.0 60.0 3.5

Rarely 0.0 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.3

Occasionally 83.3 50.0 100.0 50.0 16.7 50.0 0.0 50.0 9.7

Frequency of listening Radio

Daily 80.0 16.7 100.0 50.0 20.0 83.3 0.0 50.0 30.6

3-4 times a week 66.7 66.7 40.0 42.9 33.3 33.3 60.0 57.1 25.0

1-2 times a week 0.0 100.0 0.0 0.0 0.0 0.0 100.0 0.0 2.8

1-2 times a month 100.0 100.0 0.0 33.3 0.0 0.0 0.0 66.7 9.7

Rarely 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Occasionally 100.0 87.5 100.0 40.0 0.0 12.5 0.0 60.0 31.9

Frequency of reading Magazine/News paper

Daily 90.0 90.5 100.0 83.3 10.0 9.5 0.0 16.7 63.1

3-4 times a week 100.0 0.0 50.0 50.0 0.0 100.0 50.0 50.0 11.9

1-2 times a week 100.0 0.0 100.0 100.0 0.0 0.0 0.0 0.0 3.6

1-2 times a month 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.0 2.4

Rarely 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 1.2

Occasionally 100.0 50.0 100.0 50.0 0.0 50.0 0.0 50.0 17.9

66

Table A 15b: Type of entertainment and recreation facilities available/allowed in the Family

Percent distribution of adolescents by Type of entertainment and means of recreation facilities available/allowed in family, according to age, sex and educational status of adolescents, Nanital district of Uttrakhand, 2009.

Available Means of Recreation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Television 78.8 53.9 63.6 61.8 21.2 46.1 36.4 38.2 49.0

Radio/Transistor 73.9 42.9 62.5 60.0 26.1 57.1 37.5 40.0 21.5

Tape recorder 100.0 50.0 50.0 83.3 0.0 50.0 50.0 16.7 4.3

Magazine/News paper 90.9 56.3 73.3 80.6 9.1 43.8 26.7 19.4 15.4

Frequency of watching TV

Daily 79.5 54.5 67.9 62.2 20.5 45.5 32.1 37.8 78.1

3-4 times a week 66.7 54.5 44.4 72.7 33.3 45.5 55.6 27.3 13.1

1-2 times a week 100.0 50.0 0.0 0.0 50.0 0.0 100.0 3.2

1-2 times a month 100.0 0.0 100.0 0.0 0.0 100.0 0.0 100.0 1.8

Rarely 50.0 0.0 0.0 0.0 50.0 0.0 0.0 0.0 0.7

Occasionally 100.0 66.7 33.3 100.0 0.0 33.3 66.7 0.0 3.2

Frequency of listening Radio

Daily 71.4 37.9 60.0 42.9 28.6 62.1 40.0 57.1 54.0

3-4 times a week 71.4 28.6 100.0 63.6 28.6 71.4 0.0 36.4 24.2

1-2 times a week 0.0 50.0 42.9 100.0 0.0 50.0 57.1 0.0 11.3

1-2 times a month 0.0 0.0 0.0 33.3 0.0 0.0 0.0 66.7 2.4

Rarely 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0.0

Occasionally 100.0 100.0 50.0 100.0 0.0 0.0 50.0 0.0 8.1

Frequency of reading Magazine/News paper

Daily 100.0 70.0 75.0 88.9 0.0 30.0 25.0 11.1 57.3

3-4 times a week 75.0 37.5 50.0 100.0 25.0 62.5 50.0 0.0 20.2

1-2 times a week 100.0 0.0 100.0 50.0 0.0 100.0 0.0 50.0 6.7

1-2 times a month 0.0 0.0 0.0 50.0 0.0 0.0 100.0 50.0 5.6

Rarely 0.0 0.0 0.0 0.0 0.0 100.0 0.0 0.0 1.1

Occasionally 100.0 50.0 100.0 66.7 0.0 50.0 0.0 33.3 9.0

67

Table A 15c: Type of entertainment and recreation facilities available/allowed in the Family

Percent distribution of adolescents by Type of entertainment and means of recreation facilities available/allowed in family, according to age, sex and educational status of adolescents, Udhamsingh Nagar district of Uttrakhand, 2009.

Available Means of Recreation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Television 58.2 53.0 53.3 55.0 41.8 47.0 46.7 45.0 69.7

Radio/Transistor 50.0 37.5 54.5 57.9 50.0 62.5 45.5 42.1 11.1

Tape recorder 66.7 66.7 33.3 60.0 33.3 33.3 66.7 40.0 3.0

Magazine/News paper 81.8 60.5 75.0 74.3 18.2 39.5 25.0 25.7 17.9

Frequency of watching TV

Daily 50.0 56.2 52.7 57.3 50.0 43.8 47.3 42.7 78.2

3-4 times a week 70.0 42.1 40.0 46.2 30.0 57.9 60.0 53.8 13.0

1-2 times a week 0.0 100.0 0.0 0.0 0.0 0.0 0.0 100.0 0.5

1-2 times a month 0.0 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.2

Rarely 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Occasionally 90.0 40.0 63.6 50.0 10.0 60.0 36.4 50.0 8.2

Frequency of listening Radio

Daily 60.0 12.5 20.0 66.7 40.0 87.5 80.0 33.3 45.7

3-4 times a week 0.0 83.3 100.0 40.0 100.0 16.7 0.0 60.0 18.6

1-2 times a week 0.0 0.0 100.0 0.0 100.0 100.0 0.0 0.0 7.1

1-2 times a month 0.0 0.0 0.0 100.0 0.0 100.0 0.0 0.0 7.1

Rarely 100.0 0.0 100.0 0.0 0.0 0.0 0.0 0.0 2.9

Occasionally 33.3 60.0 50.0 33.3 66.7 40.0 50.0 66.7 18.6

Frequency of reading Magazine/News paper

Daily 100.0 71.4 100.0 72.7 0.0 28.6 0.0 27.3 27.4

3-4 times a week 100.0 60.9 100.0 86.7 0.0 39.1 0.0 13.3 39.8

1-2 times a week 0.0 33.3 100.0 0.0 100.0 66.7 0.0 0.0 4.4

1-2 times a month 0.0 0.0 0.0 0.0 100.0 0.0 0.0 100.0 1.8

Rarely 0.0 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.9

Occasionally 100.0 33.3 64.7 57.1 0.0 66.7 35.3 42.9 25.7

.

68

Table A 15d: Type of entertainment and recreation facilities available/allowed in the Family

Percent distribution of adolescents by Type of entertainment and means of recreation facilities available/allowed in family, according to age, sex and educational status of adolescents, Hardwar district of Uttrakhand, 2009.

Available Means of Recreation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Television 62.8 59.0 56.4 53.4 37.2 41.0 43.6 46.6 53.7

Radio/Transistor 100.0 83.3 50.0 75.0 0.0 16.7 50.0 25.0 2.4

Tape recorder 50.0 56.3 0.0 0.0 50.0 43.8 100.0 100.0 3.5

Magazine/News paper 72.7 76.9 77.8 76.5 27.3 23.1 22.2 23.5 7.8

Frequency of watching TV

Daily 60.7 58.3 52.5 48.6 39.3 41.7 47.5 51.4 78.4

3-4 times a week 66.7 75.0 72.7 62.5 33.3 25.0 27.3 37.5 13.5

1-2 times a week 100.0 0.0 33.3 85.7 0.0 0.0 66.7 14.3 3.5

1-2 times a month 0.0 0.0 100 100 0.0 0.0 0.0 0.0 0.6

Rarely 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Occasionally 0.0 57.1 100.0 40.0 0.0 42.9 0.0 60.0 4.1

Frequency of listening Radio

Daily 0.0 75.0 100 66.7 0.0 25.0 0 33.3 53.3

3-4 times a week 100.0 0.0 0 100 0.0 0.0 100 0 20.0

1-2 times a week 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

1-2 times a month 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 6.7

Rarely 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Occasionally 100.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 20.0

Frequency of reading Magazine/News paper

Daily 62.5 75.0 83.3 57.1 37.5 25.0 16.7 42.9 58.0

3-4 times a week 0.0 100.0 100.0 100.0 0.0 0.0 0.0 0.0 12.0

1-2 times a week 0.0 100.0 0.0 100.0 0.0 0.0 0.0 0.0 8.0

1-2 times a month 100.0 0.0 50.0 66.7 0.0 50.0 33.3 12.0

Rarely 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Occasionally 100.0 66.7 0.0 0.0 0.0 33.3 0.0 0.0 10.0

69

Table A 16: Watching movies/visit to fairs/melas and friend/ neighbors’

Percent distribution of adolescents by Type of entertainment and means of recreation facilities allowed in family, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Means of Recreation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Watching movies 41.7 41.7 0.0 100.0 58.3 58.3 0.0 0.0 6.1

Visit to fair/melas 74.5 48.0 60.0 48.6 25.5 52.0 40.0 51.4 41.8

Visit to friends/neighbors 57.1 50.0 59.4 50.7 42.9 50.0 40.6 49.3 94.9

Nanital

Watching movies 0.0 38.5 100.0 0.0 100.0 61.5 0.0 0.0 2.6

Visit to fair/melas 50.0 48.0 50.0 75.0 50.0 52.0 50.0 25.0 6.8

Visit to friends/neighbors 72.4 49.0 59.8 54.1 27.6 51.0 40.2 45.9 86.5

Udhamsingh Nagar

Watching movies 0.0 20.0 0.0 0.0 100.0 80.0 0.0 0.0 1.3

Visit to fair/melas 37.5 54.5 0 75.0 62.5 45.5 0.0 25.0 3.6

Visit to friends/neighbors 50.7 49.4 51.3 53.1 49.3 50.6 48.7 46.9 97.1

Hardwar

Watching movies 25.0 21.4 0.0 100.0 75.0 78.6 0.0 0.0 3.8

Visit to fair/melas 54.9 49.1 55.8 51.0 45.1 50.9 44.2 49.0 65.1

Visit to friends/neighbors 54.7 49.4 50.3 48.1 45.3 50.6 49.7 51.9 96.9

70

Personal hygiene, health and health seeking behavior of adolescents

Table A 17: Daily Hygiene Routine by district

Percent distribution of adolescents by daily routine of hygiene practices, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Means of Recreation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Brush teeth early morning 58.3 51.0 61.5 52.1 41.7 49.0 38.5 47.9 89.3

Take bath regularly 61.6 57.4 58.4 52.6 38.4 42.6 41.6 47.4 64.4

Take bath regularly with soap 65.9 58.2 77.2 54.7 34.1 41.8 22.8 45.3 56.4

Cut and clean nails 66.2 57.5 77.5 56.9 33.8 42.5 22.5 43.1 40.8

Wear washed and clean cloths 58.3 50.3 63.0 56.3 41.7 49.7 37.0 43.7 86.9

Brush teeth at night before sleep 67.9 67.6 69.6 49.1 32.1 32.4 30.4 50.9 23.8

Comb hair regularly and frequently 58.3 49.0 61.9 51.4 41.7 51.0 38.1 48.6 91.6

Wash hands with soap before meals 61.2 52.9 62.8 52.8 38.8 47.1 37.2 47.2 71.5

Wash hands before cooking 69.2 57.4 54.8 51.1 30.8 42.6 45.2 48.9 51.6

Wash hands with soap after defecation 57.1 48.4 62.5 51.4 42.9 51.6 37.5 48.6 92.1

Nanital

Brush teeth early morning 74.5 48.4 58.5 51.0 25.5 51.6 41.5 49.0 95.8

Take bath regularly 74.4 50.4 60.6 53.0 25.6 49.6 39.4 47.0 73.0

Take bath regularly with soap 77.4 55.2 65.9 56.9 22.6 44.8 34.1 43.1 62.6

Cut and clean nails 73.8 53.9 76.1 60.0 26.2 46.1 23.9 40.0 48.4

Wear washed and clean cloths 74.5 52.5 59.8 53.0 25.5 47.5 40.2 47.0 88.6

Brush teeth at night before sleep 92.9 65.9 74.1 65.1 7.1 34.1 25.9 34.9 21.7

Comb hair regularly and frequently 73.5 49.3 58.6 50.6 26.5 50.7 41.4 49.4 94.3

Wash hands with soap before meals 75.9 50.4 62.4 53.2 24.1 49.6 37.6 46.8 67.9

Wash hands before cooking 54.5 60.5 57.1 50.5 45.5 39.5 42.9 49.5 36.4

Wash hands with soap after defecation 73.8 47.7 57.7 49.0 26.2 52.3 42.3 51.0 94.8

Udhamsingh Nagar

Brush teeth early morning 52.1 50.0 51.4 51.6 47.9 50.0 48.6 48.4 94.9

Take bath regularly 55.2 50.0 51.7 53.2 44.8 50.0 48.3 46.8 83.4

Take bath regularly with soap 59.6 51.1 51.9 54.4 40.4 48.9 48.1 45.6 75.9

Cut and clean nails 58.5 52.1 60.0 67.2 41.5 47.9 40.0 32.8 42.2

Wear washed and clean cloths 56.6 50.3 52.4 51.6 43.4 49.7 47.6 48.4 94.0

Brush teeth at night before sleep 70.0 68.3 53.6 68.2 30.0 31.7 46.4 31.8 21.1

Comb hair regularly and frequently 52.1 49.7 50.6 50.6 47.9 50.3 49.4 49.4 97.5

71

Table A 17: Daily Hygiene Routine by district

Percent distribution of adolescents by daily routine of hygiene practices, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Means of Recreation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Wash hands with soap before meals 52.1 52.9 56.4 56.5 47.9 47.1 43.6 43.5 68.6

Wash hands before cooking 47.8 48.5 36.9 55.0 52.2 51.5 63.1 45.0 38.2

Wash hands with soap after defecation 51.7 49.7 50.6 51.0 48.3 50.3 49.4 49.0 97.1

Hardwar

Brush teeth early morning 61.7 53.6 54.1 52.4 38.3 46.4 45.9 47.6 84.1

Take bath regularly 61.0 53.8 54.8 54.9 39.0 46.2 45.2 45.1 79.9

Take bath regularly with soap 61.0 53.2 54.2 55.9 39.0 46.8 45.8 44.1 74.4

Cut and clean nails 70.1 56.5 55.9 51.5 29.9 43.5 44.1 48.5 46.5

Wear washed and clean cloths 61.2 52.8 55.1 48.7 38.8 47.2 44.9 51.3 90.4

Brush teeth at night before sleep 70.0 51.3 56.1 48.2 30.0 48.7 43.9 51.8 26.1

Comb hair regularly and frequently 58.5 49.7 52.6 48.1 41.5 50.3 47.4 51.9 93.6

Wash hands with soap before meals 65.7 53.8 52.3 50.0 34.3 46.2 47.7 50.0 76.1

Wash hands before cooking 54.3 48.8 48.6 47.8 45.7 51.3 51.4 52.2 58.2

Wash hands with soap after defecation 54.7 50.0 51.9 47.8 45.3 50.0 48.1 52.2 97.2

72

Table A 18a: Observations on Personal Hygiene and Living Conditions of Adolescents

Percent distribution of the adolescents by personal hygiene and living condition through observation, according to age, sex and educational status of adolescents, Dehradun district of Uttrakhand, 2009.

Observation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Hygiene

Nails

Clean 63.8 59.5 57.5 55.4 36.2 40.5 42.5 44.6 60.7

Not so clean 48.9 27.5 68.5 52.6 51.1 72.5 31.5 47.4 33.9

Dirty 0.0 20.0 27.3 9.1 100.0 80.0 72.7 90.9 5.4

Hair

Clean 60.8 58.0 61.2 54.8 39.2 42.0 38.8 45.2 71.8

Not so clean 53.7 27.3 59.4 46.4 46.3 72.7 40.6 53.6 23.8

Dirty 14.3 0.0 37.5 12.5 85.7 100.0 62.5 87.5 4.4

Clothing

Clean 58.9 58.5 60.2 57.3 41.1 41.5 39.8 42.7 69.3

Not so clean 57.9 26.8 65.4 43.3 42.1 73.2 34.6 56.7 22.1

Dirty 33.3 12.5 47.4 15.4 66.7 87.5 52.6 84.6 8.5

Teeth

Clean 60.5 60.0 57.4 53.5 39.5 40.0 42.6 46.5 69.2

Not so clean 52.2 25.5 71.0 50.0 47.8 74.5 29.0 50.0 24.9

Dirty 46.2 0.0 46.2 0.0 53.8 100.0 53.8 100.0 5.9

Living Conditions

House

Clean 57.8 56.3 62.1 55.9 42.2 43.7 37.9 44.1 68.7

Not so clean 60.6 30.8 54.8 38.5 39.4 69.2 45.2 61.5 25.1

Dirty 30.0 22.2 55.6 50.0 70.0 77.8 44.4 50.0 6.2

Surroundings

Clean 56.3 58.9 57.3 56.3 43.7 41.1 42.7 43.8 57.2

Not so clean 64.1 31.3 72.7 50.0 35.9 68.8 27.3 50.0 26.9

Dirty 42.1 25.0 50.0 41.7 57.9 75.0 50.0 58.3 15.9

73

Table A 18b: Observations on Personal Hygiene and Living Conditions of Adolescents

Percent distribution of the adolescents by personal hygiene and living condition through observation, according to age, sex and educational status of adolescents, Naintal district of Uttrakhand, 2009.

Observation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Hygiene

Nails

Clean 74.1 58.8 70.5 57.8 25.9 41.2 29.5 42.2 53.2

Not so clean 63.0 29.5 46.9 39.4 37.0 70.5 53.1 60.6 41.1

Dirty 100.0 16.7 20.0 40.0 0.0 83.3 80.0 60.0 5.7

Hair

Clean 76.0 54.9 63.9 56.1 24.0 45.1 36.1 43.9 73.8

Not so clean 62.9 23.5 40.0 20.7 37.1 76.5 60.0 79.3 25.6

Dirty 100.0 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.5

Clothing

Clean 83.9 55.4 68.0 54.0 16.1 44.6 32.0 46.0 64.6

Not so clean 62.5 29.7 43.8 33.3 37.5 70.3 56.3 66.7 29.3

Dirty 47.1 22.2 37.5 100.0 52.9 77.8 62.5 0.0 6.1

Teeth

Clean 80.0 58.9 62.7 50.8 20.0 41.1 37.3 49.2 66.7

Not so clean 65.2 32.2 40.0 46.9 34.8 67.8 60.0 53.1 31.5

Dirty 40.0 0.0 0.0 0.0 60.0 100.0 0.0 100.0 1.7

Living Conditions

House

Clean 80.4 55.6 58.6 52.9 19.6 44.4 41.4 47.1 62.9

Not so clean 70.8 34.5 52.5 40.0 29.2 65.5 47.5 60.0 35.0

Dirty 14.3 25.0 0.0 0.0 85.7 75.0 100.0 0.0 2.1

Surroundings

Clean 73.5 59.7 65.0 51.9 26.5 40.3 35.0 48.1 41.6

Not so clean 73.8 36.7 47.9 47.4 26.2 63.3 52.1 52.6 50.4

Dirty 58.3 50.0 56.3 50.0 41.7 50.0 43.8 50.0 8.0

74

Table A 18c: Observations on Personal Hygiene and Living Conditions of Adolescents

Percent distribution of the adolescents by personal hygiene and living condition through observation, according to age, sex and educational status of adolescents, Udhamsingh Nagar district of Uttrakhand, 2009.

Observation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Hygiene

Nails

Clean 65.0 50.0 59.7 59.8 35.0 50.0 40.3 40.2 53.9

Not so clean 34.3 49.2 44.7 33.3 65.7 50.8 55.3 66.7 43.9

Dirty 50.0 50.0 25.0 50.0 50.0 50.0 75.0 50.0 2.2

Hair

Clean 53.8 50.3 52.4 52.9 46.2 49.7 47.6 47.1 86.4

Not so clean 31.8 40.0 41.2 35.0 68.2 60.0 58.8 65.0 13.6

Dirty 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Clothing

Clean 60.2 53.1 58.3 54.4 39.8 46.9 41.7 45.6 75.3

Not so clean 28.3 39.3 34.0 27.3 71.7 60.7 66.0 72.7 23.1

Dirty 66.7 20.0 0.0 0.0 33.3 80.0 100.0 0.0 1.6

Teeth

Clean 61.0 51.5 54.6 52.4 39.0 48.5 45.4 47.6 81.8

Not so clean 26.1 42.3 30.0 27.3 73.9 57.7 70.0 72.7 17.9

Dirty 100.0 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.3

Living Conditions

House

Clean 57.6 52.8 57.3 52.5 42.4 47.2 42.7 47.5 75.8

Not so clean 37.7 40.5 30.2 36.8 62.3 59.5 69.8 63.2 24.1

Dirty 0.0 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.2

Surroundings

Clean 63.0 54.1 60.0 54.6 37.0 45.9 40.0 45.4 44.2

Not so clean 45.1 48.4 43.2 45.6 54.9 51.6 56.8 54.4 51.7

Dirty 50.0 28.6 27.3 25.0 50.0 71.4 72.7 75.0 4.1

75

Table A 18d: Observations on Personal Hygiene and Living Conditions of Adolescents

Percent distribution of the adolescents by personal hygiene and living condition through observation, according to age, sex and educational status of adolescents, Hardwar district of Uttrakhand, 2009.

Observation

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Hygiene

Nails

Clean 67.5 59.8 61.2 57.9 32.5 40.2 38.8 42.1 56.8

Not so clean 42.6 30.9 40.6 34.4 57.4 69.1 59.4 65.6 39.1

Dirty 21.4 50.0 42.9 0.0 78.6 50.0 57.1 100.0 4.1

Hair

Clean 71.3 57.7 58.8 53.7 28.7 42.3 41.2 46.3 71.1

Not so clean 35.3 27.9 32.4 15.4 64.7 72.1 67.6 84.6 24.6

Dirty 17.6 60.0 20.0 82.4 40.0 80.0 0.0 4.2

Clothing

Clean 70.3 61.1 61.4 51.4 29.7 38.9 38.6 48.6 71.4

Not so clean 38.3 22.2 30.8 22.2 61.7 77.8 69.2 77.8 23.4

Dirty 5.9 50.0 12.5 0.0 94.1 50.0 87.5 100.0 5.2

Teeth

Clean 70.0 60.9 58.9 56.0 30.0 39.1 41.1 44.0 67.2

Not so clean 37.5 33.3 40.5 7.1 62.5 66.7 59.5 92.9 27.2

Dirty 11.8 42.9 16.7 0.0 88.2 57.1 83.3 0.0 5.7

Living Conditions

House

Clean 64.9 58.8 59.1 50.4 35.1 41.2 40.9 49.6 67.8

Not so clean 42.5 31.5 35.6 37.9 57.5 68.5 64.4 62.1 26.4

Dirty 23.8 62.5 33.3 0.0 76.2 37.5 66.7 100.0 5.8

Surroundings

Clean 70.6 64.0 63.3 51.7 29.4 36.0 36.7 48.3 48.5

Not so clean 40.4 27.9 50.8 47.5 59.6 72.1 49.2 52.5 37.7

Dirty 40.0 60.9 9.5 21.4 60.0 39.1 90.5 78.6 13.8

76

Table A 19: Knowledge Levels of Adolescents and Information Sources

Percent of the adolescents by knowledge and source of information, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Awareness on

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Personal hygiene 58.7 53.4 60.2 52.7 41.3 46.6 39.8 47.3 90.7

De-worming 75.0 65.5 66.7 68.4 25.0 34.5 33.3 31.6 21.8

Prophylaxis against anaemia 73.7 56.1 62.0 64.1 26.3 43.9 38.0 35.9 30.8

Prophylaxis against goitre 87.5 63.6 82.4 60.0 12.5 36.4 17.6 40.0 28.2

Prophylaxis against vitamin-A 77.3 64.3 81.3 63.3 22.7 35.7 18.8 36.7 25.6

Prophylaxis against tetanus 70.5 55.4 62.2 51.2 29.5 44.6 37.8 48.8 57.2

Prophylaxis against diphtheria 85.7 59.5 65.5 65.0 14.3 40.5 34.5 35.0 26.2

Prophylaxis against measles 24.1 48.7 49.1 63.9 75.9 51.3 50.9 36.1 33.4

Nanital

Personal hygiene 73.1 48.6 57.0 49.4 26.9 51.4 43.0 50.6 95.0

De-worming 77.4 54.9 71.4 62.3 22.6 45.1 28.6 37.7 39.5

Prophylaxis against anaemia 85.2 55.6 64.5 59.4 14.8 44.4 35.5 40.6 31.4

Prophylaxis against goitre 87.1 50.0 69.0 54.3 12.9 50.0 31.0 45.7 32.9

Prophylaxis against vitamin-A 77.6 53.2 70.0 66.7 22.4 46.8 30.0 33.3 38.8

Prophylaxis against tetanus 78.2 51.9 64.1 56.6 21.8 48.1 35.9 43.4 58.6

Prophylaxis against diphtheria 90.0 64.3 63.3 67.1 10.0 35.7 36.7 32.9 23.9

Prophylaxis against measles 81.8 65.8 72.4 64.1 18.2 34.2 27.6 35.9 26.5

Udhamsingh Nagar

Personal hygiene 49.3 49.0 51.4 50.3 50.7 51.0 48.6 49.7 95.4

De-worming 48.0 63.9 46.0 55.2 52.0 36.1 54.0 44.8 26.8

Prophylaxis against anaemia 42.9 60.0 48.8 65.7 57.1 40.0 51.2 34.3 31.1

Prophylaxis against goitre 60.6 56.0 64.3 58.2 39.4 44.0 35.7 41.8 36.3

Prophylaxis against vitamin-A 53.0 52.1 51.7 69.1 47.0 47.9 48.3 30.9 39.0

Prophylaxis against tetanus 51.2 53.3 58.4 59.7 48.8 46.7 41.6 40.3 65.8

Prophylaxis against diphtheria 50.0 57.7 44.7 64.6 50.0 42.3 55.3 35.4 25.0

Prophylaxis against measles 45.5 56.7 50.0 66.7 54.5 43.3 50.0 33.3 24.6

Hardwar

Personal hygiene 55.7 52.3 52.9 48.7 44.3 47.7 47.1 51.3 89.5

De-worming 72.2 46.7 58.6 55.3 27.8 53.3 41.4 44.7 19.5

Prophylaxis against anaemia 76.2 58.1 60.5 57.4 23.8 41.9 39.5 42.6 24.5

Prophylaxis against goitre 68.4 61.9 66.7 54.1 31.6 38.1 33.3 45.9 28.1

Prophylaxis against vitamin-A 80.0 61.8 71.9 65.7 20.0 38.2 28.1 34.3 24.0

Prophylaxis against tetanus 60.4 57.1 55.6 51.2 39.6 42.9 44.4 48.8 53.7

Prophylaxis against diphtheria 68.2 65.5 53.2 50.5 31.8 34.5 46.8 49.5 35.2

77

Table A 19: Knowledge Levels of Adolescents and Information Sources

Percent of the adolescents by knowledge and source of information, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Awareness on

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Prophylaxis against measles 63.0 55.6 59.1 53.5 37.0 44.4 40.9 46.5 36.7

Table A 20: IFA Tablets/Syrup

Percent of the adolescents by status of IFA tablets/syrup, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009

Status of IFA Tablets/Syrup

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Ever Received

Yes 50.0 46.7 80.0 66.7 50.0 53.3 20.0 33.3 8.4

No 56.6 48.7 57.8 48.5 43.4 51.3 42.2 51.5 91.6

Received in last six month

Yes 0.0 45.5 66.7 78.6 100.0 54.5 33.3 21.4 62.7

No 100.0 50.0 100.0 50.0 0.0 50.0 0.0 50.0 37.3

Nanital

Ever Received

Yes 33.3 33.3 90.0 50.0 66.7 66.7 10.0 50.0 7.3

No 73.1 47.7 53.3 49.6 26.9 52.3 46.7 50.4 92.7

Received in last six month

Yes 100.0 0.0 80.0 25.0 0.0 100.0 20.0 75.0 35.7

No 0.0 50.0 100.0 61.1 100.0 50.0 0.0 38.9 64.3

Udhamsingh Nagar

Ever Received

Yes 100.0 33.3 90.9 63.2 0.0 66.7 9.1 36.8 6.0

No 49.0 50.0 47.0 48.9 51.0 50.0 53.0 51.1 94.4

Received in last six month

Yes 100.0 0.0 0.0 83.3 0.0 0.0 0.0 16.7 18.4

No 100.0 33.3 90.9 53.8 0.0 66.7 9.1 46.2 81.6

Hardwar

Ever Received

Yes 83.3 16.7 75.0 50.0 16.7 83.3 25.0 50.0 4.1

No 52.3 51.0 50.3 47.4 47.7 49.0 49.7 52.6 95.9

Received in last six month

Yes 100.0 0.0 100.0 33.3 0.0 100.0 0.0 66.7 42.3

No 66.7 25.0 60.0 66.7 33.3 75.0 40.0 33.3 57.7

78

Table A 21: Status of TT vaccine

Percent of the adolescents by status of TT vaccine, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Status of TT vaccine

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Received TT at 10 years of age

Yes 73.8 57.1 79.2 63.2 26.2 42.9 20.8 36.8 32.8

No 35.1 43.4 39.7 43.2 64.9 56.6 60.3 56.8 42.1

Don’t Know 63.0 37.8 82.9 54.2 37.0 62.2 17.1 45.8 25.1

Received TT at 16 years of age

Yes 0.0 50.0 0.0 47.6 100.0 50.0 0.0 52.4 16.1

No 0.0 41.1 100.0 43.3 0.0 58.9 0.0 56.7 74.8

Don’t Know 100.0 42.9 0.0 22.2 0.0 57.1 0.0 77.8 8.8

Not Applicable 0.0 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.4

Nanital

Received TT at 10 years of age

Yes 77.4 57.4 75.0 64.3 22.6 42.6 25.0 35.7 33.3

No 65.9 43.8 48.8 35.7 34.1 56.2 51.2 64.3 47.3

Don’t Know 71.4 33.3 52.0 57.1 28.6 66.7 48.0 42.9 19.4

Received TT at 16 years of age

Yes 0.0 66.7 0.0 85.7 0.0 33.3 0.0 14.3 13.8

No 0.0 41.0 0.0 38.7 100.0 59.0 0.0 61.3 78.8

Don’t Know 0.0 12.5 0.0 72.7 0.0 87.5 0.0 27.3 7.1

Not Applicable 0.0 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.4

Udhamsingh Nagar

Received TT at 10 years of age

Yes 67.9 58.0 65.7 55.0 32.1 42.0 34.3 45.0 33.6

No 40.0 41.4 44.9 50.7 60.0 58.6 55.1 49.3 47.9

Don’t Know 43.8 40.9 47.2 46.5 56.3 59.1 52.8 53.5 18.5

Received TT at 16 years of age

Yes 0.0 31.8 0.0 65.0 0.0 68.2 0.0 35.0 16.6

No 0.0 41.8 0.0 43.0 100.0 58.2 100.0 57.0 79.8

Don’t Know 0.0 50.0 0.0 0.0 0.0 50.0 0.0 100.0 1.6

Not Applicable 100.0 50.0 0.0 0.0 0.0 50.0 100.0 100.0 2.0

Hardwar

Received TT at 10 years of age

Yes 55.4 51.9 69.6 55.6 44.6 48.1 30.4 44.4 29.0

No 51.5 46.7 50.0 44.0 48.5 53.3 50.0 56.0 43.0

79

Don’t Know 54.8 48.6 46.2 48.3 45.2 51.4 53.8 51.7 27.9

Received TT at 16 years of age

Yes 0.0 35.6 0.0 83.3 0.0 64.4 0.0 16.7 20.7

No 0.0 46.2 100.0 44.3 100.0 53.8 0.0 55.7 68.7

Don’t Know 0.0 80.0 0.0 22.2 0.0 20.0 0.0 77.8 9.3

Not Applicable 0.0 0.0 0.0 50.0 0.0 0.0 100.0 50.0 1.2

Table A 20: Contact with Health Workers

Percent of the adolescents by meeting with health worker in last six months, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009

Met Health Workers

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

At health facility 71.1 54.0 79.2 51.8 28.9 46.0 20.8 48.2 40.3

At home 0.0 50.0 0.0 100.0 100.0 50.0 100.0 0.0 0.8

At home and health facility 100.0 100.0 100.0 100.0 0.0 0.0 0.0 0.0 0.8

Never met 49.5 44.6 47.0 49.3 50.5 55.4 53.0 50.7 58.0

Met with:

ASHA 0.6 0.5 0.0 0.0 0.2 0.0 0.3 0.3 1.9

AWW 0.0 0.6 0.2 0.2 0.2 0.2 0.0 0.0 1.3

NGO worker 0.5 0.5 0.0 0.3 0.3 0.5 0.0 0.0 2.1

ANM 0.5 0.8 0.5 1.1 0.5 0.3 0.2 0.3 4.2

Other 4.5 4.2 6.4 6.2 1.3 4.0 1.4 6.1 34.0

Nanital

At health facility 71.0 50.0 48.0 46.2 29.0 50.0 52.0 53.8 22.5

At home 25.0 50.0 50.0 37.5 75.0 50.0 50.0 62.5 3.5

At home and health facility 0.0 0.0 0.0 33.3 100.0 100.0 66.7 2.0

Never met 75.0 46.7 58.8 51.7 25.0 53.3 41.2 48.3 71.9

Met with:

ASHA 0.3 0.0 0.3 0.2 0.5 0.3 0.3 0.5 2.3

AWW 0.2 0.0 0.5 0.5 0.3 0.3 0.0 0.9 2.6

NGO worker 0.2 0.6 0.0 0.5 0.2 0.5 0.0 0.2 2.0

ANM 0.9 0.8 0.5 0.5 0.3 0.8 0.5 0.6 4.8

Other 2.6 3.0 1.4 1.2 1.1 2.5 2.0 1.9 15.7

Udhamsingh Nagar

At health facility 60.0 54.2 48.5 57.5 40.0 45.8 51.5 42.5 21.7

At home 69.2 60.0 62.5 85.7 30.8 40.0 37.5 14.3 5.2

At home and health facility 0.0 100.0 33.3 62.5 0.0 0.0 66.7 37.5 1.9

Never met 44.4 48.1 50.0 44.7 55.6 51.9 50.0 55.3 71.2

Met with:

80

Table A 20: Contact with Health Workers

Percent of the adolescents by meeting with health worker in last six months, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009

Met Health Workers

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

ASHA 0.7 0.0 0.3 0.6 0.6 0.1 0.1 0.3 2.8

AWW 0.4 0.1 0.6 1.0 0.1 0.1 0.1 0.4 3.1

NGO worker 0.1 0.1 0.0 0.3 0.3 0.0 0.0 0.0 0.9

ANM 0.6 0.9 0.3 1.0 0.7 0.1 1.2 0.3 5.1

Other 3.5 1.3 2.5 2.5 1.6 1.6 1.8 2.3 17.1

Hardwar

At health facility 62.5 54.0 59.8 49.4 37.5 46.0 40.2 50.6 44.0

At home 33.3 25.0 50.0 50.0 66.7 75.0 50.0 50.0 2.7

At home and health facility 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 0.4

Never met 48.4 47.8 42.9 45.9 51.6 52.2 57.1 54.1 53.1

Met with:

ASHA 0.1 0.1 0.3 0.0 0.1 0.3 0.0 0.1 1.1

AWW 0.0 0.4 0.0 0.0 0.1 0.0 0.3 0.0 0.9

NGO worker 0.3 0.4 0.0 0.0 0.3 0.3 0.0 0.0 1.3

ANM 0.0 0.6 0.1 0.0 0.7 0.1 0.0 0.9 2.4

Other 4.9 4.0 7.0 6.2 2.4 4.2 4.7 5.9 39.3

81

Table A 41a: Advice on Treatment for Illness

Percent of the adolescents by illness and seeking advice, according to age, sex and educational status of adolescents, Dehradun district of Uttrakhand, 2009.

Characteristics

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Fallen Sick in Last Three Months

Yes 69.8 51.6 78.4 50.7 30.2 48.4 21.6 49.3 37.9

No 51.0 46.6 48.3 51.7 49.0 53.4 51.7 48.3 62.1

Suffered From

Fever 3.5 3.8 4.3 3.5 1.1 4.0 1.4 3.5 25.2

Cough 1.9 0.8 1.9 1.3 0.6 0.8 0.5 2.4 10.2

Cold 0.8 1.0 1.1 1.1 0.3 0.6 0.0 1.4 6.4

Diarrhoea 0.2 0.3 0.5 0.0 0.2 0.0 0.0 0.5 1.6

Abdominal pain 1.1 1.1 1.0 1.1 0.3 1.3 0.8 1.1 7.8

Depression 0.0 0.3 0.0 0.0 0.0 0.2 0.0 0.0 0.5

Headache 1.3 2.1 1.3 0.5 0.3 1.1 0.2 1.3 8.0

Loss of appetite 0.2 0.0 0.0 0.0 0.0 0.2 0.2 0.2 0.6

Other 0.8 0.6 2.1 2.1 0.5 1.1 0.5 1.8 9.4

Advice on Treatment Received From

Parents 4.5 4.5 5.3 5.3 1.9 4.3 1.4 5.0 32.1

Grandparents 0.0 0.5 0.6 0.2 0.3 0.0 0.3 0.3 2.2

Friends 0.6 2.1 0.0 0.2 0.5 2.4 0.2 0.5 6.4

Teachers 1.0 1.8 0.0 0.0 0.2 0.2 0.2 0.0 3.2

ASHA 0.3 0.2 0.0 0.0 0.0 0.2 0.0 0.3 1.0

AWW 0.0 0.3 0.0 0.0 0.0 0.2 0.0 0.0 0.5

Relatives 0.0 0.0 0.0 0.2 0.0 0.2 0.0 0.2 0.5

Sister-in-law 0.0 0.0 0.5 0.0 0.0 0.2 0.0 0.3 1.0

Self 0.5 0.8 0.6 0.3 0.0 0.8 0.2 0.5 3.7

ANM 0.2 0.5 0.0 0.2 0.0 0.3 0.2 0.2 1.4

NGO worker 0.2 0.3 0.0 0.0 0.0 0.2 0.0 0.0 0.6

Other 0.6 0.6 1.8 0.6 0.3 0.8 0.3 1.0 6.1

Still/currently suffering from illness

Yes 55.6 44.4 85.7 50.0 44.4 55.6 14.3 50.0 16.0

No 73.5 52.7 77.3 50.8 26.5 47.3 22.7 49.2 84.0 Sought Treatment

Yes 75.0 51.6 79.2 51.4 25.0 48.4 20.8 48.6 94.4

No 42.9 50.0 66.7 0.0 57.1 50.0 33.3 100.0 5.6

82

Table A 21b: Advice on Treatment for Illness

Percent of the adolescents by illness and seeking advice, according to age, sex and educational status of adolescents, Nanital

district of Uttrakhand, 2009.

Characteristics

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Fallen Sick in Last Three Months

Yes 67.2 50.6 56.1 51.2 32.8 49.4 43.9 48.8 49.4

No 77.4 44.3 55.6 48.1 22.6 55.7 44.4 51.9 50.6

Suffered From

Fever 4.5 5.6 5.0 5.3 2.2 5.3 3.7 4.5 36.0

Cough 2.2 2.0 1.9 1.7 0.5 1.7 2.2 1.1 13.2

Cold 2.8 3.3 3.0 2.2 1.1 3.3 1.7 2.2 19.4

Diarrhoea 0.2 0.2 0.2 0.2 0.3 0.3 0.0 0.3 1.6

Abdominal pain 1.2 0.8 1.2 1.9 0.6 1.9 0.6 1.2 9.5

Depression 0.0 0.2 0.0 0.6 0.0 0.2 0.0 0.2 1.1

Headache 1.4 1.4 0.8 1.1 1.2 1.4 0.5 1.1 8.9

Loss of appetite 0.2 0.2 0.0 0.3 0.0 0.0 0.0 0.0 0.6

Other 0.6 0.8 0.6 0.6 0.3 0.6 0.5 1.4 5.4

Advice on Treatment Received From

Parents 5.6 4.7 5.3 5.4 2.3 5.1 4.0 5.0 37.4

Grandparents 0.8 0.5 0.3 0.5 0.3 0.0 0.3 0.5 3.1

Friends 0.5 0.2 0.2 0.3 0.3 0.8 0.0 0.3 2.5

Teachers 1.1 1.2 0.0 0.0 0.3 0.3 0.0 0.0 3.0

ASHA 0.3 0.3 0.2 0.0 0.2 0.2 0.2 0.0 1.2

AWW 0.2 0.2 0.0 0.2 0.2 0.2 0.0 0.2 0.9

Relatives 0.2 0.0 0.2 0.0 0.2 0.2 0.2 0.3 1.1

Sister-in-law 0.0 0.2 0.0 0.3 0.0 0.3 0.0 0.3 1.1

Self 0.2 1.2 0.0 0.0 0.6 1.4 0.0 0.2 3.6

ANM 0.3 0.3 0.0 0.0 0.2 0.2 0.0 0.0 0.9

NGO worker 0.0 0.2 0.0 0.0 0.0 0.0 0.2 0.0 0.3

Other 1.2 1.4 0.6 1.6 0.3 1.2 0.5 1.2 8.1

Still/currently suffering from illness

Yes 75.0 50.0 66.7 40.0 25.0 50.0 33.3 60.0 17.2

No 64.3 50.7 55.0 53.7 35.7 49.3 45.0 46.3 82.8 Sought Treatment

Yes 65.4 48.7 55.9 53.4 34.6 51.3 44.1 46.6 91.2

No 83.3 100.0 57.1 33.3 16.7 0.0 42.9 66.7 8.8

83

Table A 21c: Advice on Treatment for Illness

Percent of the adolescents by illness and seeking advice, according to age, sex and educational status of adolescents, Udhamsingh Nagar district of Uttrakhand, 2009.

Characteristics

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Fallen Sick in Last Three Months

Yes 52.4 50.7 51.8 50.5 47.6 49.3 48.2 49.5 52.5

No 48.5 48.9 48.0 50.7 51.5 51.1 52.0 49.3 47.5

Suffered From

Fever 5.1 4.1 5.1 5.6 4.5 4.0 5.1 4.7 38.2

Cough 1.5 1.2 2.2 2.2 1.9 2.2 1.6 1.5 14.2

Cold 2.8 3.4 2.3 1.8 3.7 2.9 2.0 1.9 20.8

Diarrhoea 0.0 0.0 0.3 0.1 0.3 0.4 0.0 0.1 1.3

Abdominal pain 1.2 1.0 1.0 1.3 0.4 0.9 0.9 1.6 8.3

Depression 0.1 0.1 0.1 0.1 0.0 0.1 0.0 0.0 0.7

Headache 1.5 1.6 1.3 1.6 2.0 1.8 1.2 0.7 11.7

Loss of appetite 0.3 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.4

Other 1.6 0.4 0.7 0.9 0.3 0.1 0.7 1.0 5.9

Advice on Treatment Received From

Parents 5.9 4.8 6.1 6.4 5.6 4.4 5.4 6.0 44.7

Grandparents 0.7 0.3 0.1 0.4 0.1 0.3 0.4 0.1 2.6

Friends 0.3 0.1 0.1 0.1 0.3 0.1 0.6 0.0 1.8

Teachers 1.5 0.1 0.0 0.0 0.0 0.0 0.0 0.0 1.6

ASHA 0.1 0.0 0.0 0.3 0.1 0.0 0.0 0.1 0.7

AWW 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1

Relatives 0.0 0.0 0.1 0.0 0.0 0.0 0.1 0.3 0.6

Sister-in-law 0.0 0.0 0.3 0.1 0.1 0.3 0.3 0.0 1.2

Self 1.5 1.9 0.0 0.3 1.2 1.2 0.1 0.9 7.0

ANM 0.0 0.0 0.0 0.1 0.3 0.1 0.1 0.1 0.9

NGO worker 0.1 0.1 0.0 0.1 0.0 0.0 0.0 0.0 0.4

Other 0.7 0.1 0.6 0.6 0.3 0.1 0.0 1.2 3.7

Still/currently suffering from illness

Yes 60.0 50.0 70.0 62.5 40.0 50.0 30.0 37.5 16.0

No 50.7 50.8 49.3 48.0 49.3 49.2 50.7 52.0 84.0 Sought Treatment

Yes 52.4 50.7 51.9 50.6 47.6 49.3 48.1 49.4 98.2

No 0.0 0.0 50.0 50.0 0.0 0.0 50.0 50.0 1.8

84

Table A 21d: Advice on Treatment for Illness

Percent of the adolescents by illness and seeking advice, according to age, sex and educational status of adolescents, Hardwar district of Uttrakhand, 2009.

Characteristics

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Fallen Sick in Last Three Months

Yes 60.6 50.8 55.4 48.1 39.4 49.2 44.6 51.9 46.8

No 47.6 48.9 47.4 47.0 52.4 51.1 52.6 53.0 53.2

Suffered From

Fever 4.7 3.9 5.5 3.9 3.0 3.7 4.0 4.2 32.9

Cough 1.6 1.3 2.3 1.0 0.7 0.7 1.3 1.1 10.0

Cold 0.7 0.9 2.2 0.9 0.4 0.7 0.9 1.3 7.9

Diarrhoea 0.3 0.0 0.4 0.7 0.1 0.1 0.3 0.7 2.7

Abdominal pain 1.0 1.0 0.6 0.6 0.3 1.0 0.3 1.0 5.7

Depression 0.0 0.0 0.0 0.1 0.0 0.1 0.0 0.0 0.3

Headache 0.9 0.7 1.4 0.9 1.1 1.0 0.3 0.7 7.0

Loss of appetite 0.3 0.4 0.0 0.0 0.0 0.0 0.1 0.0 0.9

Other 1.6 0.4 1.9 1.3 1.0 0.7 1.6 1.9 10.3

Advice on Treatment Received From

Parents 6.0 4.4 6.3 4.9 3.7 3.9 4.6 5.3 39.2

Grandparents 0.4 0.3 0.3 0.7 0.0 0.6 0.0 0.1 2.4

Friends 0.7 1.0 0.3 0.3 0.9 1.4 0.3 0.1 5.0

Teachers 0.7 0.3 0.0 0.1 0.0 0.1 0.0 0.0 1.3

ASHA 0.1 0.0 0.1 0.0 0.0 0.0 0.1 0.0 0.4

AWW 0.1 0.0 0.1 0.0 0.1 0.1 0.0 0.0 0.6

Relatives 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1

Sister-in-law 0.0 0.0 0.0 0.6 0.3 0.3 0.4 1.0 2.6

Self 0.3 1.1 0.4 1.1 0.4 1.1 0.7 1.4 6.7

ANM 0.3 0.1 0.1 0.0 0.3 0.0 0.1 0.1 1.1

NGO worker 0.0 0.3 0.0 0.0 0.1 0.3 0.0 0.0 0.7

Other 0.9 0.6 1.1 0.6 0.7 0.9 1.0 0.9 6.6

Still/currently suffering from illness

Yes 64.3 30.0 63.6 25.0 35.7 70.0 36.4 75.0 14.4

No 59.6 54.5 54.2 50.7 40.4 45.5 45.8 49.3 85.6 Sought Treatment

Yes 62.7 52.4 53.8 48.1 37.3 47.6 46.3 51.9 97.0

No 25.0 0.0 100.0 0.0 75.0 100.0 0.0 0.0 3.0

85

Table A 22a: First Treatment, preference to provide and satisfaction level

Percent of the adolescents by first treatment, preference to provider and satisfaction level, according to age, sex and educational status of adolescents, Dehradun district of Uttrakhand, 2009.

Categories

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Public Medical Sector

Govt/Municipal hosp. 100.0 71.4 66.7 44.4 0.0 28.6 33.3 55.6 10.6

Govt. Dispensary 0.0 33.3 50.0 66.7 100.0 66.7 50.0 33.3 5.0

UHC/UHP/UFWC 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

CHC/PHC/FP Centre 100.0 40.0 71.4 56.3 0.0 60.0 28.6 43.8 13.8

Sub centre 100.0 25.0 0.0 50.0 0.0 75.0 0.0 50.0 3.2

Govt. Paramedic 100.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 0.9

Camp 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other public health facility 0.0 0.0 100 0.0 0.0 0.0 0.0 0.0 0.5

NGO/Trust hospitals

NGO Hosp./Clinic 100 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.5

NGO worker 0.0 0.0 0.0 0.0 0.0 100 0.0 0.0 0.5

Mobile clinic 0.0 100 0.0 0.0 0.0 0.0 0.0 100 0.5

Private Medical Sector

Pvt.Hosp./Clinic 75.0 50.0 91.7 66.7 25.0 50.0 8.3 33.3 18.3

Pvt.Doctor 58.3 51.7 83.3 50.0 41.7 48.3 16.7 50.0 28.9

Pvt. Paramedic 75.0 50.0 85.7 40.0 25.0 50.0 14.3 60.0 12.4

Vaidya/Hakim/Homeo 0.0 100 100 0.0 0.0 0.0 0.0 0.0 0.9

Traditional Healer 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Pharmacy/Drug House 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

ASHA 100 50 0.0 0.0 0.0 50 0.0 100 2.3

Dai 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other pvt. health facility 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other sources 0.0 100 0.0 0.0 0.0 0.0 100 100 1.4

Preference for providers

Known acquaintance 9.6 10.6 4.1 4.1 3.7 9.2 2.3 5.0 48.6

Easily accessible 4.1 4.1 7.3 8.7 0.9 4.6 1.4 7.3 38.5

Convenient location 5.5 4.1 6.4 6.9 0.9 2.3 0.5 2.8 29.4

free treatment 2.8 2.3 1.8 3.2 0.5 2.8 0.5 4.1 17.9

No other choice 0.0 0.5 1.4 0.9 0.5 1.4 0.9 0.9 6.4

Others 0.0 0.5 0.9 0.0 0.0 0.5 0.5 1.4 3.7

Satisfaction level

Satisfied 78.8 52.6 81.6 57.6 21.2 47.4 18.4 42.4 85.8

Somewhat satisfied 0.0 25.0 77.8 25.0 100.0 75.0 22.2 75.0 11.9

Not satisfied 50.0 100.0 0.0 0.0 50.0 0.0 100.0 100.0 2.3

86

Table A 22b: First Treatment, preference to provide and satisfaction level

Percent of the adolescents by first treatment, preference to provider and satisfaction level, according to age, sex and educational status of adolescents, Nanital district of Uttrakhand, 2009.

Categories

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Public Medical Sector

Govt/Municipal hosp. 66.7 53.8 66.7 100.0 33.3 46.2 33.3 0.0 12.2

Govt. Dispensary 0.0 60.0 100.0 100.0 0.0 40.0 0.0 0.0 4.7

UHC/UHP/UFWC 0.0 0.0 0.0 0.0 100.0 100.0 0.0 0.0 0.8

CHC/PHC/FP Centre 50.0 100.0 42.9 42.1 50.0 0.0 57.1 57.9 11.4

Sub centre 20.0 71.4 0.0 50.0 80.0 28.6 0.0 50.0 5.5

Govt. Paramedic 100.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 1.6

Camp 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other public health facility 100.0 0.0 0.0 50.0 0.0 100.0 100.0 50.0 2.7

NGO/Trust hospitals

NGO Hosp./Clinic 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.0 0.4

NGO worker 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.0 0.4

Mobile clinic 0.0 0.0 0.0 100.0 0.0 100.0 0.0 0.0 0.4

Private Medical Sector

Pvt.Hosp./Clinic 81.3 30.8 44.4 31.6 18.8 69.2 55.6 68.4 22.4

Pvt.Doctor 83.3 54.2 54.5 58.3 16.7 45.8 45.5 41.7 20.8

Pvt. Paramedic 0.0 0.0 75.0 66.7 0.0 0.0 25.0 33.3 5.5

Vaidya/Hakim/Homeo 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Traditional Healer 0.0 0.0 0.0 0.0 0.0 100.0 100.0 0.0 0.4

Pharmacy/Drug House 0.0 100.0 60.0 100.0 100.0 0.0 40.0 0.0 0.8

ASHA 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Dai 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other pvt. health facility 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other sources 33.3 25.0 66.7 100.0 66.7 75.0 33.3 0.0 4.7

Preference for providers

Known acquaintance 7.3 10.0 2.3 6.9 3.8 10.4 2.7 3.5 46.9

Easily accessible 8.1 9.2 5.8 6.2 3.1 9.2 5.0 6.2 52.7

Convenient location 3.5 3.5 1.9 4.2 1.9 3.5 1.9 2.3 22.7

free treatment 1.9 2.7 0.8 1.2 1.2 2.3 0.8 0.4 11.2

No other choice 0.0 0.8 1.2 0.4 1.2 0.8 0.0 1.5 5.8

Others 0.4 0.0 0.8 2.3 0.0 0.0 0.8 1.9 6.2 Satisfaction level

Satisfied 65.9 50.0 54.0 50.7 34.1 50.0 46.0 49.3 86.5

Somewhat satisfied 50.0 42.9 50.0 100.0 50.0 57.1 50.0 0.0 8.5

Not satisfied 100.0 42.9 100.0 100.0 0.0 57.1 0.0 0.0 5.0

87

Table A 22c: First Treatment, preference to provide and satisfaction level

Percent of the adolescents by first treatment, preference to provider and satisfaction level, according to age, sex and educational status of adolescents, Udhamsingh Nagar district of Uttrakhand, 2009.

Categories

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Public Medical Sector

Govt/Municipal hosp. 50.0 66.7 100.0 0.0 50.0 33.3 0.0 0.0 5.2

Govt. Dispensary 100.0 0.0 0.0

100.0 0.0 100.0 0.0

0.0 1.2

UHC/UHP/UFWC 0.0 0.0 0.0

0.0 100.0 100.0 0.0

0.0 0.6

CHC/PHC/FP Centre 100.0 75.0 25.0 50.0 0.0 25.0 75.0 50.0 7.4

Sub centre 45.5 60.0 14.3 100.0 54.5 40.0 85.7 0.0 7.4

Govt. Paramedic 50.0 100.0 0.0 50.0 50.0 0.0 50.0 1.9

Camp 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other public health facility 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

NGO/Trust hospitals

NGO Hosp./Clinic 0.0 100.0 0.0 100.0 0.0 0.0 0.0 0.0 0.6

NGO worker 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Mobile clinic 0.0 100.0 0.0 0.0 0.0 0.0 0.0 100.0 0.6

Private Medical Sector

Pvt.Hosp./Clinic 50.0 50.0 47.1 57.9 50.0 50.0 52.9 42.1 24.7

Pvt.Doctor 62.5 38.9 64.7 45.8 37.5 61.1 35.3 54.2 25.6

Pvt. Paramedic 28.6 28.6 52.6 50.0 71.4 71.4 47.4 50.0 17.0

Vaidya/Hakim/Homeo 0.0 0.0 0.0 50 0.0 0.0 0.0 50 0.6

Traditional Healer 0.0 0.0 0.0 0.0 0.0 100 0.3

Pharmacy/Drug House 0.0 0.0 71.4 50.0 0.0 0.0 28.6 50.0 2.8

ASHA 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Dai 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other pvt. health facility 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other sources 0.0 100.0 100.0 33.3 100.0 0.0 0.0 66.7 4.0

Preference for providers

Known acquaintance 8.0 6.2 4.9 5.2 7.4 6.5 4.0 3.4 45.5

Easily accessible 8.3 7.1 7.7 8.3 5.8 5.2 5.5 8.0 56.0

Convenient location 4.6 4.3 3.4 4.3 4.0 2.8 3.4 3.7 30.5

free treatment 1.8 0.3 0.3 0.6 0.3 0.6 0.6 0.0 4.6

No other choice 1.2 0.0 0.3 1.5 0.9 0.9 1.2 0.6 6.8

Others 0.3 0.6 1.5 0.3 0.0 0.3 0.3 1.5 4.9 Satisfaction level

Satisfied 52.3 46.6 50.7 51.3 47.7 53.4 49.3 48.8 83.7

Somewhat satisfied 50.0 69.2 54.5 42.9 50.0 30.8 45.5 57.1 15.1

Not satisfied 100.0 0.0 100.0 50.0 0.0 0.0 0.0 50.0 1.2

88

Table A 22d: First Treatment, preference to provide and satisfaction level

Percent of the adolescents by first treatment, preference to provider and satisfaction level, according to age, sex and educational status of adolescents, Hardwar district of Uttrakhand, 2009.

Categories

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Public Medical Sector

Govt/Municipal hosp. 0.0 0.0 25.0 100.0 0.0 100.0 75.0 0.0 2.4

Govt. Dispensary 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3

UHC/UHP/UFWC 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.0 0.7

CHC/PHC/FP Centre 100.0 0.0 66.7 0.0 0.0 100.0 33.3 100.0 2.8

Sub centre 33.3 0.0 0.0 100.0 66.7 0.0 100.0 0.0 1.7

Govt. Paramedic 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Camp 0.0 0.0 0.0 100 0.0 0.0 0.0 0.0 0.3

Other public health facility 0.0 100 0.0 0.0 0.0 0.0 0.0 0.0 0.3

NGO/Trust hospitals

NGO Hosp./Clinic 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

NGO worker 0.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7

Mobile clinic 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Private Medical Sector

Pvt.Hosp./Clinic 90.9 33.3 66.7 47.4 9.1 66.7 33.3 52.6 25.3

Pvt.Doctor 51.7 52.4 57.1 50.0 48.3 47.6 42.9 50.0 35.3

Pvt. Paramedic 62.5 63.6 47.6 47.6 37.5 36.4 52.4 52.4 23.9

Vaidya/Hakim/Homeo 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Traditional Healer 100.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 1.0

Pharmacy/Drug House 33.3 0.0 0.0 0.0 66.7 0.0 0.0 100.0 1.4

ASHA 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Dai 100 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3

Other pvt. health facility 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other sources 0.0 0.0 33.3 50.0 0.0 0.0 66.7 50.0 3.5

Preference for providers

Known acquaintance 7.6 10.4 5.9 5.9 6.9 9.7 3.8 5.9 56.1

Easily accessible 11.4 5.9 7.6 6.9 4.5 3.5 7.6 8.7 56.1

Convenient location 6.2 9.3 5.2 5.5 6.6 8.0 2.8 4.2 47.8

free treatment 1.4 0.7 1.7 0.3 0.0 1.0 0.3 0.0 5.5

No other choice 0.0 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.3

Others 0.3 0.0 1.0 1.4 0.0 0.0 2.8 1.7 7.3 Satisfaction level

Satisfied 59.6 55.4 57.1 50.7 40.4 44.6 42.9 49.3 87.2

Somewhat satisfied 85.7 0.0 16.7 12.5 14.3 100.0 83.3 87.5 7.6

Not satisfied 66.7 33.3 50.0 100.0 33.3 66.7 50.0 0.0 5.2

89

Table A 23: Happiness

Percent of the adolescents by reason of happiness, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Reasons

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Health Related 66.7 75.0 100.0 100.0 33.3 25.0 0.0 0.0 2.3

Family Related 65.5 37.0 58.7 50.7 34.5 63.0 41.3 49.3 39.2

Financial Reason 0.0 26.7 46.2 36.4 100.0 73.3 53.8 63.6 7.4

Employment 79.2 80.0 57.1 43.8 20.8 20.0 42.9 56.3 17.5

Availability of Basic Needs 44.7 52.6 67.6 72.7 55.3 47.4 32.4 27.3 23.4

Other 37.5 36.0 40.0 26.7 62.5 64.0 60.0 73.3 10.0

Nanital

Health Related 60.0 33.3 66.7 75.0 40.0 66.7 33.3 25.0 3.8

Family Related 78.9 40.9 63.9 41.5 21.1 59.1 36.1 58.5 35.8

Financial Reason 0.0 60.0 14.3 11.1 100.0 40.0 85.7 88.9 3.8

Employment 81.5 57.9 39.0 52.6 18.5 42.1 61.0 47.4 24.8

Availability of Basic Needs 77.8 52.1 87.0 72.4 22.2 47.9 13.0 27.6 21.9

Other 37.5 30.0 12.5 40.0 62.5 70.0 87.5 60.0 9.3

Udhamsingh Nagar

Health Related 33.3 25.0 42.9 60.0 66.7 75.0 57.1 40.0 3.5

Family Related 56.8 52.9 44.9 43.6 43.2 47.1 55.1 56.4 53.2

Financial Reason 0.0 33.3 20.0 28.6 100.0 66.7 80.0 71.4 4.1

Employment 68.0 58.1 72.4 58.1 32.0 41.9 27.6 41.9 18.5

Availability of Basic Needs 55.2 50.0 64.7 57.1 44.8 50.0 35.3 42.9 15.4

Other 37.5 35.3 60.0 25.0 62.5 64.7 40.0 75.0 6.7

Hardwar

Health Related 33.3 25.0 42.9 60.0 66.7 75.0 57.1 40.0 3.5

Family Related 56.8 52.9 44.9 43.6 43.2 47.1 55.1 56.4 52.4

Financial Reason 0.0 33.3 20.0 28.6 100.0 66.7 80.0 71.4 4.1

Employment 68.0 58.1 72.4 58.1 32.0 41.9 27.6 41.9 18.2

Availability of Basic Needs 55.2 50.0 64.7 57.1 44.8 50.0 35.3 42.9 15.2

Other 37.5 35.3 60.0 25.0 62.5 64.7 40.0 75.0 6.6

90

Table A 24: Satisfied with health

Percent of the adolescents who had satisfied with health , according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Reasons

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Very Satisfied 80.0 40.0 58.3 52.9 20.0 60.0 41.7 47.1 6.4

Satisfied 70.3 46.0 67.3 50.0 29.7 54.0 32.7 50.0 43.8

OK 37.9 50.9 48.1 56.4 62.1 49.1 51.9 43.6 33.8

Unsatisfied 68.8 55.6 70.0 45.9 31.3 44.4 30.0 54.1 14.9

Very unsatisfied 0.0 0.0 50.0 66.7 100.0 0.0 50.0 33.3 1.1

Nanital

Very Satisfied 72.7 28.6 55.2 58.8 27.3 71.4 44.8 41.2 13.9

Satisfied 75.0 49.1 55.1 39.3 25.0 50.9 44.9 60.7 51.6

OK 68.0 57.1 51.5 45.2 32.0 42.9 48.5 54.8 22.0

Unsatisfied 64.3 20.0 80.0 70.6 35.7 80.0 20.0 29.4 9.6

Very Unsatisfied 100.0 100.0 50.0 71.4 0.0 0.0 50.0 28.6 2.8

Udhamsingh Nagar

Very Satisfied 90.0 72.7 63.6 72.7 10.0 27.3 36.4 27.3 12.1

Satisfied 45.3 44.1 48.9 46.7 54.7 55.9 51.1 53.3 63.3

OK 50.0 54.5 43.9 48.6 50.0 45.5 56.1 51.4 20.1

Unsatisfied 66.7 50.0 57.1 44.4 33.3 50.0 42.9 55.6 4.5

Hardwar

Very Satisfied 60.0 55.6 58.3 46.2 40.0 44.4 41.7 53.8 6.1

Satisfied 53.9 49.5 53.8 49.3 46.1 50.5 46.2 50.7 51.3

OK 55.3 52.9 47.4 50.0 44.7 47.1 52.6 50.0 24

Unsatisfied 50.0 47.4 51.6 44.7 50.0 52.6 48.4 55.3 17.0

Very Unsatisfied 33.3 25.0 0.0 25.0 66.7 75.0 100.0 75.0 2.0

91

Table A 25: Reason for satisfied with health

Percent of the adolescents who had satisfied with health by reason , according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Reasons

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Maintain Health and Hygiene 57.5 50.7 55.0 50.8 42.5 49.3 45.0 49.2 83.0

Physical Appearance 45.5 33.3 66.7 58.3 54.5 66.7 33.3 41.7 10.7

Family support 50.0 0.0 100.0 0.0 50.0 100.0 0.0 100.0 1.3

Affordability of Treatment 0.0 0.0 100.0 50.0 100.0 0.0 0.0 50.0 1.3

Exercise/ Daily workout 0.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2

Others 100.0 40.0 100.0 60.0 0.0 60.0 0.0 40.0 3.4

Nanital

Maintain Health and Hygiene 72.2 48.2 55.4 49.3 27.8 51.8 44.6 50.7 90.7

Physical Appearance 40.0 66.7 66.7 80.0 60.0 33.3 33.3 20.0 3.3

Family support

Affordability of Treatment 0.0 100.0 0.0 0.0 0.0 0.0 0.0 100.0 0.3

Exercise/ Daily workout 50.0 0.0 0.0 0.0 50.0 100.0 0.0 0.0 0.9

Others 88.9 36.4 0.0 0.0 11.1 63.6 100.0 0.0 3.6

Udhamsingh Nagar

Maintain Health and Hygiene 49.3 49.4 50.0 51.3 50.7 50.6 50.0 48.7 95.4

Physical Appearance 100.0 0.0 66.7 33.3 0.0 100.0 33.3 66.7 2.2

Family support

Affordability of Treatment

Exercise/ Daily workout 0.0 0.0 0.0 100.0 0.0 0.0 100.0 0.0 0.3

Others 33.3 75.0 100.0 0.0 66.7 25.0 0.0 100.0 1.9

Hardwar

Maintain Health and Hygiene 52.9 48.6 51.9 45.5 47.1 51.4 48.1 54.5 85.9

Physical Appearance 60.0 53.8 50.0 58.8 40.0 46.2 50.0 41.2 9.1

Family support 33.3 0.0 0.0 60.0 66.7 0.0 100.0 40.0 1.4

Affordability of Treatment 100.0 0.0 0.0 0.0 0.0 0.0 100.0 0.0 0.5

Exercise/ Daily workout 0.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2

Others 100.0 75.0 80.0 57.1 0.0 25.0 20.0 42.9 2.7

92

Table A 26: Adolescents’ Mental State

Percent of the adolescents by mental state in past one month, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Mental state

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Able to concentrate on whatever doing 57.0 52.5 60.2 53.1 43.0 47.5 39.8 46.9 74.4

Losing sleep over worry 63.6 45.9 52.9 41.6 36.4 54.1 47.1 58.4 27.9

Feel that they are playing a useful role 60.0 49.6 60.6 53.0 40.0 50.4 39.4 47.0 62.8

Feel capable of making decisions about things 52.2 48.9 46.7 50.5 47.8 51.1 53.3 49.5 64.9

Feel constantly under strain 66.7 28.6 63.6 32.7 33.3 71.4 36.4 67.3 16.6

Feel they can overcome difficulties 56.0 46.6 60.0 50.7 44.0 53.4 40.0 49.3 73.8

Able to enjoy normal day to day activities 56.3 48.8 63.4 54.9 43.8 51.2 36.6 45.1 77.9

Able to face up to problems 66.3 48.5 62.0 51.8 33.7 51.5 38.0 48.2 71.0

Feel unhappy and depressed 52.6 31.0 64.3 44.4 47.4 69.0 35.7 55.6 21.3

Lost confidence 63.6 44.0 71.9 47.8 36.4 56.0 28.1 52.2 20.5

Have thoughts of worthlessness 33.3 28.6 61.1 45.5 66.7 71.4 38.9 54.5 8.7

Feel responsible and happy 66.7 50.7 70.6 54.5 33.3 49.3 29.4 45.5 83.0

Nanital

Able to concentrate on whatever doing 73.9 45.7 51.4 48.2 26.1 54.3 48.6 51.8 81.9

Losing sleep over worry 59.1 35.5 45.7 46.0 40.9 64.5 54.3 54.0 23.8

Feel that they are playing a useful role 68.5 46.7 54.7 53.8 31.5 53.3 45.3 46.2 62.8

Feel capable of making decisions about things 74.3 47.1 59.3 53.5 25.7 52.9 40.7 46.5 72.6

Feel constantly under strain 68.2 25.9 37.9 42.2 31.8 74.1 62.1 57.8 21.2

Feel they can overcome difficulties 73.8 47.6 58.7 51.9 26.2 52.4 41.3 48.1 78.1

Able to enjoy normal day to day activities 73.3 48.6 57.4 49.7 26.7 51.4 42.6 50.3 94.5

Able to face up to problems 69.1 47.4 59.8 52.2 30.9 52.6 40.2 47.8 78.0

Feel unhappy and depressed 59.1 21.9 39.5 51.6 40.9 78.1 60.5 48.4 26.5

Lost confidence 73.1 54.5 54.8 50.8 26.9 45.5 45.2 49.2 29.4

Have thoughts of worthlessness 54.5 50.0 25.0 41.2 45.5 50.0 75.0 58.8 8.6

Feel responsible and happy 74.3 47.9 57.0 49.7 25.7 52.1 43.0 50.3 94.3

Udhamsingh Nagar

Able to concentrate on whatever doing 51.3 49.0 52.2 52.7 48.7 51.0 47.8 47.3 86.4

Losing sleep over worry 31.6 30.8 45.7 44.6 68.4 69.2 54.3 55.4 19.6

93

Table A 26: Adolescents’ Mental State

Percent of the adolescents by mental state in past one month, according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Mental state

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Feel that they are playing a useful role 48.3 47.4 50.5 49.6 51.7 52.6 49.5 50.4 68.9

Feel capable of making decisions about things 51.1 47.9 49.5 53.4 48.9 52.1 50.5 46.6 73.7

Feel constantly under strain 42.1 35.7 28.2 54.2 57.9 64.3 71.8 45.8 21.4

Feel they can overcome difficulties 49.1 48.7 50.0 51.9 50.9 51.3 50.0 48.1 81.2

Able to enjoy normal day to day activities 51.1 49.0 49.3 51.0 48.9 51.0 50.7 49.0 95.5

Able to face up to problems 51.9 47.4 52.5 52.5 48.1 52.6 47.5 47.5 79.7

Feel unhappy and depressed 30.0 25.0 39.0 50.9 70.0 75.0 61.0 49.1 22.6

Lost confidence 30.0 53.1 37.8 51.4 70.0 46.9 62.2 48.6 20.1

Have thoughts of worthlessness 0.0 100.0 33.3 35.7 100.0 0.0 66.7 64.3 4.8

Feel responsible and happy 50.7 50.0 50.3 49.3 49.3 50.0 49.7 50.7 95.5

Hardwar

Able to concentrate on whatever doing 48.9 46.5 49.5 46.6 51.1 53.5 50.5 53.4 65.5

Losing sleep over worry 37.5 26.7 43.3 42.2 62.5 73.3 56.7 57.8 29.0

Feel that they are playing a useful role 50.0 49.1 50.0 43.9 50.0 50.9 50.0 56.1 64.1

Feel capable of making decisions about things 43.6 47.1 42.9 52.6 56.4 52.9 57.1 47.4 53.8

Feel constantly under strain 33.3 42.1 38.9 39.5 66.7 57.9 61.1 60.5 16.5

Feel they can overcome difficulties 48.4 47.5 49.5 50.8 51.6 52.5 50.5 49.2 71.0

Able to enjoy normal day to day activities 52.3 49.6 52.2 47.7 47.7 50.4 47.8 52.3 79.6

Able to face up to problems 50.6 50.0 46.4 50.8 49.4 50.0 53.6 49.2 67.8

Feel unhappy and depressed 36.4 28.0 33.3 38.6 63.6 72.0 66.7 61.4 20.4

Lost confidence 52.2 58.3 36.6 46.9 47.8 41.7 63.4 53.1 21.5

Have thoughts of worthlessness 37.5 14.3 37.5 28.6 62.5 85.7 62.5 71.4 8.2

Feel responsible and happy 56.5 49.7 54.2 50.7 43.5 50.3 45.8 49.3 85.9

94

Table A 27: Issues that bothered adolescents

Percent of the adolescents by issues that bothered , according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Issues

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Studies 13.4 10.2 20.8 20.2 7.8 6.8 9.9 10.9 52.8

Body image 9.9 9.9 13.6 22.2 12.3 11.1 8.6 12.3 13.3

Illness 19.2 17.9 11.5 10.3 10.3 12.3 5.1 12.3 12.8

Unemployment 7.3 2.5 0.0 2.4 23.2 41.5 1.2 6.1 13.4

Career 4.5 22.7 0.0 0.9 26.4 27.3 13.6 4.5 18.0

Marriage 1.6 4.8 0.0 6.5 24.2 21.0 3.1 11.3 10.2

Work at home 11.2 11.2 9.8 7.0 14.7 11.9 21.7 12.6 23.4

Relationship with parents 6.1 27.3 0.0 24.2 6.1 3.0 6.1 27.3 5.4

Relationship with friends 28.9 15.8 13.2 21.1 5.3 5.3 5.3 5.3 6.2

Nutritional status 29.2 33.3 12.5 0.0 4.2 16.7 0.0 4.2 3.9

Sexual problem 0.0 53.8 0.0 0.0 0.0 0.0 46.2 0.0 2.1

Menstrual problem 0.0 0.0 33.3 33.3 0.0 0.0 33.3 0.0 1.0

Lack of money 12.4 10.5 7.6 10.0 10.0 16.2 10.5 22.9 34.4

Alcohol abuse 7.1 7.1 14.3 28.6 0.0 0.0 35.7 7.1 2.3

Drug abuse 33.3 0.0 0.0 33.3 0.0 0.0 33.3 0.0 0.5

Other 4.8 7.1 21.4 26.2 2.4 4.8 7.1 26.4 6.9

Don’t Know 47.1 23.5 5.9 5.9 11.8 5.9 0.0 0.0 2.8

Nanital

Studies 20.8 18.0 12.5 12.5 6.7 14.5 9.0 5.9 43.9

Body image 20.0 16.0 12.0 12.0 12.0 16.0 4.0 8.0 4.3

Illness 18.9 9.7 5.9 10.8 8.1 25.9 9.2 11.4 31.8

Unemployment 1.4 19.4 2.8 8.3 4.2 44.4 9.7 9.7 12.4

Career 5.6 33.3 1.9 3.7 0.0 42.6 5.6 7.4 9.3

Marriage 0.0 3.7 0.0 11.1 3.7 0.0 44.4 37.0 4.6

Work at home 4.8 11.1 6.3 6.3 7.9 12.7 20.6 30.2 10.8

Relationship with parents 11.5 11.5 7.7 15.4 15.4 15.4 11.5 11.5 4.5

Relationship with friends 5.9 11.8 17.6 47.1 0.0 5.9 11.8 0.0 2.9

Nutritional status 0.0 0.0 0.0 16.7 16.7 16.7 16.7 16.7 1.0

Sexual problem 0.0 33.3 33.3 33.3 33.3 33.3 33.3 33.3 1.5

Menstrual problem 0.0 0.0 0.0 20.0 20.0 20.0 20.0 20.0 0.9

Lack of money 10.4 15.3 9.0 5.6 6.9 15.3 18.1 19.4 24.8

Alcohol abuse 0.0 11.1 33.3 33.3 0.0 11.1 0.0 11.1 1.5

Drug abuse 0.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2

95

Table A 27: Issues that bothered adolescents

Percent of the adolescents by issues that bothered , according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Issues

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Other 13.2 13.2 19.1 23.5 8.8 10.3 2.9 8.8 11.7

Don’t Know 21.4 11.9 28.6 11.9 7.1 7.1 9.5 2.4 7.2

Udhamsingh Nagar

Studies 13.2 14.2 13.5 12.2 14.5 12.5 10.5 9.5 47.2

Body image 20.0 20.0 3.3 20.0 13.3 3.3 16.7 3.3 4.8

Illness 17.5 13.6 7.9 11.3 15.8 19.2 6.2 8.5 28.2

Unemployment 2.3 16.3 4.7 2.3 20.9 29.1 14.0 10.5 13.7

Career 3.5 25.2 1.7 7.8 11.3 41.7 4.3 4.3 18.3

Marriage 0.0 15.0 5.0 20.0 0.0 20.0 15.0 25.0 3.2

Work at home 0.0 35.0 0.0 60.0 35.0 35.0 65.0 65.0 9.9

Relationship with parents 19.0 4.8 14.3 23.8 0.0 4.8 19.0 14.3 3.3

Relationship with friends 0 0 0 28.6 42.9 28.6 0.0 0.0 3.3

Nutritional status 0 0 0 28.6 42.9 28.6 0.0 0.0 3.3

Sexual problem 0.0 0.0 0.0 1.0 0.0 0.0 0.0 0.0 0.0

Menstrual problem 0.0 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.2

Lack of money 8.4 8.4 10.8 6.4 18.7 15.8 15.3 16.3 32.4

Alcohol abuse 0.0 0.0 7.7 53.8 7.7 0.0 23.1 0.0 2.1

Drug abuse 0.0 0.0 100.0 0.0 0.0 0.0 0.0 0.0 2.1

Other 17.3 8.6 25.9 18.5 2.5 3.7 9.9 13.6 12.9

Don’t Know 23.1 0.0 26.9 7.7 7.7 0.0 26.9 7.7 4.1

Hardwar

Studies 14.9 11.4 19.0 16.7 7.0 9.6 11.1 10.2 53.7

Body image 12.2 10.8 12.2 20.3 12.2 12.2 9.5 10.8 11.6

Illness 10.4 9.7 7.5 2.2 11.2 28.4 16.4 14.2 21.0

Unemployment 3.6 21.4 0.0 2.4 20.2 40.5 2.4 9.5 13.2

Career 4.3 26.1 2.9 7.2 21.7 37.7 0.0 0.0 10.8

Marriage 0.0 5.0 0.0 30.0 15.0 10.0 0.0 40.0 3.1

Work at home 3.1 17.3 6.1 7.1 16.3 18.4 12.2 19.4 15.4

Relationship with parents 8.3 4.2 8.3 16.7 4.2 0.0 25.0 33.3 3.8

Relationship with friends 21.4 21.4 7.1 10.7 17.9 3.6 7.1 10.7 4.4

Nutritional status 6.7 20.0 0.0 0.0 6.7 40.0 6.7 20.0 2.4

Sexual problem 0.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 0.3

Menstrual problem 0.0 0.0 0.0 50.0 0.0 0.0 0.0 50.0 0.3

Lack of money 0.0 0.0 25.0 25.0 0.0 0.0 0.0 50.0 0.6

Alcohol abuse 9.7 12.1 8.1 6.0 16.5 17.7 14.1 15.7 38.9

Drug abuse 0 0 9.1 54.5 0.0 0.0 9.1 27.3 1.7

96

Table A 27: Issues that bothered adolescents

Percent of the adolescents by issues that bothered , according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Issues

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Other 0.0 0.0 0.0 15.2 6.1 1.5 15.2 16.7 10.4

Don’t Know 60.0 40.0 10.0 20.0 40.0 30.0 20.0 0.0 1.6

Percent may add to more than 100 due to multiple responses

Table A 28: Advice seeking by adolescents

Percent of the adolescents by advice sought from and concern discussed with , according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Advice sought from

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Father 14.9 13.3 11.9 12.5 11.3 13.7 9.7 12.7 81.3

Mother 18.1 16.0 7.1 8.9 14.9 16.8 9.9 8.4 62.6

Friends 11.4 19.0 12.0 17.9 4.3 17.9 6.0 11.4 30.2

Teacher 36.1 31.1 16.4 14.8 0.0 1.6 0.0 0.0 10.0

AWW 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

ASHA 0.0 25.0 0.0 0.0 25.0 25.0 0.0 25.0 0.7

ANM 50.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3

Sibling 13.2 11.8 16.0 14.6 5.6 14.6 9.0 15.3 23.6

Sister-in-law 16.7 0.0 25.0 16.7 16.7 0.0 8.3 16.7 2.0

Other 3.0 6.1 9.1 15.2 12.1 21.2 3.0 30.3 5.4

Nanital

Father 12.6 13.2 15.2 13.4 6.2 13.7 12.1 13.7 78.1

Mother 19.8 20.1 6.7 8.1 9.2 21.2 7.4 7.4 48.7

Friends 12.7 18.7 11.4 16.3 4.8 21.7 6.6 7.8 28.6

Teacher 39.8 28.7 10.2 8.3 2.8 7.4 0.9 1.9 18.6

AWW 50.0 50.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7

ASHA 20.0 20.0 0.0 0.0 20.0 40.0 0.0 0.0 0.9

ANM 33.3 0.0 0.0 0.0 66.7 0.0 0.0 0.0 0.5

Sibling 11.6 16.1 8.0 14.3 5.4 20.5 8.9 15.2 19.3

Sister-in-law 0.0 13.3 6.7 20.0 6.7 33.3 13.3 6.7 2.6

Other 14.9 8.5 10.6 10.6 4.3 14.9 6.4 29.8 8.1

Udhamsingh Nagar

Father 12.7 11.2 13.1 12.9 11.6 12.0 13.3 13.1 82.6

Mother 16.4 18.9 6.8 7.9 17.2 18.9 7.6 6.2 56.5

97

Table A 28: Advice seeking by adolescents

Percent of the adolescents by advice sought from and concern discussed with , according to age, sex and educational status of adolescents by district of Uttrakhand, 2009.

Advice sought from

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Friends 10.9 14.4 10.4 14.4 12.9 23.4 9.5 4.0 32.1

Teacher 35.7 41.7 8.3 10.7 0.0 2.4 1.2 0.0 13.4

AWW 33.3 33.3 33.3 0.0 0.0 0.0 0.0 0.0 0.5

ASHA 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 0.2

ANM 0.0 0.0 0.0 0.0 100.0 0.0 0.0 0.0 0.2

Sibling 11.0 11.9 7.6 13.6 13.6 14.4 11.9 16.1 18.8

Sister-in-law 5.6 5.6 5.6 11.1 0.0 16.7 22.2 33.3 2.9

Other 8.7 8.7 8.7 13.0 4.3 4.3 21.7 30.4 3.7

Hardwar

Father 13.9 14.7 12.9 10.7 11.9 13.1 10.9 11.7 77.7

Mother 14.5 20.4 7.7 6.5 19.4 19.1 6.2 6.2 50.9

Friends 8.3 15.0 11.1 20.0 8.3 14.4 7.2 15.6 28.3

Teacher 23.6 30.6 19.4 16.7 4.2 2.8 1.4 1.4 11.3

AWW 0.0 50.0 0.0 0.0 0.0 0.0 0.0 50.0 0.3

ASHA 0.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2

ANM 0.0 66.7 33.3 0.0 0.0 0.0 0.0 0.0 0.5

Sibling 11.3 18.5 6.2 10.8 11.8 19.0 9.7 12.8 30.6

Sister-in-law 9.5 19.0 0.0 9.5 14.3 33.3 0.0 14.3 3.3

Other 12.8 9.3 14.0 7.0 9.3 8.1 20.9 18.6 13.5

Percent may add to more than 100 due to multiple responses

98

Table A 29: Suggestions on Improving Health Services

Percent of the adolescents by suggestions on health services, according to age, sex and educational status of adolescents, by district of Uttrakhand, 2009.

Health facility

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Dehradun

Convenient timing - Morning 7.5 7.8 4.0 4.5 5.3 6.9 4.8 5.8 46.5

Convenient timing - Evening 4.0 5.1 3.2 3.4 3.8 5.0 4.2 4.2 32.7

Convenient location - SC 2.9 3.4 0.2 0.8 1.9 2.9 0.3 0.5 12.8

Convenient location - PHC 1.1 1.8 0.3 0.2 0.5 2.9 0.2 0.2 7.0

Convenient location - CHC 0.2 0.2 0.2 0.6 0.2 0.6 0.2 0.3 2.4

Outside health facility 1.4 0.8 0.2 0.5 0.5 1.0 0.3 0.2 4.8

Doctor of same sex 2.6 5.1 2.7 5.3 2.6 3.5 1.8 4.0 27.5

Privacy 2.4 4.2 2.1 2.9 2.2 3.0 1.3 1.3 19.3

Confidentiality of information 0.6 1.4 0.8 0.8 0.3 1.8 0.0 0.5 6.2

Providing services at home 3.0 3.2 2.9 4.2 1.8 3.0 1.8 4.5 24.3

Other 0.3 0.8 1.1 2.9 0.2 0.5 1.0 2.2 8.9

Don’t know/can’t say 1.8 0.0 3.2 0.6 1.4 0.6 1.1 0.6 9.4

Nanital

Convenient timing - Morning 1.7 3.0 0.8 1.2 0.3 2.0 0.0 0.8 9.8

Convenient timing - Evening 2.2 2.8 0.5 0.9 0.5 2.0 0.6 0.8 10.2

Convenient location - SC 3.3 3.1 0.2 0.3 2.0 4.5 0.5 0.5 14.3

Convenient location - PHC 2.3 2.8 0.8 1.4 0.8 3.0 1.1 2.2 14.3

Convenient location - CHC 1.2 1.4 2.3 1.4 0.5 0.9 1.2 2.0 11.0

Outside health facility 1.4 1.6 0.9 1.7 0.3 1.7 0.3 1.1 9.0

Doctor of same sex 3.3 3.4 2.3 3.9 1.1 3.9 0.8 2.6 21.3

Privacy 0.3 0.9 0.3 0.8 0.0 1.2 0.2 0.5 4.2

Confidentiality of information 0.0 0.3 0.3 0.2 0.0 0.2 0.2 0.0 1.1

Providing services at home 1.1 1.9 1.6 3.3 1.1 1.9 2.0 3.1 15.8

Other 0.3 0.8 1.9 1.9 0.0 0.5 1.2 2.8 9.3

Don’t know/can’t say 4.3 2.6 3.4 0.5 1.7 3.7 3.9 1.7 21.9

Udhamsing Nagar

Convenient timing - Morning 1.3 1.6 0.3 0.6 0.7 1.3 0.1 0.4 6.4

Convenient timing - Evening 1.5 1.6 0.9 1.5 0.9 1.0 1.0 0.6 8.9

Convenient location - SC 2.9 3.2 1.0 0.9 1.9 3.2 1.0 0.4 14.6

Convenient location - PHC 4.8 6.1 2.0 3.4 4.2 5.6 2.3 1.8 30.3

Convenient location - CHC 2.9 4.1 3.2 4.0 2.2 2.3 3.4 4.1 26.2

Outside health facility 1.5 2.2 1.2 1.8 2.0 2.6 1.2 2.0 14.5

Doctor of same sex 4.2 5.1 2.0 2.0 2.3 4.2 1.3 2.2 23.6

99

Table A 29: Suggestions on Improving Health Services

Percent of the adolescents by suggestions on health services, according to age, sex and educational status of adolescents, by district of Uttrakhand, 2009.

Health facility

School going Non-school going

Total

Male Female Male Female

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

10-14 years

15-19 years

Privacy 0.3 2.9 0.4 0.7 1.0 2.8 0.3 0.6 9.1

Confidentiality of information 0.0 0.1 0.0 0.3 0.3 0.3 0.1 0.0 1.2

Providing services at home 1.9 2.5 2.8 2.0 2.6 3.7 3.5 2.5 21.5

Other 0.4 0.6 1.9 3.1 0.1 0.6 1.2 1.8 9.7

Don’t know/can’t say 1.9 0.4 1.8 0.4 2.5 0.4 2.0 1.2 10.7

Hardwar

Convenient timing - Morning 6.0 6.9 4.4 4.7 5.0 7.0 3.6 4.2 41.9

Convenient timing - Evening 4.4 3.7 3.2 3.9 3.7 4.0 2.0 4.0 29.0

Convenient location - SC 1.4 4.6 0.3 0.0 1.9 3.6 0.3 0.0 12.1

Convenient location - PHC 2.0 3.0 0.0 0.1 1.1 3.0 0.0 0.4 9.8

Convenient location - CHC 0.1 0.6 0.0 0.0 0.1 0.1 0.0 0.0 1.0

Outside health facility 1.1 1.9 0.0 0.0 1.3 1.1 0.1 0.0 5.6

Doctor of same sex 4.6 5.3 1.7 3.0 3.4 6.3 1.9 3.0 29.3

Privacy 2.2 4.9 2.0 1.1 2.4 4.2 1.3 0.9 18.9

Confidentiality of information 0.6 1.4 0.4 1.7 0.4 1.7 0.9 1.4 8.6

Providing services at home 2.4 2.0 1.6 2.4 1.6 1.1 2.6 2.6 16.4

Other 1.3 0.3 1.1 2.2 0.1 0.7 1.3 1.0 8.0

Don’t know/can’t say 1.6 0.0 4.0 1.4 1.6 0.1 3.6 2.7 15.1

Percent may add to more than 100 due to multiple responses