Publication: The Good Sight
Publication Date: September 27, 2022

Eleven-year-old Parveen is a petite, docile child at first glance till she speaks with fiery courage and confidence for one so young. Parveen, living in JJ Colony of Bawana in North Delhi, saw her grandfather and father addicted to alcohol in a community where this was more the norm than the exception. They were resistant to any change even though the grandfather had suffered three cardiac arrests. Little Parveen, upon associating with the Youth Health Program (YHP) with Plan India became aware of the dangers of alcohol addiction. Armed with this knowledge, she marched straight to her dadu, the patriarch, and convinced him of the dangers of alcohol to his health, the family finances, and the disruption of their normal life. And, with a little help, both the grandfather and father left alcohol. Where others had failed Parveen struck gold – changing the health and quality of life of her family for the better.

Parveen’s mother Sabina is proud of her daughter’s achievements and credits YHP for bringing this big change in their lives. Today, she is an active advocate of YHP and volunteers for campaigns and activities that bring change in her “street, community, and country” adding many others to this program.

The Program: Overview & Impact

YHP was started in Bawana, a large resettlement colony, inhabited by mostly daily wagers working in the factories of the Bawana Industrial area, in October 2021. It is a program that has been successfully conducted since 2010 by Plan India and AstraZeneca India in parts of Karnataka, Tamil Nadu, and Delhi. The program works by educating youth from the target communities themselves on the ill effects of tobacco and alcohol. Thus, the initiative undertakes a community-based approach to develop the youth into peer educators who in turn shoulder the responsibility of expanding the message to the entire community. In a span of 12 years in India, YHP, in its different phases, has so far positively impacted over 4,60,000 young people and more than 7,800 peer educators.

It is a successful model that has been implemented globally, too, and reached more than 8 million young people in more than 30 countries around the world to date, with 10 million more targeted between 2021 and 2025.

An HIC Facilitator interacts with the community members.
YHP aims to address the risk factors for non-communicable diseases (NCDs) like cancers, diabetes, heart, and respiratory ailments, tobacco and alcohol addiction, mental and physical ill health, unhealthy diet, and air pollution that are the leading cause of mortality. According to the World Health Organisation, 70% of these are preventable and linked back to risks encountered and behaviours started during adolescence. Thus, YHP aims to focus on enhancing responsive health-seeking behaviour among adolescents and other stakeholders so that they lead a happy and disease-free life. This will also reduce the growing burden of NCDs on the health system.

Due to the availability and accessibility of tobacco and alcohol, and different kinds of illegal drugs in this unauthorized colony, Bawana has a huge scope for awareness creation on risks associated with consumption of tobacco, alcohol, unhealthy diet and benefits of physical activity for young girls and boys so that they may take preventive action against NCD.

Safe Spaces: HICs

The program creates a Health Information Centre (HIC) that acts as a safe space for the children in the area. Across Delhi, Tamil Nadu, and Karnataka, 21 HICs are now operational. HIC is a hub of activities and sessions conducted by two facilitators (male and female each) or HICF, popularly addressed as ‘didi’ and ‘bhaiya’ by the children, for creating a web of awareness, empowering the stakeholders to take informed decisions, and bringing change in the community. Children associated with the program are so inspired that they become agents of change for themselves, their family, and their community. They conduct sessions and activities in turn, even deciding the schedule and topics, and are known as Peer Educators.

The key drivers of the program are community-based interventions like outreach by YHP staff, peer educators, and Health information centre (HIC) which is a platform where young people learn about risk associated with NCD and take informed decisions about their health.

Peer Power

Meet Afreen. A fifteen-year-old girl, who first changed herself with the awareness gained from the sessions and then others. Afreen used to consume junk food easily available from roadside vendors like chowmein every day after school. Afreen says, “I used to feel very tired and sick all the time and my mother used to take me to the doctor quite often. But after the sessions, I learned that this has a bad effect on our health so I stopped eating chowmein. I started doing yoga that didi, bhaiya taught us, and now I eat ‘Tiranga food’. I feel much healthier and don’t get sick now.” She spreads awareness about Tiranga food that includes vegetables (greens), lentils (orange), and whites (rice etc.) and counsels children not to fall prey to unhealthy food. This is just one of the topics that she talks about as she proudly displays the posters that she and her peers made as awareness-generating tools.

The story of Renu is no different. Renu, a class 11th student, too turned from unhygienically prepared roadside junk food to “Tiranga food”. She also gave up video games that she spent all her time on. In a place where space, especially a ‘safe space’ is at a premium, she stepped into a nearby park along with others her age to play football, perhaps enjoying the freedom of running freely for the first time in her youthful life. She enjoys the healthy camaraderie with her peers, no longer missing the world of video games, and even played football in a friendly match on International Youth Day.

This healthy camaraderie amongst boys and girls and respect for women has been inculcated by the program. One such case in point is seventeen-year-old Sachin who brought conversations about menstruation in the open, understood his sister’s pain, and supported her in her activities at home, often raising his voice against associated social taboos.

YHP has also supported the government machinery of Anganwadi workers and Asha workers providing them with sanitary napkins for distribution and holding sessions for awareness about menstruation in their areas. The lack of knowledge about menstrual hygiene and access to hygienic menstrual products leads to infections amongst women which the program is trying to overcome.

Sachin also talks about substance abuse and alcohol addiction endemic in the area and how as an inspired peer educator he has brought about change. Children his age often like to make reels for social media for ‘tashan’ (style) where they are smoking a hukkah, falling prey to the falsely perpetuated ideas of masculinity. Sachin helped rescue as many as five children from the trap of substance abuse by counseling them and engaging them in activities at the HIC. The Aanganwadi workers also validate the large substance abuse amongst adolescent children in the area like bhang, hukkah, whitener ink, nasha, and alcohol among others. The HICF facilitate intergenerational dialogues between parents and children, bringing taboo subjects like addiction and menstruation into the open and getting family support for children to overcome their challenges.

Addiction often begins at home when parents give money to children to bring tambaku. Recognizing this, volunteers made posters at the HIC in the local language that “baccho ko nasheele cheeze bechana kanooni apradh hai”. As a result, the shopkeepers stopped selling such substances to children. Nukkad natak (street theatre) and campaigns are often held by adolescents and other adult volunteers like Parveen to bring awareness to the larger community.

YHP is thus sowing the seeds of social and behaviour change amongst adolescents and other stakeholders to enhance responsive health-seeking behaviour and enable them to lead a happy and disease-free life. Change is being wrought by empowering young people, mobilizing the community, creating an enabling environment for caregivers, and encouraging advocacy for the changing environment.