Direct and indirect estimation of adolescent sexual intercourse and contraceptive use in Rajasthan India: an application of the best friend methodology – BMC Women’s Health

Social Network-Based Approach to Improve Estimates of Adolescent Sexual and Reproductive Health (ASRH) in Rajasthan, India

This report presents the findings of a study that aimed to improve estimates of Adolescent Sexual and Reproductive Health (ASRH) indicators among adolescent girls in Rajasthan, India. The study used a social network-based approach to reduce potential bias related to premarital relationships, sexual intercourse, and contraceptive behaviors. The findings provide insights into the ASRH situation in Rajasthan and highlight the need for interventions to address the challenges faced by unmarried adolescents.

Methodology

The study utilized a social network-based approach to estimate ASRH indicators. This approach involved collecting data from both respondents and their close friends to obtain more accurate estimates of sexual intercourse and contraceptive use among adolescent girls. The study compared the indirect estimates obtained through the social network-based approach with the direct estimates reported by the respondents.

Key Findings

1. The overall indirect estimates of sexual intercourse and contraceptive use were not significantly higher compared to the direct estimates.
2. Estimates for unmarried adolescents were significantly higher in relation to ever having a partner, but not statistically significantly higher in relation to estimates of sexual intercourse and current contraceptive use.
3. Social patterns of sexual intercourse and contraceptive use were generally comparable between the two methodologies.

These findings suggest that the social network-based approach may not significantly improve the estimation of ASRH indicators compared to direct reports. However, it does provide valuable insights into the social patterns of sexual behavior and contraceptive use among adolescent girls in Rajasthan.

Implications for Sustainable Development Goals (SDGs)

• The study contributes to SDG 3 (Good Health and Well-being) by providing insights into the ASRH situation in Rajasthan and highlighting the need for interventions to improve access to sexual and reproductive health services for unmarried adolescents.
• It also aligns with SDG 4 (Quality Education) by emphasizing the importance of comprehensive sexual education in schools to address the knowledge gaps and social barriers faced by adolescent girls.
• Furthermore, the study supports SDG 5 (Gender Equality) by shedding light on the social scripts and restrictions that prevent adolescent girls from accessing contraception and making autonomous decisions about their sexual and reproductive health.

Limitations

The study has several limitations that need to be considered:

1. The low prevalence of sexual intercourse among the study participants limited the sample size for estimating contraceptive behaviors, leading to imprecise estimates.
2. The analysis of intercourse among unmarried adolescents was also limited due to the small number of respondents in this group.
3. The study did not capture the ASRH experiences or needs of boys and non-binary populations, limiting the generalizability of the findings.

Conclusion

Despite the limitations, this study contributes to the methodological quest for improving ASRH measurement. It highlights the need for early interventions, comprehensive sexual education, and community engagement to create an enabling environment for healthy and safe relationships among adolescents in Rajasthan. The findings also underscore the importance of addressing the social barriers that prevent unmarried adolescents from accessing sexual and reproductive health services and making informed decisions about their sexual behavior and contraceptive use.

SDGs, Targets, and Indicators Analysis

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 4: Quality Education
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities

The article discusses issues related to adolescent sexual and reproductive health (ASRH) in India, specifically focusing on premarital relationships, sexual intercourse, and contraceptive behaviors among adolescent girls. These issues are connected to the SDGs mentioned above, which aim to improve health and well-being, ensure quality education, promote gender equality, and reduce inequalities.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.
• SDG 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship, and appreciation of cultural diversity and of culture’s contribution to sustainable development.
• SDG 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Program of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.

The article highlights the need for universal access to sexual and reproductive health services, comprehensive sexual education, and the promotion of reproductive rights. These targets align with the SDGs mentioned above.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator: Proportion of adolescents aged 15-19 who have ever had sexual intercourse
• Indicator: Proportion of sexually active adolescents aged 15-19 who are using contraception
• Indicator: Proportion of sexually active unmarried adolescents aged 15-19 who have engaged in a relationship
• Indicator: Proportion of sexually active adolescents aged 15-19 who have disclosed their sexual experiences to their friends
• Indicator: Proportion of sexually active adolescents aged 15-19 who have shared their contraceptive needs with providers

The article provides information on these indicators, which can be used to measure progress towards the identified targets. These indicators reflect the prevalence of sexual intercourse, contraceptive use, disclosure of sexual experiences, and access to reproductive health services among adolescents.

Table: SDGs, Targets, and Indicators

Source: bmcwomenshealth.biomedcentral.com