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Healthy and Confident- A Facilitaors manual NCC Cadets |
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POPULATION FOUNDATION OF INDIA
B-28, Qutab Institutional Area, New Delhi- 110016
Tel.: +91-11-43894100, Fax: +91-11-43894199
Website : www.populationfoundation.in
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Healthy and Confident
A Facilitator’s Manual on Adolescent
Health and Life Skills for NCC Cadets
Population Foundation of India
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Contributors
l Nikita Sinha, Former State Project Coordinator, Jharkhand, PFI
l Ajay Srivastava, Child In Need Institute (CINI), Jharkhand
l Aprajita Mishra, Former State Project Associate, Jharkhand, PFI
l Anup Hore, CINI, Jharkhand
l Saoirse De Bont, VSO, UNESCO
l Satya Ranjan Mishra, Former Project Manager, PFI
l Sudipta Mukhopadhyay, Senior Advisor – Youth, CEDPA
A team from PFI has put together and reviewed the manual.
Copyright © Population Foundation of India
December 2011
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Pledge
“We, the cadets of the National Cadet Corps,
do solemnly pledge
that we shall always uphold the unity of India.
We resolve to be disciplined and responsible citizens of our nation.
We shall undertake positive community service
in the spirit of selflessness
and concern for our fellow beings.”
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Foreword by PFI
I am delighted to introduce the Manual on Adolescent Health and Life Skills for NCC Cadets.
It is well known that parental guidance in the context of reproductive and sexual health is
not available to most Indian adolescents, including those from highly educated families. The
parents or elders simply do not feel comfortable discussing these issues with their children.
Studies across diverse regions and settings also indicate that teens and young adults are
experimenting in sexual activities at an increasingly younger age and in larger proportions.
The National Cadet Corps is one of the largest youth organizations. It exposes our young
people to martial training and in the process, teaches them the values of dedication, hard
work and compassion and develops their leadership, negotiation, organization and other
skills. These are some of the values and skills which the ARSH workshop intends to feed
into. ARSH education fits naturally within the NCC training.
Population Foundation of India (PFI) approached the Department of Art, Culture, Sports and
Youth Affairs, Government of Jharkhand, to develop programmes for extending knowledge
on Life Skills and ARSH to NCC cadets. It was also envisaged that the NCC cadets would
act as peer leaders in their own institutions to reach out to a large number of students, who
are not enrolled with the NCC. Many meetings with NCC officials, government officers,
principals and headmasters of the institutions, NGOs and UN institutions (in particular
UNESCO, Delhi) were organized. It was decided that it would be appropriate to conduct
workshops for imparting ARSH and Life Skills exposure as an adjunct activity in NCC
camps on account of cost efficiency, availability of time and a large peer group.
This manual would not have been possible without the outstanding contributions of some
key colleagues and experts. The list of such persons is long and each of them deserves our
sincere praise. We, in particular, thank Mr. R. S. Verma, former Secretary, Department of
Art, Culture, Sports and Youth Affairs, Government of Jharkhand; Col. Anand Bhushan,
Group Commander, NCC, Jharkhand; Dr. Shankar Choudhary, National Officer – Education,
UNESCO; Dr. Suranjeen Prasad, Jharkhand Unit Co-ordinator, CINI and their team for their
active support and cooperation. We thank all the contributors for their valuable inputs in
developing this document. We gratefully acknowledge the support from the David & Lucile
Packard Foundation in bringing out this document.
I hope this document will be a useful tool for disseminating Life Skills and ARSH messages
to a large majority of NCC cadets and associated youth groups. PFI would be delighted to
receive feedback from the users for further improvement and enrichment of this document.
Poonam Muttreja
Executive Director
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Foreword by NCC
I am happy to know about the Manual on Adolescent Health and Life Skills for NCC
Cadets. Society is changing at a very fast pace. It is difficult, and sometimes confusing, for
young people to understand whether these changes are for their good or bad. It is therefore,
necessary for them to have the right kind of knowledge to cope with the pressure and lead
the change.
NCC is one of the largest and the most disciplined organizations in India. The NCC
Headquarters of Jharkhand in Ranchi is served by 11 battalions. This HQ serves in all the
24 districts of Jharkhand through 59 colleges and 145 schools and has a total strength of
23,000 cadets.
Apart from military training, the motto of NCC is to create disciplined, responsible and well-
grounded citizens. Such persons would not only be physically strong and mentally agile,
but also well informed about their bodies and selves, their surroundings, the larger society,
the problems and issues confronting them at various levels, their goals, their roles, etc.,
making them emotionally stable and providing skills to navigate through life successfully.
NCC adopts a slew of training tools to achieve these objectives, including drills, martial
training, camps, etc., all of which combined develop tremendous self-confidence in the
cadets. To this we have now added training on adolescent health and life skills.
The manual provides information on different ARSH topics. It also lists different life skills
and illustrates these with concrete examples. The training is designed to be interactive
by including games and exercises so that the impatient young minds could be effectively
engaged and thereby increase retention of knowledge. The training has also been designed
so that it can be easily included in ongoing NCC camps. I would urge our Associate NCC
Officers (ANOs), the users of this manual, to read it carefully and devise their own ways
to impart these lessons in our camps. The innate creativity of the instructors and trainers
would widen the repertoire of teaching aids even further.
I would like to thank PFI, CINI and UNESCO teams for taking this initiative so that the
cadets emerge as the leaders of their generation with the right kind of knowledge and
behaviour.
Colonel Anand Bhushan
Group Commander
NCC Group Headquarters Ranchi, Jharkhand
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Preliminary
Introduction
11
Different Training Methods
15
Content Matrix
16
The Workshop
Session 1
Let’s Start
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1.1
Pre-Workshop Questionnaire
1.2
The Ball Name Game
1.3
Expectations and Objectives of the Training
1.4
Setting the Ground Rules
1.5
Summing up and the Question Box
Session 2
Life Skills
25
2.1
What are Life Skills?
2.2
Using Life Skills
2.3
Summing up – Reflecting on the Life Skills Used
Session 3
Adolescence to Adulthood
28
3.1
What is Adolescence?
3.2
Understanding the Changes during Adolescence
3.3
Put Yourself in My Shoes
Session 4
Nutrition and Health Practices
30
4.1
Food Chart – What is Missing in Your Diet?
4.2
Anaemia
4.3
Summing up
Session 5
Personal Hygiene
32
5.1
The Basics of Personal Hygiene
5.2
Lilawati’s Story
Session 6
Gender
34
6.1
Sex or Gender
6.2
The Influence of Gender
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6.3
6.4
Session 7
7.1
7.2
7.3
7.4
Session 8
8.1
8.2
Session 9
9.1
9.2
9.3
9.4
9.5
9.6
Session 10
10.1
10.2
Session 11
11.1
11.2
11.3
Session 12
12.1
12.2
12.3
Reflecting on Gender
Summing up – Reflecting on the Life Skills Used
Sexual Health
Understanding Sex and Sexuality
Human Reproductive Process
Responsible Sexual Behaviour
Misconceptions about Sexual Health
Early Marriage and Early Pregnancy
Early Marriage – A Story of Two Sisters
Consequences of Early Pregnancy
RTI/STI and HIV/AIDS
RTIs and STIs
The Basics of HIV and AIDS
The Wildfire Game
Know the Risk
The Importance of Testing for HIV
Removing Stigma and Discrimination
Abuse and Violence
Understanding Different Types of Abuse
Sexual Abuse
Risky Behaviour and Peer Pressure
Introducing Substance Abuse
Saying No – Dealing with Peer Pressure
Consequences of Substance Abuse
Goal Setting and Future Activities
Setting Goals – Case Stories
Set Goals for Yourself
Post-Workshop Questionnaire
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40
42
48
50
53
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Training Materials
RESOURCE MATERIAL
56
R1.1 Training Sessions
R1.4 Setting the Ground Rules
R2.1.1 Life Skills
R2.1.2 How Akul Succeeded
R3.1 Adolescence – A Critical Phase of the Human Lifecycle
R3.2 Changes in Adolescence
R4.1.1 Nutrition
R4.1.2 How to Reduce Nutritional Wastage
R4.2 Anaemia
R5.1.1 Diseases Caused by Poor Hygiene
R5.1.2 List of Personal and Environmental Hygiene Activities
R5.2 Lilawati Needs to Learn Some Things
R6.1.1 Gender and Gender Discrimination
R6.1.2 Sex and Gender
R6.3 Meena Ki Kahani
R7.1 Sex Vs. Sexuality
R7.2.1 Female Reproductive Organs and their Functions
R7.2.2 Menstruation
R7.2.3 Male Reproductive Organs and their Functions
R7.2.4 Conception
R7.3.1 Responsible Sexual Behaviour
R7.3.2 Case Studies of Sexual Behaviour
R7.4 Quiz on Sexuality
R8.1 Causes and Consequences of Early Marriage
R8.2.1 Causes and Consequences of Early Pregnancy
R 8.2.2 Contraceptive Methods in Brief
R8.2.3 Oral Contraceptive Pills
R8.2.4 The Male Condom
R8.2.5 Brief Information on Contraceptive Methods
R9.1.1 Reproductive Tract Infections and Sexually Transmitted Infections
R9.1.2 Lakhan’s Hesitation
R9.2 HIV/AIDS
R9.4 Whether a Behaviour is HIV Risky
R9.5 Testing for HIV
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R9.6
R10.1
R10.2
R11.1
R11.2
R12.1
Stigma and Discrimination
Abuse and Violence
Sexual Abuse
Substance Abuse and Addiction
Negotiation Skills – Saying No
Goal Setting
HANDOUTS AND QUESTIONNAIRES
H1.1 Pre-Workshop Questionnaire
H1.3 Training Sessions
H2.1.1 Life Skills
H2.1.2 Akul’s Story
H4.1.1 Recommended Dietary Allowances for Indians
H4.1.2 Proximate Principles: Common Foods
H5.1 List of Personal and Environmental Hygiene Activities
H5.2 Lilawati Needs to Learn Some Things
H8.2.5 Brief Information on Contraceptive Methods
H11.2 Negotiation Skills – Saying ‘No’
H12.1 Format for Goal Setting
H12.3 Post-Workshop Questionnaire
TEMPLATES
T2.2 Some Life Skills Listed
T4.1 Format for Preparing a Food Chart
T6.1.1 Template
T6.1.2 Sex and Gender Statements
T6.2.1 Role Play
T6.2.2 Gender Role Statements
T6.3 Gender Discrimination Table
T7.2.1 Female Reproductive Organs
T7.2.2 Male Reproductive Organs
T7.2.3 Human Reproductive Organs
T7.3 Case Studies of Sexual Behaviour
T7.4 Quiz on Sexuality
T8.1 Case Study – Choices of Two Sisters
T9.1 Lakhan’s Hesitation
T9.2 Template
T9.3 Template
T9.4.1 Template
T9.4.2 Whether a Behaviour is HIV Risky
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169
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T10.1
T10.2
T11.2
T11.3
T12.1
Quiz on Abuse and Violence
Case Stories of Sexual Abuse
Scenarios of Peer Pressure
Kartik’s Blunder
Case Stories of Goal Setting
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Introduction
Are you a person who works daily with young people who face difficult situations and
are struggling to find a positive direction in life, or dealing with challenges such as their
nutrition, health situation like potential unwanted pregnancy, or alcohol and drug use, gender
abuse and violence, HIV, and so on?
Are you a parent or community member fearful of, and concerned about, the situation of
young people?
Are you a young person ready to do something to help lead your friends into a brighter
future?
If you answered Yes to any of these questions, this manual may be of benefit to you.
What is a Life Skills Education Approach?
Changing behaviour is always difficult; changing sexual behaviour is even more so. Although
it is important to provide information in the early phases of a behaviour change intervention
and to reinforce such knowledge periodically, information is rarely enough to motivate people
to change behaviour. Just think about behaviour that you have been trying to change over the
years with your students or cadets. May be it is reading more, exercising, eating a balanced diet,
or getting them to quit smoking. Have you been able to make the changes successfully? Have
they relapsed into inappropriate behaviour?
The Life Skills Education Approach is a comprehensive behaviour change approach that
concentrates on the development of skills that enrich one’s life such as communication,
decision-making, thinking, managing emotions, assertiveness, self-esteem building, resisting
peer pressure and relationship skills. Additionally, it addresses the important related issue of
promoting respect for others and positive values among youth and adolescents. The approach
moves beyond simply providing information. It addresses the development of the whole
individual so that s/he will have the skills to make use of all types of information to enrich his
or her life. These aspects may be related to career development, marriage, parenthood, safe
motherhood, reproductive health, HIV/AIDS, other health issues, or further communication
and decision-making situations. The Life Skills Approach used in this workshop is participatory
and interactive, using methods such as role plays, games, puzzles, group discussions, and a
variety of other innovative teaching techniques to keep the participant wholly involved in the
sessions.
National Cadet Corps
The National Cadet Corps (NCC) was established under the National Cadet Corps Act, 1948.
The NCC strives to provide opportunities to the youth of our country for all-round development,
instilling a sense of commitment, dedication, self-discipline and moral values, so that they
become good leaders and useful citizens and can take their appropriate place in all walks of life
in the service of the nation.
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The aims of NCC are:
1. To develop the qualities of character, courage, comradeship, discipline, leadership, secular
outlook, spirit of adventure and the ideals of selfless service amongst the youth of the
country.
2. To create a human resource of organized, trained and motivated youth for providing
leadership in all walks of life and be always available for the service of the nation.
3. To provide a suitable environment to motivate the youth to take up a career in the armed
forces.
The total sanctioned strength of NCC cadets is 13 lakh. The NCC is present in 607 districts of
the country covering 8,514 schools and 5,255 colleges. In Jharkhand, the NCC is present in all
24 districts covering 145 schools and 59 colleges. The NCC membership in the state is around
23,000 students.
Why Life Skill Education for NCC Cadets?
NCC cadets are divided into Junior Wing (class VI to X) and Senior Wing (XI to Bachelor’s
degree). These cadets, especially the Junior Wing, are at a phase of life that is the most intriguing
and at the same time bewildering. During this phase of rapidly growing sexual maturity, many
physiological changes are taking place in their bodies. The associated social changes also bring
many psychological/emotional changes. A change is also noticeable in their social attitude.
These physical changes demand a great deal of adjustments both socially and emotionally.
Many young people find it difficult to face these changes due to ignorance. They are beset with
problems related to questions such as – Who am I? Who can listen to my concerns and answer
my questions? To what extent should I listen to my friends? Are the changes in my body normal?
Do others also go through this? Stress and anxiety increase when one is unable to address these
concerns. Often, young people are unable to talk with others about their problems. They may
also be unable to find words to describe their situations. The crossroads of right and wrong are
their constant companions at this stage of their lives.
The cadets are disciplined, young and vibrant. To help them enrich their life and channel their
creativity and energy towards being responsible citizens and to also discuss these concerns
with their peers, they need to be provided with proper guidance, counselling, consolation
and scientifically validated information. With this objective, Population Foundation of India
(PFI) along with Child In Need Institute (CINI), with technical support from UNESCO, and in
collaboration with NCC, have developed this manual for the Associate NCC Officers (ANOs).
It is hoped that this volume will enhance the ANOs’ capacity to impart life skill training to the
cadets, such as sensitizing them about the dangers of HIV, helping them to acquire the skills
to protect themselves and to live healthier lives, and become ambassadors of healthy living,
including HIV prevention, in the country.
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About the Manual
This manual has been developed for NCC ANOs for imparting ARSH and Life Skills
Education among the cadets at camp sites.
The training covers 12 topics, comprising 40 sessions, to be completed in a span of 7 days.
The content matrix gives a comprehensive preview of the sessions.
The manual is written for youth who are part of NCC. However, the workshop is easy to
adapt for youth in general.
How to use the manual
The manual has been put together in such a way that it is easy to use. After the Introduction,
the different training methods that will be employed during the workshop are listed. This
is followed by a Content Matrix that gives the name of the session, lists the sub sessions,
the topics that will be covered and training material that will be needed. The training
methods to be used, the main life skills that will be needed as well as the time the session
is expected to take have also been given. Each of the sessions is then detailed with the
steps to guide the facilitator in the conduct of the session.
The resource material for the facilitator has been arranged session wise in section titled
- Training Material. The readings are marked as ‘R’ followed by the session number. For
example, a reading marked as R3.1 is the resource material for session 3 and its first sub
session. The handouts and questionnaires that will be given out during the sessions follow
and have been given the alphabet ‘H’ followed by the session number. Similarly, the
templates that will be used have been arranged with the letter ‘T’.
Tips for Facilitators
As most life skills sessions involve games or role plays, it may be most effective to have
the cadets sit in a circle, with a lot of open space. This will allow for unhindered movement
within the group for the exercises.
Own the training space. Be sure to move around a great deal within the circle, approaching
various participants, acting things out, and using different tones of voice. The facilitators’
confident bearing makes it easier for the participants to feel comfortable as they perform
role plays or play games.
Having an equal number of men and women facilitating the programme is a powerful
way to demonstrate gender equality rather than merely talking about it. It also helps to
introduce a variety of perspectives on the topics.
Be respectful towards the co-facilitators. Avoid correcting or interrupting them while they
are facilitating. Be conscious of your body language and facial expressions during their
sessions.
Only the facilitator guiding the group should stand; the other facilitators should be seated,
to minimize distraction.
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For sensitive topics, it may be best to separate into single-sex groups to encourage better
participation. It is however, important for the youngsters to come together as one group to
present their ideas to each other. This sharing of information between the sex groups and
attempting to work together is essential for the success of the programme.
Do not be judgemental with the response of the participants.
Keep your participants involved by eliciting answers from them rather than lecturing
them.
Summarize the points on a flip chart or blackboard, if possible.
Pay attention to the scheduling of the sessions. Afternoon sessions should be particularly
lively to keep the participants awake. One session should move logically into the next
session.
Monitor how your group is feeling. Use an alternative way to teach the same subject. It
should be prompt, give hints and change styles as needed.
Prepare well beforehand. This includes reading the resource materials (code-marked R),
photocopying the handouts (code-marked H) for all the participants and preparing the
templates (code-marked T) as instructed, on the day’s subject. To reiterate: material code-
marked R is only for the facilitator’s briefing.
Engage at least one participant as a volunteer to assist with implementing the training
activity.
Improvise to suit the needs of the occasion.
Preparation before the Workshop
If the training is being held in a room, have the chairs placed in a circle. Put any desks against
the wall or away from the room, creating as much space as is possible.
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The Workshop
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Session 1: Let’s Start
Duration: 50 minutes
Expected Outcomes
l Promote a sense of informality and belongingness within the group
l Assess participants’ expectations
l Facilitate a participant-centred, comfortable and rule-based learning environment
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
1.1
Pre-test to assess knowledge, skills Pre-workshop
Photocopy H1.1 10
and attitudes
questionnaire (H1.1)
and pen/pencil for each
participant
1.2
The Ball Name Game
To get acquainted with the facilita-
tor and the participants in the
workshop
Ball or other soft
objects which can be
thrown
Get one or two
balls/soft objects
20
To promote a positive atmosphere
during the training
1.3
Expectations and Objectives of the Training schedule Photocopy H1.3 10
Training
(H1.3) for each Read R1.1
To understand the purpose and
participant
objectives of the training from the Flip chart and
participants’ and the facilitator’s
markers/board and
perspectives
chalk/white board
and markers
1.4
Setting the Ground rules
Flip chart and markers/ Keep R1.4, Setting 5
To create training rules, which are board and chalk/white the Ground Rules,
decided jointly by the participants board and markers ready for reference
and the facilitator
To promote a positive atmosphere
during the training
1.5
Summing up and the Question Box Loose papers and a Prepare the carton to 5
To sum up the session and give carton
serve as a question
them space and opportunities to
box (closed, with a
raise questions
slit on top)
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Sub-Session 1.1: Pre-Workshop Questionnaire
Time
10 minutes
Materials A copy of H1.1 and pen/pencil for each participant
Method Questionnaire
Steps
1. Tell the participants that this sub-session is to assess their knowledge and attitudes about
the subjects which you will be discussing in the workshop, so that in the end you can assess
whether it has enhanced their knowledge.
2. Make them sit in a circle.
3. Pass around copies of questionnaire (H1.1) and a pencil/pen each.
4. Ask them to fill in the questionnaire individually, in silence.
5. Ask one of the participants to collect the papers after ten minutes.
Sub-Session 1.2: The Ball Name Game
Time
20 minutes
Materials One or two balls/soft objects that can be thrown
Method Game
Steps
1. Tell the participants that this sub-session is intended to make them feel comfortable so
that their ability to learn from this workshop increases. (Explain that when a learner is
comfortable, s/he learns much better, because s/he is more receptive to learning.)
2. Make the participants stand in a circle. Make two circles if the group is large and take help
from a co-facilitator.
3. Ask them to think of one interesting fact about themselves.
4. Begin by stating your name and one interesting fact about yourself. For example, my name
is Nikita and my favourite colour is blue/I am scared of spiders/I like mangoes.
5. Then throw the ball to one of the participants. The participant repeats the information given
by the previous participant and adds a similar statement about himself/herself. For example,
“Her name is Nikita and her favourite colour is blue. My name is Prakash and I have a pet
lizard.”
6. The next participant to receive the ball reports what the previous person said and then
speaks about himself/herself. For example, “His name is Prakash and he has a pet lizard.
My name is Shweta and I am allergic to peanuts.”
7. The game continues until everybody has had their turn with the ball.
8. The game ends once the ball is returned to the facilitator.
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Sub-Session 1.3: Expectations and Objectives of the Training
Time
10 minutes
Materials Copy of Training Schedule, H1.3, for each participant; flip chart and markers/
board and chalk/chart paper and markers
Method Brainstorming
Steps
1. Tell the participants that this sub-session is to help them learn how they expect to benefit
from this workshop.
2. Pass around a copy of H1.3. Allow them two or three minutes to go through it.
3. Ask what they hope to gain from the training.
4. Ask if they have any suggestions to offer. Write the suggestions on the flip chart/board.
5. If the suggestions offered are few, take the extra time to briefly outline what each session
contains and discuss how the training will be organized, i.e. objectives given for each
session, participatory methods, number of days, following the ground rules, etc.
Notes
Get them to tell you what they expect from the training. Remember these expectations as
you go through the programme.
Do not dismiss or ridicule any suggestions. Listen carefully and write down all of them.
Explain why the training may not fulfil some of the expectations. Help them understand
what the training is about.
Sub-Session 1.4: Setting the Ground Rules
Time
5 minutes
Materials Flip chart and markers
Method Brainstorming
Steps
1. Tell the participants that this sub-session is to lay down some ground rules for the ensuing
sessions so that the entire workshop becomes useful for them.
2. Explain that they should be comfortable in the training space.
3. Explain that the first rule of the workshop is that everybody should actively participate.
Write this rule down on a sheet of paper.
4. Ask them to give suggestions. Write these suggestions on the sheet.
5. At the end, check the rules in the checklist (R1.4) are on the sheet. If not, suggest these
rules. Ask for their approval and then write them down on the sheet.
6. Put up the sheet on the wall for the duration of the workshop.
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Sub-Session 1.5: Summing up and the Question Box
Time
5 minutes
Materials Carton, loose papers, markers
Method Lecture/presentation
Steps
1. Tell the participants that this sub-session is to facilitate the ensuing sessions and to enrich
their knowledge, as they will see from the sub-session activities.
2. Show the question box carton. Tell them this is the question box. Explain that if they have
questions that they do not want to ask publicly, they can drop them in the question box,
without writing their names.
3. Explain that you will try to answer as many questions as you can. These answers will be
written on sheets of paper and put up on the question wall. Identify the question wall in the
room.
4. Explain that you may not be able to answer all the questions but will try your best.
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Session 2: Life Skills
Duration: 85 minutes
Expected Outcomes
l Understand what are life skills
l Be able to identify life skills
l Know their importance and uses in daily life
l Know their relation to needs and concerns of adolescents
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
2.1
What are life skills?
How to identify life skills
One copy of life Read resource 50
skills handout
material R2.1.1,
(H2.1.1) for each
Life Skills;
participant
R2.1.2, Akul’s
Copies of Akul’s
Story (H2.1.2),
one between two
participants
Story
Photocopy
H2.1.1 and
H2.1.2
2.2
Using life skills
Cards with individual From T2.2, prepare 20
To promote understanding of life life skills written on a card for each
skills and how they are used
them (T2.2)
participant with a
life skill written on
it. (The life skills
can be repeated.)
2.3
Summing up – Reflecting on life
skills used
Ask the participants to reflect on
what life skills they have used in
the session
R2.1.1
15
Sub-Session 2.1: What are Life Skills?
Time
50 minutes
Materials Life Skills (H2.1.1), Akul’s Story (H2.1.2)
Method Story and discussion, reading, question-and-answer
Steps
1. Tell the participants that in this session they will be considering life skills.
2. Briefly describe what life skills are.
3. Explain that these are skills or abilities that help people to cope positively with the challenges
of life. Supplement the talk with information from R2.1.1.
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4. Pass around a copy of H2.1.1 to each participant and a copy of H2.1.2 between two
participants. Explain that they are going to read the story of Akul as a group, and then
identify what life skills Akul uses. Make it a point to remind them that this is a true story.
5. Ask a participant to begin reading. Stop her/him at the break.
6. Facilitate the discussion by asking questions linked to each life skill. For example:
a. What problems did he face?
b. How did he solve his problem?
7. You can also link the story to each life skill. For example:
a. What did Akul wear to school? Why?
b. Why did he think of selling berries?
8. Ask a second participant to continue reading.
9. Facilitate the discussion by asking questions as in points 6 and 7.
10. Ask them to explain how and why he used those skills and how positive thinking is
important.
11. Conclude the session by explaining why life skills are important in everyday life.
Sub-Session 2.2: Using Life Skills
Time
20 minutes
Materials One card/slip of paper for each participant with a life skill written on it (T2.2)
Method Story Generation
Steps
1. Divide the participants into groups of not more than 20 in each group. Ask the groups to sit
in circles.
2. Tell them that they are going to make up a story, which probably will not have a plot. Each
participant will add two or three sentences to the story.
3. Give each participant a card with a life skill written on it. Explain that in their contribution
to the story they have to include this life skill and mention this life skill at the end of their
contribution.
4. Give an example, such as “Abhishek’s parents told him he could not meet his friends. He
felt like shouting and hitting something. But he decided this would not be of any benefit and
instead he took a couple of deep breaths. Anger management.”
5. Now start the story with the life skill positive thinking. For example: “Sunita woke up in
the morning and felt like she really did not want to get out of bed. No, she said to herself,
I will get up and it is going to be a good day.” Or start with life skill empathy: “Once there
was a sage who got a lot of knowledge living in an ashram. He realized that his knowledge
had no value if it was not passed on to the common people (Critical Thinking). One day a
king came to him and requested him to teach his sons. The sage was wondering whether he
should teach the common people or the king’s sons. The king could pay him handsomely,
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the common people could not (Active Listening). The sage could understand the language
of birds. The birds were discussing this matter. The sage listened to the birds’ discussion”
…
6. The circle of participants then continues with the story.
7. If the story finishes with an issue that could be discussed in the group, and if there is time,
ask the group how the character should proceed.
8. Ask them if they have any questions.
9. Conclude by explaining that the story shows how life skills are used in everyday life.
10. Finally, thank them for their time.
Sub-Session 2.3: Summing up – Reflecting on the Life Skills Used
Time
15 minutes
Materials None
Method Discussion
Steps
1. Ask the participants that what life skills were discussed in the day’s sessions. (For example:
active listening, verbal communication, creative thinking, empathy, cooperation, team
work, assertiveness …)
2. What skills do they want their parents to have?
3. What skills would their parents like them to have?
4. The participants can consult the handouts given to them.
5. Ask them if they have any questions.
6. Finally, thank them for their time.
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Session 3: Adolescence to Adulthood
Duration: 50 minutes
Expected Outcomes
l Defining the terms – adolescence, youth, young people and young adult
l Understanding the changes that occur during adolescence
l Understanding that these changes are normal
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
3.1
What is Adolescence?
White board/chart Read resource
10
General definition of adolescence paper and markers material R3.1
3.2
Understanding the changes during White board and Read resource
adolescence
markers/chart paper, material R3.2
30
Changes that take place in their sketch pens
body
These are perfectly normal
3.3
Put yourself in my shoes
None
R3.2
10
Everybody recognizes and accepts
these changes subconsciously
Sub-Session 3.1: What is Adolescence?
Time
10 minutes
Materials White board/chart paper and markers
Method Open Discussion
Steps
1. Start with the life skills the participants used yesterday (Give one or two examples).
2. Write the word ADOLESCENT or ADOLESCENCE on the white board.
3. Ask whether they have heard this word. What does it mean to them?
4. Note the responses on the board and substantiate the answers referring to the resource
material.
5. Ask if they think that there are changes during adolescence. Tell them that they will have
group discussions to list those changes.
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Sub-Session 3.2: Understanding the Changes during Adolescence
Time
30 minutes
Materials White board, marker, chart papers, sketch pens
Method Group Discussion
Steps
1. Divide the participants into four groups.
2. Provide each group with chart paper and sketch pens.
3. Allot each group the following topics. Ask them to discuss them and write their findings on
the chart paper.
a. What are the physical changes during adolescence?
b. What are the social changes during adolescence?
c. What are the emotional changes during adolescence?
d. What are the sexual changes during adolescence?
4. Let each group make its own presentation.
5. Facilitate the discussion and verify the facts from the resource material.
Sub-Session 3.3: Put Yourself in My Shoes
Time
10 minutes
Materials None
Method Group Discussion
Steps
You can opt to cite examples to elicit more suggestions to make the participants put themselves in
the shoes of their parents/siblings/teachers to reflect upon what changes (physical, behavioural)
they have noticed in the participants. For example:
They smile when I talk (voice change).
They say I look at the mirror more often (social change).
They say now I do not listen to them and prefer talking and playing with my friends more
(social change).
They say I am taking part in community activities more (social change).
Notes
1. The examples are only illustrative. They may not happen with every adolescent at the same
time, so they have to come up with their own examples.
2. Facilitate the discussion and verify the facts from the resource material.
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Session 4: Nutrition and Health Practices
Duration: 70 minutes
Expected Outcomes
l Understand the importance of nutrition requirement for different age groups
l Understand the need for a balanced diet and its importance
l Understand the problems and consequences of anaemia and its prevention
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
4.1
Food chart – What is missing in your Daily allowance Read resource 40
diet?
of food handout, material R4.1.1,
To learn about the nutritional
H4.1.1
R4.1.2
requirement of the body
Nutritive value Photocopy
To learn about the different kinds
of foods available and their
nutritive value
of food handout,
H4.1.2
Format for
preparing a food
H4.1.1,
H4.1.2
for each
participant
To learn how to reduce the loss
chart, T4.1
Make copies of
of nutrition
T4.1 as required
4.2
Anaemia
H4.1.2
To learn about causes, symptoms
and consequences of anaemia
To learn about how to retain iron
4.3
Summing up
None
Read resource
20
material R4.2
R4.1.1, R4.1.2
10
Sub-Session 4.1: Food Chart – What is Missing in Your Diet?
Time
40 minutes
Materials Copies of H4.1.1, H4.1.2, T4.1
Chart paper and markers
Method Discussion
Steps
1. Recap the earlier session on physical changes and explain that due to these physical changes,
good nutrition is very important during (and after) adolescence.
2. Tell them that this session is about food and nutrition. Ask: why do we eat food?
3. List the answers.
4. Explain about nutrition and the importance of a balanced diet. Explain the concept of ‘three-
colour food’.
5. Pass around copies of H41.1.1 and H4.1.2 to each participant.
6. Show them how to read and use the nutritional chart.
7. Arrange them in groups of four or five. Pass a copy of T4.1 to each group.
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8. Ask the different groups to make dietary charts for different age groups: (i) adolescents, (ii)
pregnant women and (iii) old people.
9. Give them an example of the dietary chart so that they can copy the format.
10. Tell them to include locally available food.
11. Ask any two groups to volunteer to present their work, while the other groups comment.
12. Ensure that all three-coloured foods are included in the charts.
13. Ask the participants whether all the nutrition in the food reaches their body.
14. What difference can they find in the diets of adolescents, pregnant women and old
persons?
15. Explain how nutrition in food gets lost in storage, preparation and cooking.
Sub-Session 4.2: Anaemia
Time
Materi
Method
20 minutes
None
Discussion
Steps
1. Ask the participants whether they have felt breathless while climbing steps, running or any
other physical work.
2. Explain anaemia, causes, symptoms and consequences.
3. Explain what steps can be taken to prevent it.
4. Ask them to list some of the iron-rich food from the nutritional chart.
5. Explain that the only way to diagnose anaemia is through a blood test.
Sub-Session 4.3: Summing up
Time
Materi
Method
10 minutes
None
Discussion
Steps
Sum up the session by telling the participants about the nutritional needs of growing individuals.
It is not necessary to eat costly food for their nutritional requirements-locally available food
has sufficient amount of nutrition and should be taken in the right amount to remain healthy.
Anaemia is a common nutritional problem prevalent in many regions, more so among women.
This can be prevented by taking an iron-rich diet and supplements provided free of cost at
health centres.
Finally, thank them for their time.
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Session 5: Personal Hygiene
Duration: 30 minutes
Expected Outcomes
l Understand the importance of good hygiene
l Understand the diseases due to unhygienic practices
l Understand how these diseases can be prevented
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
5.1
The Basics of Personal Hygiene Two glasses with Photocopy 10
To understand the importance of water, one bowl
personal hygiene
personal hygiene
Handout on
handout, H5.1
personal hygiene, Read resource
H5.1
material R5.1.1,
R5.1.2
Arrange two
glasses and a
bowl
5 .2 Lilawati’s Story
To identify unhygienic
conditions
Lilawati’s Story, H5.2 Photocopy 20
Lilawati’s Story,
H5.2
Read resource
material R5.2
Sub-Session 5.1: The Basics of Personal Hygiene
Time
10 minutes
Materials Two glasses of water, one bowl, H5.1
Method Brainstorming, Activity, Discussion
Steps
1. Start with the life skills the participants trained in the previous day (Give one or two
examples).
2. Explain that Day 2’s discussion will be on hygiene.
3. Ask for a volunteer who feels that his/her hands are clean.
4. Take two glasses of water. Tell the volunteer to wash one hand using water from one of
glass.
5. Then pour the water back to the same glass.
6. Compare the water in the two glasses.
7. Explain that hands may look clean when they actually are not.
8. Ask how often they should wash hands (Explain the importance of washing hands before
touching food, before eating, and after urinating/defecating).
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9. Also provide them various reasons for poor hygiene like apathy, ignorance, poor childhood
training, thoughtlessness, poor time management, etc.
Further Discussion
1. Ask the participants why good personal (and environmental) hygiene is important.
(Examples include body odour, skin infections, contracting diseases).
2. Ask them to list a few diseases that spread with poor personal, household and community
hygiene (R5.1.1).
3. Ask them whether any member of their family has suffered from these diseases recently.
Sub-Session 5.2: Lilawati’s Story
Time
20 minutes
Materials Lilawati’s Story, H5.2
Method Story, discussion
Steps
1. Explain that they are going to read a story about Lilawati and then discuss in what ways
her practices are unhygienic.
2. Hand out H5.2 and ask two or three volunteers to take turns reading it.
3. Ask the participants which practices are unhygienic and could cause Lilawati and her
family to become sick.
4. Write the comments on the board and complement with further information.
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Session 6: Gender
Duration: 90 minutes
Expected Outcomes
l Know the differences between sex and gender
l Understand the influence of gender in the society
l Begin thinking critically about gender issues
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work
Minutes
Allotted
6.1
Sex or Gender
Two large sheets Take two large
20
To understand the differences (T6.1.1), markers
sheets. Title one
between sex and gender
List of statements, of them SEX
T6.1.2
and the other
one GENDER.
Hang them on
opposite sides of
the room before
starting the
session. These
(T6.1.1) will stay
on the walls for
the duration of
Session 6.
Prepare list
of statements,
T6.1.2
Read resource
material R6.1.1,
R6.1.2
6 .2 The Influence of Gender
Slips of paper/cards Prepare the cards, 25
To understand ways by which
with various roles
T6.2.1
gender can restrict one’s life
written out, T6.2.1 Keep T6.2.2
List of statements, ready
T6.2.2
6.3
Reflecting on Gender
Video Meena Ki Prepare for
40
Kahani, R6.3
projection of
Gender
video R6.3
discrimination
(subject to
table, T6.3, sketch availability of
pens
facilities)
Flip chart and
Prepare the
sketch pens/white
required number
board and markers of T6.3 charts
R6.1.1
6.4
Summing up – Reflecting on the
Life Skills Used
R6.1.1
5
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Sub-Session 6.1: Sex or Gender
Time
20 minutes
Materials T6.1.1, T6.1.2
Method Game
Steps
1. Tell the participants that in this session you will be discussing gender roles.
2. Ask them if they know the difference between sex and gender. Take down their comments
and fill in any gaps in their knowledge using resource material R6.1.1. Explain that SEX
refers to the biological or physiological characteristics that define men and women, and
that GENDER refers to the socially constructed roles, behaviours, activities and attributes
that a given society considers appropriate for men and women.
3. Explain that you will read out a series of statements, and depending on whether they think
the statement is related to SEX or GENDER they should go and stand in front of the
relevant sheet.
4. Give two examples: “Women can breastfeed their babies” (SEX) versus “Women are better
at cooking” (GENDER). Follow it up with reading aloud the statements from T6.1.2 for
the game.
5. Afterwards, ask them whether they have understood the differences between sex and
gender. Ask if they have any questions on the topic, discuss and clarify them.
Sub-Session 6.2: The Influence of Gender
Time
25 minutes
Materials T6.2.1 roles written on slips of paper/cards; T6.2.2 list of statements
Method Game (role play)
Steps
1. Ask the participants to line up across the room, facing you. Give each one a role to play
(T6.2.1).
2. Explain that you will be reading out a list of statements. If they think a particular statement
is true to their role they should step forward; if it is not, to take one step backward. If they
are not sure they should stay where they are.
3. By the end of the list of statements the participants would be spread out across the room in
several rows.
4. After this, ask the participants at the back individually who they were. Then ask those who
are in the front.
5. The game should reveal how gender, as conceived by society, limits people. But it should
also show how wealth and class interlink with gender. Explain this.
6. If you included the two identical roles about the 12-year-old girl and boy ask the role
players to reveal themselves. If they are in different places, ask why.
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7. Finally, ask all the participants who played the role of women to raise their hands.
Sub-Session 6.3: Reflecting on Gender
Time
40 minutes
Materials Video (Meena Ki Kahani), T6.3, sketch pens, chart paper or board, markers
Method Group Work, Discussion
Steps
1. Show the film Meena Ki Kahani (if the facilities exist).
2. Divide the participants into two or four groups, depending on the number of participants.
3. Ask one (or two) group/s to discuss the advantages and disadvantages of being a female
and the other group/s to discuss the advantages and disadvantages of being a male, from
childhood to adolescence to adulthood.
4. Give copy of T6.3 and a sketch pen to each group and tell them to write down their findings
on it. Give examples: Got sweets to eat (gender, boy); Could not move outside home
(gender, girl).
5. Give 15 minutes for the group work.
6. Ask a volunteer from each group to come and share their group work.
7. After a group makes its presentation, the other group or groups give feedback.
8. Promote a discussion about gender. Ask the participants whether the advantages and
disadvantages listed are a result of sex or gender. Ask what can be done to address gender
discrimination.
9. List the points on a chart paper or board.
Sub-Session 6.4: Summing up – Reflecting on the Life Skills Used
Time
5 minutes
Materials None
Method Discussion
Steps
1. Ask the participants to list the life skills they used the previous day in the sessions.
(Examples include active listening, verbal communication, creative thinking, cooperation
and teamwork, perhaps assertiveness skills in group work …)
2. Ask if they have any questions/queries on the topic, discuss and clarify them.
3. Finally, thank them for their time.
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Session 7: Sexual Health
Duration: 120 minutes
Expected Outcomes
l Be rightly informed about male and female reproductive organs and their functions
l Take informed decisions related to sexual health
l Have responsible sexual behaviour
l Be a responsible member of society; be a responsible husband/wife
Session at a Glance
Sub-
Session
Activity
Training Materials
Preparation Work Minutes
Allotted
7.1
Understanding Sex and
White board, markers/ Read resource material 10
Sexuality
chart paper
R7.1, Sex vs Sexuality
To know about different terms
7 .2 Human Reproductive Process Enlarged cut-outs Read resource
60
of the reproductive
material R7.2.1,
organs, T7.2.1,
Female reproductive
T7.2.2
organs and their
Name tags
functions; R7.2.2,
for individual
Menstruation;
reproductive parts
R7.2.3, Male
with pins attached,
reproductive organs
T7.2.3
and their functions;
Handkerchief to
and R7.2.4,
blindfold
Conception
White board and
Prepare T7.2.1,
markers/chart
T7.2.2, T7.2.3
paper, sketch pens Fold name tags
(T7.2.3) and place
them in an open box
Keep a handkerchief
ready
7.3
Responsible Sexual Behaviour Case studies of sexual Read resource
25
To help them take informed behaviour, T7.3
material R7.3.1,
decision and act responsibly
Responsible Sexual
Behaviour; R7.3.2,
Case Studies of
Sexual Behaviour
Make sufficient
copies of T7.3
7.4
Misconceptions about Sexual T7.4 with statements Read resource
25
Health
written on individual
material R7.4, Quiz
To be rightly informed about slips
on Sexuality
prevalent misconceptions
Prepare T7.4. Keep
the statement slips
folded individually
in an open box.
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Sub-Session 7.1: Understanding Sex and Sexuality
Time
10 minutes
Materials White board, markers/chart paper
Method Discussion
Steps
1. Start with the life skills the participants used the previous day (Give one or two
examples).
2. Write the words SEX and SEXUALITY on the white board.
3. Ask the participants whether they have heard these words and what is their understanding
of them.
4. Note the responses on the board and substantiate the answers with resource material.
Sub-Session 7.2: Human Reproductive Process
Time
60 minutes
Materials Cut-outs of the reproductive organs, T7.2.1 and T7.2.2; name tags for individual
reproductive parts (T7.2.3); handkerchief to blindfold; white board and markers/
chart paper, sketch pens
Method Group Exercise
Steps
1. Tell six volunteers to pick up the name tags (T7.2.3) from the box.
2. Blindfold one of the volunteers and ask him/her to label by putting the name tag on the
right organ. Ask the other participants to guide the volunteer from their seat.
3. Repeat the process with other volunteers as well until all the parts are labelled.
4. Discuss the functions of each labelled part.
5. Ask the participants to describe what menstruation is. Ask them how they feel about the
fact that all girls go through it. Be sure to correct any false information they may have and
clarify missing information.
6. Ask them to describe how conception occurs. Talk about sexual intercourse and fertilization
of the egg. Explain that it is the male’s sperm that determines whether the fertilized egg
will develop into a male or female baby.
Note: Encourage the participants to ask questions. The questions that they do not
feel comfortable asking aloud can be put in the Question Box, as explained in
Sub-session 1.5.
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Sub-Session 7.3: Responsible Sexual Behaviour
Time
25 minutes
Materials T7.3 case studies
Method Group Work, Discussion
Steps
1. Divide the participants into groups of 6 to 8. Give each group a case study to work on. One
case study may be given to more than one group. Give them ten minutes to complete the
task.
2. Ask each group to read aloud its case study and share its answers. Ask the other groups for
comments.
3. Taking from participants’ experiences, initiate a discussion for inculcating the values given
in R7.3.1.
Sub-Session 7.4: Misconceptions about Sexual Health
Time
25 minutes
Materials T7.4
Method Game, Quiz
Steps
1. Tell the participants that this session will conduct a quiz on sexuality.
2. Divide the group into Team A and Team B. Ask a participant from Team A to pick a T7.4
statement slip. The statements have to be answered in two parts: (1) True or False and (2)
Reasons for their answer. Give two points if they answer both parts correctly; one point if
they answer only one part correctly. If the team is unable to answer correctly the statement
will be passed to Team B. Team B also earns points similarly. Next, Team B will pick up a
statement slip. The process ends when all the statements are answered.
3. If necessary, further explain the statements with the help of resource materials.
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Session 8: Early Marriage and Early Pregnancy
Duration: 75 minutes
Expected Outcomes
l Define the right age at marriage
l Understand the causes and consequences of early marriage
l Understand the causes and consequences of early pregnancy
l Be aware of safe and effective family planning methods to prevent early pregnancy
l Understand the importance of negotiation and decision-making in early marriage
and early pregnancy
Session at a Glance
Sub-
Session
Activity
8.1
Early Marriage – A Story of Two
Sisters
To know about the right age at
marriage
To understand the causes and
consequences of early marriage
8 .2 Consequences of Early Pregnancy
To learn about the consequences
of early pregnancy
To learn about safe and effective
family planning methods to
prevent early pregnancy
Training Materials Preparation Work Minutes
Allotted
Writing paper,
sketch pens
Case study – The
Choices of Two
Sisters, T8.1
Read resource 45
material
R8.1, Causes
and
Consequences of
Early Marriage
T8.1, make 4
copies
Contraceptive
methods, H8.2.2 to
H8.2.5 copies for all
participants
Read resource 30
material R8.2.1–
R8.2.5
Photocopy H8.2
Sub-Session 8.1: Early Marriage – A Story of Two Sisters
Time
45 minutes
Materials White board/chart paper, markers, writing paper, sketch pens, T8.1
Method Group Work, Interactive Discussion
Steps
1. Start with the life skills the participants used yesterday (Give one or two examples).
2. Explain that today’s topic is early marriage.
3. Make four groups. Give each group a copy of T8.1, writing paper and sketch pen.
4. Ask two groups to list the factors that contributed to Amina’s current situation and the
other groups to list the factors that contributed to Ayesha’s current situation. Allot them 10
minutes to work on their case study. Ask them to list their findings.
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5. Ask the male participants at what age they would want their sister to get married. Ask them
why.
6. Ask the female participants when they would want to get married. Again ask them why.
7. Ask the participants what the negative impacts of early marriage are.
8. Conclude by discussing the legal age at marriage and the reasons (social, biological,
psychological) for this.
Sub-Session 8.2: Consequences of Early Pregnancy
Time
30 minutes
Materials H8.2
Method Discussion
Steps
1. Explain that now they are going to discuss early pregnancy.
2. Ask a volunteer to read the Two Sisters case study aloud.
3. Facilitate the discussion by asking the following:
What was Amina’s age when she had her first child? What was Ayesha’s age when
she gave birth to her first child?
Who was in a better situation and why?
What were the effects of early and multiple pregnancies on Amina?
What were the effects of early and multiple pregnancies on Amina’s children?
How could Amina and her husband have delayed their first pregnancy and maintained
space between two pregnancies?
4. Conclude the discussion by explaining the advantages of contraception and the three
common forms of contraception. Distribute handout H8.2.
5. Finally, thank them for their time.
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Session 9: RTI/STI and HIV/AIDS
Duration:
Day 5 – 45 minutes (Sub-sessions 9.1 and 9.2)
Day 6 – 70 minutes (Sub-sessions 9.3–9.6)
Expected Outcomes
l Understand the causes, signs and symptoms of RTI/STI and aspects of treatment-
seeking behaviour
l Understand the basics of HIV/AIDS and how young people are at risk
l Understand the routes of transmission and mode of prevention
l Assess risky behaviour
l Understand how to remove stigma and discrimination
Session at a Glance
Sub-
Session
Activity
9.1
RTIs and STIs
Aspects of treatment-seeking
behaviour
Training Materials
White board/chart
paper, markers
Lakhan’s
Hesitation, T9.1,
three copies
9 .2 The Basics of HIV and AIDS
White board/chart
paper, markers
Template
Statements, T9.2
9.3
The Wildfire Game
T9.3
To realize the speed of HIV
transmission and means of prevention
9.4
Know the Risk
To understand the different
behaviours related to HIV
transmission
T9.4.1
9.5
The Importance of Testing for HIV
Preparation Work Minutes
Allotted
Read resource 20
material R9.1.1,
R9.1.2
Copy T9.1
Keep R9.1.2
ready for
reference
Prepare T9.2 25
questions and
answers as
instructed
Read resource
material R9.2
R9.2
20
Prepare T9.3 as
instructed
Read resource 20
material R9.4,
Whether a
behaviour is HIV
risky
Prepare T9.4.1 as
instructed
Prepare T9.4.2 as
instructed
Read resource
15
material R9.5
9.6
Removing Stigma and Discrimination White board/chart
Read resource
15
paper, markers
material R9.6
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Sub-Session 9.1: RTIs and STIs
Time
20 minutes
Materials White board/chart paper, markers, copies of T9.1
Method Case Study Analysis, Role Play, Interactive Discussion
Steps
Start with the life skills the participants used yesterday (Give one or two examples).
2. Explain that today’s discussion will be on HIV/AIDS.
3. Write the words RTI and STI on the board in two columns. Ask whether they have heard
about these words and what they think these words mean.
4. Note the responses on the board.
5. Ask them to recall the reproductive parts of the human body. Then contextualize what are
RTIs and STIs by giving definitions with the help of resource material.
6. Tell them that they will try to understand the aspects of RTI/STI treatment-seeking
behaviour with role play.
7. Ask for three volunteers to enact the skit on the story of Lakhan, with one being the narrator,
the others being Lakhan and Ramu.
8. Facilitate the discussion with the following questions:
a. What do they think could be wrong with Lakhan?
b. What could he have done to be feeling this way?
c. What should he have done differently?
d. What should he do now?
e. Should he have told his wife about his problem?
Sub-Session 9.2: The Basics of HIV and AIDS
Time
25 minutes
Materials White board/chart paper, markers, and Template statements T9.2
Method Question-and-Answer and Interactive Discussion
Steps
1. Ask eight volunteers to come forward and pick a sheet each of T9.2 kept in an open box.
2. Ask the participant with sheet number 1 to read the question aloud and give his own
answer.
3. Then ask the participants whether the answer is right.
4. Supplement their responses with the correct answer.
5. Follow through for the other seven slips.
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Note: Alternatively, this game could be played in teams. The participants might feel less
embarrassment in providing the answers and may make it more fun.
6. Explain that young people are more susceptible to HIV. Ask them why they think this might
be. Note their responses on the white board.
Guide the discussion with the following points:
Young people often feel that they will not get into problems.
Young girls are biologically more susceptible as their reproductive tracts are still
developing.
Young people do not have sufficient knowledge or experience to reduce their risks.
Young people are less likely to recognize potentially risky situations or negotiate safe
sex behaviours.
Peer pressure, drug and alcohol use and other factors may increase their likelihood of
engaging in high-risk behaviours.
Young people lack access to information and services or are not able to afford them
due to socio-economic circumstances.
7. Sum up the session by reinforcing that young people are particularly vulnerable and that
to protect themselves, it is important to have correct information about transmission and
prevention of HIV infection. They also need access to proper counselling and medical
services.
8. Tell the participants that you will continue the session on HIV tomorrow.
Sub-Session 9.3: The Wildfire Game
Time
20 minutes
Materials T9.3 slips as instructed
Method Game and discussion
Steps
1. Explain that they are going to play a game which will highlight how HIV infection spreads.
Tell them to remember that shaking hands does not spread HIV.
2. Randomly distribute the T9.3 slips. Tell them to keep whatever is written on the slips
confidential.
3. Ask them to name three participants they would like to shake hands with. They should
remember the names of the people they shook hands with.
4. Emphasize that this is just a game. Ask the participant with ‘HIV’ on his/her paper slip to
stand up. Ask the three to shake hands with him/her. (Boys cannot select only boys; the
same with girls.)
5. Ask if any of the three participants with whom the ‘HIV’ student wanted to shake hands
has a ‘Condom’ slip or a ‘Refuse to shake hand’ slip. If yes, ask them to sit down.
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6. Now ask the participants who are still standing to identify the three participants with whom
each of them shook hands.
7. Ask again, if any of these participants are carrying the ‘Condom’ slip or a ‘Refuse to shake
hand’ slip. Ask them to sit down.
8. Carry on the game till only the two students with the ‘Condom’ slip and the two participants
with the ‘Refuse to shake hand’ slip are sitting and the rest are standing.
9. Now tell the group that this game shows how easily the virus can spread among sexually
active people. It also shows that people should always use a condom when they are not
certain if their sexual partner has the virus or not. Anyone can get HIV. No one is safe.
Shaking hand is not actual infection of a person but a representation of how HIV spreads.
10. Now share with the participants that to enter in a human body the HIV virus needs to use
specific doors and a vehicle (medium). Body fluids are the medium that carry the virus.
The main body fluids that transmit HIV are:
Blood
Semen
Vaginal secretions
Breast milk
Other body fluids containing blood
11. Sum up by telling the participants that HIV infection can be prevented by practising the
ABC of prevention.
A – Abstinence
B – Being faithful to your spouse
C – Condom
Sub-Session 9.4: Know the Risk
Time
20 minutes
Materials T9.4.1, T9.4.2
Method Risk Assessment Game and Discussion
Steps
1. Have T9.4.1 prepared and placed in the room as instructed.
2. Call 18 volunteers and distribute the T9.4.2 slips among them. Tell them to read the
behaviour statements given to them, decide the level of risk and stand near the captions –
High risk, Low risk or No risk.
3. Ask one or two volunteers to explain why they are standing under their chosen zone.
4. Use the resource material to explain each behaviour statement.
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Sub-Session 9.5: The Importance of Testing for HIV
Time
15 minutes
Materials Case study
Method Case Study Analysis and Discussion
Steps
1. Read out the following case study:
Case Study
Jagan works in a factory in Ranchi. After his day’s work he often drinks with his
friends, visits sex workers and has unprotected sexual intercourse with them. Now
he is scared of acquiring HIV/AIDS. He wants to get tested for HIV.
2. Facilitate discussion by asking the following questions:
i. Can such a situation occur in real life?
ii. Is Jagan at risk of acquiring HIV? Why?
iii. Should he go for a test for HIV?
iv. Where should he go?
v. What is it like to have a test for HIV?
vi. What are the advantages and disadvantages of getting tested?
vii. When and where should Jagan go for a test?
viii. If he tests positive, whom should he tell?
3. Clarify any misconceptions and supplement the participants’ answers using the resource
material.
Sub-Session 9.6: Removing Stigma and Discrimination
Time
15 minutes
Materials White board, markers
Method Interactive Discussion/Brainstorming
Steps
1. Ask the participants to imagine that a 16-year-old boy in Grade XI has been diagnosed
with HIV.
2. Ask them in what ways they think the boy would be discriminated against.
a. At home? In school? In the community? In employment?
b. Why do they think the boy would be discriminated against?
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c. Why is it important not to discriminate against him?
3. Note down all responses on the board.
4. Conduct a brainstorming session on how participants can fight discrimination against those
infected with HIV/AIDS.
5. Ask them to list some ways through which they can change the negative attitude of their
family and community members against those infected with HIV/AIDS.
6. Note down all the responses on the board.
7. Next go through each method (response) one by one and ask them which methods are
practical, i.e. which methods can be carried out by the participants themselves and how
they can carry them out.
8. Ask them:
a. Should we be scared of a fellow participant/instructor who is HIV-positive?
b. Do you think a participant/instructor living with HIV should come to a camp?
c. What should we do if we come to know that our family member/friend is HIV-
positive?
Identify incorrect information and facilitate the group to correct it. Fill in the additional
information.
9. Finally, thank them for their time.
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Session 10: Abuse and Violence
Duration: 50 minutes
Expected Outcomes
l Identify different types of abuse.
l Understand the feelings of an abused person
l Coping with abuse and stopping abuse
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
10.1
10 .2
Understanding different types of
abuse
To recognize the effects of
violence and abuse on self and
family
How to stop abuse
Sexual Abuse
To understand sexual abuse
To know how to cope with it
White board/chart Read resource 25
paper, markers
material R10.1
Chart reproducing on Abuse and
T10.1, Quiz on
Violence
Abuse and Violence Prepare a copy
of chart T10.1
White board/chart Read resource 25
paper, markers
material R10.2
Case Stories, T10.2 Prepare a copy
of T10.2
Sub-Session 10.1: Understanding Different Types of Abuse
Time
25 minutes
Materials Chart paper/white board, markers; Chart T10.1
Method Discussion using Chart
Steps
1. Start with the life skills the participants used the previous day (Give one or two
examples).
2. Tell them that today’s discussions will be on abuse and violence.
3. Ask them to give some examples of abuse and violence. Write the answers on the board.
4. Explain the various types of abuse and violence.
5. Put up Chart T10.1. Explain that in the incidents that you refer, there can be physical,
emotional, verbal abuse or a mixture of them. Explain that different types of abuse can
occur simultaneously, so multiple boxes can be checked.
6. Read out each incident and ask which type of abuse, they think, is involved. Check the
boxes according to their answer.
7. Ask who they think is at fault in each of these situations.
8. Ask them to give examples of some solutions to each kind of abuse or violence. The
solutions can be at an individual or societal level.
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Sub-Session 10.2: Sexual Abuse
Time
25 minutes
Materials White board/chart paper, markers T10.2
Method Open Discussion using Chart
Steps
1. Hand over the copy of T10.2 to a participant, and ask her/him to read the first story. Each
story is read by a different participant.
2. Ask the participants what they think of the stories and how they feel about them.
a. Can the given cases constitute sexual abuse? Why?
b. Whose fault was it that these things happened?
c. Why do young people not speak out or tell somebody what happened?
d. What should be done by:
(i) The child?
(ii) The family?
(iii) Society?
3. Explain what sexual abuse is, that it happens in all communities, and how difficult the
situation could be for the survivors even though it is never their fault.
4. Ask them what life skills could be used to protect oneself against abuse. Write the answers
on the board. (Examples include assertiveness skills, refusal skills, communication skills,
expressing feelings, self-awareness skills, and self-esteem/confidence-building skills.)
5. Ask them to practise these skills in everyday life. For example, to act assertive at least once
every day, or to do one activity every day that boosts their self-esteem or confidence.
6. Finally, thank them for their time.
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Session 11: Risky Behaviour and Peer Pressure
Duration: 70 minutes
Expected Outcomes
l Increased awareness about the forms and consequences of substance abuse
l Developed participants’ skills in coping with peer pressure
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
11.1 Introducing Substance Abuse
White board/chart
Read resource
15
To assess the participants’
paper, markers
material R11.1
perception about substance abuse
To impart knowledge on different
types of substance abuse
11.2 Saying No
H11.2, Negotiation Read resource 40
To develop participants skills to
Skills for all
material R11.2
handle peer pressure
participants
Photocopy H11.2
T11.2, Scenarios of
Peer Pressure
11.3 Consequences of Substance Abuse T11.3, Kartik’s Blunder Prepare 3 or 4 15
To make the participants aware
copies of T11.2
of the consequences of substance
Prepare 3 or 4
abuse
copies of T11.3
To know about the closest
R11.1
rehabilitation and drug de-
R11.2
addiction centre
Sub-Session 11.1: Introducing Substance Abuse
Time
15 minutes
Materials White board/chart paper, markers
Method Brainstorming
Steps
1. Tell the participants that today’s topic is on substance abuse.
2. Ask them to list the names of any drugs or substances that they have heard of. Record their
responses on the board. Supplement their suggestions with information from the resource
material. Include both illegal and legal substances.
3. Ask them how they would define substance abuse. Supplement the discussions with
information from the resource material.
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Sub-Session 11.2: Saying No – Dealing with Peer Pressure
Time
40 minutes
Materials H11.2, T11.2
Method Role Play, Brainstorming
Steps
1. Tell the participants that this sub-session will tell them how to deal with peer pressure that
is against our long-term interest.
2. Pass around copies of H11.2.
3. Organize the participants into three or four groups.
4. Assign each group a particular scenario.
5. Ask the groups to role play the given scenario, including ways of saying ‘no’. Give them
five minutes to prepare.
6. Ask the other participants to provide feedback on the chosen way of saying ‘no’ and to
propose alternative strategies for the same situation.
7. Depending on the time available, ask one or two other groups to perform their scenarios
and carry out discussion on those role plays.
8. Discuss why people take substances, the influence of peers in this context, and the ways to
resist peer pressure.
Sub-Session 11.3: Consequences of Substance Abuse
Time
15 minutes
Materials Copies of Kartik’s Blunder, T11.3
Method Story Reading and Analysis
Steps
1. Organize the participants into three or four groups.
2. Distribute T11.3 to each group.
3. Ask one of the participants to read out the story.
4. Ask them to answer the following questions.
a. How could Kartik have avoided what happened?
b. Does alcohol effect your ability to drive?
c. How do you think Kartik feels now?
d. What are the effects of substance abuse:
(i) On the individual?
(ii) On families?
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e. Sum up the session by explaining that even occasional users of narcotics/addictive
substances can end up being addicted to the substance. Therefore, it is best to remain
away from such substances. Tell them that learning to say ‘no’ in some situations
is good. By using life skills like critical thinking, creative thinking, interpersonal
relationship skills, and effective communication we can prevent ourselves from being a
prey to situations that put us, our family or our friends, in difficult and sometimes life-
threatening positions.
6. Finally, thank the participants for their time.
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Session 12: Goal Setting and Future Activities
Duration: 60 minutes
Expected Outcomes
l Understand the specificities of a goal
l Understand the need of smaller goals for achieving bigger goals
l Understand that life keeps on throwing challenges at every step
Session at a Glance
Sub-
Session
Activity
Training Materials Preparation Work Minutes
Allotted
12.1 Set a goal for yourself
Writing paper,
Read resource 30
To understand the specificities sketch pens
material R12.1
of a goal
H12.1, Format for Photocopy
To set smaller goals in the
Goal Setting, for
H12.1
process of achieving the bigger each participant Make two copies
goal
T12.1, Case Stories of T12.1
12.2
White board/chart
R12.1
20
Setting Short-term Goals
paper, markers, writing
paper, sketch pens
12.3
Post-Workshop Questionnaire
Questionnaire H12.3 Photocopy H12.3 10
for each participant
Sub-Session 12.1: Setting Goals – Case Stories
Time
30 minutes
Materials H12.1, T12.1, writing paper, sketch pens, white board/chart paper, markers
Method Writing, Brainstorming
Steps
1. Provide handout H12.1 to all the participants.
2. Ask them to fill up only the first item and write only one long-term goal. (They retain this
for the ensuing sub-session.)
3. Now divide the participants into two groups. Hand over a copy of T12.1 to each group and
assign them one of the two stories. Tell them to understand the case story with respect to
the importance of goal setting.
4. Ask them to read the story and collate their views on goal setting.
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Sub-Session 12.2: Set Goals for Yourself
Time
20 minutes
Materials White board/chart paper, markers, writing paper, sketch pens
Method Writing, Question-and-Answer
Steps
1. Explain that an important purpose of this workshop is to inculcate the value of goal setting
in them both long-term and short-term. Tell them about the importance of setting goals in
one’s life.
2. Ask them to write in T12.1 how they will meet their short-term challenges.
3. Ask some of them to read and collate their views on goal setting.
4. Thank them and remind them that now it is their responsibility to propagate the knowledge
given to them among their friends.
5. Remind them that in the ensuing sub-session they will be asked to answer a questionnaire
like the one they answered at the beginning of the workshop. This is to assess how much
they have learnt in the workshop.
Sub-Session 12.3: Post-Workshop Questionnaire
Time
10 minutes
Materials Copies of H12.3, pens
Method Writing
Steps
1. Explain that in this sub-session, the participants will be asked what they learnt during the last
seven days. Its purpose is to think about how they have grown during the programme.
2. Pass around a copy each of H12.3 to all the participants.
3. Ask them to fill it individually, without talking.
4. Ask a participant to collect the answers after 10 minutes.
5. Answer all their queries.
6. Thank them for their time and tell them that you have learnt a lot in the process of this
workshop.
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Training Material
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Resource Material
Sl. Day Session Topic
No.
11 1
Let’s Start
2
R1.1
Training Sessions
Sub- Topic
session
Main Life Skills
1.1 Pre-Workshop
Questionnaire
Active Listening
1.2 The Ball Name Game
3
4
5
61 2
7
8
92 3
10
11
12 2 4
13
14
15 3 5
16
17 3 6
18
19
1.3
1.4
1.5
Life Skills 2.1
2.2
2.3
Adolescence 3.1
to
Adulthood
3.2
3.3
Nutrition 4.1
and Health
Practices
4.2
4.3
Personal 5.1
Hygiene
5.2
Gender
6.1
6.2
6.3
Expectations and
Objectives of the
Training
Setting the Ground
Rules
Summing up: The
Question Box
What are Life Skills? Active listening, Effective
communication, Critical thinking
Using Life Skills
Critical thinking, Creative
thinking, Self-awareness,
Empathy, Time management,
Cooperation and Team work
Summing up –
Active listening, Effective
Reflecting on the Life verbal communication, Creative
Skills Used
thinking, Critical thinking
What is Adolescence? Information gathering, Creative
thinking
Understanding the
Changes during
Adolescence
Information gathering, Self-
awareness
Put Yourself in My
Shoes
Problem solving, Critical thinking
Food Chart – What is Critical thinking, Problem solving
Missing in Your Diet?
Anaemia
Summing up
The Basics of
Personal Hygiene
Lilawati’s Story
Sex or Gender
The Influence of
Gender
Reflecting on Gender
Critical thinking, Self-awareness
Active listening
Creative thinking,
Communication skills
Critical thinking, Communication
skills
Critical thinking
Critical thinking
Active listening, Effective
verbal communication, Creative
thinking, Critical thinking, Team
work, Decision-making
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Sl. Day Session Topic
No.
Sub- Topic
session
Main Life Skills
20
21 4 7
22
23
24
25 5
8
26
27 5 9
28
6.4
Sexual 7.1
Health
7.2
7.3
7.4
Early 8.1
Marriage
and Early
Pregnancy
8.2
RTI/STI and 9.1
HIV/AIDS
9.2
Summing up –
Reflecting on the Life
Skills Used
Active listening, Effective
verbal communication, Creative
thinking, Critical thinking, Team
work, Decision-making
Understanding Sex and Critical thinking
Sexuality
Human Reproductive Critical thinking, Self-awareness
Process
Responsible Sexual
Behaviour
Critical thinking, Decision-
making
Misconceptions about Critical thinking, Decision-
Sexual Health
making, Self-awareness
Early Marriage – A
Story of Two Sisters
Critical thinking, Team work,
Cooperation, Communication
skills, Creative thinking
Consequences of Early Critical thinking, Communication
Pregnancy
skills
RTIs and STIs
Self-awareness, Critical thinking,
Decision-making, Problem
solving
The Basics of HIV and Self-awareness, Critical thinking
AIDS
29 6
30
31
32
33 6 10
34
35 7 11
36
37
38 7 12
9.3
9.4
9.5
9.6
Abuse and 10.1
Violence
10.2
Risky 11.1
Behaviour
and Peer
Pressure
11.2
11.3
Goal Setting 12.1
and Future
Activities
The Wildfire Game Self-awareness, Critical thinking
Know the Risk
Self-awareness, Critical thinking,
Decision-making
The Importance of
Testing for HIV
Self-awareness, Critical thinking
Removing Stigma and Empathy, Self-awareness, Coping
Discrimination
with emotions
Understanding
Different Types of
Abuse
Sexual Abuse
Critical thinking, Problem
solving, Decision-making
Decision-making, Problem
solving, Empathy, Critical
thinking
Introducing Substance Team work, Information
Abuse
gathering
Saying No – Dealing
with Peer Pressure
Consequences of
Substance Abuse
Setting Goals – Case
Stories
Team work, Negotiation skill,
Critical thinking
Empathy, Decision-making
Critical thinking, Self-awareness
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Sl. Day Session Topic
No.
39
40
Sub- Topic
session
Main Life Skills
12.2 Set Goals for Yourself Critical thinking, Self-awareness
12.3 Post-Workshop
Questionnaire
Critical thinking, Self-awareness
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R1.4
Setting the Ground Rules
What is discussed in the training sessions should remain confidential; it should not be
discussed with outsiders.
Punctuality – both the participants and the facilitator should be punctual.
Participants should feel free to disagree with one another. However, any criticism should
be directed towards the idea, not the person. Also, criticism should be constructive and
not negative.
Participants should not interrupt one another.
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R2.1.1
Life Skills
Life Skills are skills or abilities that help people cope positively with the challenges of life.
Life Skills have been defined by WHO as “the abilities for adaptive and positive behaviour that
enable individuals to deal effectively with the demands and challenges of everyday life”. Life
Skills, from this perspective, are essentially those abilities that help to promote physical, mental
and emotional well-being and competence in young people as they face the realities of life.
‘Living skills’ refer to the personal competence that enables a person to deal effectively with the
demands and challenges confronted in everyday life.
Life skills identified by WHO for the promotion of health and well-being of children and
adolescents are:
Self-Awareness
Empathy
Communication skills
Critical thinking
Creative thinking (including value clarification)
Problem solving
Decision-making (including goal setting)
Interpersonal relationship skills (including assertiveness)
Negotiation skills
Coping with stress
Coping with emotions
According to UNICEF, Core Life Skills can be divided into three major areas:
Decision-making and
critical thinking skills
Communication and
interpersonal skills
Coping and self-
management skills
Information gathering, critical thinking, decision making,
problem solving, creative thinking
Interpersonal communication skills, negotiation skills, empathy,
cooperation and team work
Self-awareness skills, goal-setting skills, self-esteem skills, anger
management, time management, positive thinking
Following are the expected outcomes of the life-skills intervention:
Increased self-esteem, self-confidence
Assertiveness, social sensitivity
Listening and communication skills, ability to establish relationships
Ability to plan and set goals
Acquisition of knowledge related to specific content
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Explanation of identified life skills
1. Self-awareness includes recognition of self: our character, strengths and weaknesses,
desires and dislikes.
2. Empathy is the ability to be sensitive to another person’s situation, as in the case of those
living with HIV, or people with mental illnesses, who may be stigmatized and ostracized
by the very people they depend on for support.
3. Effective communication is the ability to express, both verbally and non-verbally, in ways
that are culturally acceptable. Listening is an important component of communication.
Sometimes, non-verbal communication is more powerful than verbal communication.
4. Critical thinking is the ability to analyse information and experiences in an objective
manner. It can help us recognize and assess the factors that influence attitudes and
behaviour, such as the media and peer pressure influences. For example: Why was it said?
What option do I have? Is it my final option? Is it what I want?
5. Creative thinking enables us to explore the available alternatives and various consequences
of our actions or non-action. It helps us to look beyond our direct experience, and to
respond adaptively and with flexibility to situations in our daily lives, even if no problem
is identified, or no decision is to be made.
6. Problem-solving enables us to deal constructively with problems that arise in our lives.
Significant problems that are left unattended can cause mental stress and physical strain.
It is the power not only to control our problems but to turn them into opportunities. It also
leads to decision-making and managing emotions and stress.
7. Decision-making helps us to deal constructively with decisions about our lives, for
example, ready to take a decision after exploring all possible areas and ready to face the
consequences.
P.O.W.E.R. Model of Decision-Making
P = PROBLEM
Step 1 : Stop and state (or identify) the problem
O = OPTIONS
W = WEIGH the
options
Step 2 : Think of the different things that you can do. The
more options you have, the better.
Step 3 : Look at the advantages and weigh them against the
disadvantages of every option you thought of to solve
your problem. (The things you value should guide
you in your decision-making.)
E = ELECT
Step 4 : Choose the best option. If possible, talk to a person
you respect and then take the best option. Elect the
option that obtains what is important to you (values).
R = REFLECT
Step 5 : Think or reflect about what happened because of your
decision.
Source: Training Manual on Adolescent Health, CINI
8. Interpersonal relationship skills help us relate with people in a positive way. It means
being able to make and maintain friendly relationships, for example, father-son, mother-
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daughter, brother-sister, husband-wife, friend-friend, which can be of great importance
to our mental and social well-being. Relationships change with time and require constant
nurturing.
9. Negotiation skills is a result of rational thinking based on informed choices and effective
communication to get one’s ideas/plans accepted by the other person. Thus, to negotiate
rationally and effectively, one needs to enhance thinking and social skills. It is a process of
self-realization and development, but is facilitated by others who are mature and thinking
individuals. Young people need to negotiate with others for a healthy and happy life style
and to overcome the strong influence of peer pressure for experimenting with drugs,
alcohol and sex.
10. Coping with stress means recognizing the sources of stress in our lives and how they affects
us. Acting in ways that help us control our levels of stress by changing our environment or
lifestyle and learning how to relax.
11. Coping with emotions involves recognizing emotions within us and others, being aware of
how emotions influence behaviour, and being able to respond to emotions appropriately.
Intense emotions like anger or sadness can have negative effects on our health if we do not
respond appropriately.
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R2.1.2
How Akul Succeeded
Note: The life skills illustrated in this story are given in italics.
Akul Chandra Karua grew up in a community knowing how difficult it was to live and grow
up. As a young child he had no stitched clothes to wear. He went to school wearing a gamcha
(a piece of cotton cloth used for drying the body after bath). He was not allowed to take water
from the village hand pump and had to go to the nearby river for drinking water. He had no
blanket during winters. He lived with his parents in a small mud house in the Bahragora Block
of Jharkhand. He started contributing to his family income by selling berries from his garden at
the age of 10 years (Problem-solving, critical thinking, creative thinking). With this money he
purchased one shirt and a pair of pants which he washed and wore for a long time. He could not
complete his 10th standard examination as he had no money for fees. He could not ask anybody
for the fees (Self-awareness, coping with stress/emotions).
BREAK
Akul thought that there was no prospect in the village so he went to the nearest town in Bengal
and worked in a medicine factory, sticking labels on cartons. He came back to his village
after four years and came toknow about a job in a social service organization. He did not
know whether the organization was fake or genuine, whether the government was running
this programme or not. He went and met the District Chief Medical Officer; he also met the
Block Development Officer (BDO) to enquire about it (active listening, information-gathering,
critical thinking, effective communication). He found the organization to be genuine and
decided to join it (decision-making). He made many friends in and outside the organization.
He worked for his village and the panchayat. He helped the village women start Self-Help
Groups (SHG). The women started earning for themselves (goal-setting, problem solving, team
work). They praised Akul. He motivated and helped the inhabitants of many villages to set up
hand pumps, get electricity connection, roads, a post office and Anganwadi centre in Bahragora
(decision-making, critical thinking, creative thinking). He also facilitated old age pensions,
birth certificates, etc. for the villagers. The villagers are happy with Akul’s work. Akul says that
it is the childhood pain in his heart that motivates him to do this work so that other children do
not suffer like him (empathy).
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R3.1
Adolescence – A Critical Phase of the Human Lifecycle
The World Health Organization (WHO) defines adolescence in terms of age between 10
and 19 years. The United Nations defines young people as persons between the ages
of 15 and 24 years.
The National Youth Policy (2003) defines youth in the age group of 13 to 35. The age
group 13–19 is defined as adolescents.
Adolescence is a transition stage between childhood and adulthood. Key events during this
time are:
w Rapid physical growth
w Physiological and psychosocial changes, most importantly involving the reproduc-
tive system.
In this phase adolescents feel attracted to the opposite sex. They are more influenced by their
peers than their parents. A need for independence and a strong desire to establish an identity
beyond the family may lead them to experiment with smoking, substance abuse and even sexual
relationships. This in turn makes them very vulnerable to sexual and other forms of abuse,
exploitation and violence. These risks can have far-reaching consequences on their health and
development.
Adolescents need to learn how to make choices and commitments and follow through with them.
They need to be guided to make the right choices. An informed choice is one of the best ways to
make the right choice. Hence adolescents need to be provided with accurate information.
Status of Adolescents in India
Out of every100 persons in India at least 38 are young people. (Census 2001)
61.2 per cent women aged 20–24 years were married by age 18 and 47.1 per cent men aged
25–29 were married by 21 years. [National Family Health Survey (NFHS-3)]
71.4 per cent ever married women are anaemic; 68.4 per cent pregnant women are anae-
mic; 37.4 per cent men are anaemic (all data ages 15–49, NFHS-3).
28.9 per cent women have heard of AIDS ; 52.8 per cent men have heard of AIDS. (All
data ages 15–49, NFHS-3)
37 per cent women have experienced spousal violence. (Data ages 15–49, NFHS-3)
19 per cent of males were involved in a physical fight. (Population Council 2006)
27 per cent of rural married males and 15 per cent of urban married males were involved
in premarital sex. (Population Council 2006)
Unemployment among unmarried women, unmarried men and married women is 33 per
cent, 27 per cent and 42 per cent, respectively. (Population Council 2006)
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R3.2
Changes in Adolescence
Adolescence marks the transition between childhood and adulthood. During this stage hormone-
induced physical differences between a boy and a girl child become particularly evident.
Physical Changes
Boys
w The voice cracks and Adam’s apple
becomes prominent
w Height and weight increase
w Pimples appear on the face
w The muscles develop
w Nightfall occurs
w Hair appears on the face, chest,
underarms and genital area
w Sperm production begins
w Ejaculation occurs
w The genital organs increase in size
Girls
w The breasts develop
w Height and weight increase
w Pimples appear on the face
w The back becomes heavier (waistline
narrow and hips widen)
w Ovulation starts
w Menstruation starts
w Hair appears on the genital area and
underarms
w The genital organs increase in size
Emotional Changes
w Increased curiosity
w Develop attraction for members of the other sex
w Increased excitability
w Increased awareness about one’s looks and one’s body
w Consider themselves to be always correct
w Friends rather than parents seem to be closer
w Want to imitate or copy peers
w Dissipated attention span
w Increased imaginativeness and impulsive behaviour
w Increased mood swings.
Social Changes
As a result of certain expectations and responsibilities placed on adolescents by society, some
social changes also occur:
w Boys start working and contributing to the family income.
w Girls used to take on additional responsibilities of sibling care traditionally; but with time
girls are also looking at ways to contribute to the family income.
w Restrictions are placed on the girls’ movements outside the home; strict rules are
enforced on mixing with members of the opposite sex.
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w Boys are given more freedom than girls and spend more time with peers.
w Both boys and girls have serious concerns about their life ahead, especially in relation to
marriage, income and their role beyond that defined within the family.
w Adolescents develop a sense of responsibility towards their community and often participate
actively in community events. This gives them recognition beyond their family. This is
very important for them.
Menstruation
Menstruation is the periodic shedding of the uterine lining.
Ovulation
Ovulation refers to the physical act of expulsion of a mature ovum or egg from the ovary into
the fallopian tube.
From the first stage of its development, until after menopause, the ovary undergoes constant
change. The number of ova at the onset of puberty has been estimated at 2,00,000 to 4,00,000.
Since only one ovum is ordinarily cast off during each menstrual cycle, it is evident that only
a few hundred ova (400-450) suffice for the purpose of reproduction and the rest of them die
naturally. Each ovum or egg is lodged in a small follicle or capsule in the ovary. One follicle
alone matures each month to let out one mature ovum.
Ovulation takes place 14 days prior to the next menstrual cycle.
Role of Hormones
Name of female sex hormones — Oestrogen and Progesterone
Site of production
— Ovaries
Cyclical fluctuations in the hormone levels establish the menstrual cycle. The oestrogen is
produced before ovulation and stimulates the uterine lining to grow. After the release of the
ovum (usually during mid-cycle) progesterone is secreted which thickens and softens the uterine
lining and prepares the bed for the fertilized ovum.
If the ovum is not fertilized, the level of oestrogen and progesterone decline. The uterine lining
cannot be maintained without these hormones and is shed. This leads to menstruation.
Following menopause, the ovaries stop developing ovum and stop secreting oestrogen. Oestrogen
is also beneficial for other reasons:
• It maintains good cardiovascular function
• It prevents heart attacks
• It prevents weakening of bones and guards against fractures
Ejaculation
From adolescence onwards a white thick liquid comes out of the penis during ejaculation. This
liquid is called semen. This fluid is secreted by two glands – the seminal vesicles and the
prostate. It contains sperms. Sperms are the male sex cells. They are too small to be seen
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without a microscope. They are shaped like tadpoles, and move by lashing their tails. Sperm
production usually begins between ages 12-14. Total number per ejaculation is 200 million
to 500 million, but only a few are capable of fertilizing properly. Only one among them can
fertilize an egg.
Ejaculation can occur even when one is fantasizing. It is not necessary, that every time the penis
become erect, one needs to ejaculate. After some time, the penis will again assume its normal
shape. This does not harm the body in any way.
Fertilization
During sexual intercourse, millions of sperms are deposited into the vagina. The sperms swim
up through the cervix into the uterus, and reach the fallopian tubes, seeking a mature ovum. If a
mature ovum is present, one sperm meets with it. Although millions of sperms may be present,
only one sperm cell can penetrate the ovum. This is called fertilization and takes place in the
fallopian tube.
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R4.1.1
Nutrition
Food is the essential foundation of human development. Food is important for:
v Physical growth
v Mental development
v Performance and productivity
v Health and well-being
Nutritional Requirements in Adolescence
During adolescence the body is rapidly developing. This happens over a longer period in boys
and more rapidly in girls. Most adolescents achieve their full height during this period. As a
result of these changes and to sustain this growth spurt, the nutritional requirement increases in
both boys and girls. Energy requirement increases by about 25 per cent in girls and by nearly
100 per cent in boys over their earlier requirements. The requirements of protein and other
essential minerals such as iron and calcium also increase.
Failure to meet these increased nutritional requirements leads to various health problems, which
manifest slowly and affect normal and healthy development. Most often, energy requirements
are met by consumption of large quantities of cereals (e.g. rice and wheat), which provide
carbohydrates but not adequately to meet the energy needs. Also for proper growth and
development are proteins, vital building blocks of all body tissues; fats, which contribute to
stored energy; and minerals and vitamins (micro-nutrients).
Balanced Diet
To meet all nutritional requirements appropriately, adolescents must consume a balanced diet.
A balanced diet provides an optimum quantity of all types of foods. In addition, an adequate
quantity of water (3–4 litres) must be consumed daily. Keeping in mind the above, a balanced
diet can be planned as regular food habits of families and it does not require any expensive
food.
A simple and practical way to plan a balanced diet is using the Indian Tricolour (saffron, white,
green) as a guide. The diet should contain foods of all three colours. This will ensure that foods
with all necessary nutrients are present in the diet.
The Tricolour Guide
Diet should contain sufficient amounts of green leafy vegetables, other vegetables, pulses and
legumes, plant/animal source proteins and carbohydrates. A little fat/oil is essential for the
absorption of vitamins and minerals. Iron is an essential mineral for adolescents. The daily diet
should contain at least a raw vegetable or a seasonal fruit, washed and freshly cut just before
eating.
Colour
Food item
Red, yellow,
orange
White
Green
Mango, ripe papaya, carrot, egg yolk, pumpkin, jackfruit, tomato,
orange, gram, etc.
Rice, rice flakes, puffed rice, potato, milk, fish, banana, roti, radish,
coconut, salt, etc.
Spinach, cauliflower, cabbage, peas, coriander, capsicum, ladyfin-
ger, beans, chilly, lemon, pear, green leafy vegetables
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R4.1.2
How to Reduce Nutritional Wastage
Cooking has several beneficial effects on food. It improves the appearance and taste of food and
adds new flavours. It destroys harmful micro-organisms. It increases the digestibility of food,
particularly starch. Cooking also increases the digestibility of eggs and legumes. At the same
time, cooking can reduce the mineral and vitamin content in the food. For example:
v If the vegetables are boiled in water and the water is discarded.
v Rice and pulses are repeatedly washed (It removes water-soluble vitamins).
The following care should be taken to preserve nutrition and to maintain hygiene in food:
Dos
l Wash vegetables thoroughly before
cutting
l Cut vegetables in large pieces
l Cook food covered and over a slow
flame
l Cook cereals and pulses in the water
that they are soaked in
l Cook in a minimum amount of water
or use the cooking water in soup or
gravies.
l Use a pressure cooker
l Cook vegetables in the minimum
amount of water covering with a lid
(to prevent the loss of Vitamin C)
l Keep the food covered after cooking
l Always wash your hands before
serving food
l Take out water using a long-handed
ladle
Note : Steaming prevents loss of nutrients.
Don’ts
l Discard the starch of rice
l Deep-fry fresh vegetables
l Chop vegetables too fine
l Overcook food
l Repeatedly heat fat and oil (this
releases toxic substances)
l Let flies sit on the food
l Serve food with dirty hands
l Put your hand in drinking water
l Drink or eat from a dirty glass or plate
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R4.2
Anaemia
Iron as an element in the diet essential to maintain health. The human red blood cells have a
substance called haemoglobin, which contains iron. The main function of haemoglobin is to
carry oxygen to all body tissues. Haemoglobin cannot form well in the absence of sufficient
protein, iron and folic acid. Low levels of haemoglobin in the blood is called anaemia.
Adolescents, growing rapidly, need more iron elements in their food. Adolescent girls, when
they start menstruating, lose blood every month. If the loss of iron through menstrual blood
is not replaced by eating iron rich foods, anaemia can occur. Improper hygiene leads to worm
infestation, which also contributes to anaemia.
According to the National Family Health Survey (1998-99), more than half of the children
in India below three years are undernourished and about half of adult women suffer from
anaemia.
Causes
l Major Causes
1. Iron deficiency
2. Hookworm
3. Vitamin A deficiency
4. Malaria infection
l Other Important Causes
1. Chronic infections: TB, HIV
2. Diet low in vitamin B12 or folic acid
3. Poor absorption of nutrients
4. Blood loss due to excessive bleeding particularly during periods
5. Internal bleeding, for example in the presence of an ulcer or a tumour
6. Blood diseases such as leukaemia
7. Deficiency of other vitamins
8. Genetic defects
Types
Iron deficiency anaemia: The main reason for shortage of iron is that the body is losing blood
faster than the body can remake it. This can be caused by gastritis, piles, stomach cancer, ulcers
or bowel cancer. In women the most common reason is periods. Another possible reason is
shortage of iron in diet. Good sources of iron include fruit, dark green vegetables, wholemeal
bread, fortified breakfast cereals, jaggery, beans and meat.
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Vitamin B12 deficiency anaemia: Vitamin B12 deficiency anaemia (also called Pernicious
Anaemia) occurs when there is inadequate absorption of vitamin B12 from the diet. This can be
due to ulcers, stomach cancer, diseases of the small intestine or from the after-effects of surgery.
Vitamin B12 is also essential for the nervous system. Persons lacking vitamin B12 can also
develop inflammation of the nerves or dementia.
Vitamin B12 is found only in foods of animal origin, such as liver, meat and dairy products.
Folic acid deficiency: The main reason for lack of folic acid is due to poor diet and drinking too
much alcohol, which can reduce the uptake of folic acid. Folic acid is found in fresh fruit, raw
green vegetables, beans and whole grain cereals.
Folic acid deficiency and vitamin B12 deficiency anaemia are also known as Megaloblastic
anaemia.
Symptoms
1. General fatigue
2. Headaches
3. Lethargy due to tiredness and decreased capacity for physical work
4. Exhaustion after doing a little work
5. Reduced concentration
6. Paleness of the inside of lower eyelids, nails, tongue, palm and skin
7. Decreased appetite
8. Dizziness
9. Palpitations and fast breathing
10. Angina – Experience of chest pain or tightness due to narrowness of coronary arteries and
reduced supply of oxygen to the heart
11. A red, sore tongue and a reduced sense of taste. This is usually only a symptom with folic
acid and vitamin B12 deficiency anaemia.
Consequences
l Decrease in work capacity
l Premature delivery and low birth weight (in pregnant women)
l Maternal mortality
l Child mortality
l Impaired neuro-cognitive function in children
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Prevention
1. Consumption of iron-rich foods
Plant sources rich in iron are: leafy vegetables, sprouted bengal gram (chola), green gram
(moong), groundnuts; fruits; and jaggery. Animal sources are also rich in iron.
Important points to follow and remember:
v Stick to a healthy balanced diet.
v Vitamin C, as found in amla (gooseberry) or lemon added to food helps with the
absorption of iron.
v Girls should take more iron than boys.
v Tea hampers the absorption of iron and therefore tea should be avoided one hour
before or after eating.
v Cut down alcohol consumption.
2. Prevention of worm infestation
Worm infestation is a common cause of anaemia.
Common symptoms of worm infestation are pain in the lower abdomen, loss of appetite
and itching in the anal region. Treatment is simple under the advice of a doctor.
The best way to prevent worm infestation is maintenance of personal hygiene and following
basic clean practices during the preparation of food.
Points to remember:
v Take de-worming tablets every six months
v Wash hands with soap before every meal
v Cut finger nails regularly and keep them clean
v Avoid walking barefoot
v Avoid defecation in open areas; use of a sanitary latrine is best
v Clean hands properly with soap after defecation
v Keep all foods covered
v Wash fruits and vegetables before eating
3. Consumption of iron tablets
Anaemia due to iron deficiency can be treated with the consumption of iron tablets. One
tablet a week, which can be obtained from the Primary Health Centre or the Anganwadi
Centre, is enough. The consumption of iron tablets may initially cause some discomfort or
unpleasant symptoms, such as (i) bad taste in the mouth (ii) constipation (iii) nausea and
(iv) passing of black stools. These are not a cause for worry.
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R5.1.1
Diseases Caused by Poor Hygiene
Diarrhoea: Commonly results from inflammation caused by viral infections, parasites or
bacterial toxins. For ill or malnourished individuals, untreated diarrhoea can lead to severe
dehydration and possibly death.
Dysentery is typically a result of unsanitary water containing micro-organisms. Symptoms
include frequent passage of stools, which damages the intestinal lining.
Malaria: The mosquito breeds on stagnant water. When a mosquito bites an infected person,
it ingests blood containing the malaria parasite. When it bites another person, this parasite is
injected into that person.
Hepatitis A: is an acute infectious disease of the liver caused by the Hepatitis A virus, which is
most commonly transmitted by the faecal-oral route via contaminated food or drinking water.
Worms: The stomach is infested with worms due to ingestion of contaminated food or water.
These worms suck blood from the stomach and make people anaemic.
Typhoid is a fever caused by the Salmonella typhi bacteria. It is transmitted through the ingestion
of food or water contaminated by the faeces or urine of infected people or by eating food items
that have been handled by an infected person.
Cholera is caused by eating food or drinking water contaminated by the cholera germ.
Commonly, the disease progresses from the first liquid stool to shock in 4 to 12 hours, with
death following in 18 hours to several days.
Polio is an acute viral infectious disease spread from person to person, primarily via the faecal-
oral route by ingesting contaminated food or water.
Dengue is a mosquito-borne infection that causes a severe flu-like illness, and sometimes a
potentially lethal complication called Dengue Haemorrhagic Fever (DHF). There are four
distinct but closely related viruses that cause dengue. Recovery from infection by one of the
viruses provides lifelong immunity against that particular virus but confers only partial and
transient protection against subsequent infection by the other three viruses. There is good
evidence that sequential infection increases the risk of developing DHF.
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R5.1.2
List of Personal and Environmental Hygiene Activities
Personal Hygiene
v Brush teeth twice daily, in the morning and at night
v Bathe daily
v Defecate in a toilet
v Wash hands with soap or ash after defecation
v Keep nails trimmed and clean
v Comb hair daily
v Wear footwear
v Wear clean and washed clothes
v Observe menstrual hygiene
Household and Food-related Sanitation
v Clean the house daily with a broom
v Clean the kitchen after every meal
v Wash vegetables and fruits before eating or cooking
v Wash hands with soap or ash and water before cooking and serving food
v Eat freshly cooked warm food
v Keep food covered
v Avoid eating uncovered food from outside
v Wash hands with soap before eating and after defecation
Use and Upkeep of Drinking Water
v Use water from a hand pump or tap for drinking
v Water from a source other than a hand pump should be boiled for 15–20 minutes
v Keep water in clean utensils
v Keep the water covered while bringing it from the source and storing
v Use a long-handed ladle when taking out water
v Keep the stored water at a high place
Community Hygiene
v Keep roads and lanes clean
v Keep public places clean
v Put garbage and litter in the rubbish bin
Disposal of Animal and Household Waste
v Make a pit for disposal of animal and household waste
v Use animal waste as manure
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R5.2
Lilawati Needs to Learn Some Things
The italicized phrases highlight unhygienic practices.
Lilawati lives in a remote village in Jharkhand. She thinks that she is a good housewife. Her
mother-in-law praises her efforts in keeping the family united. She almost single-handedly
handles all the work of her house apart from taking care of her aged in-laws. But when we
visited her house we found that almost all the persons there were ill. We went through Lilawati’s
daily routine and found out exactly where the problem was. Can you also figure out where the
problem is?
q Lilawati wakes up at 5:30 a.m. and goes to the jungle for defecation (Defecating in open
places leads to many diseases). She washes her hand with mud and water from the nearby
pond (mud/soil itself contains many harmful germs). She brushes her teeth with datun and
uses the water from the same pond.
q She starts cleaning her house at 6:30 a.m. Her two-year-old child wakes up at 7:00 a.m.
and defecates in the courtyard. She washes the child’s bottom with water. She removes her
child’s faeces with her hands and throws them a little away from the courtyard. Then she
washes her hand with plain water and wipes her hand on her sari (plain water does not
clean hands of harmful germs). Lilawati thinks that the faeces of a child is not harmful to
good health (faeces of children also contain harmful germs).
q After cooking she leaves the pot half open. Flies sit on the food (open food gets contaminated
by insects, flies and germs).
q She goes for a bath in the pond where everybody cleans after defecation. In the afternoon
she gives food to her in-laws and the child eat from her plate. She does not bother to
clean the hands or the nails of her child (the pores and the nail deposits contain harmful
germs).
q Her husband returns after work at 6:00 p.m. He washes his hands with water and sits to
have his dinner at 6:30 p.m. (plain water does not clean the hands of germs).
q Occasionally she goes to the village haat with her husband and eats tikki-chat and
golgappa, which are stored in open vessels (unhygienically kept food can contain disease-
causing elements).
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R6.1.1
Gender and Gender Discrimination
Difference between Sex and Gender
People are born male and female. That is their sex. But they learn to be boys and girls who grow
up into men and women. That becomes their gender.
Sex is biological; it cannot be changed. Gender refers to the differences between men and women
created by society; this can be changed.
Gender refers to the socially constructed roles, behaviour, activities and attributes that a
particular society considers appropriate for men and women (WHO).
Gender Roles and Stereotypes
Men and women have been slotted into certain roles traditionally. For example:
v The woman stays at home, looks after the children, cooks and cleans.
v The man goes out and earns to support the family.
v Women are emotional.
Gender Discrimination
Though in some religions goddesses are worshipped and regarded as powerful and givers of
great blessings and happiness, in real life women are often treated badly, as they are regarded as
weak and incapable of doing many things that are done by men. This needs to be changed.
The girl child faces discrimination in the Indian society in general. For example, the boy in the
family receives preferential treatment and is given more opportunities for education. The girl
often stays at home to help with the housework. If the family faces financial constraints, the girl
is often taken out of school while the boy continues with his studies. In healthcare and medical
treatment, the girl suffers neglect more often than the boy. During family discussions, the girl’s
opinion is mostly neglected.
A son’s birth is mostly a reason for celebration; that of a daughter often is not. In many societies,
the boy is considered to be an asset to the family; the girl is looked upon as a liability. In some
communities, when pregnancy tests on a pregnant woman reveal that the foetus is a female,
the pregnancy is terminated. Such acts are wrong and are punishable by law. Very often, a girl
remains malnourished and deprived of love, care and attention.
This negative attitude needs to be changed. Girls have as much potential as boys to become
contributing citizens of their country and lead independent lives. They are as capable as boys of
becoming a support to their families, if given the same opportunities. Women can do almost all
things that men can do; some tasks they can do even better. Under law, women have the same
rights as men.
Girl children need adequate nourishment to grow into healthy adults. An undernourished girl
child is likely to be anaemic. A weak mother will give birth to weak children and add to the
problems of the family, the community and the country.
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Some Statistics Regarding Gender Discrimination
v Average wage received per day by female casual labourers in 2004-05 was Rs. 36.15, which
was Rs. 20.38 less than the average wage earning for male casual labourers. (Ministry of
Women and Child Development)
v In the 2001 Census, the literacy rate for males was 75.3 per cent while for females it was
53.7 per cent in the 7-plus age group.
v While one in every five adolescent boys is malnourished, one in every two girls in India is
undernourished. (CRY)
v As of January, 2007, women members constitute only 9.07 per cent of the national
Parliament. (Ministry of Women and Child Development)
v As of January, 2007, the proportion of seats held by women in the Lok Sabha was 8.6
per cent and the proportion of seats held in the Rajya Sabha was 10 per cent. (Ministry of
Women and Child Development).
v The deaths of young girls in India exceed those of young boys by over 300,000 each
year and every sixth infant death is specifically due to gender discrimination. (Azad India
Foundation)
v Nearly 117,000 Indian women, accounting for almost 22 per cent of estimated global
maternal deaths, die every year due to causes related to pregnancy and childbirth (UNFPA).
The Ministry of Women and Child Development reports that in 2005-6, 51.7 per cent of
deliveries were not conducted safely.
Gender-based Vulnerability and Restrictions on women
Due to gender differences in the society, women are more vulnerable to sexual abuse, violence
and exploitation. This vulnerability often poses restrictions on a young girl’s movements and
activities. Adolescent girls may often feel very restricted and deprived of freedom in comparison
to boys. It is important that girls equip themselves with information on self-protection.
Some Instances of Gender Discrimination from Womb to Tomb
Foetus
(1) Sex selection (2) preference for a male child (3) abortion of female foetus.
Infant
(1) Killing the girl infant (2) not breastfed (3) neglect during illness (4) malnourishment.
Girls: Middle and late childhood
(1) Not sent to school or education discontinued (2) multiple domestic responsibilities (3)
sibling care (4) hazardous work (5) lack of access to healthcare (6) malnutrition.
Adolescent Girls
(1) Neglect of education (2) lack of life skills (3) victims of sexual abuse and violence (4) sold
off to work as domestic/sexual labour (5) early marriage, early pregnancy (6) dowry deaths
(7) iron deficiency (8) increased chances of disease and death due to pregnancy (9) restricted
mobility translating into decreased access.
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Adult Women
(1) Lack of life skills (2) lack of decision-making opportunities (3) lowered self-esteem (4)
economic insecurity.
Ageing Women
Desertion and neglect - emotional, financial and social
A Girl has the Right to:
• Be born
• Remain alive after birth and not be killed within the first few hours or killed slowly through
sheer neglect or gross indifference
• A name and identity
• A family and a home
• Childcare including love and affection
• Childhood – this means the right to be free from working at a tender age
• Education
• Be healthy – this includes right to nutrition, clean water and health services
• Life skills education, including information about law, healthcare and opportunities
• Protection from criminal assault, including rape, prostitution, violence, forced beggary
within or outside the family
• Marry only after the age of 18 years
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R6.1.2
Sex and Gender
S. No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Statement
Category
Boys are better than girls at mathematics
Gender
Women give birth to babies, men do not
Sex
Men do not cry
Gender
Women are weaker; therefore they should not take up labour-
intensive occupations
Little girls are gentle, little boys are tough
Gender
Gender
Men’s voices break at puberty, while women’s do not
Men make better mechanics than women
Men need more nutrition due to the active lives they lead
Sex
Gender
Gender
Women are more emotional than men
Gender
In some societies, a girl’s birth is met with sorrow while a boy’s birth Gender
is celebrated and acclaimed
Women are paid less than men for the same work
Gender
Men have a greater sexual desire than women
Gender
Women are less ambitious than men
Gender
The male chromosomes XX and XY decide the sex of the child at
Sex
conception
Women are unclean when they menstruate
Gender
It is negligence if women pay attention to their careers while they
have little children
Gender
Girls should not travel alone
Boys do not cry
Gender
Gender
Women should take jobs which are less labour-intensive like teacher, Gender
lecturer
Women are not responsible for the sex of a child
Sex
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R6.3
Meena Ki Kahani
Type of production :
Subject
:
Duration
:
Producer
:
Animation
Gender
13 minutes
UNICEF; Can be downloaded from <http://www.unicef.org/
videoaudio/video_7683.html>.
Summary: Meena: Dividing the Mango – Meena works hard every day but it is Raju,
her brother, who is always given the larger portion of food. When Meena and Raju
decide to swap jobs for the day, Raju realises that Meena works hard and deserves the
same share of the food. Raju decides to help Meena and from then onwards to share their
food equally.
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R7.1
Sex vs Sexuality
Sexuality is a total expression of us as human beings. It includes all the thoughts, feelings and
behaviour of being male and female, being attractive, being in love as well as being in relation-
ships that include intimacy, emotions, personality, likes and dislikes. It is a mistake to think that
issues of sex and sexuality pertain to sexual intercourse only; sexuality covers a much broader
area.
Sexuality is an integral part of human life. It carries the awesome potential to create new life.
It can foster intimacy and bonding as well as the sharing of pleasure in our relationships. Yet
when exercised irresponsibly it can also have negative aspects such as sexually transmitted
diseases including HIV/AIDS, unintended pregnancy, and coercive or violent behaviour. To
enjoy the important benefits of sexuality, while avoiding negative consequences, some of which
may have long-term or even lifetime implications, it is necessary for individuals to be sexually
healthy, to behave responsibly, and to have a supportive environment in order to protect their
own sexual health as well as that of others.
During adolescence, sexual exploration and expression is common and normal. Sexual rela-
tionships may begin in adolescence either within or outside marriage. While sexual activity
can be pleasurable, the consequences of unwanted and unprotected sex in adolescents can have
life-long health and economic consequences.
Sexual Identity
Every adolescent has his or her own personal sexual identity. Sexual identity has two compo-
nents: (i) biological identity, i.e. being male or female, and (ii) gender identity, which is how
one feels about being male or female. Gender roles are society’s expectation of us based on our
sex. For example, girls are supposed to be meek and submissive, boys are not supposed to cry,
and so on. Another part of sexual identity is the sex that adolescents are attracted to romanti-
cally. This is called sexual orientation. This can be heterosexual (attracted to the opposite sex),
bisexual (attracted to both sexes) or homosexual (attracted to the same sex).
Sex Drive and Adolescent Sexual Behaviour
Sex is a basic drive upon which both reproduction and personal happiness depends. Sex drive
begins to be expressed in the clearest of terms during adolescence, which is a period of height-
ened feelings, arousal, urges and sexual feelings directed towards self and the others. The awak-
ened sexual drive and thoughts produce a certain restlessness of character in the youth so that
they are often considered by their elders as different or difficult. Spontaneous erections, noc-
turnal emissions (wet dreams) and masturbation manifest in the middle or early adolescence in
majority of boys. They may be troubled, confused and feel guilty by these changes. Increased
vaginal discharge, tingling and pain in the breasts and masturbation, along with menstrual con-
cerns may be troublesome for young girls.
The moods may become variable and impulsive. It may be difficult to concentrate for a great
length of time. Often, even their school performance or work suffers. This can lead to various
kinds of problems.
Sex and sexuality are issues that confuse and sometimes stress adolescents. This often stems
from unawareness of the issue, misinformation and peer pressure. While they undergo
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physical changes that occur during puberty, adolescents develop and become aware of their
sexual drive and feelings. They also tend to explore the various aspects/dimensions of being
sexual. This happens because of sex hormones that circulate in higher amounts in their bodies,
and the opportunities available to them for experimenting with sex and sexuality.
Developing a Healthy Sexual Lifestyle
Adolescents, to function as effective and well-adjusted adults, need to have clear, accurate and
precise information to understand the various aspects of human sexuality, sexual roles and re-
sponsibilities. They also need to possess skills to negotiate sexual demands that may be put on
them, or that they may put on others.
Adolescents must understand the following issues before they venture into sexual activity:
v Indulging in a sexual act is a major decision. Careful analysis of the associated responsibili-
ties and capability of entering into commitments are necessary before undertaking such a
step.
v Adolescence may not be the right age for sex as girls are not able to bear the burden of
pregnancy physically, mentally and emotionally. Boys are not in a position to shoulder the
responsibility of fatherhood. If marriage takes place earlier the pregnancy should be de-
layed till the girl is biologically and psychologically mature enough (i.e. at least 19 years).
v Adolescents at times may be impulsive and do not hesitate to take risks. They may take
decisions without realizing the consequences. They are easily attracted to the opposite sex
physically and get infatuated readily (falling in love blindly).
v They may indulge in sexual intercourse at the spur of the moment. They need to be careful
and realise the immediate and long-term consequences of their acts.
How Sexuality is Expressed in our Day-to-day Life
Acknowledge that many people find it difficult to discuss sex and sexuality and may feel embar-
rassed or uncomfortable. Tell them that some of us may not be comfortable with this subject,
which is usually not discussed. It is normal to be uncomfortable but rational discussion about the
subject is helpful and useful. It even reduces the embarrassment. Inform the participants what is
sexuality and how it is related to sex. The term sex can mean intimate sexual contact or sexual
intercourse. Sex also refers to a person’s gender, that is to whether a person is male or female. It
is primarily a physical trait, determined by genetics. Your sex or gender was established at the
moment you were conceived.
Sexuality, on the other hand, is a much broader aspect of who you are. Sexuality is everything
about you that relates to, reflects or expresses your maleness and femaleness. Sexuality involves
how you think, how you feel about yourself and others, how you behave and how you look.
People express their sexuality in nearly everything they do. You do not need a partner to express
sexuality. Sexual activity, including sexual intercourse, is just one of the many ways of express-
ing sexuality. Reproduction is only one of the main functions of sexuality. Many more like pair
bonding, assertion of feminity and masculinity, pleasure and removal of stress are some other
functions, so it is entirely normal to have a sexual dimension to the personality.
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R7.2.1
Female Reproductive Organs and their Functions
The female reproductive system enables a woman to produce eggs (ova), have sexual inter-
course, protect and nourish the fertilized egg until it is fully developed and give birth. Unlike
the male, the female sexual organs are mostly hidden.
The female reproductive system comprises the following:
v Ovaries
v Fallopian tube
v Uterus
v Vagina
INTERNAL PARTS
v Vaginal mouth
v Labia Majora and Labia Minora (vulva)
v Clitoris
EXTERNAL PARTS
Ovaries: Ovum is Latin for egg. Ovaries are the parts that produce eggs in the female. A human
female has two ovaries. The ovaries are situated in the pelvic region, one on either side of
the uterus. An ovary is about the size and shape of an almond. It produces female hormones
(oestrogen and progesterone) and eggs (ova). Ovaries are also responsible for the development
of secondary sex characters in girls. The ovary contains ovarian follicles, in which eggs develop.
There are three to five lakh egg cells at birth. Eggs begin to be released at puberty. Once a follicle
is mature, the developing egg is ejected from the ovary into the fallopian tubes. This is called
ovulation. A human egg is about the size of a pinhead. Usually, one egg is released monthly,
from either the right or left ovary at random. Occasionally, more than one egg is released.
Fallopian tubes: Two thin tubular structures arising from the upper part of the uterus and
having funnel-shaped free ends. This is the passage for the egg from the ovary to the uterus and
the place where fertilization occurs. Fertilization occurs when the sperm meets the egg.
Uterus: It is a hollow muscular, pear-shaped pouch located in the pelvic cavity (lower part
of the abdomen) and measures the size of one’s fist. Here the baby grows until birth. During
pregnancy the uterus enlarges to accommodate the foetus (baby). In the non-pregnant state,
the non-fertilized egg passes out of the body through the vagina during the monthly menstrual
cycle.
Vagina: Passage extending from the uterus to the outside of the body. Canal through which
v Menstrual blood flows out
v Intercourse occurs
v Delivery of a baby takes place.
Vaginal Opening: Located between the urethral opening and the anus, usually covered by
a thin membrane (hymen). It is the opening for menstrual flow and penetration of the penis
during intercourse.
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Labia Majora and Labia Minora: Two pairs of lip-like structures on either side of the vaginal
opening. They provide protection to the other female sexual parts.
Clitoris: A small triangular and fleshy structure. It is located above the urethral opening at the
point where the labia meet. It is the focal point of sexual stimulation for the female.
The urethral opening is a small opening in front of the vaginal opening for passage of urine.
Anus is the outlet for expulsion of faeces. They are not parts of female reproductive system.
Fallopian Tube
Uterus
Urinary bladder
Labium minora
Ovary
Rectum
Cervix
Vagina
Anus
Source: www.dhmc.org
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R7.2.2
Menstruation
Menstruation, also called menses, menstrual period or period, is partly blood and partly tissues
from the inner lining of the uterus which is periodically shed through the vagina. The menstrual
period usually lasts from three to five days.
Menstruation signifies the onset of puberty (age 9–14) and continues till menopause (age 45–
50). The menstrual cycle averages 28 days. It marks the onset of sexual maturity in girls.
Every month, when one egg ripens in the ovary, the inner lining of the uterus starts thickening,
like a thick spongy layer of blood, preparing for the fertilized egg. If the egg does not get fertilized
within three days (72 hours) it dies and the lining formed breaks down. It usually occurs 14 days
after ovulation. It stops during pregnancy and starts again after the baby is born.
Menstrual Hygiene
v Clean, soft and dry cotton cloth pieces should be used during periods to absorb the menstrual
blood. Sanitary pads are expensive but a useful alternative. Based on affordability, they
could be reserved for situations where changing will not be possible for a long time and
then discarded.
v If cloth is used, it should be washed daily with soap and cold water and dried in the sunlight.
If the cloth is not dried well, it can get contaminated by germs.
v The cloth should be stored in clean plastic packets for using the following month. A cloth
can be used only for two months if its condition looks fine.
v Every time after urinating and before changing the cloth, the genitals should be washed
with water.
Fertile period
Women’s bodies work in cycles, and they are only able to conceive in one particular part of
their cycle, and this part is called their fertile period. The exact length of a fertile period varies
between women, and even for one woman at different times in her life. Knowing when her
fertile period is can be of great use to a woman; it can be used to avoid pregnancy or increase
the chances of becoming pregnant. Thus, many women like to know when they are likely to be
fertile each month.
In general terms, a woman menstruates (or has a period) every 28 days. The first day of bleeding
is counted as day one of her cycle, with day 28 being the last day before her next cycle. In this
‘typical’ woman, ovulation, or release of an egg from the ovary, then occurs on day 14 of the
cycle. The peek fertile period is three days on either side of ovulation, although pregnancy can
occur within 7 days of anticipated ovulation.
For pregnancy to occur, sperm must reach the egg within 12 - 24 hours of release. Allowing for
sperm’s potential life span of 72 hours, there is a small amount of time for conception to occur
and this is why knowing when ovulation happens is of such importance. However, as very few
women have a cycle of exactly 28 days, it can be hard to predict exactly when she will ovulate.
Menstruation always occurs 13-15 days after ovulation, so women with regular cycles may
be able to determine the likely time of ovulation from this. Some women experience a small
amount of spotting or abdominal pain at ovulation, which certainly simplifies the issue.
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R7.2.3
Male Reproductive Organs and their Functions
The male reproductive system enables a man to have sexual intercourse. The male organs
produce and transfer sperm to the female organs for fertilization. The sexual organs of the male
are partly visible and partly hidden within the body.
v Penis
v Scrotum
EXTERNAL PARTS
v Testes
v Vas Deferens/Sperm Duct
v Seminal Vesicle
v Prostate
v Urinary Bladder
v Urinary Tract
INTERNAL PARTS
Urinary Bladder
Prostrate
Spermatic Duct
Urethra
Penis
Testis
Scrotum
Penis: A rod-like structure, the passage for urination and for sexual intercourse. When a man
is sexually excited the penis becomes hard, erect, large and thick. Ejaculation of semen occurs
at the height of excitement called orgasm. The penis places the sperms in the woman’s vagina
during intercourse.
The size of the penis varies from person to person but its size does not affect normal functions.
The tip of an erect penis may be pointed upward, straight, downward or sideways. This is
natural. It gives no problem during sexual intercourse. Though the passage for semen (containing
sperms) and urine is the same, urine and semen cannot pass at the same time.
Erection of the Penis: In response to sexual thoughts, fantasies, temperature, touch or sexual
stimulation, the penis fills with blood and becomes hard and erect for sexual intercourse.
Sometimes, even when the bladder is full the penis becomes erect.
Scrotum: This pouch, which contains the testes, is located behind the penis. The scrotum
protects the testes and controls the temperature necessary for sperm production and survival.
Normal body temperature hampers sperm production. The scrotal sac, placed outside the body,
keeps the testes at a temperature lower than the usual body temperature.
Testes: Two spherical structures within the scrotum, which produce and store sperms from the
age of puberty. The male sex hormone testosterone, which is responsible for the secondary
sexual characteristics in males, is also produced by the testes.
Seminal Vesicles: They store sperms after production in the testes. They are thin sac-like
structures behind the testes in the scrotum.
Vas Deferens: From each seminal vesicle there is a thin and long tube which is called vas
deferens. Sperms are carried from each seminal vesicle to the urethra through the vas deferens
for ejaculation.
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Prostate: This small sac-like structure lies just below the urinary bladder. It secretes a thick
milk-like fluid that forms part of the semen.
Kidney & Ureters: Urine comes from the kidneys to the bladder through pipe like structures,
called ureters, and then passes through the lower urinary tract called urethra, which is situated
within the penis, to pass out of the body.
Urinary Bladder: This is a sac-like structure inside the body. The urine, which is created by
the kidneys, gets stored in the urinary bladder before passing through the urethra from out of
the body.
Penile Hygiene
The foreskin at the tip of the penis should be pulled back for cleaning. The penis should be
cleaned twice every day, during bath and at night before going to bed. The genitals should be
kept dry and clean.
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R7.2.4
Conception
After the male ejaculates in the vagina during sexual intercourse, sperm cells travel through
the vagina and reach the fallopian tubes seeking an egg. The egg is fertilized when a sperm
enters it. Only one sperm can fertilize one egg. The fertilized egg moves through the fallopian
tube into the uterus. Here it gets implanted into the uterine lining, which has become thick and
spongy expecting a fertilized egg. After fertilization, the lining of the uterus remains in place and
menstruation stops for the entire duration of pregnancy. The fertilized egg grows into a foetus
and birth occurs approximately after nine months and seven days, measured from the first day
of the last menstrual period.
Infertility is failure to conceive. It can be due to problems in the male or the female partner and
sometimes in both. Infertility is treatable, but treatment may be expensive.
Points to Note
v Unprotected sexual intercourse even once can lead to pregnancy.
v Pregnancy can occur if the man ejaculates close to the vaginal opening too, even if they do
not actually have sexual intercourse. The sperms can still swim their way through to the
uterus.
If a girl has had unprotected sexual intercourse and has any one or combination of the following
symptoms, she should immediately consult a doctor to rule out pregnancy.
v Missed menstrual period
v Nausea/vomiting particularly on waking up in the morning or in the evening
v Feeling tired and sleepy more than usual
v Frequent urination
v Enlargement of the breasts with darkening of the nipples
v Tenderness of the breasts
Test for Pregnancy
Pregnancy can be confirmed even a few days after a missed period by a simple urine test. Self-
test kits are available at chemist shops with accompanying instructions. Most laboratories and
government hospitals also have facilities to carry out the test.
Sex of the Child
Every human being has 23 pairs of chromosomes. These chromosomes are responsible for
different characteristics of a person. A woman has a pair of X chromosomes; man has one X and
one Y chromosome. If a sperm containing man’s X chromosome impregnates the woman, the
result is a girl child; if a sperm contains man’s Y chromosome impregnates the woman, the result
is a boy child. It is thus seen that the man’s chromosomes are responsible for the sex of a child.
Multiple Pregnancies
Twins are born in one of two ways:
1. When more than one egg is released by the ovary and these are fertilized by individual sperms,
it results in the formation of more than one independently fertilized egg (fraternal twins).
2. It is also possible for one egg fertilized by one sperm to divide into two. The division may be
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complete or incomplete. If complete, two babies are born (identical twins). If incomplete,
twins who are joined at the hip/head/chest are born and need to be separated after birth.
Identical Twins
Sperm
Single
Non-identical twins
Two
Triplets, quadruplets, etc. Multiple
Ovum
Single
Two
Multiple
Special features
• Always of the same sex
• Usually there is a family history
Of different sexes or same sex
Of different sexes or same sex
Ante-natal Care
Ante-natal care is the care given to a pregnant woman during her pregnancy. The objective
of the ante-natal care is to assure that every wanted pregnancy culminates in the delivery of a
healthy baby without impairing the health of the mother. This is done by
• Promoting, protecting and maintaining the health of the mother and foetus during
pregnancy
• Foreseeing complications and preventing them
• Removing the dread and anxiety associated with delivery
• Taking steps to minimize maternal and infant mortality and morbidity
• Teaching the mother elements of child care, nutrition, personal hygiene and environmental
sanitation
• Sensitizing the mother to the need of family planning
Ideally, a pregnant woman should attend the ante-natal clinic once a month during the first
seven months, twice a month during the next two months, and thereafter, once a week, till
delivery. A large number of women, however, cannot attend the clinic so frequently. In these
cases, a minimum of three visits is advised.
• First visit at or before 20 weeks or as soon as pregnancy is confirmed
• Second visit at 32 weeks
• Third visit at 36 weeks
At each visit, a check-up of blood, urine, blood pressure and weight should be done. Two
injections of Tetanus Toxoid should be given, starting at five months, at an interval of one
month. However, the second injection should be given at least one month before the Expected
Date of Delivery. Since, during pregnancy, dietetic iron is not enough to meet the increased
requirements, one tablet of iron and folic acid should be taken daily, as a supplement, during the
latter half of the second trimester and early third trimester, for at least 100 days. No drugs should
be taken during the first trimester of pregnancy, unless prescribed by a qualified physician.
Safe Delivery
Safe delivery is promoted primarily through the encouragement of all families to seek the
care of skilled birth attendants for all births, because all pregnant women are at risk of life-
threatening complications, many of which are unpreventable and unpredictable. Frontline
providers are trained and supervised to provide personal support, good surveillance (including
use of the partogram) to identify potential complications, a clean environment, avoidance of
unnecessary and potentially dangerous practices, and active management of the third stage of
labor. Immediate care of the newborn includes assistance with initiation of breathing, warming,
resuscitation and care in the event of birth asphyxia, hygienic cord care, eye care, immediate
breastfeeding, and a referral to higher-level care if necessary.
Basic Immunization
To prevent six life threatening diseases like Tetanus, Poliomyelitis, Diphtheria, Whooping
Cough (Pertussis), Tuberculosis and Measles, vaccines are given to the child. All the vaccines
are given free of charge, at health centres, by the Government.
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Conception – Parts and Process
Source: embryology.med.unsw.edu.au
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R7.3.1
Responsible Sexual Behaviour
Sexual behaviours are actions that allow the expression of one’s sexual feelings. These
behaviours include holding hands and kissing as well as masturbation and penetrative intercourse.
Responsible sexual behaviours are consensual, non-exploitive and honest and include actions
that protect against unintended pregnancies and sexually transmitted diseases. Measures of
responsible sexual behaviours include condom use among people with multiple sexual partners
and rates of sexually transmitted disease and unintended pregnancy.
Responsible sexual behaviours include effective use of contraceptives, when appropriate, as
well as reducing the number of sexual partners and choosing ones’ sexual partners carefully.
Sexually responsible people practice other preventive health actions such as breast or testicular
self-exams, getting screened for cervical cancer, and, if appropriate, being tested for Human
Immunodeficiency Virus (HIV).
Some objectives/indicators to measure progress in responsible sexual behavior among
adolescents are:
1. Increase the proportion of adolescents who abstain from sexual intercourse
2. Increase the proportion of adolescents who abstain from multiple sexual partners
3. Increase the proportion of adolescents who use condoms, if currently sexually active
4. Reduce the rate of unplanned pregnancies in adolescent females
5. Increase the age at marriage and delay the first pregnancy
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R7.3.2
Case Studies of Sexual Behaviour
Case Study 1
Ravi is 15 years old. He visits a sex worker with some friends. A few days later, he feels
pain while urinating and also observes some boils around his genitals. He gets very
scared and visits a doctor. After a medical examination, the doctor tells him that he has
contracted a sexual infection. He also adds that some infections can be fatal. Ravi feels
very guilty, ashamed and curses his friends.
l Did Ravi think about the consequences of having sex with a commercial sex worker?
Why do you think so?
l What were the options available to him?
l What kind of pressures were working on him?
l What factors should he have considered before his action?
l What should have been his decision?
Case Study 2
Mohan is 17 years. He enjoys going out everyday with his girlfriends, buying them gifts
and partying. One day he tries to force a girlfriend to have sex. She complains to the
teacher and Mohan is threatened with expulsion from his school. He feels guilty, humili-
ated and shameful.
l Did Mohan think about the consequences of forcing a girl to have sex? If your an-
swer is No, why do you think so?
l What were the options available to him?
l What kind of pressures were working on him?
l What factors should he have considered before trying to force a girl to have sex?
l What should have been his decision?
Case Study 3
Vijay is 17 years old. Anita is a girl in his village. For some days when Anita’s parents
were not at home, Vijay lived with her in her house secretly. Soon Anita realized that she
was pregnant. She told Vijay about this but he was not ready to take on the responsibility.
He ran away from the village. Anita went to the police and registered a complaint against
Vijay. Vijay was put in the police lock-up when he was found.
l Do you think that Anita and Vijay behaved responsibly?
l What should Anita have done?
l What should have been Vijay’s responsible behaviour?
l How should they have avoided this kind of situation?
l Now what do they need to do? Remember: fighting, scolding, quarrelling, beating
are not solutions.
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R7.4
Quiz on Sexuality
Sl. No. S/A
Statement
Answer
Menstruation
1
S
Once a girl starts menstruating she can become pregnant.
True
A
When a girl starts having menses it means that her reproductive
organs have begun working and that she can become pregnant if
she has sexual intercourse. It does not mean, however, that her
physical organs and body and mental condition are necessarily
prepared for the birth of a child.
2
S
A girl should not engage in any physical activity/sports during False
menses.
A
Menstruation is not a reason for curtailing activities, unless she
has cramps or any such discomfort. However, she must maintain
hygiene.
3
S
Girls usually start menstruating between the age of 9 to14 years. True
A
Usually, menstruation begins between the age of 9 to 14 years.
However, some girls may start menstruating at the age of 15 or
16 years.
4
S
If a girl has not started menstruating till 18 years, it is a cause True
for concern.
A
Yes, the usual age of menstruation is between 9 and 14 years.
One should consult a doctor to find the cause of the delay.
5
S
Menstruation is unclean.
False
A
Menstruation is a natural phenomenon. It happens if the egg is
not fertilized.
6
S
Boys can tell when a girl is having her period.
A
No one can tell just by looking at a girl.
False
7
S
It is normal for menstrual flow to be heavy during the first few True
days and then become lighter.
A
The duration and the amount of menstrual flow varies between
women, but for every woman the duration and amount of flow is
fairly constant over a period of time. It is normal for menstrual
flow to be heavy in the first few days and then become lighter.
If one has a sudden change in the menstrual pattern one should
consult a doctor.
8
S
Bathing/eating sour food causes menstrual cramps.
False
A
Not true. On the other hand it is extremely important to have a
regular bath and maintain proper hygiene and eat nutritious food
during the period. Beliefs such as bathing and washing one’s
hair or eating lemon or pickles is harmful while menstruating
have no foundation.
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Sl. No. S/A
Statement
Answer
Menstruation
9
S
It is normal to have irregular periods when the menstruation True
cycle starts (the first few periods).
A
The first few periods are often irregular. It is common to skip
several periods or to have periods very close together. A regular
menstrual pattern will gradually be established.
10
S
It is normal to have pain and discomfort during menstruation. True
A
During periods, many girls/women have discomfort or pain.
This is because of the contraction (spasms) of muscles of the
uterus. If it becomes intolerable and keeps one away from
normal work, one should consult a doctor.
Masturbation
11
S
Masturbation makes a boy weak and impotent.
False
A
Masturbation is practised by both boys and girls. It has been
proven scientifically that it causes no harm.
12
S
Only boys masturbate, girls do not.
A
Masturbation is practised by both boys and girls. It is more
common in males than females.
False
13
S
If one masturbates too much, his/her adult sex life will be
affected.
False
A
It has been proven scientifically that masturbation causes no harm.
14
S
Young people who masturbate too much may have mental
problems when they get older.
False
A
Masturbation does not lead to mental health problems. However,
due to misconceptions they may feel guilty about it.
15
S
Most people stop masturbating after they get married.
False
A
Masturbation is done by both married and unmarried people.
16
S
People who masturbate too much are tired and irritable most of False
the time.
A
Masturbation is a normal sexual activity. If one is feeling tired
or irritable there may be other reasons for this.
17
S
Masturbation can cause pimples, acne and other skin problems False
in adolescents.
A
During puberty increased hormonal activity leads to increased
activity in the skin glands. Oils produced by the glands block the
skin pores and mix with bacteria to cause pimples or spots. To help
keep the skin clear, adolescents should wash the face and hands
frequently. Skin problems have nothing to do with masturbation.
18
S
Masturbation is considered more acceptable today than it used True
to be. Still, it is common for people who masturbate to feel
guilty about it.
A
It is because people do not have correct information about
masturbation.
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Sl. No. S/A
Statement
Answer
19
S
If the penis is touched a lot, it will become permanently longer.
A
There is no scientific proof.
Sex and Sexuality
False
20
S
Both men and women have the right to say No to sex any time. True
A
The decision needs to be made each time a person is thinking
of having sex with someone. A person has the right to say No if
he or she does not want to be sexual with a person even if they
have already been sexual with that person.
21
S
Boys/Men need to have sex to keep good health.
False
A
It is normal and healthy for both males and females to have
sexual feelings and desire to express them, but neither males nor
females need to have sex to be healthy.
22
S
Alcohol and other addictive drugs make it easier to get sexually False
aroused.
A
They have exactly the opposite effect. They may increase desire
and reduce inhibitions (make you feel free) but they decrease
the flow of blood to the genital area and make it more difficult
for males to have an erection and more difficult for males and
females to experience orgasm. More importantly, they can
make people feel like it is all right to do things they would not
ordinarily do sexually, such as have intercourse or not protect
themselves against pregnancy, sexually transmitted infections
and HIV infection.
23
S
Sexual intercourse is the best way to express your love for
someone.
False
A
There are several ways to show that you care about or love
someone without physical intimacy. In addition, sexual activity
includes a range of physical intimacy, including holding hands,
hugging, kissing, touching, caressing to orgasm, etc. Sexual
intercourse is only one type of sexual activity and only one way
to express love.
24
S
It is normal for some boys and girls to mature earlier than
True
others.
A
Some boys start puberty as early as 10 years old, others not
until they are 14 or 15. Some girls start puberty as early as age
8, others not until they are 13 or 14. However, if a girl does not
start menstruating by 16, she should consult a doctor.
25
S
Some parts of the body mature more quickly than others.
True
A
During puberty, there is an order in which certain physical
changes usually occur: for girls, the breasts begin to grow;
for boys, growth of the testicles is usually the earliest sign.
However, bodily changes can occur in a different order and
would still be considered normal.
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Sl. No. S/A
Statement
Answer
Sex and Sexuality
26
S
Adolescent girls and boys are more likely to have skin
True
problems.
A
During puberty increased hormonal activity leads to increased
activity in the skin glands. Oil produced by the glands blocks
skin pores and mixes with bacteria to cause pimples or spots. To
help keep the skin clear, adolescents should wash their face and
hands frequently.
27
S
A girl can get pregnant even if a boy does not ejaculate or
True
‘come’ inside her.
A
Even if a boy does not ejaculate inside the vagina, it is still
possible that pre-seminal fluids will contain sperms; therefore a
girl can get pregnant.
28
S
The female determines the sex of the baby.
False
A
The sex of the baby depends upon the sex chromosomes in
the sperm that fertilizes the ovum. There are two types of sex
chromosomes, X and Y. The girl (ovum) contains X and X and
the boy (sperm) contains X or Y chromosome. If the sperm
containing Y chromosome fertilizes the ovum, a boy will be
born. If a sperm containing X chromosome fertilizes the ovum,
a girl will be born. No medicine or religious ritual can be of help
in the selection of the sex of the baby.
29
S
A girl will not get pregnant if she has sex only once or a few
times.
False
A
A girl can get pregnant even with a single intercourse, including
her first one.
30
S
If a girl does not bleed during the first intercourse, she is not a False
virgin.
A
Bleeding may occur because of tearing of the hymen (the skin
tissue covering the mouth of the vagina) in some girls. In many
communities, much importance is attached to the presence of a
hymen. The hymen is believed to be linked to a girl’s virginity.
This is not true. The hymen can break not only by sexual
intercourse, but also by participation in certain kinds of physical
activities and even by accident. In certain cases it may not be
there at all.
31
S
A girl should be concerned if the size of her breasts is smaller False
than other girls of her age.
It takes a different amount of time for each girl. If a girl starts
later than other girls, it does not mean that her breasts will
always be smaller. There is no link between what size breasts
will be and when they start to develop.
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Sl. No. S/A
Statement
Answer
Sex and Sexuality
32
S
Having small breasts is normal.
True
A
The size and shape of the breasts depends upon the genetic
background and varies according to age. There is a lot of
variation in the normal size of the breast.
33
S
It is compulsory for all girls/women to wear a bra.
A
No, but some find it is more comfortable.
False
34
S
It is possible for a girl to know when her period is about to start. False
A
No one can be sure exactly when this will happen. Most girls
begin menstruating between the ages of 12 and 16 years. The
average age is 12 or 13 years. The best way a girl can know is to
look for signs. Underarm hair and a whitish discharge from the
vagina are signs that the period probably is not too far away.
35
S
A girl can get pregnant if she shares underwear with a boy.
False
A
A girl can get pregnant only when a boy’s penis enters her
vagina and ejaculates. Sharing of underwear will not lead to
pregnancy. However, sharing of undergarments between boys
and girls and even between girls should be avoided for hygiene
reasons.
36
S
It is normal for boys to experience breast tenderness during
True
puberty.
A
Occasionally, one or both of a boy’s breasts can become slightly
enlarged or sore. This is related to the rising levels of hormones
in the body.
37
S
If a boy has swelling in the breasts it is nothing to worry about. True
A
Some boys develop a marble sized swelling in their breasts at
puberty. The swelling may be painful. Boys may get worried
whether they would develop breasts like girls. This is a harmless
condition caused by hormonal changes and disappears in a few
months.
38
S
The size of the penis is equal to masculinity or virility.
False
A
The size of the penis either when it is flaccid (not erect) or when
erect is no indication of a man’s masculinity or sexual ability.
39
S
Nocturnal emissions make boys weak.
False
A
Loss of semen through a wet dream, masturbation or sexual
intercourse is a perfectly natural, harmless thing. It does not
make anyone weak.
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11.1 Page 101 |
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R8.1
Causes and Consequences of Early Marriage
Marriage or matrimony is a social, religious, spiritual or legal union of individuals. The cer-
emony that marks its beginning is called a wedding.
The interpersonal relationships in a marriage are acknowledged by the state or religious authori-
ties, or both. It is often viewed as a contract.
People marry for many reasons, including some of the following: legal, social, and economic
stability; the formation of a family unit; procreation and the declaration of love; or to obtain
citizenship.
Right Age at Marriage
The legal age at marriage for boys is 21 and for girls is 18 years. By this time a boy and a girl ma-
ture both physically and mentally, which enables them to take up responsibilities and decisions
on their own. In child marriage, girls are more likely to suffer physiological damage, besides a
lifetime of domestic and sexual subservience.
Causes of Early Marriage
Traditionally, girls in many cultures wed shortly after beginning to menstruate. The reasons
include:
q In many traditional cultures, a young woman’s school achievements are not viewed as an
asset to the family, so there is no incentive to keep young women in school after they reach
marriageable age.
q By contrast, the number of children a woman can bear is viewed as an asset. The younger a
woman marries, the more children she can have.
q There is a fear that if the girl is not married off early she may lose her virginity and as a
result sully the family honour.
q Also, a family can attain some economic stability through a bride price or by having one less
person to feed and clothe in the household.
q Sometimes an ailing grandparent pressurizes the parents for the early marriage of their
daughter.
q Sometimes, violence in the society plays its role where parents do not feel safe to keep a girl
unmarried for long.
Consequences of Early Marriage
q Child marriage is a violation of human rights. According to the Universal Declaration of
Human Rights, marriage should be entered into only with the free and full consent of the
intending parties. In addition, early marriage violates other rights such as the right to educa-
tion.
q Early marriage has extreme physical, emotional and intellectual consequences. The prac-
tice virtually ends a child’s chances of pursuing an education or exploring professional and
social life opportunities.
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q Married women with children and a household to run are unlikely to complete their educa-
tion. The benefits of education go beyond being able to read and do accounts; an education
also gives women the tools to think independently and to make healthier choices for them-
selves and their families.
q He may be her first, but she may not be his first. Girls who marry in their teens often marry
men who are considerably older and may have had multiple sexual partners. It is not un-
usual for women who have had sex only with their husbands to contract sexually transmit-
ted infections or HIV.
q Saying “No” is not an option. The difference in age and education creates an imbalance
of power in a relationship between a young girl and her older husband. This hypothetical
bride cannot say whether or not she wants to have sex. She cannot even demand that her
husband be monogamous or use a condom.
q Girls and women who are married younger, especially when married as children, are more
likely to experience domestic violence and to believe that it is justified for a man to beat
his wife. Domestic violence seriously endangers the physical and mental health of women
and girls and can even endanger their lives. The domestic violence that comes with early
marriage has compelled many young girls to run away from home in desperation.
q There can also be psychological damage from child marriage, as girls are more likely to
face domestic and sexual subservience.
q From playing with dolls to caring for babies, young brides can be expected to have their
first child quickly to prove their fertility — even before their bodies are ready for child-
bearing. Pregnancy in an immature body can lead to death (maternal/infant) or lifelong
disability.
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R8.2.1
Causes and Consequences of Early Pregnancy
Some Possible Causes of Early Pregnancy
q Early marriage
q The young bride is expected to have her first child quickly to prove her fertility
q Lack of scope for young girls to control their reproduction, or to make a decision about
whether they want a child
q Pressure from in-laws to have children
q Lack of information regarding contraceptive choices
Consequences of Early Pregnancy
q Pregnancy is hard on the girl’s body, especially if the pregnant girl has not herself grown
up. Those growing up need a lot of energy and many special vitamins. The foetus will
take these from her body even when she needs them. Teenage pregnancy can also cause
anaemia.
q A teenage mother will not feel as well during and after her pregnancy as a grown-up
woman who becomes pregnant would. The baby suffers too, because if it does not get all
of the food that it needs from the girl mother, it may be born very weak and small or very
early. Small babies are much more likely to be very sick, to die, or be weak and sick their
entire lives.
q A young girl’s pelvis (hips) is not as wide as a mature woman’s pelvis. This makes it difficult
or impossible for the girl to give birth. If the girl is not able to have an emergency operation
she may die, or the baby may die or become crippled. The UN Human Rights Council
reports that girls aged l0–14 years are five times more likely to die in pregnancy or childbirth
than women aged 20–24 years; girls aged 15–19 years are twice as likely to die as women
aged 20–24 years.
Family Planning/Planned Parenthood
Methods to prevent pregnancy are known as family planning methods, child spacing methods or
contraceptive methods. Family Planning is defined by WHO as, “A way of thinking and living
that is adopted voluntarily, upon the basis of knowledge and attitudes and responsible decisions,
by individuals and couples in order to promote the health and welfare of the family groups and
thus contribute effectively to social development of a country.”
Planned and responsible parenthood entails good health for the mother and child, proper
development and attention to children and welfare and caring for each member of the family.
It is directly linked to maternal and infant mortality and morbidity. Only a healthy girl can
grow into a healthy woman who is capable of bearing healthy babies. The purpose of ‘family
planning/planned parenthood’ is to plan the number, frequency and timing of pregnancies,
which ultimately affect the family size and health of the mother and the infant. It includes taking
conscious and informed decisions on: what age to marry, when to have the first child, the timing
of subsequent children and the total number of children desired.
Family planning helps everyone. It-
• prevents unwanted pregnancies
• prevents high risk pregnancies
• prevents unsafe abortions
• helps women’s body to replenish the lost stores of nutrients
• provides other health benefits such as hormonal methods, and prevents certain cancers. The
condom helps in preventing sexually transmitted diseases (STDs) such as HIV.
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R8.2.2
Contraceptive Methods in Brief
There are a number of ways to prevent pregnancy. Some are temporary contraceptive methods,
which can be used by both or either of the partners. There are also some permanent methods,
whereby the ability to procreate can be stopped totally.
Temporary Methods
q Condom – for men/women
q Oral contraceptive pills – for women
q Copper T – for women
q Injectable contraceptives – for women
Permanent Methods
q Operation (both men and women)
o Tubectomy for women
o Non Scalpel Vasectomy (NSV) for men
In addition, some other methods are also available but less commonly used-
Spacing: Barrier methods like spermicides, diaphragm, cervical caps
Hormonal methods: Hormonal patch, vaginal rings
Emergency contraception: Emergency contraceptive pills
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R8.2.3
Oral Contraceptive Pills
Oral Contraceptive Pills (OCPs) are tablets containing the hormones oestrogen and progestin. A
woman takes one tablet daily to prevent pregnancy.
OCPs work by preventing the release of the egg from the ovary. Without an egg to be fertilized,
a woman cannot become pregnant.
How to Use
l Take the first pill on the first day of period or any of the next four days.
l Take one pill every day, at the same time each day. Keep the pills in an easy to remember
place, such as near where you brush your teeth every night.
l 28-day packet: Upon finishing a packet, begin a new one the following day.
l 21-day packet: one pill each night for three weeks, wait for seven days and then begin a new
one. To remember when to start up again, mark it on a calendar.
l Read the instructions carefully on the wrapper or consult the doctor for all your queries.
How Effective Are They?
l As commonly used, about 8 pregnancies occur per 100 women using Combined oral con-
traceptives (COCs) over the first year. This means that 92 of every 100 women using COCs
will not become pregnant.
l When no pill-taking mistakes are made, less than 1 pregnancy per 100 women using COCs
over the first year (3 per 1,000 women) takes place.
Missed Pills-What to Do?
Key Message
l Take a missed hormonal pills as soon as possible.
l Keep taking pills as usual, one each day. (She may take
two pills at the same time or on the same day.)
Missed one or two pills?
l
Started new pa ck one or two days l
late?
Missed pills three or more days in a l
row in the first or second week? Started l
new pack three or more days late?
l
Take a hormonal pill as soon as possible.
Little or no risk of pregnancy.
Take a hormonal pill as soon as possible.
Use a backup method for the next seven days.
Also, if she had sex in the past five days, can consider
Emergency Contraceptive Pills (ECPs).
Missed three or more pills in the third l
week?
l
l
l
Take a hormonal pill as soon as possible.
Finish all hormonal pills in the pack. Throw away the
seven non-hormonal pills in a 28-pill pack.
Use a backup method for the next seven days.
Also, if she had sex in the past five days, can consider
Emergency Contraceptive Pills.
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Advantages
l Safe, effective and easy to use
l Women controlled – women use this method and do not have to depend on their partners
to do so
l Can be used before the onset of menses
l May lead to lighter, regular periods with less cramping
l One can become pregnant after stopping the pill
l Does not interfere with sexual pleasure
l May be beneficial for adolescents who have irregular or heavy periods, menstrual cramps,
or acne
l Decreases the risk of cancer of the female reproductive organs
Disadvantages
l Have some side-effects
l Must be taken every day
l Do not protect against sexually transmitted infections/HIV
The pill does not protect against sexually transmitted infections/HIV. Use a condom during
every act of intercourse to protect against STIs/HIV and provide further protection against
pregnancy.
Possible Side-effects
Most adolescents experience no side-effects. Occasionally, one may experience:
l Nausea
l Weight gain
l Breast tenderness
l Mood changes
l Headaches or dizziness
l Unexpected bleeding or spotting
Situations when not to Use OCP
l Possible pregnancy
l Abnormal vaginal bleeding
l 35 or older age and who smoke
l High blood pressure
l History (personal/family) of stroke and heart disease
l History of thrombosis
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l Lumps in breast/breast cancer
l Past or current history of liver disease, including viral hepatitis, or jaundice during
pregnancy
l Breastfeeding (for first six months as it reduces the flow of milk)
l History of pelvic infection and at risk of sexually transmitted diseases
l Taking certain other medications
l Severe headaches with blurred vision or temporary loss of vision
l Gall bladder disease
l Childbirth in past 21 days
l Planning surgery
l Diabetes
l Medication for tuberculosis (TB), fungal infections, or seizures
A physical (pelvic/breast) examination is desirable for all women, but not essential. Conditions
that may be contra-indications or precautions for the use of OCPs can be screened through tak-
ing a patient’s history. Consultation with a doctor/nurse is must before starting OCP.
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R8.2.4
The Male Condom
This is a narrow bag made of rubber and is like a covering, which is put over the erect penis. As
a result, man’s semen stays in the bag and the sperm cannot enter in the woman’s body.
If used properly, condoms help prevent unwanted pregnancy and sexually transmitted diseases
including HIV/AIDS.
Many boys and men do not know the proper use of the condom and they do not use it every
time they have sexual intercourse. As a result, the risk of unwanted pregnancies and contracting
sexual diseases remains.
How to use it
1. Make sure that the condom is not past its expiry date.
2. Push the condom to one end of the packet and tear open the other end. Make sure not to
damage the rubber with your fingernails, jewellery or the foil of the wrapper.
3. Put the correct side of the condom on the erect penis, before it has come into contact with
the partner’s genitals. Hold the top of the condom and press out the air from the tip, so that
you leave a centimetre of empty space for the semen at the top of the condom.
5. Roll the condom all the way to the base of the erect penis. Use both hands.
6. After ejaculation, withdraw the penis immediately before the erection is lost, holding the
rim of the condom to prevent spilling.
7. Tie a knot in the condom; wrap it in tissue and throw into a dustbin or burn it. Wash your
hands.
Remember
l A condom should be used only once.
l Normally a condom feels oily to touch. This oily texture is necessary.
l Applying oil or vaseline on the condom can damage it.
l Condoms can be acquired from any government hospital free of cost.
l Condoms are also available at a medical store.
l Some men may be allergic to the latex used for making a condom.
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How
to use
a male
condom
1. Check expiry date on packet
2. Pinch teat
3. Roll down fully
4. After intercourse remove
carefully from base
108
5. Tie a knot and put in bin
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R9.1.1
Reproductive Tract Infections and Sexually Transmitted Infections
Reproductive Tract Infections
The term reproductive tract infections (RTI) refers to any infection of the reproductive tract. In
women, this includes infections of the outer genitals, vagina, cervix, uterus, tubes or ovaries. In
men, RTIs involve the penis, testes, scrotum or prostate.
RTIs is a generic term that covers four types of infection:
1. Sexually transmitted infections
2. Infections that result from the over growth of organisms normally present in the reproductive
tract
3. Infections associated with medical procedures, including abortion or Copper-T insertion
4. Infection following vaginal delivery or spontaneous abortion requiring surgical
intervention
Sexually Transmitted Infections
Sexually transmitted infections are caused by germs such as bacteria, viruses or protozoa that
are passed from one person to another through sexual contact. The term ‘sexually transmitted
infection’ (STI), as opposed to ‘sexually transmitted disease’ (STD), is used to indicate that
infections do not always result in a disease. We consider that these terms are interchangeable in
this training and will use the term STD for the sake of simplicity. More than 20 different STIs,
including gonorrhoea, chlamydia, herpes, syphilis and HIV/AIDS have been identified. Some
STDs such as syphilis, HIV and hepatitis can also be transmitted through infected instruments
during a medical procedure or during a blood transfusion. HIV, along with Hepatitis, can be
passed by mother-to-child transmission, which is sometimes called vertical transmission. It
includes transmission (1) during pregnancy, (2) during birth, and (3) through breast milk.
The annual incidence of RTI/STI in India is estimated in over six per cent of the adult population
(as per the community based STI/RTI Prevalence Study, 2003) with approximately 40 million
new infections taking place every year. Women are particularly vulnerable because they find it
difficult to negotiate and practice safe sex at home, yet the male condom is the only available
protection against infection.
Symptoms
The following symptoms and signs of RTI/STI may occur both in men and women:
Burning pain during urination or defecation, increased frequency of urination
Single or multiple blisters and open sores on the genitals, which may or may not be
painful
Swollen and painful glands in the groin
Itching or tingling sensation in the genital area
Non-itchy rashes on the body
Warts in the genital area
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Sores in the mouth
Nodules under the skin
Female
Male
w Pus emitting from the vagina or
w White liquid/pus emitting from the penis
yellowish, greenish, smelly pus or fluid w Swelling of the penis or testes
w Itching or infection at the vaginal mouth w Burning sensation or pain while urinating
w Burning sensation or pain while urinating w Swelling of the inner joint of the base of
w Pain in the lower stomach
the penis with the upper thigh
w Swelling of the inner joint of the vagina w Some cut or bristle or painful wart on the
with the upper thigh
penis
w Under the covering of the vagina
sometimes a lump may form which can
become infectious
w Painful mole or some painful bristle at
the vaginal mouth
Anyone infected with an RTI/STI must immediately consult a doctor. A specific kind of medicine
and treatment is necessary for these infections, which must not be delayed.
Complications from RTIs/STIs
Infertility
Abdominal pain in woman owing to infection in reproductive tract
Irregular menstruation
Cancer in genital tract
Miscarriages and stillbirths
Infection in the newborn
Increased chances of HIV infection
Prevention is the key to protecting oneself from incurable STIs, such as HIV and herpes.
Vaccines are available that protect against some viral STIs, such as Hepatitis B.
The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts
or fluids which can lead to transfer. Proper use of condoms (male or female) reduces contact
and risk.
Relation between RTI/STI and HIV/AIDS
Individuals who are infected with STIs are approximately 8 to 10 times more likely than
uninfected individuals to acquire HIV if they are exposed to the virus through sexual contact.
In addition, if an HIV-infected individual is also infected with another STI, that person is more
likely to transmit HIV through sexual contact than other HIV-infected persons.
Studies indicate that detecting and treating STIs may reduce HIV transmission.
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R9.1.2
Lakhan’s Hesitation
Lakhan has been experiencing pain and itching in his genitals for quite some time. One day he
shares the problem with his friend, Ramu.
LAKHAN: Ramu, for the past few days my genitals are itching and paining a lot. It is very
troublesome and I cannot tell anybody at home. I do not want my wife to get suspicious.
RAMU: You know, when Moti came to town last time, he had a similar problem. He consulted
Jharu Ojha (the local quack) and got cured. You should go and meet Jharu Ojha.
Ramu accompanies Lakhan to Jharu Ojha and he gives him something to apply at the affected
place. After about a week, Lakhan meets Ramu.
RAMU: How are you feeling?
LAKHAN: It’s actually worse. And now my wife is also experiencing pain and itching. I do
not know what to do. May be I should go back to Jharu Ojha or to the Doctor babu at the health
centre.
Possible Answers to Questions in the Session
1. What do you think could be wrong with Lakhan?
Lakhan could have any of the STIs.
2. What could he have done to be feeling this way?
To get the STI he may have had unprotected sexual contact with somebody infected with
an STI. It could have been sexual intercourse or any sexual contact, including rubbing of
the genitals.
3. What should he have done differently?
a. Lakhan should not have had sexual relations with somebody apart from his wife.
b. If he did, he should have used protection, such as a condom.
4. What should he do now?
Lakhan needs to get tested by a qualified doctor and start medication. He also needs to tell
his wife. If Lakhan gets treated and his wife does not, he could get re-infected from her.
Also, if she is not treated then long-term complications could occur.
5. Should he have told his wife about his problem?
Yes, he should. The sooner she gets tested there is a less chance of getting serious life-long
complications.
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R9.2
HIV/AIDS
1. What does HIV stand for?
HIV stands for Human Immunodeficiency Virus. HIV is a virus that leads to a condition
called AIDS.
Human
indicates that the virus only affects humans
Immunodeficiency indicates that the virus weakens the immune system and makes it
ineffective in defending the body against infections
Virus
indicates that it is a virus as opposed to bacteria or any other micro
organisms. This means that antibiotics cannot be used to treat HIV
2. How does HIV affect the immune system?
The immune system is composed of different kinds of white blood cells. These cells work
together to defend the body against infections and diseases. When an infection enters
inside the body, the immune system gets into action.
As soon as you catch a cold the immune response gets into action. When the virus causing
the cold enters your body, the immune system sees it as an enemy. The immune system
makes more cells to fight the cold. After a few days your immune system kills or controls
the virus and you feel fine again.
When HIV inters body, it damages and destroys different cells of the immune system.
When these cells are destroyed, the body is unable to defend itself against them. HIV
can be in the body for several years before it damages the immune system. Until then the
infected person can look and feel healthy.
3. What is AIDS?
AIDS is caused by HIV. A person is diagnosed with AIDS when the immune system is too
weak to fight off infections. It is at the point of very advanced HIV infection that a person
is said to have AIDS.
A person is diagnosed with AIDS when they have developed an AIDS related condition or
symptom, called an opportunistic infection, or an AIDS related cancer. The infections are
called ‘opportunistic’ because they take advantage of the opportunity offered by a weakened
immune system.
It is possible for someone to be diagnosed with AIDS even if they have not developed an
opportunistic infection. AIDS can be diagnosed when the number of immune system cells
(CD4 cells) in the blood of an HIV positive person drops below a certain level.
Acquired
indicates that the virus is transmitted from one person to another, not
inherited like eye colour or blood type
Immune
refers to the immune system, the body’s defence mechanism against
germs or infections
Deficiency
indicates a lack of or weakening of the immune system
Syndrome
refers to the presence of multiple infections. When the body’s
defences are weakened, it is possible for many infections or diseases to
simultaneously infect the body. This grouping of symptoms is referred
to as a syndrome.
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4. What is the difference between HIV and AIDS?
HIV is a virus and AIDS is an advance stage of HIV infection. AIDS usually takes time to
develop from the time a person acquires HIV – usually from 2 to 15 years.
After AIDS has been diagnosed, the current average survival time with antiretroviral
therapy is estimated to be now more than 5 years, but because new treatments continue to
be developed and because HIV continues to evolve resistance to treatments, estimates of
survival time are likely to continue to change. Antiretroviral medication can prolong the time
between HIV infection and the onset of AIDS. Without antiretroviral therapy, death could
even occur within a year. Most patients die from opportunistic infections or malignancies
associated with the progressive failure of the immune system.
5. How is HIV transmitted?
The lining of the end of the boy’s penis and the girl’s vagina are a special kind of skin called
mucous membranes. Like our mouths, they are moist and more delicate and have more holes
than the rest of the skin. That is why they can be hurt or cut easily. That also means that
mucous membranes are more easily infected than other kinds of skin. If a person has HIV,
the virus can be transmitted when it comes into contact with a mucous membrane.
If someone has little cuts or bruises in their skin or mucous membranes, it is very easy for
STI germs or HIV to enter their bodies through those injuries. These injuries in the skin can
be microscopic, which means you cannot see them with your eyes.
6. Why does sexual intercourse increase the risk of getting HIV?
If a girl is not ready for sex and her vagina is dry, it will hurt her. Also, if she is bleeding and
if the man/boy or the girl has an STI or HIV, they are much more likely to infect each other
than they are if the girl’s vagina was wet. Therefore, forcing a girl to have sex or having sex
before a girl is ready, is dangerous for both the boy and the girl.
If the blood or secretion from a person with HIV mixes with the blood or secretion of an
uninfected person, the virus will be transmitted to that uninfected person.
HIV can be transmitted through:
w Having sexual contact without using a condom
w Transfusion of infected/unsafe blood
w Sharing of unsterilised syringes and needles
w HIV infected mother to her child during pregnancy, delivery and breastfeeding
The common route of transmission in India is the sexual route. About 85 per cent of persons
living with HIV have been infected through sexual activity.
Having sexual contact without using a condom is the common way of transmission of
HIV. HIV is present in a high concentration in semen and in cervical and vaginal fluids,
including menstrual blood. Infection with HIV through sexual relations is possible through
heterosexual and homosexual contact, including vaginal sex, anal sex and oral sex. Infection
can be passed to others as well.
Not all types of sexual intercourse carry the same risk: The risk is more when there are
higher chances of injury to the body part as HIV can enter easily through a break in the
mucous membrane. Anal intercourse carries the highest risk of transmission, followed by
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vaginal intercourse and then oral intercourse. Chances of sexual transmission or HIV are
higher if a person is suffering from a sexually transmitted infection.
Transfusion of infected blood from one person to another would directly transmit HIV into
the bloodstream of the recipient. Therefore, testing of blood for HIV before transfusion is
mandatory. However, donating blood carries absolutely no risk of acquiring HIV infection,
if it is done using sterile equipment. We should donate blood once in 3-4 months to increase
the pool of uninfected blood and thus ensure safe blood for yourself, your relatives, and
others in your area.
Infected needles and syringes: HIV can also be transmitted through the use of unsterilized
needles and syringes. Used needles and syringes are soiled with minute amounts of leftover
blood. Infected blood will directly transfer HIV into the bloodstream. Some intravenous
drug addicts tend to share their needles and syringes with other addicts to save money.
During such sharing HIV is likely to be transmitted, if any one of the addicts is infected
with HIV.
Mother to child: The baby is more at risk if the mother has been recently infected or is in a
later stage of AIDS.
A person cannot get infected with HIV from the following:
w Social contact such as shaking hands, playing together or travelling together
w Sharing towels, crockery, utensils, etc.
w Use of public toilets/swimming pools
w Eating and drinking from the same plate or cup
w Mosquito bites
w Caring for and touching a person living with HIV
w Hugging and dry kissing
w Coughing or sneezing
w Body fluids like tears, saliva, sweat, urine, etc
7. HIV Testing
You cannot tell by looking at someone whether he or she has HIV infection. Someone can
look and feel perfectly healthy and still be infected. Many people who have HIV infections
do not know it. Neither do their sex partners.
The HIV-antibody test is the only way to tell that the person is infected with HIV. When any
virus enters the body, the immune system responds by making proteins called antibodies.
Different viruses cause the body to make different antibodies. The body makes antibodies
to HIV when it is infected with the virus. The HIV-antibody test detects HIV antibodies in
the blood. It tells whether you are infected with HIV or not.
The HIV-antibody test always includes pre-test and post-test counselling. This counselling
is to help understand the result, how to protect one’s own health, and (if you are infected)
how to keep from infecting other people.
Several tests can find antibodies or genetic material (RNA) to the HIV virus such as the
Enzyme-Linked Immunosorbent Assay (ELISA), Western Blot, Polymerase Chain Reaction
(PCR).
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Testing is often done at six weeks, three months, and six months after exposure to find out
if a person is infected with HIV.
HIV counselling and testing services were started in India in 1997. There are now more than
4000 Information Counselling and Testing Centres (ICTC), mainly located in government
hospitals. An ICTC is a place where a person is counselled and tested for HIV, of his own
free will or as advised by a medical provider.
HIV counselling and testing services are a key entry point to prevention of HIV infection
and to treatment and care of people who are infected with HIV. When availing counselling
and testing services, people can access accurate information about HIV prevention and care
and undergo HIV test in a supportive and confidential environment. People who are found
HIV negative are supported with information and counselling to reduce risks and remain
HIV negative. People who are found to be HIV positive are provided psycho-social support
and linked to treatment and care.
8. HIV Window Period
The window period is the time it takes for the body to produce HIV antibodies after infected
by the virus. In most people, this period is between two and 12 weeks. In a very small
number of people, the process takes up to six months.
During the window period, an antibody test may give a ‘false negative’ result, which means
one might be infected with HIV yet test HIV-negative.
Here’s how that can happen. Let’s say Mr. A had unprotected sex on Saturday night and
become infected with HIV. On Monday, he gets an HIV test. The test almost certainly will
come back negative, because the body has not yet had a chance to make antibodies, which
are what the HIV test looks for.
Even if one goes for an HIV test one or two months later, the results might be negative
because the body has still not produced antibodies. It may take three months after exposure
for the test results to be 97 per cent accurate, and six months to be absolutely certain. If
you think you have been exposed to HIV, and your test results are negative, be sure to get
retested in three to six months, just to be sure.
During this window period the individual is already infectious and may unknowingly infect
other people. People who are exposed to or who practice high-risk behavior are well advised
to arrange for a repeat test after three to six months, and to use safer sex practices like
condoms while waiting for their results.
9. What are opportunistic infections?
In our bodies, we carry many germs – bacteria, protozoa, fungi and viruses. When our immune
system is working, it controls these germs. But when the immune system is weakened by
HIV, disease or by some medications, these germs can get out of control and cause health
problems.
Infections that take advantage of weakness in the immune defenses are called ‘opportunistic’.
The phrase ‘opportunistic infection’ is often shortened to ‘OI’.
HIV weakens the immune system so that opportunistic infections can develop. If you are
HIV-infected and develop opportunistic infections, you might have AIDS.
The most common OIs are listed here, along with the disease they usually cause, and the
CD4 cell count when the disease becomes active:
• Candidiasis (Thrush) is a fungal infection of the mouth, throat or vagina.
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• Cytomegalovirus (CMV) is a viral infection that causes eye disease that can lead to
blindness.
• Herpes simplex viruses can cause oral herpes (cold sores) or genital herpes. These are
fairly common infections, but if you have HIV, the outbreaks can be more frequent and
severe.
• Malaria is common in the developing world. It is more common and more severe in
people with HIV infection.
• Mycobacterium Avium complex (MAC or MAI) is a bacterial infection that can cause
recurring fevers, a general sick feeling, problems with digestion, and serious weight
loss.
• Pneumocystis Pneumonia (PCP) is a fungal infection that can cause a fatal Pneumonia.
Unfortunately this is a fairly common OI in people who have not been tested or treated
for HIV.
• Toxoplasmosis (Toxo) is a protozoal infection of the brain.
• Tuberculosis (TB) is a bacterial infection that attacks the lungs, and can cause
meningitis.
One can reduce the risk of new infections by keeping clean and avoiding known sources of
the germs that cause OIs. If one has developed an OI infection, medication will prevent the
development of active disease. This is called Prophylaxis.
10. What is the connection between HIV and young people?
w 50 per cent of all new infections are in the age group of 15–24 years.
w Adolescents are more vulnerable to HIV infection because of experimentation.
w Adolescents are less likely to recognize potentially risky situations or negotiate safer
sex behaviours.
w In addition, peer pressure, sexual experimentation, drug and alcohol use may increase
adolescents’ likelihood of engaging in high-risk behaviours.
w Adolescents often feel that nothing bad can happen to them.
w Young people lack access to information and services or cannot afford them due to
social and economic circumstances.
w Adolescent boys who are sexually active do not seek information about how to protect
themselves and their partners for fear of appearing inexperienced.
w Young women may be particularly vulnerable for biological reasons (immature vaginal/
cervical tissues may be more readily permeated or damaged) and for social reasons,
including lack of economic resources and negotiating power.
11. Why do girls get infected with HIV more easily than boys?
The vagina gets damaged easier than the penis, and that increases the chances for the virus
to get in. Young girls who have older sexual partners are more at risk if they are not using
condoms, because these older partners may have had many other partners and are more at
risk of having HIV. When a girl loses her virginity or if she has sex when she is not ready
or willing, she is likely to experience bleeding, which increases her chance of infection.
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In addition, the area of the mucous membrane exposed during intercourse is much larger in a
woman than in a man and the virus can easily penetrate the mucous membrane of the vagina.
Also, the concentration of the virus is higher in semen than in vaginal fluids. In addition,
social factors like low socio-economic status, low literacy rates, limited mobility and limited
access to information put women at a further risk of contracting the HIV infection.
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R9.4
Whether a Behaviour is HIV Risky
w Tattooing
Low risk: Chance of infection is very low but should not be eliminated,
especially in a group situation.
w Blood donation
No risk as long as the blood collecting bags and needles are sterile.
w Sharing needles
High risk: Sharing a needle with an infected person is very-high-risk
behaviour.
w Using a public toilet
No risk: HIV cannot be spread from a toilet seat.
w Deep kissing
Low risk, if there is bleeding cuts or wounds in the mouth.
w Having sex with someone from your locality without a condom
High risk: No one can be guaranteed to be HIV-free.
w Having many sexual partners
High risk: More partners increases the possibility of contracting HIV.
w Taking care of an HIV-infected person in a camp
No risk.
w Using vaseline/hair oil to lubricate a condom
High risk: Condoms are made of latex rubber. An oil-based lubricant will
chemically react on the rubber and produce microscopic holes which would
allow HIV to pass through. Only water-based lubricants or saliva are safe to
use.
w Not having sexual intercourse
No risk.
w Being bitten by a mosquito that has bitten someone with HIV
No risk: There is no documented proof of HIV transmission by
mosquitoes.
w Being close to an HIV-infected person who coughs or sneezes
No risk: HIV cannot be spread through sneezing or coughing – the virus
cannot survive in air.
w Masturbation
No risk.
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w Oral sex
Low risk. But the use of a condom is recommended, as other STIs can be
contracted.
w Having sex under the influence of intoxicants
High risk: Intoxicants impair judgement. It is high-risk because one cannot
be sure of proper and consistent use of a condom if it is at all used.
w Anal sex
High risk: The rectum is not naturally designed for sex, so there is more
chance of bleeding, which makes it easier for the virus to enter the body.
w Swimming with an HIV-infected person
No risk: HIV cannot survive in water.
w Caring for a person infected with HIV
No risk.
w Breastfeeding by an HIV-positive mother
High risk: The virus has been found in breast milk in low concentrations.
Children of HIV-infected mothers have been infected through breast milk.
w Sharing schools, theatres and restaurants
No risk.
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R9.5
Testing for HIV
Where does one go for diagnosis and treatment?
You can take a voluntary blood test and counselling at Integrated Counselling and Testing
Centres (ICTCs) in medical colleges and hospitals and be admitted at any government hospital.
Protecting Yourself
Right to Informed Consent: The implications of HIV are very different from most other
illnesses. Testing for HIV requires specific and informed consent of the person being tested and
any research on data of HIV positive people.
Right to Confidentiality: A person has the right to keep information on HIV status confidential.
People with HIV are often afraid to go to court to vindicate their rights for fear of their HIV
status becoming public knowledge. However, they can take the help of Suppression of Identity
under a pseudonym. This ensures that people living with HIV/AIDS can seek justice without
fear of social ostracism or discrimination.
Right against Discrimination: The right to be treated equally is a fundamental right whether it
is something as simple as using a public well or something more serious like denial of housing
or a job.
You can seek remedy in a court of law if you are tested for HIV without an informed consent, or
your confidentiality is breached, or any of your rights have been violated. You have the support
of the legal system to ensure it.
(NACO, www.nacoonline.org)
For more details, please contact:
National AIDS Control Organisation (NACO) at www.nacoonline.org
or
Lawyers Collective HIV/AIDS Unit, www.lawyerscollective.org
Mumbai – Tel: 022-22875482/3, email: aidslaw@lawyerscollective.org
New Delhi – Tel: 011-24377101/2, email: aidslaw1@lawyerscollective.org
Bangalore – Tel: 080-41239130/1, email: aidslaw2@lawyerscollective.org
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R9.6
Stigma and Discrimination
It is possible now for a person living with HIV to lead a reasonably normal and healthy life.
Children and young people living with HIV have a right to education, accurate information,
friendly health services and support and understanding from the community.
w Students living with HIV should lead as full a life as possible and should not be denied
the opportunity to receive an education to the maximum of their will and ability.
w No student may be denied admission to, or attendance at a school or an institution on
account of his or her HIV status or perceived HIV status.
w No student or educator living with HIV may be unfairly discriminated against directly
or indirectly.
w Compulsory disclosure of a student’s or educator’s HIV status to a school or institution
authorities is not advocated as this would serve no meaningful purpose. In case of
disclosure, educators should be prepared to handle such disclosures and be given support
to handle confidentiality issues.
Refusal to study with a student, or to work with or be taught by a teacher or other staff member
with, or perceived to have HIV, should be pre-empted by providing accurate and understandable
information on HIV or AIDS to all educators, staff members, learners, students and their
parents.
Students who refuse to study with a fellow student or be taught by a teacher, and staff who refuses
to work with a fellow staff member or to teach or interact with a student with or perceived to have
HIV or AIDS, and are concerned that they themselves will be infected, should be counselled.
The situation should be resolved by the Principal and teachers in accordance with the principles
contained in ‘Education for All’, and the code of professional ethics for teachers/educators.
(‘Education for All’ is a programme of the Government of India and has been adopted by the
states.) Should the matter not be resolved through counselling and mediation, disciplinary steps
may be taken.
Care and Support
People living with HIV need love and support from family and friends:
w Prompt treatment of opportunistic infections
w Healthy lifestyle
w A nutritious diet, sufficient rest and exercise
w To be treated with respect and dignity
Most people living with HIV (PLHIV) are supported by their family. However, some, especially
women, are abandoned and rejected by their families. It is important to understand that a person
living with HIV must be given a nutritious diet, love and support from the family and friends in
order for him/her to lead a reasonably healthy and normal life.
There are many groups and networks of people living with HIV, who can provide emotional,
social and medical support to the PLHIV.
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R10.1
Abuse and Violence
Abuse is the improper use of any object or person, that is the use of an object for what it is not
meant, or poor behaviour/treatment of a person in a manner that is not appropriate but harmful
to that person.
Abuse refers to a pattern of behaviour in which physical violence and/
or emotional coercion is used to gain, or maintain power or control, in a
relationship. A single incident of assault also constitutes abuse.
Violence is the expression of physical force against self or others, compelling action against
one’s will on pain of being hurt.
Sexual harassment is a related term which means intimidation, bullying or coercion of a sexual
nature, or the unwelcome or inappropriate promise of rewards in exchange for sexual favours.
In some contexts or circumstances, sexual harassment may be illegal. It includes a range of
behaviour from seemingly mild transgressions and annoyances to actual sexual abuse or sexual
assault. Sexual harassment is a form of employment discrimination, and a form of abuse (sexual
and psychological) as well as bullying. ‘Quid pro quo’ is a type of sexual harassment among
many others, which means ‘this for that’. In the workplace, this occurs when a job benefit is
directly tied to an employee submitting to unwelcome sexual advances.
Types of Abuse
Physical Abuse
w Intentional physical injury/physical assault.
w Hitting, pushing, kicking, biting, pulling hair, etc.
Verbal Abuse
w Using bad language, deprecating remarks, vulgarity, calling the person names.
Emotional Abuse
w A pattern of behaviour that can interfere with one’s emotional and social development. It
is more than just verbal abuse and can take several forms, including constantly belittling,
acting coldly towards or ignoring somebody.
Sexual Abuse
w A person forces, threatens, or tricks another person into sexual activity. The perpetrator is
in a position of power and carries out sexual activities in a harmful or unwanted way.
w Any time that a child is engaged in a sexual situation with an older person it is sexual
abuse.
Impact of Abuse
w Loss of self-confidence
w Loss of trust in people
w Withdrawal from the surroundings, depression, suicidal tendencies
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w Difficulty in forming and maintaining relationships
w Destructive behaviour
w Alcohol and substance abuse
People react to abuse in different ways:
w They may have feelings of confusion, powerlessness, helplessness, pain, betrayal, sadness,
feeling dirty, shame, vulnerability, unsafe, scared, horrified, depressed, angry, numb from
feelings, suspicious, untrusting, sensitive, anxious and feeling miserable.
w Victims can have negative beliefs about themselves, including: “I am bad, no one could
love me, I am unlovable, I am dirty, it’s my fault, I am stupid, I should have done something,
I should have told someone, I hate myself, I must be bad, I must have done something, I
am being punished, I do not want to be me, why do these things happen to me, I must have
deserved it.”
w They can deny what happened, try to rationalize the situation, or cope by engaging in
substance abuse or risky behaviour.
It is important to understand that it is not the victim’s fault!
Stopping Physical, Mental and Verbal Abuse
w Recognize that what the abuser is saying which is the result of his or her own insecurities
and has no basis in fact.
w Remember that an abuser can never be forced to change. They have to change themselves.
A victim can only truly take care of himself or herself.
w A victim can begin by explaining to and defending himself or herself against the abuser.
The victim can set boundaries and say definitively that he or she will not accept these
attacks any longer.
w Control yourself by staying balanced. To help keep your balance begin by saying nothing.
Remember, it’s all right to not verbally fight back unless you are mentally ready.
If necessary, gather the strength to leave. Learn that there can be a life outside of the
abuse.
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R10.2
Sexual Abuse
Facts about Sexual Abuse
w Sexual abuse is not limited to girls only – boys can also be victims of sexual abuse.
w An abuser may be male or female, family member, relative, domestic worker, neighbour,
teacher or friend of the family. In over 90 per cent of cases the victim knows the abuser.
w Sexual abuse is not always related to intercourse. It can also be
Touching, rubbing, or stimulating the penis or vulva
Touching of private parts (touching breasts or buttocks)
Forcing a child to touch private parts of the body
Forcing a child to watch sex
Child pornography
w Sexual abuse is a serious matter. It is never the abused person’s fault.
w If a child from the age of 0–16 has sex with someone older, this is RAPE.
w If a child between the ages of 16 and 18, has sex with an older person the child is still
considered a ‘minor’ and this could mean the older person will be punished under the
law.
Rape
Rape is defined as having sexual intercourse with any person
w Without their consent
w Against their will
w When consent it obtained through putting them in fear
w When consent is given mistakenly
w When consent is given when the person is insane or intoxicated
w When the person is under 16 years of age
In the event of a rape being discovered by the adults or an individual reporting rape to parents or
other adults, the first step should be to report the incident to the nearest police station and file a
first information report (FIR). There are Child Welfare Officers and Lady Officers in every police
station and, if the victim is female, she will be examined by a doctor in the presence of this lady
officer. If it is crucial, the victim will not take a bath or wash their private parts or change their
clothes till the examination is conducted, as this may lead to loss of crucial evidence.
Bad Touch
A touch that makes any person feel uncomfortable is usually a bad touch. Whoever gives a bad
touch is the one who is bad, not the person being touched. Nobody should be touched if they do
not want to be touched.
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How does one know what a bad touch is?
It is a bad touch if:
w you are hurt by it
w someone touches you on your body where you do not want to be touched
w a person touches you in a way that makes you feel uncomfortable
w that touch makes you feel scared and nervous
w a person forces you to touch him or her
w a person asks you not to tell anyone about the touch
w a person threatens to hurt you if you tell
Coping with Sexual Abuse
w Most importantly, remember that you are not at fault. The abuser is the person who is
wholly responsible.
w Speak to your parents/teachers/someone you trust about what happened. This might be
very difficult to do but if you remember that you are not responsible, you are not bad, and
are not afraid of being punished or should not be held responsible, it might be easier.
w If you have been hurt physically in your private parts or have any problem which was not
present earlier, see a doctor immediately (excessive discharge, difficulty in passing urine,
bleeding).
w Overcome your negative thoughts and restore your self-confidence by taking the help of
a counsellor/helpline.
w Stay involved in your daily activities, be it studying or working. Keep busy.
w Avoid situations where you might be left alone with a person you do not trust, whoever
that may be.
w Wherever you are, it is perfectly all right to yell and attract attention if someone is trying
to hurt you and to try to run away.
w Understand that it will take time to feel better. The pain and the emotional turmoil,
following abuse, last for quite some time. It is a long and hard process and all survivors
must go through it in order to heal and move on with their lives. Allow yourself to feel
angry, sad or regretful. These all feelings are perfectly normal for abuse survivors.
w Try to understand and express your feelings. Taking a moment to acknowledge these
feelings and behaviours, is good for coping with abuse.
w Listen to your body: If your body needs a break, take a break. The human body is a strong
and resilient machine, but it needs to be taken care of. Take a few minutes to do something
that gives you pleasure, or just take a minute to relax. This can make a world of difference
in your recovery process.
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w Identify your support network: Try to be aware of supportive people in your life. Knowing
whom you can and cannot talk to, will allow you the opportunity to share feelings, which
is a necessary part of recovery.
w Express your feelings through writing or art. Capturing your feelings at a particular moment
by writing down these feelings, or expressing them through artwork, can really help you
heal.
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R11.1
Substance Abuse and Addiction
A drug is any chemical substance that affects the function of living beings. What we popularly
call drugs are those substances which are harmful and lead to dependence and addiction.
Examples include ganja, glue, heroin, cocaine and brown sugar.
Medicines which are used to treat illnesses, when taken the wrong way, that is taking in excess
quantity or taking when not needed, are called substance abuse, and can be very dangerous.
In addition to these substances, legal activities like drinking alcohol, smoking, chewing tobacco
(gutkha) are also very harmful and addictive habits.
People take drugs for different reasons, such as:
w peer pressure
w curiosity
w myths about social acceptance (that it will make them ‘cool’)
w escapism (to cope with stress, family problems, emotional insecurity)
w boredom/depression
Addiction
w Once somebody starts taking drugs, the habit often stays. Research indicates that out of
those who have ever used substances, 80 per cent continue to consume alcohol, 70 per
cent continue to use cannabis, and 65 per cent continue to use opiates.
w Addiction is a process. The drug affects the body and brain as the user craves further
intake, increasing the probability of addiction.
w Most people who get addicted start out by trying it only once in a while.
w Most people feel they are in control and will know when to stop, but in reality they do
not.
The effect of drugs makes a person want to keep using them compulsively. When s/he is
deprived of the drug, s/he is unable to carry on with her/his daily activities. This is what it
means to be addicted to drugs. This powerful urge makes her/him lose all sense of reason and s/
he is driven by a compulsion to acquire the drugs by any means. This can even mean resorting
to stealing, harming his/her family, destroying his/her personal relationships and other such
destructive behaviour.
Effects of Substances
Smoking Tobacco/Chewing Tobacco
Tobacco contains nicotine, which is strongly addictive. Tobacco use causes more illness and
death than all other addictive drugs combined.
w Tobacco use results in feelings of relaxation, calmness and a mild euphoric state.
w Chewing tobacco releases more nicotine than smoking tobacco. It can cause mouth and
throat cancer, high blood pressure and dental problems.
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w Smoking tobacco can result in lung cancer, chronic cough and lung infections, mouth
ulcers and high blood pressure.
Alcohol
Alcohol is a depressant that is assumed to induce relaxation because it reduces the activity of the
central nervous system. Alcohol:
w Reduces inhibitions – can lead to risky behaviour such as rash driving and unsafe sexual
practices
w Impairs judgement and motor coordination
w Causes brain damage – long-term use can lead to failing memory, depression, stroke and
paralysis
w Leads to social problems such as family violence, absenteeism from work, and
unemployment
w Damages the liver, leading to liver disease
Inhalants
Inhalants include gassing and sniffing, using substances such as paint thinners, gasoline, glue
and aerosols. Inhalants give the user a high pleasure and can lead to addiction. Inhalants:
w Slow down bodily functions, leading to drowsiness, impaired motor function, impaired
judgement and memory and hallucinations
w Damage the brain
w Can lead to chronic lung diseases
Cannabis, Bhang, Ganja
This is a mild hallucinogen and depressant. Its effects comprise:
w Feeling of well-being, euphoria, state of relaxation. The senses are more acute – sight,
smell, taste and hearing.
w Impairment of memory, concentration and performance in studies
w Damage to heart and respiratory systems
w Potential for mental illness
w Reducing male potency
w Likelihood of cancer (Cannabis is more likely to cause cancer than the strongest tobacco.
It can be detected in the body up to 30 days after initial use).
Heroin/Smack/Brown Sugar/Snow
Heroin is made from the opium plant. It is very powerful and addictive. Its effects comprise:
w Drowsiness, lack of concentration and apathy
w Liver and respiratory diseases, depression, heart complications, coma and death
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w Loss of sex drive
w Malnutrition and extreme weight loss
w Absence of the drug results in withdrawal, including nausea and vomiting, sweating,
cramps, aches and pains, sleeplessness and running nose
w Sharing contaminated needles can lead to blood-borne diseases such as HIV and hepatitis
B
Cocaine/Crack/Candy/Coke/Blow
Cocaine is made from the coca plant. It gives an intense rush. Cocaine is addictive. Its effects
comprise:
w When using, a person may become violent, irritable and paranoid and may suffer from
mood swings.
w When the effect wears off, the person experiences an intense, highly unpleasant
depression.
w Mixing cocaine with other drugs is extremely dangerous and can lead to sudden death.
w Regular use can result in heart attacks, respiratory failure, anxiety, seizures and
paranoia.
The Problem of Drug Addiction
Apart from the effects of drugs on the individual, they are also:
w Very expensive.
w Illegal. In addition, drug users may resort to crime to get money for drugs.
w Extremely difficult to stop taking. Drug users frequently relapse when they are trying to
stop taking drugs.
w More likely to make people engage in other risky behaviour such as unprotected sex,
leading to unwanted pregnancy, sexually transmitted diseases and HIV.
Avoiding Addiction
w Understand and be convinced that any pleasure that is obtained from these substances
is only momentary but the harmful effects are long lasting. They have irreversible
consequences on one’s life and can even lead to death.
w Talk to your teachers/parents or people you can trust if you feel very tempted to try
these substances and seek their support in helping you stop yourself. But remember that
eventually you have to make the decision at that crucial moment.
w An important step in learning to say no to drugs/alcohol/smoking is educating oneself
about the harmful effects of these dangerous substances. Adolescents are often pressurized
to experiment with drugs/alcohol/smoking by others of their own age. The temptation to
say yes and belong to the group is very high. It is very difficult to say no especially to
peers. But it can be done if one is prepared on how to say no.
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R11.2
Negotiation Skills – Saying No
Tips for young people to say No in different situations
Peer Pressure (Situations Strategies that can
one may encounter)
be adopted
Possible answers
Would you like to come to Polite refusal
the cinema?
No, thanks, I have some things to do
with my family.
What about a drink?
Give reason.
I do not like alcohol – it tastes horrible.
Here, smoke this cigarette
with me… Come on, we
have done all our fun things
together. Just try it.
Broken record
No thanks ….
No thanks …
No thanks …
Hey, do you want to try
some liquor … it will give
you a kick – it really makes
you feel good.
Walk away
Say No and walk away while you are
saying it.
Do you want to watch some
porn movies tonight?
Cold shoulder (not
the best strategy
to use with close
friends)
Keep going as if you did not hear the
person.
Will you come with me for
a night show movie? All
girl friends go with their
boyfriends for outings.
Give an alternative
I would rather stay home – why don’t
you come to my house for dinner? We
can watch a movie on TV – it is really a
nice movie.
Come on, just spend some
time (alone) with me.
Reverse the
pressure (change
the topic)
What did I just tell you? Were you not
listening?
Can I bring my friend (name) along?
There is nothing harmful
in this, do it for my sake. I
have done so much for you,
will you not do this one
thing just for me.
Owning your
feeling
I am not comfortable doing this, it
makes me unhappy. Would you like
me to do something that makes me
unhappy?
Explicit high-risk situations
such as taking drugs,
drinking, etc.
Avoid the situation
If you know people or a situation where
people will pressurize you to do things
that you do not want to do, stay away
from these situations (the parties where
you know these things will definitely
happen).
Explicit high-risk situations Strength in
such as taking drugs,
numbers
drinking etc.
Hang around with people who support
your decision not to drink, not to use
drugs, not watch illegal movies, etc.
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Saying No!
l Refuse politely and walk away. Say you have other important things to do; you might not
have anything in mind but this is a good way to remove yourself from the situation.
l Explain the reason why you do not want to smoke/drink or try the drug/indulge in sex.
Give them all the information that you have about the harmful effects of addiction and
dangers of unprotected sex.
l Explain that you are not comfortable with what is being suggested and that you might
regret your actions later – you would rather not be a part of the activity being suggested
even if it means not being part of the group.
Different Techniques to Say No
1. Make a bold statement
w Thank you, but I do not smoke.
w That’s really dangerous. Why are you doing that?
2. Say No and explain why
w No thanks, I have to drive home.
w No thanks, we could be arrested for that.
w No thanks, I do not want to get drunk and look like a fool.
3. Suggest alternatives
w Why don’t we go watch a movie?
w What about we organize a game of cricket?
w I’m hungry. Let’s go for some food.
4. Assert yourself
w I do not think smoking is fun; I’m going to meet a friend.
w Thanks, but I am busy now. I shall see you tomorrow.
Other Actions
l Avoid the company of those who indulge in activities that you are not comfortable with.
Stay away from get-togethers/parties where you are afraid that the pressure to say yes,
though you want to say no, will be very high.
l Choose the right company. Exercise your judgment, keep informed and stay strong.
Protect Yourself
l Develop high self-esteem, a strong belief in yourself and a positive outlook to life.
l Manage your stress so you do not feel overwhelmed – exercise regularly, manage your
time and take breaks.
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l Do not believe everything in the media! Question what you see; the media exaggerate and
make people and things look attractive even when they are not.
l Develop your assertive and decision-making skills. Communicate with your family and
friends.
l Choose friends or peers who share your values.
Say Yes to Life
l Remember that life is a long-term commitment and short-term solutions would not take
you far.
l Ask for help from persons who would support you whatever the circumstances may be.
l You are made for better things in life.
What to Do if a Friend is Taking Drugs
w It is important to recognize when a friend needs help. Talk to them as soon as possible.
It might take more than one conversation before they admit they have a substance abuse
problem.
w If the person has only begun using drugs, talk to him/her and explain the negative
consequences. Get help from other friends or someone you trust. But do not gang up
against your friend!
w If s/he has been using for a while and the habit is more advanced, you may need professional
help, such as professional counselling centres or rehabilitation centres.
w You can always call toll-free helplines to get advice.
National Toll Free Helpline: 1800-11-3872 (from BSNL/MTNL lines only)
Rehabilitation Centres and Support Groups
There are many rehabilitation centres for drug addicts and alcoholics. Most of them would
require admission into these centres for at least 60–90 days. Most importantly, before admission
the person must commit oneself to quitting and be convinced that it is imperative to quit.
The support groups like Alcoholics Anonymous and Narcotics Anonymous can be joined once
a person has been in rehabilitation and has recovered. Here, the recovered persons can meet and
discuss their problems and draw support from each other’s experiences.
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R12.1
Goal Setting
One of the most important things you will do during the career planning process is to set goals.
A goal is something you want to achieve; the end to the means, so to speak. In order to achieve
a goal, you will need to exert some energy — generally, a lot of it.
Definition: Goal setting is the process of deciding what you want to accomplish and devising a
plan to achieve the result you desire.
This goal-setting definition emphasizes that goal setting is a two-part process. For effective
goal setting, you need to do more than just decide what you want to do; you also have to work
at accomplishing whatever goal you have set for yourself.
For many, it is the second part of the goal-setting definition that is difficult. They know that
what they want to do but have trouble creating a plan to get there. Goals without action plans
are just words.
One way to get over this hurdle is to use a goal-setting formula that incorporates a strategy for
accomplishing the goal.
You should set both long-term and short-term goals:
w Long-term goals are goals that you should be able to achieve in about three to five years.
w Short-term goals are goals that you should be able to reach in one to three years.
Your goals must be:
w Conceivable: You must be able to put your goal into words.
w Achievable: You must have the attributes, energy, and time to accomplish your goal.
w Believable: You must believe you can reach your goal.
w Achievable within a certain timeframe: You must be able to state how long it will take you
to achieve your goal.
w Clearly Defined: You must know exactly what your goal is.
w Flexible: You must be willing to modify your goal as necessary.
Goals Must Be Built on a Foundation
Goals must be built on a secure foundation in order to be meaningful.
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Case Story 1
Sohan lives in a village with his parents. He is studying in class seven in a government
school. His father is a carpenter. His father wants him to join his profession and help
him in increasing the family income. Sohan’s friend and cousin have left school in order
to help their parents. Some of his friends also tease him that he is a fool; he will not get
anything after studying. They keep telling him, “Why do you spend your time uselessly
in studying? This studying is not going to change anything in your life.”
Sohan agrees with his friends. He has left school and is now doing carpentry in the
village.
There are other carpenter families in the village and there is not enough work for all
of them. Some years later, Sohan gets married. He has two children. He does not have
enough money to look after his family. He is struggling to make ends meet and to control
his life.
Case Story 2
Chandra Mohan lives in Sohan’s village. His parents are vegetable sellers. He wants to
become a doctor. He is a very intelligent student, but his parents want him to join the
family profession. Chandra Mohan’s friends are also doing this kind of work with their
parents. They tell him that studying is useless and will get him nowhere. They tell him
to try and earn some money instead.
Somehow Chandra Mohan has convinced his parents that it would be to their advantage
if he studies further. He has decided that he would start helping his parents in their work
after school hours. He manages to study in spite of many obstacles. After completing
Higher Secondary from the village school, he qualifies for the medical examination and
now he is a doctor. He is planning to work for his community.
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Handouts and Questionnaires
H1.1
Pre-Workshop Questionnaire
Date: __________________________
State: __________________________
Sex: __________________
District: _______________
Please check one of the three boxes for your answer:
S.
Statement
No.
1 Life skills help people to cope positively with the challenges of
life.
Agree/ Disagree/ Not
True False Sure
2 A boy and a girl can be good friends without having an affair.
3 The period in which boys and girls experience rapid physical
changes and undergo sexual maturation is known as adolescence.
4 A girl will not conceive if she has sex only once or occasionally.
5 Seven women out of ten are anaemic in India.
6 The sex of the conceived child depends on the male parent.
7 Boys who like cooking are feminine in nature.
8 There is something wrong with a girl if she has not had her first
period by the age of 13 years.
9 Iron deficiency is the most common nutritional deficiency in
adolescents.
10 AIDS is caused by a virus.
11 A person may get HIV by shaking hands with a person who has
HIV/AIDS.
12 We should wash hands before cooking food.
13 Maintaining a difference in providing food to son and daughter is
good.
14 A husband has the right to beat his wife if she does something
against his wishes.
15 It is good to use addictive drugs for getting high marks in
examinations.
16 Drug abuse places a person at greater risk of HIV infection.
17 People living with HIV or people who have AIDS should be
treated the same as people with other serious illnesses.
18 The faeces (stool) of a child does not contain any harmful germs.
19 Washing with plain water cleans your hands.
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H1.3
Training Sessions
Sl. Day Session Topic
No.
11 1
Let’s Start
Sub- Topic
session
1.1 Pre-Workshop Questionnaire
2
3
4
5
61 2
7
8
92 3
10
11
12
4
13
14
15 3 5
16
17
6
18
19
20
21 4 7
22
23
24
25 5 8
1.2
1.3
1.4
1.5
Life Skills 2.1
2.2
2.3
Adolescence 3.1
to Adulthood
3.2
3.3
Nutrition 4.1
and Health
Practices
4.2
4.3
Personal 5.1
Hygiene
5.2
Gender
6.1
6.2
6.3
6.4
Sexual 7.1
Health
7.2
7.3
7.4
Early 8.1
Marriage
and Early
Pregnancy
The Ball Name Game
Expectations and Objectives of the Training
Setting the Ground Rules
Summing up and the Question Box
What are Life Skills?
Using Life Skills
Summing up – Reflecting on the Life Skills Used
What is Adolescence?
Understanding the Changes during Adolescence
Put Yourself in My Shoes
Food Chart – What is Missing in Your Diet?
Anaemia
Summing up
The Basics of Personal Hygiene
Lilawati’s Story
Sex or Gender
The Influence of Gender
Reflecting on Gender
Summing up – Reflecting on the Life Skills Used
Understanding Sex and Sexuality
Human Reproductive Process
Responsible Sexual Behaviour
Misconceptions about Sexual Health
Early Marriage – A Story of Two Sisters
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Sl. Day Session Topic
No.
Sub- Topic
session
26
27
9
28 6
8.2
RTI/STI and 9.1
HIV/AIDS
9.2
Consequences of Early Pregnancy
RTIs and STIs
The Basics of HIV and AIDS
29
9.3 The Wildfire Game
30
9.4 Know the Risk
31
9.5 The Importance of Testing for HIV
32
9.6 Removing Stigma and Discrimination
33
10
Abuse and 10.1 Understanding Different Types of Abuse
Violence
34
10.2 Sexual Abuse
35 7 11
Risky
11.1
Behaviour
and Peer
Pressure
Introducing Substance Abuse
36
11.2 Saying No – Dealing with Peer Pressure
37
11.3 Consequences of Substance Abuse
38
12
39
Goal Setting 12.1
and Future
Activities
12.2
Setting Goals – Case Stories
Set Goals for Yourself
40
12.3 Post-Workshop Questionnaire
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H2.1.1
Life Skills
Life Skills are skills or abilities that help people cope positively with the challenges of life.
Life Skills have been defined by WHO as “the abilities for adaptive and positive behaviour that
enable individuals to deal effectively with the demands and challenges of everyday life”. Life
Skills, from this perspective, are essentially those abilities that help to promote physical, mental
and emotional well-being and competence in young people as they face the realities of life.
‘Living skills’ refer to the personal competence that enables a person to deal effectively with the
demands and challenges confronted in everyday life.
Life skills identified by WHO for the promotion of health and well-being of children and
adolescents are:
Self-awareness
Empathy
Communication skills
Critical thinking
Creative thinking (including value clarification)
Problem solving
Decision-making (including goal setting)
Interpersonal relationship skills (including assertiveness)
Negotiation skills
Coping with stress
Coping with emotions
According to UNICEF, Core Life Skills can be divided into three major areas:
Decision-making and
critical thinking skills
Communication and
interpersonal skills
Coping and self-
management skills
Information gathering, Critical thinking, Decision making,
Problem solving, Creative thinking
Interpersonal communication skills, Negotiation skills, Empathy,
Cooperation and Team work
Self-awareness skills, Goal-setting skills, Self-esteem skills,
Anger management, Time management, Positive thinking
Following are the expected outcomes of life-skills intervention:
Increased self-esteem, self-confidence
Assertiveness, social sensitivity
Listening and communication skills, ability to establish relationships
Ability to plan and set goals
Acquisition of knowledge related to specific content
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Explanation of identified life skills
1. Self-awareness includes recognition of self: our character, strengths and weaknesses,
desires and dislikes.
2. Empathy is the ability to be sensitive to another person’s situation, as in the case of those
living with HIV, or people with mental illnesses, who may be stigmatized and ostracized
by the very people they depend upon for support.
3. Effective communication is the ability to express, both verbally and non-verbally, in ways
that are culturally acceptable. Listening is an important component of communication.
Sometimes, non-verbal communication is more powerful than verbal communication.
4. Critical thinking is the ability to analyse information and experiences in an objective
manner. It can help us recognize and assess the factors that influence attitudes and
behaviour, such as the media and peer pressure influences. For example: Why was it said?
What option do I have? Is it my final option? Is it what I want?
5. Creative thinking enables us to explore the available alternatives and various consequences
of our actions or non-action. It helps us to look beyond our direct experience, and to
respond adaptively and with flexibility to situations in our daily lives, even if no problem
is identified, or no decision is to be made.
6. Problem solving enables us to deal constructively with problems that arise in our lives.
Significant problems that are left unattended can cause mental stress and physical strain. It
is the power not only to control our problem but turn them into opportunities. It also leads
to decision-making and managing emotions and stress.
7. Decision making helps us to deal constructively with decisions about our lives, for
example, ready to take a decision after exploring all possible areas and ready to face the
consequences.
P.O.W.E.R. Model of Decision-Making
P = PROBLEM
Step 1 : Stop and state (or identify) the problem
O = OPTIONS
W = WEIGH the
options
Step 2 : Think of the different things that you can do. The
more options you have, the better.
Step 3 : Look at the advantages and weigh them against the
disadvantages of every option you thought of to solve
your problem. (The things you value should guide
you in your decision-making.)
E = ELECT
Step 4 : Choose the best option. If possible, talk to a person
you respect and then take the best option to act upon.
Elect the option that helps you get what is important
for you (values).
R = REFLECT
Step 5 : Think or reflect about what happened because of your
decision.
Source: Training Manual on Adolescent Health, CINI
8. Interpersonal relationship skills help us relate with people in a positive way. It means
being able to make and maintain friendly relationships, for example, father-son, mother-
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daughter, brother-sister, husband-wife, friend-friend, which can be of great importance
to our mental and social well-being. Relationships change with time and require constant
nurturing.
9. Negotiation skills is a result of rational thinking based on informed choices and effective
communication to get one’s ideas/plans accepted by the other person. Thus, to negotiate
rationally and effectively, one needs to enhance thinking and social skills. It is a process of
self-realization and development but is facilitated by others who are mature and thinking
individuals. Young people need to negotiate with others for a healthy and happy life style
and to overcome the strong influence of peer pressure for experimenting with drugs,
alcohol and sex.
10. Coping with stress means recognizing the sources of stress in our lives, recognizing how
this affects us, and acting in ways that help us control our levels of stress, by changing our
environment or lifestyle and learning how to relax.
11. Coping with emotions involves recognizing emotions within us and others, being aware of
how emotions influence behaviour, and being able to respond to emotions appropriately.
Intense emotions like anger or sadness can have negative effects on our health if we do not
respond appropriately.
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H2.1.2
Akul’s Story
Akul Chandra Karua grew up in a community knowing how difficult it was to live and grow
up. As a young child he had no stitched clothes to wear. He went to school wearing a ‘gamcha’
(a piece of cotton cloth used for drying the body after bath). He was not allowed to take water
from the village hand pump and had to go to the nearby river for drinking water. He had no
blanket during winters. He lived with his parents in a small mud house in Bahragora Block of
Jharkhand. He started contributing to his family income by selling berries from his garden at
the age of 10 years. With this money he purchased one shirt and a pair of pants which he washed
and wore for a long time. He could not complete his High School examination as he had no
money for fees. He could not ask anybody for the fees.
BREAK
Akul thought that there was no prospect in the village. So he went to the nearest town in
Bengal and worked in a medicine factory, sticking labels on cartons. He came back to his
village after four years and came to know about a job in a social service organization. He
did not know whether the organization was fake or genuine, whether the government was
running this programme or not. He went and met the District Chief Medical Officer and the
Block Development Officer (BDO) in this regard. He found the organization to be genuine
and decided to join in it. He made many friends in and outside the organization. He worked
for his village and the panchayat. He helped the village women start Self-Help Groups (SHG).
The women started earning for themselves. They praised Akul. He facilitated the inhabitants
of many villages to set up hand pumps, get electricity connection, roads, a post office and
anganwadi centre in Bahragora. He also facilitated old age pensions and birth certificates for
the villagers. The villagers are happy with Akul’s work. Akul says it is the childhood pain in his
heart that motivates him to do this work so that other children do not suffer like him.
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H5.1
List of Personal and Environmental Hygiene Activities
Personal Hygiene
l Brush teeth twice daily, in the morning and at night
l Bathe daily
l Defecate in a toilet
l Wash hands with soap or ash after defecation
l Keep nails trimmed and clean
l Comb hair daily
l Wear footwear
l Wear clean and washed clothes
l Observe menstrual hygiene
Household and Food-related Sanitation
l Clean the house daily with a broom
l Clean the kitchen after every meal
l Wash vegetables and fruits before eating or cooking
l Wash hands with soap or ash and water before cooking and serving food
l Eat freshly cooked warm food
l Keep food covered
l Avoid eating uncovered food from outside
l Wash hands with soap before eating and after defecation
Use and Upkeep of Drinking Water
l Use water from a hand pump or tap for drinking
l Water from a source other than a hand pump should be boiled for 15–20 minutes
l Keep water in clean utensils
l Keep the water covered while bringing it from the source and storing
l Use a long-handed ladle when taking out water
l Keep the stored water at a high place
Community Hygiene
l Keep roads and lanes clean
l Keep public places clean
l Put garbage and litter in the rubbish bin
Disposal of Animal and Household Waste
l Make a pit for disposal of animal and household waste
l Use animal waste as manure
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H5.2
Lilawati Needs to Learn Some Things
The italicised phrases highlight unhygienic practices.
Lilawati lives in a remote village in Jharkhand. She thinks that she is a good housewife. Her
mother-in-law praises her efforts in keeping the family united. She almost single-handedly
handles all the work of her house apart from taking care of her aged in-laws. But when we
visited her house we found that almost all the persons there were ill. We went through Lilawati’s
daily routine and found out exactly where the problem was. Can you also figure out where the
problem is?
Lilawati wakes up at 5:30 a.m. and goes to the jungle for defecation. She washes her hand
with mud and water from the nearby pond. She brushes her teeth with datun and uses the
water from the same pond.
She starts cleaning her house at 6:30 a.m. Her two-year-old child wakes up at 7:00 a.m. and
defecates in the courtyard. She washes the child’s bottom with water. Then she removes
her child’s faeces with her hands and throws it a little away from the courtyard. Then she
washes her hand with plain water and wipes her hand on her sari. Lilawati thinks that the
faeces of a child is not harmful to health.
After cooking she leaves the pot half open. Flies sit on the food.
She goes for a bath in the pond where everybody cleans after defecation. In the afternoon
she gives food to her in-laws and the children eat from her plate. She does not bother to
clean the hands or the nails of her child.
Her husband returns after work at 6:00 p.m. He washes his hands with water and sits to
have his dinner at 6:30 p.m.
Occasionally she goes to the village haat with her husband and eats tikki-chat and
golgappa, which are stored in open vessels.
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H11.2
Negotiation Skills – Saying ‘No’
Tips for young people to say No in different situations
Peer Pressure (Situations one may Strategies that can
encounter)
be adopted
Possible answers
Would you like to come to the Polite refusal
cinema?
No, thanks, I have some things to
do with my family
What about a drink?
Give reason
I do not like alcohol – it tastes
horrible
Here, smoke this cigarette with me… Broken record
Come on, we have done all our fun
things together. Just try it.
No thanks ….
No thanks …
No thanks …
Hey, do you want to try some liquor Walk away
… it will give you a kick – it really
makes you feel good.
Say no and walk away while you
are saying it
Do you want to watch some porn Cold shoulder (not Keep going as if you did not hear
movies tonight?
the best strategy the person
to use with close
friends)
Will you come with me for a night Give an alternative I would rather stay home – why
show movie? All girlfriends go with
don’t you come to my house
their boyfriends for outings.
for dinner? We can watch the
movie on TV – it is really a nice
movie.
Come on, just spend some time Reverse the
(alone) with me.
pressure (change
the topic)
There is nothing harmful in this, do Owning your
it for my sake. I have done so much feeling
for you, will you not do this one thing
just for me.
What did I just tell you? Were
you not listening?
Can I bring my friend (name)
along?
I am not comfortable doing this,
it makes me unhappy. Would
you like me to do something that
makes me unhappy?
Explicit high-risk situations such as Avoid the situation If you know people or a situation
taking drugs, drinking, etc.
where people will pressurize
you to do things that you do not
want to do, stay away from these
situations (the parties where you
know these things will definitely
happen).
Explicit high-risk situations such as Strength in
taking drugs, drinking etc.
numbers
Hang around with people who
support your decision not to
drink, not to use drugs, not watch
illegal movies, etc.
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Saying No!
l Refuse politely and walk away. Say you have other important things to do; you might not
have anything in mind but this is a good way to remove yourself from the situation.
l Explain the reason why you do not want to smoke/drink or try the drug/indulge in sex. Give
them all the information that you have about the harmful effects of addiction and dangers
of unprotected sex.
l Explain that you are not comfortable with what is being suggested and that you might regret
your actions later – you would rather not be a part of the activity being suggested even if it
means not being part of the group.
Different Techniques to Say No
1. Make a bold statement
w Thank you, but I do not smoke.
w That’s really dangerous. Why are you doing that?
2. Say No and explain why
w No thanks, I have to drive home.
w No thanks, we could be arrested for that.
w No thanks, I do not want to get drunk and look like a fool.
3. Suggest alternatives
w Why don’t we go for a movie?
w What about us organizing a game of cricket?
w I’m hungry. Let’s go for some food.
4. Assert yourself
w I do not think smoking is fun; I’m going to meet a friend.
w Thanks, but I am busy now. I shall see you tomorrow.
Other Actions
l Avoid the company of those who indulge in activities that you are not comfortable with.
Stay away from get-togethers/parties where you are afraid that the pressure to say Yes,
though you want to say No, will be very high.
l Choose the right company. Exercise your judgment, keep informed and stay strong.
Protect Yourself
l Develop high self-esteem, a strong belief in yourself and a positive outlook to life.
l Manage your stress so you do not feel overwhelmed – exercise regularly, manage your time
and take breaks.
l Do not believe everything in the media! Question what you see; the media exaggerate and
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make people and things look attractive even when they are not.
l Develop your assertive and decision-making skills. Communicate with your family and
friends.
l Choose friends or peers who share your values.
Say Yes to Life
l Remember that life is a long-term commitment and short-term solutions would not take you
far.
l Ask for help from persons who would support you whatever the circumstances may be.
l You are made for better things in life.
What to Do if a Friend is Taking Drugs
w It is important to recognize when a friend needs help. Talk to him/her as soon as possible.
It might take more than one conversation before they admit they have a substance abuse
problem.
w If the person has only begun using drugs, talk to him/her and explain the negative
consequences. Get help from other friends or someone you trust. But do not gang up against
your friend!
w If s/he has been using drugs for a while and the habit is more advanced, you may need to
take her/him for professional help, such as to a counselling or rehabilitation centre.
w You can always call toll-free helplines to get advice.
National Toll Free Helpline: 1800-11-3872 (from BSNL/MTNL lines only)
Rehabilitation Centres and Support Groups
There are many rehabilitation centres for drug addicts and alcoholics. Admission is required
into these centres for at least 60–90 days. Most importantly, before admission the person must
commit to quitting the habit and be convinced that it is imperative to quit.
The support groups like Alcoholics Anonymous and Narcotics Anonymous can be joined once
a person has been in rehabilitation and has recovered. Here, recovered persons meet and discuss
their problems and draw support from each other’s experiences.
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H12.1
Format for Goal Setting
Long-term Goal
________________________________________________________________________
________________________________________________________________________
Challenge: Your parents want you to help them in earning money
Write 2–3 steps how you will meet this challenge as a short-term goal:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Challenge: Your parents want you to get married
Write 2–3 steps how you will meet this challenge as a short-term goal:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Challenge: You find that there are some shortcuts to earn money
Write 2–3 steps how you will meet this challenge as a short-term goal:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Challenge: You are not getting a good job as you were expecting
Write 2–3 steps how you will meet this challenge as a short-term goal:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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H12.3
Post-Workshop Questionnaire
Date: __________________________
State: __________________________
Sex: __________________
District: _______________
Please check one of the three boxes for your answer:
S.
Statement
No.
1 Life skills help people to cope positively with the challenges of
life.
Agree/ Disagree/ Not
True False Sure
2 A boy and a girl can be good friends without having an affair.
3 The period in which boys and girls experience rapid physical
changes and undergo sexual maturation is known as adolescence.
4 A girl will not conceive if she has sex only once or occasionally.
5 Seven women out of ten are anaemic in India.
6 The sex of the conceived child depends on the male parent.
7 Boys who like cooking are feminine in nature.
8 There is something wrong with a girl if she has not had her first
period by the age of 13 years.
9 Iron deficiency is the most common nutritional deficiency in
adolescents.
10 AIDS is caused by a virus.
11 A person may get HIV by shaking hands with a person who has
HIV/AIDS.
12 We should wash hands before cooking food.
13 Maintaining a difference in providing food to son and daughter is
good.
14 A husband has the right to beat his wife if she does something
against his wishes.
15 It is good to use addictive drugs for getting high marks in
examinations.
16 Drug abuse places a person at greater risk of HIV infection.
17 People living with HIV or people who have AIDS should be
treated the same as people with other serious illnesses.
18 The faeces (stool) of a child does not contain any harmful germs.
19 Washing with plain water cleans your hands.
20 Three key things I learned during the workshop which I feel will
be useful in my life.
1.
2.
3.
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S.
Statement
No.
21 Any additional information you require? If so, what?
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Templates
T2.2
Some Life Skills Listed
Self-Awareness
Critical Thinking
Problem Solving
Communication Skills
Coping with Stress
Empathy
Creative Thinking
Decision-making
Interpersonal Relationship Skills
Coping with Emotions
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T4.1
Format for Preparing a Food Chart
Group for which you are making dietary plan: Adolescent, Old, Pregnant
Calories Required:
Ideal Diet Plan Calories Diet they take normally Calories What is missing in their diet
Breakfast
Lunch
Dinner
What are the cheaper substitutes for costly food?
Does your ideal diet contain the three-coloured food items?
Does your daily diet contain the three-coloured food items?
List three changes you need to make in your diet:
1. _______________________________________________________________________
_______________________________________________________________________
2. _______________________________________________________________________
_______________________________________________________________________
3. _______________________________________________________________________
_______________________________________________________________________
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T6.1.1
Template
(Two A4 size sheets, with ‘Sex’ and ‘Gender’ printed in large letters.)
Sex
Gender
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T6.1.2
Sex and Gender Statements
1. Boys are better than girls at mathematics.
2. Women give birth to babies, men do not.
3. Men do not cry.
4. Women are weaker; therefore they should not take up labour-intensive occupations.
5. Little girls are gentle, little boys are tough.
6. Men’s voices break at puberty, while women’s do not.
7. Men make better mechanics than women.
8. Men need more nutrition due to the active lives they lead.
9. Women are more emotional than men.
10. In some societies, a girl’s birth is met with sorrow while a boy’s birth is celebrated and
acclaimed.
11. Women are paid less than men for the same work.
12. Men have greater sexual desire than women.
13. Women are less ambitious than men.
14. The male chromosomes XX and XY decide the sex of the child at conception.
15. Women are unclean when they menstruate.
16. It is negligence if women pay attention to their careers while they have little children.
17. Girls should not travel alone.
18. Boys do not cry.
19. Women should take jobs which are less labour-intensive like teacher, lecturer.
20. Women are not responsible for the sex of a child.
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T6.2.1
Role Play
(Depending on the number of participants use between 7 and 9 of the roles. In all cases, the last
two roles must be included.)
You are a 14-year-old girl from a village. You dropped out of school in Class 5. You
are married.
You are a 20-year-old man in college. Your father is a senior government official. You
are not married.
You are a 50-year-old widow from a rural area. You live in a small hut. You have three
children and eight grandchildren.
You are an 18-year-old woman from a small town. Your father owns a small grocery
shop. You are not married.
You are a 20-year-old man from a rural area. You are a casual labourer. Your father is
dead. You live with your mother and sister.
You are a 30-year-old woman with a degree in business. You live and work in a city.
You are married but have no children.
You are a 45-year-old man. You are the village headman. You are married, with four
children.
You are a 12-year-old girl. You dropped out of school three years ago. Your mother
and father are casual labourers. You have three younger sisters.
You are a 12-year-old boy. You dropped out of school three years ago. Your mother
and father are casual labourers. You have three younger sisters.
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T6.2.2
Gender Role Statements
1. You are involved in decision-making in the family.
2. You have a bank account.
3. You can go on holidays with some friends.
4. You can own property.
5. You can read and write.
6. You have a day off every week to rest or do things you enjoy.
7. You can decide whom to marry/you decided whom you married.
8. You are involved in decision-making in the community.
9. If you get sick, somebody will call a doctor.
10. You can walk around safely at night.
11. You can travel on your own wherever you want.
12. You can decide how many children to have.
13. If you wanted to, you could set up your own business.
14. You could accept a job that involves a lot of travel.
15. You can wear whatever clothes you like.
16. You can go to the cinema with a group of friends.
17. At mealtimes, you are among the first to eat.
18. You own a motorbike or a car.
19. You have a wage-paying job.
20. When you were born, there was much celebration and happiness.
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T6.3
Gender Discrimination Table
Life Stage
Advantages
Boy Girl
Childhood
Disadvantages
Boy
Girl
Adolescence
Adulthood
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T7.2.1
Female Reproductive Organs
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T7.2.2
Male Reproductive Organs
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T7.2.3
Human Reproductive Organs
Ovaries
Fallopian Tube
Uterus
Vagina
Vaginal Mouth
Labia Majora and Labia Minora
Cervix
Urinary Bladder
Spermatic Duct/ vas deferens
Prostrate
Urethra
Penis
Testis/Testicle
Scrotum
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T7.3
Case Studies of Sexual Behaviour
Case Study 1
Ravi is 15 years old. He visits a sex worker with some friends. A few days later, he feels
pain while urinating and also observes some boils around his genitals. He gets very
scared and visits a doctor. After a medical examination, the doctor tells him that he has
contracted a sexual infection. He also adds that some infections can be fatal. Ravi feels
very guilty, ashamed and curses his friends.
Did Ravi think about the consequences of having sex with a commercial sex worker?
Why do you think so?
What were the options available to him?
What kind of pressures were working on him?
What factors should he have considered before his action?
What should have been his decision?
Case Study 2
Mohan is 17 years old. He enjoys going out with his girlfriends everyday, buying them
gifts and partying. One day he tries to force a girlfriend to have sex. She complains to
the teacher and Mohan is threatened with expulsion from his school. He feels guilty,
humiliated and shameful.
Did Mohan think about the consequences of forcing a girl to have sex? If your
answer is No, why do you think so?
What were the options available to him?
What kind of pressures were working on him?
What factors should he have considered before trying to force a girl to have sex?
What should have been his decision?
Case Study 3
Vijay is 17 years old. Anita is a girl in his village. For some days when Anita’s parents
were not at home, Vijay lived with her in her house secretly. Soon Anita realized that she
was pregnant. She told Vijay about this but he was not ready to take on the responsibility.
He ran away from the village. Anita went to the police station and registered a complaint
against Vijay. Vijay was put in the police lock-up when he was found.
Do you think that Anita and Vijay behaved responsibly?
What should Anita have done?
What should have been Vijay’s responsible behaviour?
How should they have avoided this kind of situation?
Now what do they need to do? Remember: fighting, scolding, quarrelling, beating
are not solutions.
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T7.4
Quiz on Sexuality
Instructions: Each statement should be written on an individual slip, folded, and placed in an
open box.
Menstruation
1. Once a girl starts menstruating she can become pregnant.
2. A girl should not engage in any physical activity/sports during menses.
3. Girls usually start menstruating between the age of 9 to 14 years.
4. If a girl has not started menstruating till 18 years, it is a cause for concern.
5. Menstruation is unclean.
6. Boys can tell when a girl is having her period.
7. It is normal for menstrual flow to be heavy in the first few days and then become lighter.
8. Bathing/eating sour food causes menstrual cramps.
9. It is normal to have irregular periods when the menstruation cycle starts.
10. It is normal to have pain and discomfort during menstruation.
Masturbation
11. Masturbation makes a boy weak and impotent.
12. Only boys masturbate, girls do not.
13. If one masturbates too much, his/her adult sex life/ sex life after marriage will be affected.
14. Young people who masturbate too much may have mental problems when they get older.
15. Most people stop masturbating after they get married.
16. People who masturbate too much are tired and irritable most of the time.
17. Masturbation can cause pimples, acne and other skin problems in adolescents.
18. Masturbation is considered more acceptable today than it used to be. Still, it is common for
people who masturbate to feel guilty about it.
19. If the penis is touched a lot, it will become permanently longer.
Sex and Sexuality
20. Both men and women have the right to say No to sex any time.
21. Boys/Men need to have sex to keep good health.
22. Alcohol and other addictive drugs make it easier to get sexually aroused.
23. Sexual intercourse is the best way to express your love for someone.
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24. It is normal for some boys and girls to mature earlier than others.
25. Some parts of the body mature more quickly than others.
26. Adolescent girls and boys are more likely to have skin problems.
27. A girl can get pregnant even if a boy does not ejaculate or ‘come’ inside her.
28. The female determines the sex of the baby.
29. A girl cannot get pregnant if she has sex only once or a few times.
30. If a girl does not bleed during the first intercourse, she is not a virgin.
31. A girl should be concerned if the size of her breasts is smaller than other girls of her age.
32. Having small breasts is normal.
33. It is compulsory for all girls/women to wear a bra.
34. It is possible for a girl to know when her period is about to start.
35. A girl can get pregnant if she shares underwear with a boy.
36. It is normal for boys to experience breast tenderness during puberty.
37. If a boy has swelling in the breasts it is nothing to worry about.
38. The size of the penis is equal to masculinity or virility.
39. Nocturnal emissions make boys weak.
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T8.1
Case Study – Choices of Two Sisters
Amina was born in 1981, and her sister, Ayesha, was born in 1983. Both went to the village
primary school until they were 13 years old. Their father allowed them to continue their education,
if they so wished. Amina was a good-looking girl and at an early age she had many admirers.
She finally accepted a marriage proposal from a local trader and married him. Ayesha finished
her higher secondary education and joined for a teacher’s training course. She completed her
training by her eighteenth birthday. She got a job in a primary school in another village away
from her home.
At that school, Ayesha met a handsome young man called Mohammed and fell in love with him.
Mohammed was also teaching in the same school. Since both of them had a steady income, they
were able to save enough money to buy the things they needed to set up a good home. The young
couple then came to Ayesha’s home and asked her father’s permission. Ayesha’s father was very
happy and proud of his daughter’s choice and gave her his blessing. Ayesha and her husband
were mentally and physically mature. They were educated and were aware of the difficulties of
having a large family. They wanted to have a small family, so that they could look after their
children properly, and give them a good education. As planned, they had their first child two
years after marriage and their second child three years after the first child. Both the children
were girls. They enjoyed a comfortable life, had a good education, and had educated parents.
Amina, on the other hand, had problems. She had delivered a baby almost every year since her
marriage, and was now the mother of four children. She had become weak and her body needed
rest. She found it difficult to attend to and provide basic needs for her children, such as their
education, food, health and clothing. This was because she was sick most of the time.
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T9.1
Lakhan’s Hesitation
Lakhan has been having pain and itching in his genitals for quite some time. One day he shares
the problem with his friend Ramu.
LAKHAN: Ramu, for the past few days my genitals are itching and paining a lot. It is very
troublesome and I cannot tell anybody at home. I do not want my wife to get suspicious.
RAMU: You know, when Moti came to town last time, he had a similar problem. He consulted
Jharu Ojha (the local quack) and got cured. You should go and meet Jharu Ojha.
Ramu accompanies Lakhan to Jharu Ojha, who gives Lakhan something to apply at the affected
place. After about a week, Lakhan meets Ramu.
RAMU: How are you feeling?
LAKHAN: It’s actually worse. And now my wife is also experiencing pain and itching. I do
not know what to do. May be I should go back to Jharu Ojha or to the Doctor babu at the health
centre.
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T9.2
Template
Instructions: These eight questions need one sheet of paper each. Fold the paper along its
length. Write the question on the outside. Write the answer on the inside.
Answers
Q 1 What does HIV stand for?
HIV stands for Human Immunodeficiency
Virus
Q 2 What is AIDS?
AIDS stands for Acquired lmmune Deficiency
Syndrome. AIDS is caused by HIV. A person
is diagnosed with AIDS when the immune
system is too weak to fight off infections. It
is at the point of very advanced HIV infection
that a person is said to have AIDS.
A person is diagnosed with AIDS when they
have developed an AIDS related condition or
symptom, called an opportunistic infection,
or an AIDS related cancer. The infections
are called ‘opportunistic’ because they take
advantage of the opportunity offered by a
weakened immune system.
It is possible for someone to be diagnosed
with AIDS even if they have not developed an
opportunistic infection.AIDS can be diagnosed
when the number of immune system cells
(CD4 cells) in the blood of an HIV positive
person drops below a certain level.
Q3 How does HIV affect the immune
system?
The immune system is composed of different
kinds of white blood cells. These cells work
together to defend the body against infections
and diseases. When an infection enters inside
the body, the immune system gets into action.
As soon as you catch a cold the immune
response gets into action. When the virus
causing the cold enters your body, the
immune system sees it as an enemy. The
immune system makes more cells to fight the
cold. After a few days your immune system
kills or controls the virus and you feel fine
again.
When HIV enters the body, it damages and
destroys different cells of the immune system.
When these cells are destroyed, the body is
unable to defend itself against them. HIV
can be in the body for several years before it
damages the immune system. Until then the
infected person can look and feel healthy.
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Answers
Q4 What is the difference between HIV
and AIDS?
Q5 What is the connection between HIV/
AIDS and young people?
HIV is a virus and AIDS is an advance stage
of HIV infection. AIDS usually takes time to
develop from the time a person acquires HIV
– usually from 2 to 15 years.
After AIDS has been diagnosed, the current
average survival time with antiretroviral
therapy is estimated to be now more than 5
years, but because new treatments continue to
be developed and because HIV continues to
evolve resistance to treatments, estimates of
survival time are likely to continue to change.
Antiretroviral medication can prolong the
time between HIV infection and the onset
of AIDS. Without antiretroviral therapy,
death could even occur within a year. Most
patients die from opportunistic infections or
malignancies associated with the progressive
failure of the immune system.
w 50 per cent of all new infections are in the
age group of 15–24 years.
w Adolescents are more vulnerable to HIV
infection because of experimentation.
w Adolescents are less likely to recognize
potentially risky situations or negotiate
safer sex behaviours.
w In addition, peer pressure, sexual
experimentation, drug and alcohol use
may increase adolescents’ likelihood of
engaging in high-risk behaviours.
w Adolescents often feel that nothing bad
can happen to them.
w Young people lack access to information
and services or cannot afford them due to
social and economic circumstances.
w Adolescent boys who are sexually active
do not seek information about how to
protect themselves and their partners for
fear of appearing inexperienced.
w Young women may be particularly
vulnerable for biological reasons
(immature vaginal/cervical tissues may
be more readily permeated or damaged)
and for social reasons, including lack
of economic resources and negotiating
power.
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Answers
Q6 How is HIV transmitted from one HIV can be transmitted through:
person to another?
q A sexual contact without using condom
q Transfusion of infected/unsafe blood
q Sharing of unsterilized syringes and
needles
q HIV infected mother to her child during
pregnancy, delivery and breastfeeding
About 85 per cent of transmission in India is
through the sexual route.
Q7 Why are girls more vulnerable to HIV
than boys?
The vagina gets damaged easier than the
penis, and that increases the chances for the
virus to get in. Young girls who have older
sexual partners are more at risk if they are not
using condoms, because these older partners
may have had many other partners and are
more at risk of having HIV. When a girl loses
her virginity or if she has sex when she is not
ready or willing, she is likely to experience
bleeding, which increases her chance of
infection.
In addition, the area of the mucous membrane
exposed during intercourse is much larger
in a woman than in a man and the virus
can easily penetrate the mucous membrane
of the vagina. Also, the concentration of
the virus is higher in semen than in vaginal
fluids. Besides, social factors like low socio-
economic status, low literacy rates, limited
mobility and limited access to information
put women at a further risk of contracting the
HIV infection.
Q8 What are opportunistic infections?
In our bodies, we carry many germs –
bacteria, protozoa, fungi, and viruses. When
our immune system is working, it controls
these germs. But when the immune system
is weakened by HIV disease or by some
medications, these germs can get out of
control and cause health problems.
Infections that take advantage of weakness
in the immune defenses are called
‘opportunistic’. The phrase ‘opportunistic
infection’ is often shortened to ‘OI’.
HIV weakens the immune system so that
opportunistic infections can develop. If you
are HIV-infected and develop opportunistic
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infections, you might have AIDS.
The most common OIs are listed here, along
with the disease they usually cause:
• Candidiasis (Thrush) is a fungal infection
of the mouth, throat or vagina.
• Cytomegalovirus (CMV) is a viral
infection that causes eye disease that
can lead to blindness.
• Herpes simplex viruses can cause oral
herpes (cold sores) or genital herpes.
These are fairly common infections, but
if you have HIV, the outbreaks can be
more frequent and severe.
• Malaria is common in the
developing world. It is more
common and more severe in
people with HIV infection.
• Mycobacterium Avium Complex (MAC
or MAI) is a bacterial infection that can
cause recurring fevers, a general sick
feeling, problems with digestion, and
serious weight loss.
• Pneumocystis Pneumonia (PCP) is a
fungal infection that can cause a fatal
pneumonia. Unfortunately this is a
fairly common OI in people who have
not been tested or treated for HIV.
• Toxoplasmosis (Toxo) is a protozoal
infection of the brain.
• Tuberculosis (TB) is a bacterial infection
that attacks the lungs, and can cause
meningitis.
One can reduce the risk of new infections by
keeping clean and avoiding known sources
of the germs that cause OIs. If one has
developed and OI infection, medication will
prevent the development of active disease.
This is called Prophylaxis.
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T9.3
Template
Instructions: Cut out slips of paper to correspond with the number of participants. One slip
printed HIV; two printed ‘Refuse to shake hands’; two printed ‘Condom’; the remaining, ‘Follow
the facilitator’.
HIV
Refuse to shake hands
Refuse to shake hands
Condom
Condom
Follow the facilitator
Follow the facilitator
Follow the facilitator
Follow the facilitator
Follow the facilitator
Follow the facilitator
Follow the facilitator
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T9.4.1
Template
Instructions: Take three large sheets (A4 size), with the different risk levels printed on each in
big letters. Hang them on three walls of the room.
High-risk Behaviour
Low-risk Behaviour
No-risk Behaviour
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T9.4.2
Whether a Behaviour is HIV Risky
Instructions: Take 18 slips of paper and write a behavioural item on each.
q Tattooing
q Blood donation
q Sharing needles
q Using a public latrine
q Deep kissing
q Having sex with girls from the same locality
q Having many sexual partners
q Taking care of an HIV-infected person at the camp
q Not having sexual intercourse
q Being bitten by a mosquito that has bitten someone with HIV
q Sharing of shaving blades at home or in a barber shop
q Being close to an HIV infected person who coughs or sneezes
q Masturbation
q Oral sex
q Sharing a towel with a person infected with HIV/AIDS
q Swimming with an HIV-infected person
q Caring for a person infected with HIV/AIDS
q Breastfeed by an HIV-positive mother
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T10.1
Quiz on Abuse and Violence
S. No.
1
2
3
4
5
6
7
8
9
10
Incident
Physical
Man beats his pregnant wife using
abusive language in front of the
neighbours.
Husband or in-laws taunting their
wife/daughter-in-law for dowry.
Forced abortion of a female foetus.
A man not providing any financial
help to his wife to meet her daily
needs.
A child being beaten/punished
harshly by teacher for not doing
his/her homework.
Providing different levels of
food and clothing to a son and a
daughter.
Not allowing a daughter-in-law to
leave the house, or not giving her
enough food to eat at home.
A lower caste student abused by
peers for drinking water from the
same hand pump.
A husband scolded and abused by
wife in front of friends/relatives for
not earning enough.
A handicapped child is called
abusive names.
Verbal Emotional / Mental
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T10.2
Case Stories of Sexual Abuse
Case Story 1
Ruby is 14 years old. She lives with her parents and two brothers. Her cousin Bobby,
who is older than her, also stays in the same city and frequently comes to stay with
Ruby’s family. Whenever he gets an opportunity, Bobby touches Ruby’s body (her face,
hands, breasts, waist, etc.). This makes her feel very uncomfortable. She does not like
his touch and tells him to stop, but is unable to tell anyone about it. Once she even caught
him putting his hand inside her under garments in the middle of the night. She makes
excuses and leaves home whenever he is around, and avoids him. Her mother knows
about Bobby’s behaviour but does not say anything openly. However, she tries to keep
Ruby away from him. Ruby has suddenly become more conscious of herself and her
body. She also experiences a lot of fear, guilt and anxiety all the time.
Case Story 2
Arjun, 10 year old, has gone for a holiday to his uncle and aunt’s house. One day, at 6:30
in the morning, his aunt woke him up and told him that she was going to the temple.
As soon as his aunt left, his uncle woke up and pulled the blanket off Arjun and slept
beside him. He did something strange to Arjun under his clothes, which Arjun did not
understand. He was scared and started screaming. His uncle threatened Arjun and told
him that he would beat him and would cut his body into little pieces, if he told anybody
about the incident. After that incident, Arjun did not want to stay at his uncle’s house and
he forced his aunt to send him back to his parents’ house. He came to his parents’ house,
but he felt sick. He lost interest in life. He felt scared of his uncle and all older men.
Case Story 3
Moni is five years old. She lives with her siblings and parents. They also have a domestic
servant who has lived with them for many years. One evening, Moni was alone at her
home. She started playing with her servant. While playing, he started touching her private
parts. This happened for a brief while. Moni felt uncomfortable but did not understand
what was happening. The servant told her not to tell what happened to anybody and that
it should be ‘their secret’. He later took her to an ice-cream vendor and bought her an
ice cream.
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T11.2
Scenarios of Peer Pressure
Scenario 1
Mohan is going out with his friends to a party. When he reaches there, he realizes that
there is a lot of drinking going on. One of his friends comes to Mohan with a glass of
drink and says that he would like Mohan to have it. He says that if Mohan does not drink,
he is not really a friend.
Scenario 2
Sunita has some difficulty getting along with her divorced father, with whom she is
living. She spends a lot of time alone. Amar lives in her neighbourhood and has grown
close to her. She likes him too. Amar invites her to a friend’s place who is out of town.
Amar also assures her that he loves her too much to get her into any kind of trouble.
Scenario 3
Rohan, a class XI student, lives in a hostel. He wants to become a doctor. One day one of
his friends comes to him and tells him that if he takes this new drug, he can study more.
That drug will also relieve his tension and worry and is reportedly not addictive.
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T11.3
Kartik’s Blunder
Case Story
Kartik is a boy of 20 years of age. He is studying in the 12th standard in a famous school
in Ranchi. His father, a rich businessman, has given him a new Yamaha bike. Kartik
went to a party one night and drank liquor. On the way back from the party, he and his
best friend, Alfred, were racing with two other bikers. Kartik’s bike hit a wall. Both
Kartik and Alfred were severely injured. They were admitted to a hospital. After fighting
death for six days Alfred died. Although Kartik survived, he spent one precious year
recovering and could not appear for the 10+2 board examination. In addition, he lost his
best friend.
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T12.1
Case Stories of Goal Setting
Case Story 1
Sohan lives in a village with his parents. He is studying in class seven in a government
school. His father is a carpenter and wants him to join his profession and help him in
increasing the family income. Sohan’s friend and cousin have left school in order to
help their parents. Some of his friends also tease him that he is a fool; he will not get
anything after studying. They keep telling him, “Why do you spend your time uselessly
in studying? This studying is not going to change anything in your life.”
Sohan agrees with his friends. He has left school and is now doing carpentry in the
village.
There are other carpenter families in the village and there is not enough work for all
of them. Some years later, Sohan gets married. He has two children. He does not have
enough money to look after his family. He is struggling to make ends meet and to control
his life.
Case Story 2
Chandra Mohan lives in Sohan’s village. His parents are vegetable sellers. He wants to
become a doctor. He is a very intelligent student, but his parents want him to join the
family profession. Chandra Mohan’s friends are also doing this kind of work with their
parents. They tell him that studying is useless and will get him nowhere. They tell him
to try and earn some money instead.
Somehow Chandra Mohan has convinced his parents that it would be to their advantage
if he studies further. He has decided that he would start helping his parents in their work
after school hours. He manages to study in spite of many obstacles. After completing
Higher Secondary School from the village, he qualifies for the medical examination and
now he is a doctor. He is planning to work for his community.
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