Background: India is home to more than 228 million youth between the ages of 15 and 24 years, who account for more than a quarter of the country’s population. Among this growing population, adolescents aged 15 to 19 years represent the largest generation of individuals transitioning into adulthood in India. Improving adolescent health is uniquely important, as emphasized with the “triple dividend of benefits,” because it not only addresses the immediate health needs of the larger youth population but also fosters their future health trajectories and promotes “the welfare of the next generation.” Understanding and monitoring what informs girls’ sexual health trajectories over the course of adolescence is an important step in informing educational needs and predicting demand for sexual and reproductive health services during this critical stage of life.
Methods: In 2018, Performance Monitoring and Accountability 2020 (PMA2020) conducted a survey (N=1,134) with adolescent girls aged 15 to 19 years in Rajasthan, India, to generate information on adolescents’ knowledge, attitudes, and behaviors with respect to marriage, childbearing, and family planning. The PMA2018/Rajasthan adolescent survey used a two-stage cluster design that included a total of 147 enumeration areas (EAs). In each EA, 35 households were randomly selected from the list of all households in the EA. A total of 1,134 adolescent girls aged 15 to 19 years were interviewed, representing 19% of the total sample of women of reproductive age (15 to 49 years). Data collection was conducted from May to July 2018.
Results: 19% of adolescent girls 15–19 years old reported they have had their first sexual experience. Only 37% indicate this was an autonomous decision. 83% of adolescent girls were aware of methods to space or delay pregnancy, but 57% feared social stigma and felt too shy to seek services. 21% of sexually active adolescent girls had ever used contraception and 68% of those with current need for contraception were not using a method. A minority of adolescent girls reported having ever been pregnant (7%), or ever given birth (4%). While child marriage is still a reality in Rajasthan, it was rarely reported. Only 6% of girls aged 15 to 17 years reported being married.
Conclusions: The percentage of adolescent girls in current need of contraception was higher in rural areas (10%) than in urban areas (5%) but did not differ by wealth quintile or caste. Among the minority of adolescent girls with current need for contraception, 32% were using a method at the time of the survey while 68% were not, suggesting high levels of current unmet need for contraception among sexually active adolescent girls.