Issues in Community-Based Interventions for Adolescent Psychosexual Health and Life Skill Training Module

Respected Sir,

In relation to the article, “community-based interventions for adolescent psychosexual health: The use of life skills training approaches in sexuality education,” by Sheila Ramaswamy and Shekhar Seshadri, brings into focus an important area in the Indian context. ¹ Developing and bringing out a manual intended to be used among adolescents not only in privileged sections of society but also in the underpreviliged or vulnerable section is commendable. However, there is need to highlight certain areas of concerns about the article and some suggestions which may improve the utility of module on wider population of adolescents.

The article mentions that the manual has been piloted, refined, and revised following its use with over hundred adolescents belonging to various categories of underprivileged or vulnerable sections. However, there is no information provided as to how these adolescents were identified? What was the socioeconomic status of adolescents? What was the percentage of each vulnerable section (eg, children with sexual abuse) involved in the pilot project? The division of the genders and their age group is not mentioned. There is no information regarding the particular facilitators/counselors who have used this manual and what were their prior training. There is no information on how was the outcome of intervention assessed. Also, the methodology used in the article is unclear as to how the manual was administered and how much time it has taken for each module to be specifically carried out. There is no information on the ethical issue in carrying out intervention or pilot study. This article at its best for any journal can be considered as view point or part of education section or other sections but does not fulfill the criteria of being used as an original paper.

Since the article has mentioned that module was piloted in adolescents from low socioeconomic status, the orphans, or those from streets with low or no education at all, the authors have failed to provide information about what language adolescents were fluent in, what formal or informal education, the adolescents had, and how was the facilitator trained for using the manual tailored to those needs. The cards and clips in the manual are either in English or vernacular language and thus there is possibility of difficulty in reading them. Considering that many of the facilitators, such as those managing Anganwadi or child care centers mentioned in modules, are not run by much educated resource personnel and the recipient adolescents from the underprivileged section may not be able to read. The exact mode of administering them to the adolescents or children needs clarification. Furthermore, many of them might not be equipped enough to even read or comprehend the discussion questions. Thus, the use of pictorial format such as drawings or cartoons could have been elaborated.

Nevertheless, the article is indeed insightful. The use of life skills and the concept of positive adolescent sexuality are much needed, but this is still not being implemented for the benefit of a majority of the Indian adolescents. More modules and more ways to carry out research in implementing the modules, to educate, to provide information, and to enhance skills are needed for Indian adolescent population.