Fig. 6.1 Relationship of sexual health, gender roles, and psychological well-being. This figure illustrates the inter- actional relationship between sexual health, gender roles, and psychological well-being
94 E. Adelson et al.
Conclusion
This study focuses on adolescent girls living in slums because they make up a significant seg- ment of the population that is vulnerable to challenges that women face in India. In order to improve the gender inequality gap in India, it is imperative to empower adolescent girls. Using an etic–emic approach to qualitative analysis, the research aimed to understand psychologi- cal well-being, sexual health, and interpersonal relationships as defined by adolescent girls. The author began the inductive–deductive process of analysis using key terms defined by Nastasi et al.
(2013) in their Narrative Intervention Model used to inform a sexual health intervention designed for married women in India. After initial coding, gender roles emerged as a major construct, in addition to psychological well-being and sexual health, whereas interpersonal relationships were better understood as a context in which these phenomenon occur. For the constructs of sexual health and gender roles, themes were generated by observing patterns that emerged from the data.
Psychological well-being was analyzed through identification of stressors, reactions to stressors, and supports within various contexts. Findings showed overlap among sexual health, gender roles, and psychological well-being, with each influencing the other. Although these findings were strongly influenced by culture and context, the interaction of sexual health, gender roles, and psychological well-being is likely generalizable to most places in the global community where women continue to struggle with gender inequal- ity issues.
Acknowledgments Funding for this project was pro- vided for by a faculty seed grant to the second author from Tulane University Framework for Global Health Program.
The content of this document is based on the master’s the- sis of the first author, completed as partial fulfillment of requirements for a doctoral degree in School Psychology at Tulane University. Gratitude is extended to Apnalaya, a community-based organization in Mumbai, for assistance in recruitment and data collection.
References
Abraham, L. (2001). Understanding youth sexuality: A study of college students in Mumbai City. The Indian Journal of Social Work 62(2), 233–248.
Bloom, S. S., & Griffiths, P. L. (2007). Female auton- omy as a contributing factor to women’s HIV-related knowledge and behavior in three culturally con- trasting states in India. Journal of Biosocial Sci- ence, 39(4), 557–573. http://www.ncbi.nlm.nih.gov/
pubmed/17018172. Accessed 23 June 2013.
Bott, S., Jejeebhoy, S., Shah, I., & Puri, C. (2003).
Towards adulthood: Exploring the sexual and repro- ductive health of adolescents in South Asia (pp 73–77).
Geneva: World Health Organization. http://whqlibdoc.
who.int/publications/2003/9241562501.pdf. Accessed 23 June 2013.
Chakraborty, K. (2010). The sexual lives of Muslim girls in the bustees of Kolkata, India. Sex Educa- tion: Sexuality, Society and Learning, 10(1), 1–21.
doi:10.1080/14681810903491339.
Dube, S., & Sharma, K. (2012). Knowledge, attitude and practice regarding reproductive health among urban and rural girls: A comparative study. Eth- noMed, 6(2), 85–94. http://www.krepublishers.
com/02-Journals/S-EM/EM-06-0-000-12-Web/
EM-06-2-000-12-Abst-PDF/S-EM-06-2-085-12- 217-Dube-S/S-EM-06-2-085-12-217-Dube-S-Tt.pdf.
Accessed 23 June 2013.
Ghule, M., Balaiah, D., & Joshi, B. (2007). Attitude towards premarital sex among rural college youth in Maharashtra, India. Sexuality & Culture, 11(4), 1–17.
doi:10.1007/s12119-007-9006-6.
Government of India Ministry of Home Affairs. (2011).
Provisional population totals paper 1 of 2011. New Delhi, India: Office of the Registrar General & Cen- sus Commissioner. http://www.censusindia.gov.
in/2011-prov-results/prov_results_paper1_india.html.
Accessed 23 June 2013.
Guilamo-Ramos, V., Soletti, A. B., Burnette, D., Sharma, S., Leavitt, S., & McCarthy, K. (2012).
Parent-adolescent communication about sex in rural India: US–India collaboration to prevent adolescent HIV. Qualitative Health Research, 22(6), 788–800.
doi:10.1177/1049732311431943.
Gupta, S. D. (2003). Adolescent and youth reproductive health in India: Status, issues, policies, and programs.
POLICY Project. http://pdf.usaid.gov/pdf_docs/
PNACT789.pdf. Accessed 23 June 2013.
Hindin, M., & Hindin, J. (2009). Premarital roman- tic partnerships: Attitudes and sexual experiences of youth in Delhi, India. International Perspectives on Sexual and Reproductive Health, 35(2), 97–104.
doi:10.1363/3509709.
International Institute for Population Sciences (IIPS), &
Macro International. (2007). National family health survey (NFHS-3), 2005–2006: India (Vol. 1). Mum- bai: IIPS.
Jaya, J., & Hindin, M. J. (2007). Nonconsensual sexual experiences of adolescents in urban India. Journal of Adolescent Health, 40(6), 573–580. doi:10.1016/j.
jadonhealth.2007.01.014.
Jejeebhoy, S. (1998). Adolescent sexual and reproduc- tive behaviour: A review of the evidence from India.
Social Science and Medicine, 10, 1275–1290. pii:
S0277-9536(97)10056-0.
Jejeebhoy, S. J. (2000). Adolescent sexual and reproduc- tive behaviour: A review of the evidence from India.
In R. Ramasubban & S. J. Jejeebhoy (Eds.), Women’s reproductive health in India (pp. 40–101). Jaipur:
Rawat Publications.
Jejeebhoy, S. (2006). Sexual and reproductive health of young people: Expanding the research and program agenda. Prepared for the David and Lucile Packard Foundation, Population Program Review Task Force.
New Delhi: Population Council. http://www.packard.
org/assets/files/population/program%20review/pop_
rev_jejeebhoy.pdf. Accessed 23 June 2013.
Jejeebhoy, S., & Sebastian, M. (2003). Actions that pro- tect: Promoting sexual and reproductive health and choice among young people in India. Regional work- ing paper No. 18. New Delhi: Population Council.
http://www.popcouncil.org/uploads/pdfs/wp/seasia/
seawp18.pdf. Accessed 23 June 2013.
Jejeebhoy, S. J., Zavier, A. J., & Santhya, K. G. (2013).
Meeting the commitments of the ICDP Programme of Action to young people. Reproductive Health Matters, 21(41), 18–30. doi:10.1016/S0968-8080(13)41685-3.
Lloyd, C., & Mensch, B. (2006). Marriage and childbirth as factors in school exit: An analysis of DHS data from Sub-Saharan Africa. Policy research division working paper 219. New York: Population Council.
Mehra, S., Savithri, R., & Coutinho, L. (2002, June).
Sexual behaviour among unmarried adolescents in Delhi, India: Opportunities despite parental controls.
Paper presented at the 2002 IUSSP Regional Popula- tion Conference, Bangkok.
Mensch, B., Grant, M., Sebastian, M., Hewett, P., & Hun- tington, D. (2004). The effects of a livelihood inter- vention in an urban slum in India: Do vocational counseling and training alter the attitudes and behav- ior of adolescent girls? Population council work- ing paper No. 194. New York: Population Council.
http://www.popcouncil.org/uploads/pdfs/wp/194.pdf.
Accessed 23 June 2013.
Ministry of Health and Family Welfare (MOHFW).
(2000). National Population Policy 2000. New Delhi:
Government of India. http://mohfw.nic.in/WriteRe- adData/l892s/FAMILYWELFARE-38385935.pdf.
Accessed 23 June 2013.
Municipal Corporation of Greater Mumbai. (2010). Mum- bai Human Development Report 2009. New Delhi:
Oxford University Press.
Nastasi, B. K. (2014). Empowering child voices through research. In C. Johnson, H. Friedman, J. Diaz, Z.
Franco, & B. Nastasi (Eds.), Praeger handbook of social justice and psychology: Volume 3. Youth and disciplines in psychology (pp. 75–90). Santa Barbara:
ABC-CLIO/Praeger.
Nastasi, B. K., Maitra, S., & RISHTA team. (2013).
Manual: Narrative Prevention Counseling (NPC) for Married Women and Couples: Promoting Sexual Health, Psychological Well- Being and Healthy Mari- tal Relationships. New Delhi: International Center for Research on Women (ICRW).
National AIDS Control Organisation (NACO), & UNI- CEF. (2002). Knowledge, attitudes and practices of young adults (15–24 years). New Delhi: NACO and UNICEF.
Parkar, S. R., Fernandes, J., & Weiss, M. G. (2003). Con- textualizing mental health: Gendered experiences in a Mumbai slum. Anthropology & Medicine, 10(3), 292–308. doi:10.1080/1364847032000133825.
Parkar S. R., Nagareskar, B. B., & Weiss, M. G. (2012).
Explaining suicide: Identifying common themes and diverse perspectives in an urban Mumbai slum.
Social Science & Medicine, 75(11), 2037–2046.
doi:10.1016/j.socscimed.2012.07.002.
Patel, V., Andrews, G., Pierre, T., & Kamat, N. (2001).
Gender, sexual abuse and risk behaviours in adolescents: A cross sectional survey in schools in Goa. National Medical Journal of India, 14(5), 263–267.
Population Reference Bureau. (2011). Abortion Facts and Figures. http://www.prb.org/pdf11/abortion-facts- and-figures-2011.pdf.
RamaRao, S., & Anrudh, J. (2001, August). Quality of services: Issues of measurement. Paper presented at the annual XXIVth conference of the International Union for the Scientific Study of Population, Salva- dor, Brazil.
Santhya, K. G., Jejeebhoy, S. J., & Ghosh, S. (2008).
Early marriage and sexual and reproductive health risks: Experiences of young women and men in Andhra Pradesh and Madhya Pradesh, India. New Delhi: Population Council.
Sarkar, S. (2003). Gender as a cultural factor influencing mental health among the adolescents students in India and Sri Lanka: A cross-cultural study. Unpublished doctoral dissertation. Department of Educational and Counseling Psychology, University at Albany, State University of New York.
Sathe, A. G., & Sathe, S. (2005). Knowledge and behav- ior and attitudes about adolescent sexuality amongst adolescents in Pune: A situational analysis. Journal of Family Welfare, 51, 49–59. http://medind.nic.in/jah/
t05/i1/jaht05i1p49.pdf. Accessed 23 June 2013.
Singh, R., & Trapithi, V. (2013). Maternal factors contrib- uting to under-five mortality at birth order 1 to 5 in India: A comprehensive multivariate study. Springer- Plus, 2(284), 1–12.
Singh, R., Rai, R., & Singh, P. (2012). Assessing the uti- lization of maternal and child health care among mar- ried adolescent women: Evidence from India. Journal of Biosocial Science, 44, 1–26.
Sodhi, G., & Verma, M. (2003). Sexual coercion among unmarried adolescents of an urban slum in India. In S.
Bott, et al. (Eds.), Towards adulthood: Exploring the sexual and reproductive health of adolescents in South Asia (pp. 91–94).Geneva: World Health Organisation.
96 E. Adelson et al.
Sodhi, G, Verma, M, & Schensul S. (2004). Tradition pro- tection for adolescent girls and sexual risk: Results of research and intervention from an urban community in New Delhi. In R. Verma, P. Pelto, S. Schensul, &
A. Joshi (Eds.), Sexuality in the time of AIDS: Con- temporary perspectives from communities in India (pp. 68–90). New Delhi: Sage.
United Nations Children’s Fund (UNICEF). (2012). Prog- ress for children: A report card on adolescents. New York: UNICEF Division of Communication. http://
www.unicef.org/publications/files/Progress_for_Chil- dren_-_No._10_EN_04272012.pdf. Accessed 16 June 2013.
United Nations Development Programme. (2013). Human development report 2013. The rise of the South:
Human progress in a diverse world. Washington, DC:
Communications Development Incorporated. www.
undp.org. Accessed 17 June 2013.
United Nations General Assembly. (1989). Convention on the rights of the child. New York: United Nations.
http://www.unicef.org/crc/. Accessed 23 June 2013.
United Nations General Assembly. (2000). United Nations millennium declaration. Resolution adopted by the General Assembly. New York: United Nations.
http://www.un.org/millenniumgoals/.
United Nations-HABITAT. (2007). State of the world’s cities 2006/2007. Nairobi: Press & Media Relations Unit. http://www.unhabitat.org/documents/media_
centre/sowcr2006/SOWCR%205.pdf. Accessed 23 June 2013.
van Reeuwijk, M., & Nahar, P. (2013). The importance of positive approach to sexuality in sexual health programs for unmarried adolescents in Bangla- desh. Reproductive Health Matters, 21(41), 69–77.
doi:10.1016/S0968-8080(13)41694-4.
Weiss, M. G., Parkar, S. R., Chowdhury, A. N., & Ragu- ram, R. (2001). Global, national, and local approaches to mental health: Examples from India. Tropical Medi- cine and International Health, 6(1), 4–23. http://www.
ncbi.nlm.nih.gov/pubmed/11251893. Accessed 23 June 2013.
Verma, R., Pelto, P., Schensul, S., & Joshi, A. (Eds.).
(2004). Sexuality in the time of AIDS: Contemporary perspectives from communities in India. New Delhi:
Sage.
Vindhya, U. (2007). Psychological research on gender quality of women’s lives in India: Some findings from two decades of research. Feminism Psychology, 17(3), 337–356. doi:10.1177/095935350707908.
97