EHSAS: Endline Survey Report (2023)

The EHSAS Endline Survey Report (2023) by SNEHA (Society for Nutrition, Education & Health Action) evaluates the impact of its adolescent health program in Dharavi and Kalwa. Conducted in November 2023, this cross-sectional study surveyed 691 adolescents through face-to-face interviews to assess changes in their nutritional status, sexual and reproductive health awareness, emotional resilience, gender attitudes, parental involvement, and access to public health services compared to the baseline survey (2020-21). The findings indicate significant progress in several areas. Dietary diversity has improved, though 59% of adolescents still lack a balanced diet. The proportion of underweight adolescents decreased from 34% to 31%, while the rate of overweight/obesity slightly increased from 9% to 10%. Awareness of anaemia and its prevention grew significantly, with 90% recognizing iron deficiency as a cause, compared to 42% in the baseline survey, and anaemia screening rates rose from 6% to 78%. In terms of sexual and reproductive health (SRH), more adolescents are now aware of puberty-related changes, with only 1% unaware, down from 11%. Knowledge about wet dreams being normal rose from 13% to 45%, while legal awareness of the minimum age of marriage for women increased from 35% to 53%. Menstrual hygiene management among girls improved, with 99% using hygienic methods and 100% having access to proper disposal facilities.

Despite these advancements, emotional resilience scores showed only a slight improvement, rising from 25.8 to 27.1, and 39% of adolescents remained in the lowest resilience category, suggesting the need for additional support in this area. Encouragingly, gender-equitable attitudes improved significantly, with 72% of adolescents supporting gender equality, compared to 52% in the baseline. Civic participation also saw a boost, as 19% of adolescents engaged in community initiatives, up from 3%. Parental involvement remained relatively stable, with 74% of adolescents feeling understood by their parents, and 53% reported that their parents monitored their activities, slightly higher than the 49% recorded in the baseline. Health-seeking behavior also improved, with 71% of adolescents reporting health issues in the past three months, up from 38%, and 81% seeking medical care, primarily from private doctors. Notably, access to iron and folic acid tablets increased from 3% to 30%, and deworming tablets from 7% to 40%.

In conclusion, the EHSAS program has made a meaningful impact on adolescent well-being, particularly in nutrition, SRH awareness, gender attitudes, and access to healthcare. However, challenges remain in emotional resilience, dietary diversity, and parental regulation. The findings underscore the need for continued efforts and investments to ensure a lasting, positive impact on adolescent health in vulnerable urban communities.