Reproductive health status and life skills of adolescent girls dwelling in slums in Chennai, India

Background. Adolescent girls dwelling in slums are vulnerable to poor reproductive health due to lack of awareness about reproductive health and low life skills. These girls are in a crucial stage of their life cycle and their health can impact the health of future generations. Despite adolescents comprising almost one-quarter of the Indian population they are ill served in terms of reproductive health. Methods. This cross-sectional study was done among 130 slum-dwelling adolescent girls, aged 13-19 years, using multistage sampling method from five slums in Chennai, southern India. The reproductive and menstrual morbidity profile, personal and environmental menstrual hygiene was assessed to determine their reproductive health-seeking behaviour and life skills. Results. Ninety-five (73%) girls (95% Cl 66.23-81.36) reported menstrual morbidity and 66 (51%; 95% Cl 50.74-52.25) had symptoms suggestive of reproductive/urinary tract infection. Of the girls surveyed, 55 (42%) were married. Nearly 25% (95% CI 23.07-26.92) of the married girls had a history of abortion and 18% (95% Cl 11.32-25.07) had self-treated with medications for the same. Contraceptive use among ever-married girls was 22.7% (95% Cl 20.83-24.56). Even though 75% of respondents knew about HIV/AIDS, their knowledge of modes of transmission and prevention were low (39% and 19%, respectively). Almost 39% of respondents felt shame or insecurity as the key barrier for not seeking reproductive healthcare. About 52% had low life skill levels. On logistic regression, menstrual morbidity was high among those with low life skills, symptoms suggestive of reproductive/urinary tract infection were high among those who were married before 14 years of age and life skills were high among those who belonged to the scheduled caste community. Conclusion. There is a high prevalence of menstrual/reproductive morbidity, self-treated abortion and low knowledge about modes of HIV transmission/prevention and use of contraceptives among adolescent girls in slums in Chennai. There is a need to initiate community-level life skill education, sex education and behaviour change communication for slum-dwelling adolescents as a part of the adolescent reproductive and sexual health programme.