Are young women in India prepared to deal with sexual and reproductive health issues? A case study of Jharkhand, India

Young Indian women often face social, economic, logistical, policy and health system barriers when accessing sexual and reproductive health services, including safe abortion care.  A cross-sectional household survey was conducted in July – August 2012 in Jharkhand, India. We interviewed 1,381 young women (15-24 years) to assess their knowledge, agency, and skills on SRH issues, including safe abortion, and to identify barriers and influencers that lead to particular behaviors, decisions, or service utilization. Even with high levels of literacy  and mass media exposures, the composite knowledge scores of sex and pregnancy, contraception,  and abortion  related issues were low. Multivariate analyses revealed age, education, and exposure to SRH information as the influencing attributes of knowledge level. Around 4% of married young women reported experiencing induced abortion; one-third of them had no role in decision-making and 92% had approached private and illegal providers. This study also identified limited agency among rural young women in terms of taking decisions, freedom of mobility, self-efficacy, and sense of self-worth. Findings of this study have policy implications and guidance of topics and strategies for youth-focused interventions.