Investing in Young People Leads to Far-Reaching Ripple Effects


Muskan, an 18-year-old from the village of Bhatolia in the Bihar state of India, began working as a peer educator (PE) with the TARUNYA program in July 2019. Since joining the program, her growth has been remarkable.

Initially hesitant to discuss sexual and reproductive health (SRH) topics with her peers, Muskan’s journey to confidence began with peer educator training. Through games, role play, and discussions, she gained a deeper understanding of bodily changes, societal gender norms, and other SRH topics. Her development into a confident advocate was spurred by six-day training session. Muskan went on to lead peer group meetings, support school events on Adolescent Health and Wellness Days, and eventually became a master trainer for newly recruited PEs.

In 2017, EngenderHealth launched the TARUNYA project in the Sitamarhi district of Bihar with support from the David and Lucile Packard Foundation. In 2020, EngenderHealth expanded the scope of TARUNYA to support the government of Bihar in strengthening Rashtriya Kishor Swasthya Karyakram (RKSK)—an adolescent health program—in two additional districts.

Bihar is India’s third most populous state and ranks low on many critical health indices and high on gender and social inequalities. While the legal age for marriage in India is 18 for girls and 21 for boys, 41% of women aged 20 to 24 in Bihar were married before 18, and 11% of girls aged 15 to 19 in Bihar have delivered a baby or are pregnant.1 There is a notable shortage of health facilities, secondary schools, and secondary schools. Bihar also has a sizeable gender gap for completion of secondary school and the lowest literacy rate of women in all states.2

TARUNYA emphasizes the role of PEs and community-level activities in improving awareness, demand, and uptake of SRH health services among adolescents, contributing to healthier adolescent behaviors. Components of this work include adolescent health days, adolescent-friendly health clinics (AFHC), and adolescent-friendly clubs. 

As a PE, Muskan continued to grow as a leader and contribute to the health of her community. Her dedication and progress caught the attention of the Youth Dreamer Foundation, earning her recognition and a ₹24,000 scholarship. In 2023, her influence grew as she represented Bihar at the G-20 regional consultation in Lucknow and subsequently participated in the National G-20 event “Health of Youth-Wealth of Nation” in Delhi. As a result of her work with peer group meetings, the recognition of her work, and the economic benefits of her scholarship, Muskan has gained deep confidence in her abilities.

Not only did Muskan thrive after her training, her peers were more likely to thrive as well. TARUNYA surveys found a strong association between interaction with PEs and the knowledge level of adolescents and attendance at adolescent-friendly health clinics in areas with PEs. While only 3.5% of adolescents who did not meet a PE in the past year went to an AFHC, 46.3% of the adolescents who interacted with the PE accessed at least one service from an AFHC. Further, awareness of HIV/AIDS increased from 47.5% at the beginning of the program to 65.3% in 2020.

Today, Muskan is an active member of EngenderHealth’s India Youth Advisory Group, contributing her insights and experiences to shape impactful programs. She has gone on to be trained as a master trainer in the purposeful play methodology. Her dedication, resilience, and evolution from a hesitant peer educator to a confident advocate and master trainer stand as a testament to the power of youth agency and its transformative impact on SRH awareness.

1 – MOHFW. 2021. National Family Health Survey (NFHS–5) 2019–21: Compendium of Fact Sheets. New Delhi: MOHFW.
2 – MOHFW. 2019. Rural Health Statistics 2018–19. New Delhi: MOHFW.
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