The mental health of adolescent girls from a tribal region of Central Rural India during the COVID-19 pandemic - A cross-sectional study to determine the role of gender disadvantage.

Objectives: The mental health of adolescent girls in countries of South Asia is related to several social and cultural factors including gender disadvantage, especially in low resource settings such as tribal areas. The coronavirus disease 2019 (COVID-19) pandemic has increased this vulnerability even further. This study assesses the association of gender disadvantage with psychological distress among adolescent girls residing in a tribal area of India and examines the role of resilience. Materials and Methods: The study was conducted during the COVID-19 pandemic first wave in 2020 using telephonic interviews with 102 girls aged 15-20 from one block (65.46% tribal population) of a predominantly tribal area in Central India. Trained interviewers administered translated versions of the Kessler Psychological Distress 10-item scale (K-10), the Checklist for Assessment of Gender Disadvantage (CAGED), and the Brief Resilience Scale (BRS). Pair-wise correlation was conducted between gender disadvantage, resilience and psychological distress using CAGED, BRS and K-10 scores. A one-way ANOVA was used to compare mean difference in CAGED domain scores and K-10 severity score groups. Results: The mean age of girls was 17.62 years (standard deviation 1.64). Scores on K-10 indicating moderate to severe psychological distress were seen among 27.5% of the respondents. Girls reported lack of space/privacy (39.2%), lack of freedom to pursue interests (32.4%), opinions not being considered (31.4%), and financial difficulties as hindrance to opportunities (28.4%) as common experiences of gender disadvantage. Gender disadvantage was directly associated with severity of psychological distress and inversely with resilience. Conclusion: This study indicates the importance of decreasing gender disadvantage for improving the mental health of young women and girls in underserved areas. The role of peer group interventions and engaging men and boys using gender transformative interventions in improving mental health needs to be studied.