Abstract
Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra; assess impact of need based interventions on quality of services; and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents; it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.
Highlights
Thirty percent of India’s total population comprises of adolescents and youth aged 10 to 24 years [1]
Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of Accredited Social Health Activist (ASHAs)
The study succeeded in identifying the strengths and weakness of health system as to what interventions can health system undertake on its own and which interventions need collaboration and linkages with other programmes and institutions
Summary
Thirty percent of India’s total population comprises of adolescents and youth aged 10 to 24 years [1]. To provide friendly services to the adolescents, the Ministry of Health, Government of India (GOI) launched the Adolescent Reproductive and Sexual Health Strategy [2] in 2005 under the umbrella of National Rural Health Mission (NRHM) as part of Reproductive and Child Health (RCH-II) programme. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that health system has the primary responsibility of addressing health issues among adolescents; it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram—
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