Health  Vol.9 No.1 , January 2017
Operationalizing Adolescent Health Services at Primary Health Care Level in India: Processes, Challenges and Outputs
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.
Cite this paper: Joshi, B. , Chauhan, S. , Kulkarni, R. , Kamlapurkar, B. and Mehta, R. (2017) Operationalizing Adolescent Health Services at Primary Health Care Level in India: Processes, Challenges and Outputs. Health, 9, 1-13. doi: 10.4236/health.2017.91001.

[1]   Census (2011) Government of India.

[2]   ARSH Strategy Government of India (2004).

[3]   Implementation Guide National Rural Health Mission (2006) Implementation Guide on RCH II Adolescent Reproductive Sexual Health Strategy for State and District Programme Managers.

[4]   Ambresin, A.E., Bennett, K., Patton, G.C., Sanci, L. and Sawyer, S.M. (2013) Assessment of Youth-Friendly Health Care: A Systematic Review of Indicators Drawn from Young People’s Perspectives. Journal of Adolescent Health, 52, 670-681.

[5]   Quality Assessment Guidebook (2009) A Guide to Assessing Health Services for Adolescent Clients. WHO.

[6]   Adolescent Job Aid World Health Organization (2010) WHO Production Services, Geneva.

[7]   ARSH Training Modules Orientation Programme for MOS, ANMs/LHVs to Provide Adolescent Friendly Reproductive and Sexual Health Services Govt of India.

[8]   Mehra, S., Sogarwal, R., Nair, V., Mahasweta, S., Tiwari, R. and Dwivedi, K. (2013) Determinants of Youth Friendly Services Influencing Client Satisfaction: A Study of Client’s Perspectives in India. Indian Journal of Public Health Research & Development, 4, 221-226.

[9]   Yadav, R.J., Mehta, R., Pandey, A. and Adhikari, T. (2009) Evaluation of Adolescent-Friendly Health Services in India. Health and Population Perspectives, 32, 66-72.

[10]   Sogarwal, R., Chandra, M. and Mehra, S. (2013) Youth Friendly Health Services and Role of Outreach Activities to Improve Access to Services. Open Journal of Preventive Medicine, 3, 191-198.

[11]   Gupta, M., Ramani, K.V. and Werner, S. (2012) Adolescent Health in India: Still at Crossroads. Advances in Applied Sociology, 2, 320-324.

[12]   Kumar, R., Prinja, S. and Lakshmi, P.V.M. (2008) Health Care Seeking Behavior of Adolescents: Comparative Study of Two Service Delivery Models. The Indian Journal of Pediatrics, 75, 895-899.

[13]   Joshi, B., Chauhan, S., Bhadoria, V., Varsha, T. and Neelawanti, G. (2006) Reproductive Health Problems and Help Seeking Behaviour among Adolescents in Urban India. Indian Journal of Pediatrics, 73, 509-513.

[14]   Mehra, S., Sogarwal, R. and Chandra, M. (2013) Integrating Adolescent-Friendly Health Services into the Public Health System: An Experience from Rural India. WHO South-East Asia Journal of Public Health, 2, 165-173.

[15]   Joshi, B., Chauhan, S., Ghule, M. and Kulkarni, R. (2009) Developing Service Delivery Models for Providing Adolescent Reproductive and Sexual Health Services: NIRRH Experiences. In: Ashwini, B.-G. and Parag, B., Eds., Gynecological Manual on Adolescent Girls and Young Women, FOGSI Publication, Jaypee Publishers, New Delhi, 401-421.

[16]   Chandra, M.V., Lane, C. and Wong, S. (2015) What Does Not Work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions Commonly Accepted as Best Practices. Global Health: Science and Practice, 3, 333-340.

[17]   Karyakram, R.K.S. (2014) Operational Framework, Translating Strategies into Programs. Adolescent Health Division, Ministry of Health and Family Welfare, Government of India.