Improving adolescent health: Learnings from an interventional study in Gujarat, India

Abstract

Background:There are multiple risk factors during adolescence, which become precursors of various diseases and injuries inflicting high morbidity, mortality, and disability. There are several gaps in adolescent health research in India; one among them is that programs targeting adolescent health are constrained by the absence of rigorous interventional research informing interventions for improving adolescent health. This study aims to document the effectiveness of intervention on adolescent health and knowledge change on the risk factors among adolescents in one of the selected districts in Gujarat, India.Methods:This was an interventional study with quasi-experimental design executed in one of the blocks of Gujarat. Baseline was conducted in 2013–2014 followed by intervention and the end line during 2016–2017. A structured validated questionnaire after pilot testing was executed to collect information on sociodemographic profile, nutrition status, menstrual hygiene practices, reproductive and sexual health, substance abuse, program awareness and utilization, and empowerment through life skills of adolescents in baseline and end line survey. Data analysis was carried out using IBM SPSS Statistics for Windows, Version 20.0. (Armonk, NY: IBM Corp).Results:This study documented increased awareness regarding anemia, knowledge about STD and HIV/AIDS, reduced addiction to tobacco, improved practices during menstrual hygiene and engagement with adolescent services/schemes in the intervention site.Conclusion:This study concludes that evidence-based interventions lead to increase in knowledge and practices; however, some improvements have also been documented in the nonintervention site. Therefore, changes due to interventions could not be attributed completely for improving adolescent health. Further long term interventional studies are required to develop a robust evidence on improving health of adolescents in India.

Promising practices for the design and implementation of sexuality education programmes for youth in India: a scoping review

“…Parwej et al, 2005 Chandigarh Adolescent females of classes X, XI, XII School-based Peer and health worker-led Bi-pronged structured teaching programme Didactic teaching by public health nurse Distribution of print health education materials Peer education delivered by trained peer educators Group and individual counselling available Anatomy and physiology of male and female reproductive system, physical and sexual changes during adolescence, menstrual cycle, conception, contraception, child marriage, abortion, laws regarding reproductive rights, STDs, HIV/AIDS 22 Improving Adolescent Health: Learnings from an Interventional Study in Gujarat, India. Patel et al, 2018 63 Gujarat Adolescents aged 11-18 years Community and school-based Teacher and health worker-led Structured teaching programme Delivered by trained teachers, social health activists, health workers, Anganwadi workers, local mentors Peer education delivered by trained peer educators Development of health resource centres “Adolescent Health Days” organised for wide-spread awareness, physical check-ups, referrals, counselling General sexual and reproductive health, nutrition, substance abuse, communication skills, gender equality, menstrual cycle and menstrual hygiene practices, adolescent pregnancy, changes during adolescence, HIV/AIDS, STDs 23 Effectiveness of interventional reproductive and sexual health education among school going adolescent girls in rural area. Phulambrikar et al, 2019 64 Maharashtra Adolescent females from 9th-12th standard School-based Health worker-led Structured teaching programme Didactic presentations using AV aids, videos, health education print materials Q&A sessions conducted Mental and social changes taking place during adolescence, changing relationships, peer pressure, values and attitudes, decision-making, body image, reproductive anatomy and physiology in both males and females, puberty, physiology of menstruation, ways to maintain menstrual hygiene, common menstrual disorders, seeking medical help, myths about menstruation, human reproduction, contraception, legal age of marriage, STDs including HIV/AIDS 24 ...…”

“… 44 , 49 , 66 , 74 , 75 A few programmes included home-to-home visits to provide education and counselling on a more personal level, and others also set up youth health clinics in order to serve as a designated space for youth to access accurate information, connect with healthcare services, and discuss sexual health topics in a confidential setting. 53 , 63 , 78 …”

“… 48 , 56 In some programmes, refresher training sessions were conducted for educators at set intervals during the programme duration. 48 , 53 , 63 , 66 , 67 Other components of monitoring included assessment of inputs and required resources (i.e. programme funding, employees, duration of programme activities, needed equipment/supplies, and facilities) and programme outputs (i.e.…”

Empowering adolescent girls, is sexual and reproductive health education a solution?

“…Awareness levels were around between 18.7% and 47.9%. [ 23 24 25 ] Adolescent girls do not have knowledge regarding symptoms of STD's and RTI's affecting health-seeking in them. Various studies showed poor knowledge regarding STDs and RTIs.…”

Lessons learned from conceptualising and operationalising the National Adolescent Health Programme or Rashtriya Kishor Swasthya Karyakram’s Learning Districts Initiative in six districts of India

“…8 Others have focused on individual interventions that are part of RKSK: improving the quality of adolescent-friendly health service provision, 9 strengthening outreach education by health workers and peer educators (PEs), 10 and improving the organisation of adolescent health days (AHDs). 11 Recognising the need to strengthen the application of the RKSK Programme and to draw out lessons from it, the MOHFW supported a proposal made by WHO in conjunction with partners within and outside the UN, to put in place a Learning Districts Initiative (LDI).…”