Improving adolescent health services across high priority districts in 6 states of India: Learnings from an integrated reproductive maternal newborn child and adolescent health project

Abstract

Background:India has been at the forefront of designing adolescent health (AH) policies. The National Adolescent Reproductive and Sexual Health policy (2006), the Reproductive, Maternal, Newborn Child, and AH strategy (2013), and the “Rashtriya Kishor Swasthya Karyakram (RKSK)” (2014) have been the critical milestones in this direction. However, despite policies being available, the AH outcomes need improvement through operationalization of focused and need-based AH interventions.Objectives:The objectives of this study were to improve services for RKSK interventions across select geographies of India.Materials and Methods:USAID's VRIDDHI Project has been providing technical support at the national level and in six focus states to improve uptake of evidence-based high-impact reproductive, maternal, newborn, child, and AH interventions. To improve AH services and outcomes, two approaches were implemented, namely (a) strengthen the functioning of adolescent-friendly health clinics in 95 high caseload health facilities in 26 high priority districts across six states and (b) demonstrate other operational strategies outlined in RKSK program including strengthening of district committees on AH, undertaking formative research for developing adolescent-focused communication strategy, and operationalizing weekly iron and folic acid supplementation program.Results:As a result of ongoing technical support over 2-year period (January 2016–December 2017), improvements were noted across multiple AH indicators. In addition, evidence-based learnings were also generated from the demonstration models for potential scale up to other geographies.Conclusion:The project was successful in improving AH services in the intervention facilities through an integrated approach which is replicable, sustainable, and scalable for driving the AH program in India.

A Study of Quality and Proficiency of the Service Providers in Delivering the Adolescent and Youth Friendly Services under the Rashtriya Kishor Swasthya Karyakram Programme in Madhya Pradesh

“…11 Understandably, the trained providers who knew about GATHER approach listened attentively to the client as compared to where the services were delivered by clinical providers, which makes a case for improving and expanding the scope of training and placement of trained providers in all health care facilities. Similar findings have been reported by Wadhwa R et al 17 and Bhat et al 9 Contrary to the findings of the present study Dixit GT et al, reported that more than 70% provided health education, counseling and information about services and they provided services without discrimination, 10 which provides a silver lining.…”

Compliance of Adolescent Friendly Health Clinics with National and International Standards: Quantitative findings from the i-Saathiya study

“…Despite years of establishment, the available evidence from India highlights the low footfall of adolescents in AFHCs 7–9. This is partly explained by multiple barriers to avail these services, including a lack of adolescents’ knowledge about the AFHCs in their vicinity,10 inadequate staffing, untrained service providers, social taboo, inadequate equipment, low priority accorded by programme managers and adolescents’ perceive that services are restricted to reproductive and sexual health 11. This results in a missed opportunity in the identification and treatment of health problems, hindering the assistance provided to adolescents in developing positive healthcare-seeking behaviours 12.…”

“… 11 This results in a missed opportunity in the identification and treatment of health problems, hindering the assistance provided to adolescents in developing positive healthcare-seeking behaviours. 12 This undermines the goal of RKSK to promote adolescents’ health and well-being and emphasises the pressing need for a standardised approach to enhance the quality of care across India, 11 ensuring effective utilisation by adolescents. With this, as part of the i-Saathiya study, which aims to explore the implementation of the peer education programme, we also assessed AFHC compliance with both national 13 and global standards for quality healthcare services catering to adolescents.…”

The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic review and meta-analysis

“…Health is an integral part of the Sustainable Development Goals (SDGs) [ 1 ]. Universal health coverage (UHC) is the target of SDG-3 [ 2 ]. In particular, the SDG 3.8 target aims to achieve UHC, including financial risk protection (FRP), access to quality essential health services, and safe medicines and vaccines for all [ 1 ].…”