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Santosh University Journal of Health Sciences


Challenges in implementation of Adolescent health strategies of RMNCH+A in Ghaziabad


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Author Details: Latika Nath, R.K. Arya, G.K. Gupta, Narendra Singh

Volume : 1

Issue : 2

Online ISSN : 2455-1732

Print ISSN :

Article First Page : 88

Article End Page : 98


Abstract

Background: The strategic approach to adolescent (10-19 years) health as part of the RMNCH+A consists of many community based initiatives implemented since February 2013 in India .These key strategies include adolescent reproductive health and nutrition counselling by ASHAs & ANMs, regular school health check-ups, community based services through peer educators and ARSH (Adolescent Reproductive and Sexual Health) clinics, WIFS (weekly iron folic acid supplementation) and promoting menstrual hygiene.
Methods: Multi stage sampling technique was used to select sub centres from each of the 4 rural blocks of Ghaziabad by PPS method. A cross-sectional survey of 384 adolescents from villages of selected sub centres was done and mothers were interviewed in their presence using a semi structured questionnaire on the adolescent services provided and utilized by them.
Results: Among the 384 adolescents, 63/196 (32%) girls and 19/188 (10%) boys had undergone a school health check up in the last one year. Among the respondents 15% had regular weekly iron and folic acid supplementation but only 6% said they actually consumed the tablets. None knew the location of AFHC (adolescent friendly health clinic) nor any fixed day approach to counselling services. Only 44% boys and 32% girls said they would avail of clinic-based counselling facility if provided. Among the female adolescents 32% had been counselled by ASHAs on menstrual hygiene, 83% used sanitary napkins by choice. Lack of contact with ASHA (OR: 3.0, 95%CI 1.1-7.7), preference for private health sector (OR: 3.0, 95% 1.9-7.6), lack of regular school health check- ups (OR: 2.6, 95% CI 1.6-3.8) were significant risk factors for non-adoption of menstrual hygiene advice.
Conclusions: The adolescent services are sub-optimal in the district presently. Non consumption of IFA tablets needs to be addressed by better co-ordination between Education and Health department. Home based counselling should be strengthened in our socio-cultural milieu as per need.

Key Words:
Adolescent, AFHC, Counselling, RMNCHA