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AXASF{

{Adolescent Reprodarctive and Sexual }{ealtla}

llilolesr:ents Reproductive & Sexual l{ealth (ARSH) has been identified as oner of key
strategies under RCI{-U. Adolescents (i 0-19 years) constitute about one-fifth of india's
papiilation and young people {1$-24 years} aiiout one-third of the populaiion. ilm,r,evci:
adolr:scents, especiatriy those i* marginalised and under-served sections of the popr-rla'iion.
face several chailenges such as: structulai poveRy, social discriminaticn cr negaiive
social norms inadequate education, early itariage, teenage pregnallcv. Invcstments in
adolescents will have a positirre iinpact on {ndia's health goals as u,ell as achievernent of
Miliennium Development Goais.
!ea'tervemtiorns
P{x rntaT' aru niAb hiy an

T'liis is a ccirununity level iuierr,'ention io cater the need of adolescents girls in the age
llrorip of ltl tc 19 years in r''rralareas. This is Gcvernment of Gujarat's initiative and irn
i niportant oi;treach service for adolescents.
W

hy &.{anataTarmniAbhiy,am

'l'here has been successful implerrentation of school health program w'hich cateis thfi
need of school going adolescent" Maternai Ficalth component cf RCtrl-trt covers most oi
the married adolescent and their neecis for: repr"odrictive and sexual heaith and nutritior.i.
The only group remains uncoveled is out cf school unmarried adolescents.

Various studies zurd data both fi'om central ancl state level shor,r,,s the poor nutri';ion status
ol'*ut cf school adolescents boys and girls, earl-v marriages and early pregnancies, unsale
abortions and unwanted pregnancies in this glorip, prone to sexual abuse and violence.
high risk to RfI/STi inclucling HIV/AIDS. This all in tum leads to various mental health
rrrcbler"::s.

I'his is a group lvhich has iess access the health care facilities , so a communit),hased
iiri*i:vention has been implernented unclel tire r.rnrbrella of RCH-II ARSII str?itegy tilr
ploviele heaith care out of schcotr unrrlarrie<.i. adolescent giris.
.4etitrities

Yiliage Wise Enlisting of Out of Sc,hcoi Unmarried Adolescent Giils: Ail

adolescents' girls within the age group of tr 0-i 9 are to be registereri in ihe deflned
popuiation. Registration has to be dane jointly by the AWW and ASHA. The
register ra,ill be maintained at AWC" Upciating of register will be done during ihe
month of "Ianuary every ),ear.
Services at l\4am1.a Taruni Session: \Meighing once in every quarler . Monthly
trFA" nutrition supplement tc all the girls who has less Bh{I than erpected. TT
vaccination at the age of i0 and 1{i lrears, counseling for menstrual disorders.

personal/menstrual h-vgiene, RTI/STI screening anC awareness about

contraceptives to be provideC on the Mamta Taruni Session.
lclentification of MamtaTaruni Peer Eclucators: Girls with leadership qualities are
trained in growth monitoring, nutriiion awareness, micro nutrient
supplementation, personal hygiene arrd basic health issues. These peer educators
',,,rill then play an important rcle in educating and bringing adolescent girls to the
Mamta Taruni Sessions and to heaith care faciiities for treatment if needed.

Adolescent Friendly Health clinics

Adolescent Reproductive and Sexual Fleaith strategy provides a frarnework ior a range cf
sexual and reproductive healttr services to be provided to the adolescents. The strategy'
inccrporates a core package of sr:rvices including preventive. promotive, curarive and
ecunselin.q services. Effective implementaJion of policies and programmes has
progressed frorn the past fbw 1'ears and has lead to strengthening of Ariolescent Friencilv
clinics and subsequently the outreach programmes. There are lgl AFHS Clinics in Pi It..
LrHC CHC , SDH and DHs . Everyz n'eek, \4onday for Girls and Tuesday for Bovs fion:
2-5 p"rn.) clinies are run by Medical officers and it is one point center fur getting
information, avail counseling and receive r:linical services to adolescent girls and bo1,.s.
Serv'ice pacliage in

dFHC

Objectives

'fo eontribute to the R.CH II goais of reduction cf IMR, MMR

u
*
*
*
"

and TFR"r:y

l{edueing teenage pregnancies,

Meeting unmet contraceptive needs.
Reducing nurnber of teenage maternal deaths.
l{educing incidence af S'IIs ancl l{Ttrs.
Reducing proportion of HIV positive among this age group.

Serv'iees

Pr'omr:tive Sen,ices

*
"o

Focused.care during antenatai period.

Counseling and provision tbr ernergency contraceptive pills.
Counseling and provision cf reversible contraceptives.

'

Information /advice on SRi{ issues.

f-fqrslrys&r&st

*
*
'

Services for tetanus immunization.

Services for proph,viaxis against nutritional anaernia.

Nutritioncounseling.

\',\'*e$<].v xncm F

clie Acid s uppremeerta ti*r! Fro g."a*lm e(wlF-s)

Adolescent Anemia is a long standi*g pr-rbiic health

problem in India whiej: is caused br
ilcn deficiency. Adolescents are at higlt risk of iron deficienc;,,
due to u.r,*tr*,*tli ;;"-.:;.
'bcdr
at ril
mass building- poor dietary ir:take *f iron and
high rate of \&,crm inlestatii:*. fu:
girls iieflcienc;,' cf iron is firrher aggra-o'a-ted *,ith
higher demands r,r,.lth c*sr:l. ol'
m':nstruation and also due tt the prohleti: *l-a.dolesc*ent
pi.egnancy ald c$n;*ptji)rr.
Gujr'{ed by rhe ernpiricai evidence ttrar.*ie*i<ly s.,pplemer,#;;;f
iffi;;;H:enrai In;n
and 500u-g Foiic Acid (IFA) is eifecti"'c in a*.,reasirrg
ln.;*.n*e anc prer,aicrce ci'
anenria in aCciescents.

e'{CIlFw has launched the Weeklv Iron ani I'olic Acid

Suppiemenraticn (w1i-S)
Proglamme fcr schooi going adoiescenr sirls an,J
boys and for out

cil schi;cl ad*iescent

girtrs. Tire Frograrrr*e envisages adrriinisiiaiion

,rfsupervised w,eeki3,,

Ii;A

si-ippleruentation and tlianni.:al deworming tableis

to approrirnaiely i3 ci*re ruratr and
urba* a<i*leseants through the piatfbrm oi Gr.wrGor.t.'aicred
and muni*ipa] scl:oo1 *'ri
Angan-*adi Kendra and cc.ribat the interge*erationai
c-r,cle cf anaemia.
{-FD.qec{wf

"'i'r; r*diter prevaleilce and severiiy

cf ai:enria in sch*ol going chilrjrr:i-r. tji-{-ilil
siai:ilar<i aiid no* rlchcol going aColesccnr giris

iii AWC,;

1r_:

izlir

Farget grcaips
WeeklSr Iron and Irolic Acid sr_ipulemeniaiion prsgraffime
impier:rented
ir:r the
--r *^-!vai!!u r\"r
r'u tir;iora,ine
irirti target grorips ir both rural and rirlnn areas

'
"

Adolescent girls an,l bcys enralier.i ir: govemment/goverruneni

aidedr,rn.r-uiicipral
sci:ro*]s frorlr 6th tc 12th ctrasses.
Nou schoai going Adolescent Girts.

Ii:* wiFS

programme alsc cover man'iecl adclescent

girls. pregnant ani iactatilig
girls *iiil be given lFA sr:ppien1.eil.ts, according
to cr.lrrent gu;ilelines iilr:
anter.;aal and postnatal care thrcugh ihe
exi;r.ing rr.urti, siiem of NFti-iir,{
e-dolesconi

S*r*t*g.r.

;lf;Hi:lrtion

af Weeki3, Iron and iiotir-: Acid Supplernenrariori

ii\,,jFS r. i:,ar:ti

ccnraining 100mg elernentar iror: anri 500pg

foric acid icl52 rv*eks in a
",,riri.
screening of target groi,ps *r nrccieraie/serlere
u,-,*nrru
to aa appropriate heaith flacjiirv.
Bia'*ual de-wc,nning {Arbeniaz*re 4*0rng),
six months apa{, ii;r contrcr of
ri'orinirr [cstaiiun.

*nj*r#rlir;;";rr.

Information and counseling for improving dietary intake and for taking actions fbr
prevention of intestinal worm infestation.