The document discusses several national health programs in India that address adolescent health issues. It describes programs like RKSK that focus on improving nutrition, sexual and reproductive health, and preventing injuries among adolescents. It also outlines other schemes for adolescent girls such as Kishori Shakti Yojana and Nutrition Program for Adolescent Girls that aim to enhance their health, education, and empowerment. The document provides details on services covered under these programs, including weekly iron supplementation, health clinics, peer education, and life skills training.

1. Adolescent Health And National
Health Programmes
Dr. Preeti Tiwari

2. • World Health Organization (WHO)
‘Adolescents as young people aged 10-19 years’
• Around 1 in 6 person - World
• 1.2 billion
• About one-quarter - India
• 243 million
(http://unicef.in/PressReleases/87/Adolescence-An-
Age-of-Opportunity#sthash.4jo6kVtF.dpuf)

3. • Road traffic injuries were the leading cause of death
among adolescents
• About 15% of global maternal death occurs among
adolescents girls .
• Injuries and neuro-psychiatric disorders were the
major issues in adolescents
• There is an increasing trend in adolescent obesity due
to great shift in diet and activity pattern .

5. Adolescent
• It is a vital stage of growth and development
• It is a period of transition from childhood to
adulthood

6. • Characterized by:-
 Rapid physical
 Psychological
 Cognitive
 Behavioural changes and developments

7. • Adolescence is classified into three groups:
 Early adolescence groups
 Mid adolescence groups
 Late adolescence groups

8. Early adolescence groups
Age group
• 10 years and 13 years
• Developmental changes on the onset of puberty
Behaviour
changes
• Demand for privacy
• Group activities are primarily with members of his
own sex
Priorities
changes-
• May start engaging in risky behaviors such as
experimenting with smoking, drugs

9. Mid adolescence
Age group
• 14 years and 16 years
• follows puberty by about one to one and a half
years.
Behaviour
changes
• Period of irritability, wide mood swings and rapidly
changing feelings.
Priorities
changes-
• Parental obedience is replaced by conformity to peer
group standards and loyalties.
• Contact with adults outside the family

10. Late adolescence
Age group
• 17 and 19 years
• Period of transition – individual gains grip of his/her
future.
Behaviour
changes
• Realize that their parents can be their best friends.
• Increase bonding between parent and adolescents
especially if both shows mutual respect for each other.
Priorities
changes-
• More selective and discriminating in his relationships.
• Very concerned about the future

11. The determinants of adolescent
health and development :an
ecological model

13. Why pay attention to health of
Adolescents
• To reduce burden of disease in later life
 Malnutrition – life long health problems
 High incidence of STD - risk taking behaviour
 Disease of late middle age
e in adolescents.
Some of the highest infection rates for sexually
transmitted infections are in adolescents.

14. • To invest in health today for tomorrow:
Healthy and unhealthy practices adopted today
may last a lifetime.
Today’s adolescents are tomorrow’s parents,
teachers and community leaders.
Adolescence is a period of curiosity, when young
people are receptive to information about
themselves and their bodies, and when they begin
to take an active part in decision making.

15. Major adolescent problems:-
• Risk-taking behavior.
• Substance abuse.
• Eating habits – Anorexia Nervosa/ Obesity
• Lack of "connectedness" with parents or other adults
etc
• Early pregnancy
• STDs

16. Adolescent health programmes
1. RMNCH+A
2. Rashtriya Kishor Swasthya Karyakram (RKSK)
3. Kishori Shakti Yojana : To improve the health and
nutritional status of girls
4. Nutrition Programme for Adolescent Girls (NPAG)
5. Balika Samridhi Yojana
6. WIFS
7. National AIDS Control Programme
8. Adolescent Friendly Health Clinics(AFHCs)

17. RMNCH+A
• Address- the major causes of mortality among
women and children
• The delays in accessing and utilizing health care and
services
• RMNCH+A
 2013
 To ensure equal focus on various life stages

18. National Iron + Initiative
• Minimum service package for the management of
anaemia across life stages
• Iron and folic acid (IFA) supplementation
 Pregnant
 Lactating women
 Children in the age group of 6–60 months
 Adolescents ; women in reproductive age group

19. • Under National Iron+ Initiative, the following age
groups are covered :
 Bi-weekly 20 mg elemental iron and 100 microgram
(mcg) folic acid per ml of liquid formulation and age
appropriate de-worming for preschool children of 6-
59 months.
 Weekly supplementation of 45 mg elemental iron and
400 mcg folic acid per child per day for children from
1st to 5th grade in Govt. & Govt. Aided schools, and
at AWC for out of school children (6 to 10 years).

20. • Weekly dose of 100 mg elemental iron and 500 mcg
folic acid with biannual de-worming in adolescents
(10–19 years) under WIFS
• Weekly supplementation for women in reproductive
age, Pregnant and lactating women

21. Rashtriya Kishor Swasthya Karyakram
(RKSK)
• The Ministry of Health & Family Welfare
• Launched on 7th January, 2014.
• RKSK has been developed to strengthen the
adolescent component of the RMNCH+A strategy

22. Objectives:
 Improve Nutrition
 Improve Sexual and Reproductive Health
 Enhance Mental Health
 Prevent Injuries and violence
 Prevent substance misuse
 Prevent non communicable disease

23. Services provided
• WIFS
• Clinics and counselling
• Peer Educator & Adolescent Health Day
• Menstrual Hygiene Scheme

24. WIFS
Weekly Iron Folic acid
Supplementation
•
• The programme covers 11.2 crore beneficiaries
• 8.4 crore in-school
• 2.8 crore out of school beneficiaries.

25. Salient features of WIFS:
• To reduce the prevalence and severity of anaemia in
adolescent population (10-19 years).

26. • Target groups
 School going adolescent girls and boys in 6th to 12th
class enrolled in government/government
aided/municipal schools.
 Out of school student
 Urban and rural area

27. Intervention
• Supervised Weekly Iron-folic Acid Supplements
100mg elemental iron and 500ug Folic acid
• Screening of target groups for moderate/severe
anaemia and referring these cases to an appropriate
health facility.
• Biannual de-worming (Albendazole 400mg)

28. Peer Education
To improve life skills, knowledge and attitude of
adolescents
• Nutrition
• Sexual and reproductive health
• Conditions for NCDs
• Substance misuse, injuries and violence
• Mental health.

29. Adolescent Health Day
• One of the strategies to achieve the objectives of the
adolescent health program
• Increase awareness among adolescents, parents and
families and stakeholders

30. • The AHD should be organized in every village
• Once every quarter on a convenient day (preferably
on a Sunday)
• AWCs or community spaces may be - venues for
organizing the AHD.
• Services should be offered to all the adolescent target
groups (male/female; 10-14 and 15-19 age; school
going, drop out; and married adolescents)

31. Counselling
• Improving dietary intake
• Taking actions for prevention of intestinal worm
infestation.
• Adolescent issues

32. Kishori Shakti Yojana
• Launched – year 2000
• Key component of ICDS
• Aim–
 Breaking the intergenerational life cycle of nutritional
& gender disadvantage and providing a supportive
environment for self development

33. Objectives
• To improve nutritional and health status of girls in age
group of 11-18 years
• To provide required literacy and numeracy skills through
the non-formal stream of education
• To stimulate a desire for more social exposure and
knowledge and to help them improve their decision
making capabilities
• To train and equip the adolescent girls to improve/
upgrade home-based and vocational skills

34. • To promote awareness of health, hygiene, nutrition and
family welfare, home management and child care
• To gain a better understanding of their environment
related social issues and the impact on their lives
• IFA supplementation along with deworming
• Education for school dropouts and functional literacy
among illiterate adolescent girls
• Non-formal education to adolescent girls. Emphasis on
life education aspects including physical, developmental
and sex education is given.

35. Beneficiaries
 Adolescent girls who are unmarried and
 Belong to families below the poverty line
 School drop-outs

36. • Scheme- I (Girl to Girl
Approach)
• Age group of 11-15 years
• Belonging to families whose
income level is below
poverty line
Scheme-II (Balika Mandal)
• Age group 11-18 years
irrespective of income levels of
the family
•Younger girls 11-15 years and
belonging to poor families

37. Nutrition Programme for Adolescent
Girls (NPAG)
• It was initiated as a pilot project (2002-03)
• Centrally sponsored scheme
• 51 identified districts across the country
• Aim - address the problem of under-nutrition among
adolescent girls.
• 2004-2005 (Stopped)

38. • Objectives
 To improve nutritional status
 To create gender awareness and development of
adolescent girls.

39. • Beneficiaries:
 Adolescent girls (11-15 years) with body weight less
than 30 kg
 Adolescent girls (15-19 years) with body weight less
than 35 kg
• Eligibility criteria:
 Adolescent girls (11-19) - registered in an
Anganwadi Centres irrespective of financial status of
the family to which they belong.

40. Benefits
• Improvement of nutritional and health status of girls.
• Training and equipment of adolescent girls to upgrade
home based vocational skills.
• 6 kg of free food grain (rice) per month per
beneficiary.
• Promotion of health, hygiene, nutrition, family
welfare, home management and childcare.
• Better understanding of their environment related
social issues and its impact on their lives.

41. Balika Samridhi Yojana
• Launched by Government of India in1997
• Aim - to delay the age of marriage
Objectives:
 To change negative family and community attitudes towards
the girl child at birth and towards her mother.
 To improve enrollment and retention of girl children in schools
,to increase the age of marriage of girls and to assist the girl to
undertake income generation activities.

42. Beneficaries
• Girl children belonging to families below the poverty
line.
• Who are born on or after 15th August, 1997.
• The benefits are restricted to two girl children in a
household irrespective of number of children in the
household.

43. • A post birth grant amount of Rs. 500
• Payment
 Attaining 18 years of age
• Withdrawl of benefit
 Girl getting married<18yrs she will not be given the
benefit
 In case of death all money will be withdrawn

44. National AIDS Control Programme
• Under NACO Adolescent Education Programme
developed which focuses primarily on prevention
through awareness building
• The Adolescent Education Programme is one of the
key policy initiatives of NACP
• Relevant messages on sexuality and relationships are
developed and disseminated for youth via posters,
booklets, panels and printed material.

45. • The Adolescence Education Programme (AEP)
 Co-curricular adolescence education in classes IX-XI
 Life skills education in classes I- VIII
 Inclusion of HIV prevention education in pre-service
and in-service teacher training and teacher education
programmes.

46.  Inclusion of HIV prevention education - out-of-
school adolescents and young persons
 Incorporating measures to prevent stigma,
discrimination against learners/students and educators
and life skills education into education policy for HIV
prevention.

47. Adolescent Friendly Health Clinics
(AFHCs)
• ‘Maitri’ in Maharashtra
• ‘Udaan’ in Uttrakhand
• ‘Sneha’ in Karnataka
• The objective of it being addressing the stigma
behind accessing the adolescent services.

48. Services provided
• Counselling and curative services
• Counselling services-
 Nutrition
 Puberty
 RTI/STI prevention
 Contraception and delaying marriage

49. • Curative Services available at AFHC
 Treatment of severe malnutrition
 Treatment of common RTI/STI problems
 Treatment of menstrual disorders
 Treatment for sexual concerns of males and female
 Mental health service/management of depression

50. • Treatment of non-communicable diseases and other
common ailments
• Management of injuries related to accidents and
violence
• Management of substance misuse
• Treatment of non-communicable diseases like
hypertension, stroke, cardio-vascular diseases and
diabetes

51. Other important services
• Delay first pregnancy
• Decrease teenage pregnancies
• Reduction in maternal deaths among adolescent girls
• Management of anaemia –
 Iron supplementation and nutritional counselling.
 Appropriate health facility referrals
 Early and safe abortion services are provided to
adolescents.

52. • Reduction in incidence of sexually transmitted
diseases and proportion of HIV positive cases in
adolescent

53. Commodities available at AFHC
• Weekly Iron & Folic Acid Supplementation &
Albendazole
• Sanitary napkins
• Contraceptives
• Medicines

54. Life Skills
• “the abilities for adaptive and positive behaviour
that enable the individuals to deal effectively with
the demands and challenges of everyday life”.

55. • 'adaptive' means that a person is flexible in approach
and is able to adjust in different circumstances
• 'positive behaviour' implies that a person is forward
looking and even in challenging situations, can find a
ray of hope.

56. Life skills
Social or
interpersonal
skills
Cognitive or
Thinking skills
Emotional Skills

57. SUMMARY

58. Adolescent health programmes
1. RMNCH+A
2. Rashtriya Kishor Swasthya Karyakram (RKSK)
3. Kishori Shakti Yojana : To improve the health and
nutritional status of girls
4. Nutrition Programme for Adolescent Girls (NPAG)
5. Balika Samridhi Yojana
6. National AIDS Control Programme
7. Adolescent Friendly Health Clinics(AFHCs)
8. School health services