The document provides guidelines for establishing Adolescent Friendly Health Clinics (AFHCs) in Jammu and Kashmir. The key points are: 1. AFHCs aim to make health services accessible, acceptable, appropriate and effective for adolescents by creating private, welcoming spaces and training healthcare staff. 2. Infrastructure recommendations include a separate room or divided space for AFHCs, with comfortable furniture, curtains for privacy, and basic medical equipment. 3. Clinics should be open after school/work hours and provide counseling and clinical services related to sexual health, mental health, nutrition and more. 4. Staff should maintain privacy and confidentiality, and clinics should register clients, conduct out

1. Adolescent Friendly
Health Clinics
(AFHCs)
State RMNCH+A Unit, J&K
Tapas Chatterjee
State Coordinator-RMNCH+A, J&K

2. Contents
State RMNCH+A Unit, J&K
 Background
 Objective
 Infrastructure for AFHC
 Privacy of clinics
 Timing of AFHC
 Registration of Adolescent
 Outreach Activities
 Recording
 Reporting Mechanism
 Monitoring of AFHC

3. Several studies have shown that adolescents fail to access
health services because of five key factors:
 Lack of knowledge about availability of services and
means of access;
 Social and cultural deterrents;
 Perceived lack of privacy or confidentiality;
 Services are difficult to access i.e. too far way or too
expensive;
 Staff appear to be unfriendly
Background
State RMNCH+A Unit, J&K

4. In this context, MoHFW launched Adolescent Health Strategy
highlights the need for rolling out Adolescent Friendly Health
Clinics (AFHC) across the country.
The aim is to provide clinical and counselling services to
adolescents through the existing health system. With a slight
physical makeover, training of existing staff, introduction of a
counsellor and provision of commodities, existing facilities
would be equipped to provide adolescent friendly health
services
Background……………contd.
State RMNCH+A Unit, J&K

5. Equitable: all adolescents in age group 10-19 years are
able to obtain services
Accessible: adolescents are able to obtain the available
health services
Acceptable: adolescents are willing to obtain the
available health services
Appropriate: the right health services (i.e. the ones
they need) are provided to adolescents
Effective: the right health services are provided in the
right way, and make a positive contribution to their
health
Objective

6. Infrastructure for an AFHC
AFHCs should be characterised by two key factors:
1. A warm and inviting space: The physical appearance of
AFHCs is important for creating an environment where
adolescents feel comfortable.
A typical health set up might not attract adolescents, but
a simple makeover with wall paint, colorful furniture,
bright posters, LCD screens with appropriate health
messages etc. can all transform the facility.
State RMNCH+A Unit, J&K

7. 2. Privacy: Globally studies have shown that the two
expectations that adolescents have from the services are
that—a) they want to be treated with respect; and b)
confidentiality is protected.
In this context, care should be taken to ensure that the AFHC
is separate from the general OPD. Efforts should be made to
maintain privacy and confidentiality, to ensure that
adolescents are comfortable attending clinics.
Infrastructure for an AFHC
State RMNCH+A Unit, J&K

8. • There has to be a separate room for AFHC, in case of non
availability of the separate room the available room
should be sub divided to create space/room for the AFHC.
• The physical appearance of AFHCs is important for
creating an environment where adolescents feel
comfortable.
• Basic amenities like sitting arrangements, clean drinking
water and clean toilets should be made available for the
adolescents visiting the clinic
Infrastructure for an AFHC
State RMNCH+A Unit, J&K

9. S No Items Quantity
1 Chair 3
2 Table 1
3 Curtains on doors and windows As per need
4 Bedside Screen 1
5 Almirah 1
6 Step Tool 1
7 Bench/Chair for waiting area As per need
Furniture
State RMNCH+A Unit, J&K

10. S No Items Quantity
1 Weighing Machine 1
2 BP Apparatus 1
3 Stethoscope 1
4 Thermometer 1
5 Measuring tape 1
6 Torch/Flashlight 1
7 Snellen’s Chart 1
8 Height Chart 1
Equipment
State RMNCH+A Unit, J&K

11.  Efforts should be made to maintain privacy and
confidentiality, to ensure that adolescents are
 comfortable attending clinics.
 Adolescents must be treated with dignity and respect.
 Place of physical examination must have screens.
 While examination of the adolescent girls ANMs/ LHVs must
remain present.
 All the doors and windows of the Clinic must have curtains.
Privacy of the Clients
State RMNCH+A Unit, J&K

12. Timing of the Clinic
SC PHC CHC DH
Medical
College
Walk in Clinics
by ANMs
Weekly AFHCs
from 2 to 4
p.m. by ANMs
and MOs
Daily AFHCs from
9 a.m. to 4 p.m.
Dedicated AH
Counselor
Daily AFHCs from
9 a.m. to 4 p.m.
Two-hour daily
clinic from 2 to 4
p.m. by MOs,
with support
from ANMs
Specialty -
AFHC with
different
specialties
from 9 a.m. to
1 p.m. and
Counselors
from 9am to
4pm
Two way role of the Counselor placed at CHC onwards
 to ensure on ground linkages with community through PE s
 and forward linkages with specialist in hospital , in case medical care is needed
by adolescent client State RMNCH+A Unit, J&K

13. Registration of the Clients
 All the adolescents visiting the AFHCs must be registered
and record must be maintained in the Client Registration
Register.
 Referring all the adolescents coming to the General OPD to
the AFHC must be avoided.
 Only those Adolescents who require counselling on specific
AH issues should be referred to the AFHC.
 Adolescents requiring clinical services for general ailments
or other diseases should be treated at the General OPD
only.
State RMNCH+A Unit, J&K

14. IEC
The signboard of the clinic should be placed at a prominent place
and it must have the logo of RKSK. AFHC services should be made
a part of Citizen Charter of the facility.
IEC material relevant to the Adolescent needs should be
strategically displayed in AFHCs.
Filip books, Pocket books, Pamphlet, posters to be utilized for
communication.
AFHC services should be widely publicized through Mid media
and Mass media so that the beneficiaries and other stakeholders
are aware of the services provided and understand the need for
the same. State RMNCH+A Unit, J&K

15. Outreach Sessions
 Counsellor at AFHCs should prepare a tour plan for visiting
Schools, Colleges, Youth Clubs, Major Health events,
Adolescent Health Day etc. twice a week to sensitize the
adolescents and the stakeholders.
 Major topics which can be covered during the outreach
sessions are nutrition, puberty related concerns,
Premarital Counselling, Sexual Problems, Contraceptive,
Abortion, RTI/STI, Substance abuse, Learning problems,
Stress, Depression, Suicidal Tendency, Violence, Sexual
Abuse, Other Mental Health Issues, health lifestyle, risky
behaviour etc.
State RMNCH+A Unit, J&K

16. State RMNCH+A Unit, J&K
Service Package DH CHC PHC SC Outreach
BMI screening √ √ √ √ √
Hb testing √ √ √ √ √
RTI/STI management √ √ √ √ √
ANC for pregnant adolescents √ √ √ √ √
Counselling on Nutrition, puberty related concerns,Premarital
Counselling, Sexual Problems,
Contraceptive, Abortion, RTI/STI, Substance abuse,
Learning problems, Stress, Depression, Suicidal
Tendency, Violence, Sexual Abuse, Other Mental
Health Issues, health lifestyle, risky behaviour
√ √ √ √ √
Management of Menstrual problem √ √ √ √ √
Management of Iron deficiency Anaemia √ √ √ √
Screening for diabetes and hypertension √ √ √ √
Management of common adolescent health problems √ √ √ √
HIV testing and counselling √ √
Management of physical violence and sexual abuse √ √
Linkages with de-addiction centres and referrals √ √
Treatment by specialists √ √
Referral √ √ √ √ √
Services

17. Types of registers
• Client Register
• Service Register
• Stock register
• Out Reach Register
• AFHC prescription Format
Record Keeping
State RMNCH+A Unit, J&K

18. AFHCs-CHC
AFHCs-PHC
AFHCs-DH
District
3rd of
every
month
State Health
Society
AFHC wise monthly
consolidated
5th of every month
Reporting Mechanism
monthly
consolidated
reports
State RMNCH+A Unit, J&K

19. Districts should regularly monitor and report on the following indicators to
understand the functioning of AFHCs at each level:
 Percentage and number of AFHC operationalised against planned (at PHC,
CHC, DH)
 Client load at Adolescent Friendly Health Clinics per month (no.)
 Client referred from community to AFHC per month (no.)
 Percentage of adolescents accessing adolescent clinics for puberty-related
problems, RTIs/STIs, mental health concerns, abortion care, nutrition
 Percentage and number of AH counsellors recruited against planned
 Total number of clients counselled
 Percentage and number of trained counsellors in place against planned
 Proportion of trained counsellors to total number of adolescents
 Percentage and number of MO trained in AFHS (male/female) against
planned
 Percentage and number of ANMs/LHVs trained on AFHS against planned.
Monitoring
State RMNCH+A Unit, J&K

20. State RMNCH+A Unit, J&K
THANK YOU