COMMUNITY HEALTH NURSING

SEMINAR
ON
ADOLESCENT
HEALTH
SERVICES

SUBMITTED TO SUBMITTES BY
MRS SHEENA P TEENA K
ASST PROFESSOR SECOND YEAR MSC NURSING
GOVT COLLEGE OF NURSING GOVT COLLEGE OF NURSING
KOZHIKODE KOZHIKODE
 INTRODUCTION
Adolescence period otherwise known as puberty period when Rapid physical
growth and psychological changes take place. It is the most important and sensitive
period of one’s life. Adolescence is a time of moving from immaturity childhood to
maturity adulthood by unfolding a set of transitions that touch upon many aspects of
the individual’s behavior, development, and adolescents constitute 22.8% of
population of India as on 1 st march 2000
Adolescence is the phase of life between childhood and adulthood, from ages 10 to
19. It is a unique stage of human development and an important time for laying the
foundations of good health. Adolescents experience rapid physical, cognitive and
psychosocial growth.

Adolescence is a critical transitional period that includes the biological changes

of puberty and developmental tasks such as normative exploration and learning to be
independent. Young adults who have reached the age of majority also face significant
social and economic challenges with few organizational supports at a time when they
are expected to take on adult responsibilities and obligations.
There are significant disparities in outcomes among racial and ethnic groups. In
general, AYAs who are African American, American Indian, or Latino, especially
those living in poverty, experience worse outcomes in a variety of areas such as
obesity, teen and unintended pregnancy, tooth decay, and educational
achievement, compared to AYAs who are Caucasian or Asian American. In addition,
sexual minority youth have a higher prevalence of many health risk behaviours.

ADOLESCENCE
Stage of human development encompassing the transition from childhood to
adulthood.
Latin word – adolescere – to grow into maturity.
 Puberty – biologic changes & sexual maturation during this transition.
Definition
WHO -age period between 10 – 19 years for both sexes, married & unmarried people
 Youth – 15- 24 years
 Young people – 10- 24 years
 Healthiest period of life & the most problematic.
Stages
 Early adolescence – 10 -13 years - growth spurt & secondary sexual characters.
  Mid adolescence – 14-16 years - independence & identity, experimentation &
relationship with peers and opposite sex.
 Late adolescence – 17 -19 years

Special characters
 Rapid physical growth &development.
 Physical, social & psychological development.
 Sexual maturity & onset of sexual activity
 Experimentation
 Onset of reproductive cycle
 Development of adult mental process & adult identity.
SECONDARY SEX CHARACTERISTICS OF FEMALE
 Breast development
 Pubic hair appear
 Axillary hair appear
 Increased width and depth of pelvis
 Uterus and vagina grow
 Acne and pimple
 Increases sweat
 Change in vaginal secretions
SECONDARY SEX CHARACTERISTICS OF MALE
 Pubic hair appear
 Axillary hair appear
 Facial hair and body hair appear
 Voice change
 Penis and testis enlarges
 Acne
 Development of body odour
 Ejaculation
COGNITIVE –INTELLECTUAL CHARACTERISTICS
 Develop ability to think abstractly
 Develop critical thinking
  More self-aware and self-critical
 Exhibit increased communication skills
 Become argumentative and demonstrate intense need to be right
 Develop decision making skills
 Lack of discipline , want voice in their voice
 Show intense focus on new interest
EMOTIONAL
 Emotionally sensitive
 Exhibit an increasing capacity for empathy
 Experience increasing sexual feeling may engage in sexual behavior
 Emotionally vulnerable and can be easily manipulated
GROWTH AND DEVELOPMENT OF ADOLESCENCE INCLUDES
I. Biological growth
II. Dentition
III. Physiologic development
IV. Maturation of other body system
V. Cognitive development
VI. Spiritual development
VII. Psychosexual development
VIII. Play and work
Growth & Development
• Physical growth
• Skeletal growth
• Secondary growth spurt – 25% of adult height
• Body composition
• Weight gain
• Increase in adipose tissue in girls
• Increase muscle mass
BIOLOGICAL DEVELOPMENT
• Physical changes of puberty are primarily the result of hormonal activity under
the influence of central nervous system.

Puberty
• Females : 8 – 12 yrs
• Males : 10 – 14 yrs
• A specific phase of sexual maturation lying between childhood and adulthood .
That point of life when reproduction became possible.
Signs of puberty in girls
• Pubarche
• Thelarche
• Menarche
• Growth spurt
• Subcutaneous fat deposition
Signs of puberty in boys
• Appearance of facial, underarm, chest & pubic hair
• Deepening of voice
• Ejaculation
• Growth spurt
• Growth of the penis &testes
• Gynaecomastia
• Increase in muscular mass
Changes in body composition
Body proportions

Dentition
• The number of permanent teeth increases.
• Second molar cusped and bicuspid teeth irrupt from 10 – 13 years.
• Irruption of third molar or wisdom teeth by 17 – 21 years.
Maturation of reproductive system
• Hormonal changes - FSH, LH, Estradiol, Testosterone, adrenal androgens.
• Secondary sexual characters
• Breast development
Pubic hairs - Development of genitalia
Sexual changes
• Sexual desire increases
• Sexual activities begin. Eg :masturbation/first sexual intercourse
• Curious to know about their own as well opposite gender experimentation
• Intimate relationships
 Spiritual development
• Adolescent are capable of understanding abstract concepts and of interpreting
analogies and symbols.
• They are able to empathize, philosophize, and think logically.
• Tendency towards introspection and emotional intensity often makes it
difficult for others to know what they are thinking.
• May reveal deep spiritual concerns
Moral development
• Strong pressure to violate the old beliefs.
• Their decision involving moral dilemmas must be based on an internalized set
of moral principles .
• Late adolescence is characterized by serious questioning of existing moral
values and their relevance to society and the individual.
Play and work
Leisure activities
Sports participation
Productive citizenship
PSYCHOSEXUAL STAGES OF DEVELOPMENT
GENITAL STAGE
• Heterosexual activities
• A time of sexual reawakening
• Source of pleasure someone outside of the family
PSYCHOSOCIAL DEVELOPMENT
• IDENTITY V/S ROLE CONFUSION
• Struggle for identity(who I am)
• Changing self image
• Breaking away from parents and transferring need to parental guidance to
mentors
• Very active socially
COGNITIVE DEVELOPMENT
 • FORMAL OPERATIONAL
• Characterized by ability to formulate hypotheses and systematically test them
to arrive at an answer to a problem
• Think abstractly and form or structure mathematical problem
Psychosocial development
• Less interest in parental activities
• Mood swings
• Intense relationship with same & opposite sex friends
• Increased cognition
• Increased need for privacy
• Lack of impulse control.
• Increased intellectual ability
• Risk- taking behaviour
Growth & Development
Physical growth
 Skeletal growth
 Secondary growth spurt – 25% of adult height
 Body composition
 Weight gain
 Increase in adipose tissue in girls
 Increase muscle mass
Maturation of reproductive system
 Hormonal changes - FSH, LH, Estradiol, Testosterone, adrenal androgens.
 Secondary sexual characters
 Breast development
 Pubic hairs - Development of genitalia.
Psychosocial development
 Less interest in parental activities
 Mood swings
 Intense relationship with same & opposite sex friends
 Increased cognition
 Increased need for privacy
 Lack of impulse control.
  Increased intellectual ability
 Risk- taking behaviour
Sexual changes
 Sexual desire increases
 Sexual activities begin. Eg :masturbation/first sexual intercourse
 Curious to know about their own as well opposite gender experimentation
 Intimate relationships
WHY ADOLESCENT HEALTH
 Major physical, psychological and behavioural changes take place.
 Sexual maturity & onset of sexual activity.
 Development of adult mental process & adult identity.
 Healthy responsible parenthood.
 Great human resource for the society.
 Growth spurt and physical activity.
 Menstruation.
 Pregnancy
Adolescent health problem
TOP KILLERS OF ADOLESCENT IN INDIA
• Suicide
• Drowning
• Accidents
• Anemia
• TB
• Burns
• Cancer

Nutritional problems
 malnutrition/ under- nutrition
 Micronutrient deficiencies
 Obesity
 Eating disorders
 45% girls, 20% boys undernourished
 66% girls, 45%boys anaemic
Reproductive health problems
 Teenage pregnancy
 Abortion related problems
 Menstrual problems
 Reproductive tract infections
 50% of females under18yrs – married
 Acne
 Irregular menstrual cycles
 Vulvovaginitis and Urologic issues

Mental health problems

 Substance abuse
 Violence - Depression & suicide
 Learning disorders
 Other psychiatric problems
 Psychosis
 Mania
 Conduct disorder
 Anxiety disorder
Behaviour problems
 Drug experimentation
 Substance abuse - tobacco, alcohol, illicit drug
 Risk behaviour - having knife, rods , rash driving
 Violence
 Bullying
SOCIAL FACTORS IN ADOLESCENT HEALTH
 Parent’s perceptions, awareness about adolescent plays major role in adolescent
health.
 School drop outs.
 Less female literacy.
 Economically weaker society.
 Health seeking behaviour was neglected and adolescent where not told, whom
to consult about the health problems.

Needs of Adolescents
 Correct information, on health, reproduction, nutrition, growth & development,
sexuality& HIV/AIDS, STDs/ STI.
  Adequate diet
 Healthy lifestyles
 Education & health
 Safe &Supportive environment
 Counselling
Prevention of Adolescent health Problems
 Primary prevention: policies, information & education.
 Secondary prevention : identification & reduction of risk
 Tertiary prevention : treatment & rehabilitation

Primary prevention
 Promoting healthy development & establishment of healthy
lifestyles.
 Policies & Legislation
 concept of minor
 reproductive health
 Substance abuse
 Occupational health
 Accidents
 Public health
 Information :one – way communication : radio, television,
newspaper, books, films
 Two – way communication : in person, by telephone
 Education
 provides information
 Intellectual, social & moral development
 Enable adolescents to manage their health destiny
 Guidance on hygiene, exercise, rest, eating, drinking, maturation,
sexuality & relationship
 Health education - school - family - others – health workers, Youth
organisation leaders
Secondary prevention
 Screening programme for visual & oral health problems & learning
disorders, illness & risk behaviours
 Through schools, work places, youth organisation.
 Services – more accessible to young.
 Health care providers – like, listen, respect adolescents.
 Counselling & guidance centre
Tertiary prevention
  Curative services, along with education & information on causes.
 Rehabilitation – develop physically, psychologically & socially.
 Cooperation between sectors.
Importance of adolescent immunization
 Prevention and control of disease is important for their healthy growth.
 Routine immunization also provides a chance of a health visit
 Gives further chance for preventive services and health counselling.
 To boost immunity that is decreasing
 Efforts to decrease disease
 To have specific Protection – To provide recent vaccines available for
immunization Why Adolescent Immunization is important
ADOLESCENCE &FAMILY LIFE

FAMILY LIFE EDUCATION

 Educate the growing children, especially the adolescent regarding
various aspects of living in a society and interacting with others at
different levels along with imparting age appropriate knowledge of
biological and sexual development.
TWO KINDS OF NEEDS
 Their current normative needs associated with changing physical,
sexual, cognitive, social and emotional development.
 Future family-related needs.
ADOLESCENCE &FAMILY LIFE
 Human relationships
 adolescent development
 Values, morals, ethics
 Family as a basic unit of society
 Decision making and problem solving
 Career goals and planning
 Diet and fitness
ADOLESCENCE & NUTRITION
 For apparent growth, nutrition is the most important factor.
 The major growth during adolescence are
 1. Height: nearly one-fifth (20%) of the adult height is gained during
adolescence.
 2. Weight gain: About 25–50% of the final adult weight is gained
during adolescence.
 3. Almost 50% of bone mass is accumulated by the end of 2nd decade of
life.
  Early adolescence is marked by rapid growth phase and pubertal
changes during which time the nutrient requirement is different as
compared to late adolescence when growth has stabilized and the
micronutrients have an important role.
 The national nutrition Monitoring Bureau (NNMB) Survey (2002) had
shown that 30–40% of girls and 33–66% of boys consume less than 70%
of the recommended daily allowance (RDA) for calories. Protein intake
is also significantly less.
ADOLESCENT COUNSELLING
 Adolescents are diverse in their age and developmental stage.
 Despite all variations, adolescence is a period of exaggerated physical,
emotional, social, intellectual and spiritual growth with their
complexities often resulting in a need for counselling.
 Adolescents might require preventive and therapeutic counselling to
address their mental health needs.
 Early adolescence (10–13 yrs.) -concrete thinkers and are unable to
clearly understand the cause and effect between their behaviours and
their health.
 Mid-adolescence (14–17 yrs.) - think more abstractly. Typically, they
are capable of complex logical thinking.
 Late adolescence (18–19 yrs.) - have a longitudinal understanding of
how their behaviours affect their health. Counselling focus on risky
behaviour and coping skills.
MENTAL HEALTH
 Non communicable diseases and mental health illness result in high
levels of medical, social and economic burden.
 Most of the adult mental health disorders have their onset during their
childhood or adolescence.
 In low and middle income countries, including India, adolescents with
mental health needs often remain outside the safety of any health care
system.
 An effective way to address is by enhancing the primary-care
paediatrician (PCP) in the recognition, treatment and referral of the
adolescents to mental health specialists.
ADOLESCENT SEXUALITY
 Sexuality encompass whole range of thoughts, feelings, fantasies,
emotions, desires and language besides action, sexual behaviour is only
a part of it.
 Sex education is important at all ages, but it is more important than it is
imparted during childhood and adolescence.
SEX EDUCATION
  Sex education on self-awareness, personal relationships, human sexual
development, reproduction and sexual behaviour.
 Human sexuality is a function of the total personality, attitudes toward
being a man or woman, and relationships among members of the same
sex and the opposite sex.
 Help adolescent to understand their sexuality, learn to respect others
feelings and to make responsible decision.
 Sexual relationship involves respect, trust and caring of the partner,
perceiving the needs of the partner and feeling free to communicate
desires and feelings.

IAP adolescent immunization schedule

 TT Booster at 10 and 16 years
 Rubella As part of MMR vaccine or (Monovalent) 1 dose to girls at 12-
13 years of age, if not given earlier MMR 1 dose at 12-13 years of age.
(if not given earlier)
 Hepatitis B 3 Doses (0, 1 and 6 m) if not given earlier
 Typhoid TA, Vi or Oral typhoid vaccine every 3 years
 Varicella* 1 dose up to 12-13 years, and 2 doses after 13 years of age.
(if not given earlier)
 Hepatitis A* 2 doses (0 and 6 months) if not given earlier
National AIDS Control Programme
 ICE activities
 AIDS Education in Schools
 University Talk AIDS Programme
ICDS
OBJECTIVES
 improve health & nutritional status
 provide literacy & numeracy skills
 awareness on health, hygiene, nutrition ,family welfare
 train & equip in vocational skills
RBSK(Rashtriya Bal Swasthya Karyakram)
 Under NHM
 Launched in February 2013
 AIM: to improve the overall quality of life of children
 OBJECTIVES: early detection and management of 4 DS prevalent in
children
Defects at Birth
 Neural tube defect
 Down's Syndrome
 Cleft Lip & Palate / Cleft palate alone
 Talipes (club foot)
 Developmental dysplasia of the hip
 Congenital cataract
 Congenital deafness
 Congenital heart diseases
 Retinopathy of Prematurity
Deficiencies
 Anemia especially Severe anemia
 Vitamin A deficiency (Bitot spot)
 Vitamin D Deficiency, (Rickets)
 Severe Acute Malnutrition
 Goitre
Developmental delays and Disabilities
 Vision Impairment
 Hearing Impairment
 Neuro-motor Impairment
 Motor delay
 Cognitive delay
 Language delay
 Behaviour disorder (Autism)
 Learning disorder
 Attention deficit hyperactivity disorder
Guiding Principals for Adolescent Health Programming
(UNICEF & WHO)
• Adolescence is a time for opportunity and risk
• Not all adolescents are equally vulnerable
• Adolescent Development underlies prevention of Health Problems
• Problems have common roots and are interrelated
• Social environment influences adolescent behavior
• Gender considerations are fundamental
Adolescent Friendly Initiative
• Two component
- Adolescent friendly health services
- Adolescent friendly counselling services
• 75 districts RCH II ( 2003- 08).
• Adolescent health clinics
- Clinical services
- Counselling services
Characters of AFHS
• Adolescent friendly policies
- fulfils the rights of adolescents
- account for special groups, including vulnerable & underserved groups
- attention to gender factor
- privacy & confidentiality
- free & affordable
Adolescent friendly procedures
• Easy registration, retrieval & storage of records
• Short waiting time
• Consultation with or without appointments
Adolescent friendly health care providers
• technically competent
 • good interpersonal communication skills
• non – judgmental & considerate
• devote adequate time
• treat all clients with equal care & respect
• provide information & support
Adolescent friendly health facilities
• provide safe environment & convenient location
• provide information &educational material
• privacy & avoid stigma
• have enough facilities
• Adolescent & community involvement
• Community based outreach & peer to peer services
• Appropriate & comprehensive services
• Effective health services
• Efficient services
Services under AFHS
• General examination
• Reproductive Health services with sexual & reproductive health education
• Contraception
• Pregnancy testing & options of MTP
• STIs/ HIV screening , counselling& treatment
• Prenatal & postpartum care
• Well baby care ( adolescent mothers)
• Nutrition services
• Growth & development monitoring
• Detection & treatment of anemia
• Guidance regarding substance abuse
• Counselling regarding life skill development
• Screening for various disorders
Adolescent Health Programme/RKSK (Rashtriya Kishor Swasthya
Karyakram)
 Adolescents are individuals aged between 10 and 19 years. Adolescence is
important phase in the life span of an individual, with long term influence
on his / her overall health. In order to promote Adolescent Health in a
holistic manner, a multi- component intervention targeting both
determinants of health problems and their consequences is imperative.
Ministry of Health and Family Welfare -National Health Mission, along
with Government of Kerala has put in place a comprehensive health
programme for adolescents, i.e.,Rashtriya Kishor Swasthya Karyakram
(RKSK)/ Adolescent Health Programme.
 I. VISION

The Adolescent Health Programme envisions that all adolescents in Kerala

are enabled to realize their full potential by-
a)Making informed and responsible decisions related to their health and
well-being
b) Accessing the existing services and support systems for resolving issues
 II. MISSION

• To increase the availability and access to information about health to all

adolescents
• To increase accessibility and utilization of quality adolescents health
service
• To develop multi-sectorial partnerships to create safe and supportive
environments for adolescents
• To institute special strategies to target adolescents residing in geographic
pockets or negative socio-economic environments, which make them
vulnerable to health and nutrition risks.
 III. GUIDING PRINCIPLES

The Adolescent Health strategy adheres to the following key principles

• Adolescent participation and leadership
• Equity, Gender Equity, inclusion
• Strategic partnerships
IV. OBJECTIVES

The specific objectives of the programme are

a) Improve nutrition
b) Enable/enhance sexual, reproductive and maternal health
c) Enhance mental health
d) Prevent/reduce injuries and violence
e) Prevent Substance misuse
f) Address non-communicable diseases prevention
 V. STRATEGIES
NUTRITION
a. To reduce the prevalence of malnutrition among adolescents
b. To reduce prevalence of Iron Deficiency Anaemia among adolescents
SEXUAL AND REPRODUCTIVE HEALTH

a) To improve knowledge, attitude and behaviour in relation to SRH

b) To promote healthy menstrual hygiene practices among adolescent girls
c) To reduce teenage pregnancies by giving knowledge about risks of early
conception
MENTAL HEALTH

To address mental health concern of adolescents

INJURIES AND VIOLENCE

To promote favourable attitudes against injuries and violence, including

GBV among adolescents
SUBSTANCE MISUSE

To raise awareness on adverse effects and consequences of substance

misuse
 NON COMMUNICABLE DISEASES

To promote behaviour change for prevention of NCDs, hypertension,

stroke, cardio vascular diseases, cancer and diabetes through healthy life
styles and promotion of physical activity.
VI.SCHEMES

1.Facility based approach

a) Adolescent Friendly Health Centres ( AFHCs) AFHCs are functioning in
the state at major hospitals DH/THQH (plus, in CHCs in Pathanamthitta,
Alappuzha, Idukki, Palakkad, Malappuram,Wayanad, and Kasargod
district).In AFHC, counselling services are delivered by the trained AH
counsellor. Those clients who require clinical services are referred to the
concerned OPs and their consultation with the specialist is facilitated. The
details regarding AFHCs location, contact persons etc. can be accessed live
through DISHA helpline, 0471 2552056 or 1056 toll free.
b) Outreach activities: -by AH counsellor (includes AH seminars/classes,
Question Box etc.) at schools and community level.
2. School –based approach
a) Weekly Iron Folic Acid Supplementation (WIFS) programme to reduce
the prevalence of Iron deficiency anaemia, and its deleterious consequences,
jointly run by the Departments of Education, Social Justice and Health
&Family Welfare.,
The strategies in WIFS are preventive weekly supplement of Iron Folic
Acid tablets for adolescents, from Class 6 to Class 12 in Govt and aided
 schools and screening and treatment of moderate to severe anemia along
with Nutrition Health education
b)Peer Educator ( PE) programme(Student Doctor Cadets/ Kutty doctors)
 A strategy to disseminate AH promotional awareness, attitude and
behaviour change in the community. The trained peer educators a) observe
their peers and spot issues by early Buddy Detection, provide Buddy Help,
and where necessary, give appropriate Buddy Referrals.
3. Community – based approach

a) Adolescent Health Days and Adolescent Friendly Clubs

Outreach programmes are conducted, focusing on the adolescent age group
which will create awareness among them regarding the AFHC services
available
b) Menstrual Hygiene
Distribution of sanitary napkins at a subsidized cost to prioritized segments
of adolescent girls and sensitization about reproductive health and hygiene
and creation of a platform for discussion of the same.

Kishori Shakti Yojana

 Redesign of the already existing Adolescent Girls Scheme being implemented
as a component under the centrally sponsored ICDS Scheme.
 Aims at empowerment of adolescent girls, so as to enable them to take charge
of their lives.
 Adolescent girls who are unmarried and belong to families below the poverty
line and school drop-outs are selected and attached to the local Anganwadi
Centers for learning and training activities.
 Adolescent girls 11- 18yrs
 2000 projects, 12.8 lakh girls
 Services
 watch over menarche
 immunisation
 deworming
 general health check-up( 6 months)
 treatment & referral - prophylactic measures against anaemia

Scheme- I (Girl to Girl Approach) •Age group

of 11-15 years •Belonging to families whose
income level is below Rs. 6400/- per annum
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
Nutritional Program 2003
 Adolescent girls < 35 kg
 BPL
 6kg ration free of cost / month
 Nutrition & health education by anganwadi worker
Adolescent Girls (AG) Scheme
 Girl to girl approach
 AG 11-15yrs, school dropouts
 family income < Rs.6400/year
 urban & rural
ADOLESCENT HEALTH PROGRAMMES
 Kishore Shatki Yojana: to improve the health and nutritional status of women.
 Balika Samridhi Yojana: To Delay the age of marriage.
 Reproductive and Child Health Programme
 Adolescent Friendly Health Services
 National AIDS Control Programme
RMNCH+A STRATERGY
 Priority intervention area on adolescent health
 Adolescent nutrition & IFA supplementation.
 Facility based adolescent reproductive and sexual health services.
 Information & counselling on adolescent sexual reproductive health & other
health issues.
 Menstrual hygiene.
 Preventive health check-ups. 40
ADOLESCENT NUTRITION & IFA SUPPLEMENT
 Nutritional education system to generate awareness on balanced diet, nutritious
food, and effects on malnutrition.
 Nutrition education sessions through kishori diwas, ICDS, school curriculum
and also linkage with Sakshar Bharat Abhiyan.
CHILD HEALTH SCREENING & EARLY INTERVENTION SERVICES
 Screening of adolescent for low body mass index and counselling at adolescent
health clinics. 41 IFA TABLET
 National Iron + initiative programme - for management of anaemia.
  Adolescents (10-19 yrs.) within school weekly iron and folic acid
supplementation (WIFS). - Out of school will be reached through AWCs.
SCHEME FOR MENSTURAL HYGINE
 Scheme promote better hygiene and ensure adequate knowledge and
information about use of sanitary napkins.
 Sanitary napkins are provided by NHM in the name ‘free days’
PREVENTIVE HEALTH CHECKUPS
 New approach in the implementation of school health programme
 Mobile School health camps by a team consisting of two medical
officers( MBBS/ dental/ AYUSH) and two paramedics ( one ANM any one of
following : pharmacist/ ophthalmic assistant/ dental assistant)
SABLA
 Rajiv Gandhi Scheme for empowerment of AG
 200 selected districts
OBJECTIVES
 Enable self-development & empowerment of AG
 Improve the nutrition & health status.
 Awareness about health hygiene and ARSH & family child care.
 Upgrade home based skill and vocational skill.
BALIKA SAMRIDI YOJANA, 1997
OBJECTIVES:
 To change negative family and community attitudes towards the girl
child at birth and towards her mother.
 To improve enrolment and retention of girl children in schools.
 To increase the age of marriage of girls.
 To assist the girl to undertake income generation activities.

Benefits: A post birth grant amount of Rs. 500/

Class Amount of Annual Scholarship
 I-III Rs. 300/- per annum for each class
 IV Rs. 500/- per annum
 V Rs. 600/- per annum
 VI-VII Rs. 700/- per annum for each class
 VIII Rs. 800/- per annum
 IX-X Rs. 1000/- per annum for each class Procedure for obtaining the
benefit
 ICDS infrastructure in rural areas and Health Department in urban areas.
  The application forms are available with Anganwadi Workers in the
villages and with Health functionaries in urban.
THE ADOLESCENT 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.
 Inclusion of HIV prevention education in the programmes for out-of-
school adolescents and young persons.
 Incorporating measures to prevent stigma and discrimination against
learners/students and educators and life skills education into education
policy for HIV prevention.
YUVA
YUVA (Youth Unite for Victory on AIDS)
Yuva comprising seven youth organisations.
 AIDS prepared Campus, AIDS prepared Community and AIDS
prepared Country.
 Prevention, education and life skills for promoting healthy and safe
behaviour and practices amongst them young people.

Red Ribbon Club (RRC)

This club is established in every school and college to provide youth with
access to information on HIV/AIDS and voluntary blood donation.

ADOLESCENT FRIENDLY HEALTH SERVICES

LEVEL OF CARE SERVICE TARGET ACTIVITY

PROVIDER
PHC & CHC Medical Adolescent Once a week teen clinic organized for
officer unmarried 2 hours
boys & girls

SERVICES IN ADOLESCENT CLINIC

 CLINICAL SERVICES
  general examination
 nutrition advise
 detect & treat anaemia
 easy & confidential assess to MTP
 antenatal care and advice regarding child birth
 RTIs/ STIs detection and treatment
 HIV detection and counselling
 treatment of psychosomatic problems
 DE addiction
 COUNSELLING SERVICES
INFORMATION & COUNSELLING ON ADOLESCENT SEXUAL HEALTH
 LIFE SKILLS “ the abilities for adaptive and positive behaviour that enable
individuals to deal effectively with the demands and challenges of everyday
life” – WHO
 “ a behaviour change or behaviour development approach designed to address a
balance of three areas: knowledge, attitude and skills” – UNICEF

INPATIENT HOSPITAL SERVICES FOR ADOLESCENTS

Adolescents aged 13–17 account for 11 percent of all hospital stays by those
aged 0–17. Adolescents are a distant second to neonates (less than 1 year of
age), who account for 71 percent of hospital stays by children and adolescents
(Owens et al., 2003).
Adolescent and young adult oncology is a branch of medicine that deals with the
prevention, diagnosis, and treatment of cancer in adolescent and young adult (AYA)
patients aged 13–30. Studies have continuously shown that while pediatric cancer
survival rates have gone up, the survival rate for adolescents and young adults has
remained stagnant. While many clinical trials exist for adults with cancer and children
with cancer, AYAs underutilize clinical trials. Most paediatric clinical trials serve
patients up to age 21. Additionally, AYAs face problems that adults and children
rarely see including college concerns, fertility, and sense of aloneness. Studies have
often shown that treating young adults with the same protocols used in pediatrics is
more effective than adult oriented treatments.
Kerala READ 2020 programme to develop skills among adolescents
• Responsible Adolescence (READ) 2020, a programme that aims at helping
adolescents develop into self-aware, socially responsible, and well-rounded
individuals, will be launched in the State on September 25
 • READ will be delivered through a series of interactive online classrooms and
seminars, which will impart skills and knowledge not usually included in
academic curriculum.
• The subjects covered include Internet safety, financial literacy, Indian
Constitution, human rights, food safety and environment among others.
• The interactive sessions will be delivered via Zoom by experts from across the
globe.
•  Support of the Indian Medical Association, Lions Club, Kerala High Court
Advocates’ Association, Thrissur Government Medical College

CONCLUSION
Some young people engage in risky behaviours that affect their health and therefore
the majority of health problems are psychosocial. Many young people experience
multiple problems. These behaviours are established as a young person and go on to
become the lifestyles of adults leading to chronic health problems. Social, cultural and
environmental factors are all important. Young people have specific health problems
and developmental needs that differ from those of children or adults: The causes of ill-
health in adolescents are mostly psychosocial rather than biological. Young people
often engage in health risk behaviours that reflect the processes of adolescent
development: experimentation and exploration, including
using drugs and alcohol, sexual behaviour, and other risk taking that affect their
physical and mental health. Adolescent health also encompasses children's and young
people's sexual and reproductive health