Family & Community Health (FCH)

Working Together with partners for promoting Adolescent Health Services

The WHO has been partnering with the Ministry of Health & Family Welfare, other Ministries of Government of India, academic institutions, United Nations agencies, development partners and civil society organisations through (a) its five core clusters – Communicable Diseases & Surveillance, Health Systems Development, Family & Community Health, Non-Communicable Diseases & Mental Health and Sustainable Development & Healthy Environment and (b) specific initiatives such as polio, routine immunization, emergency and humanitarian action, “3 by 5” Initiative for HIV/AIDS, Tobacco Free Initiative and Knowledge Management amongst others. The India Country Office also partners with designated Collaborating Centers and National Institutes of Excellence.

WHO recognizes that strong alliances are needed at national and international levels to address the emerging health challenges. This article highlights the initiatives undertaken in partnership with other agencies for adolescent friendly health services as one example among many others of working together.

Adolescents (15-19 years) form about 22 % of India’s population and have been recognized as an under-served section in National Population Policy. They contribute 19% of TFR[1] and there exists high maternal mortality among adolescent mothers. The unmet need for contraception for this group is as high as 27%[2] and about 35 % of new HIV infections occur in the age group 15 to 24 years.

Adolescent Reproductive & Sexual Health Services (ARSH) strategy has been positioned as a key strategy in the RCH-II to achieve the stated goals of reducing total fertility rate, maternal mortality ratio, infant mortality rate and reducing HIV infection prevalence. In response to the needs of the GOI, WHO-India and UNFPA-India partnered for development of an ARSH strategy. The cycle began during the initial stage of designing the National Programme Implementation Plan for RCH-2/NRHM. The key milestones achieved through the partnership include:

Development of Programme Design:

Designing the programmatic framework of adolescent health strategy for the National PIP.

Development of Training Strategy:

Designing the training strategy. A training package has been developed for medical officers and health workers to orient them on how to effectively deliver friendly services to adolescents.

Development of Operational Strategy for Implementing ARSH:

GoI organized National Consultation on RCH II ARSH Strategy to develop operational guidelines for implementation of ARSH strategy. A team of experts from WHO-HQ, Regional Office and Country Office and UNFPA Regional and Country Offices worked with other experts in this consultation to develop the standards based approach for implementation of ARSH strategy along with a process Implementation Guide.

Dissemination of Implementation Strategy:

Union Secretary MOHFW released the Implementation Guide and Training Manuals at a National Consultation organized by GoI on 9 May 2006.  The state officials and other experts were exposed to the standards-based quality approach being recommended for implementation of adolescent health services.

Assisting States in implementation of AFRSHS:

Both agencies continue to assist the State governments in drawing out implementation plans for AFRHS. Regional planning meetings have also been proposed by the GoI.

Synergy between WHO and UNFPA has been effective in assisting the Government in developing this new initiative. The WHO brings to this partnership its significant experience of implementing Adolescent Friendly Health Services with a ‘Standards of Quality’ based approach at global, regional and country level while UNFPA has strength in the field of reproductive and sexual health programming. These complementary technical strengths of WHO and UNFPA and harmony of purpose were instrumental in achieving the desired objectives. This collaboration continues with WHO providing technical support for training activities, operation research and monitoring/evaluation, and UNFPA assisting the States in implementation.