Aarti Dhar

National strategy accepted by States

Guidelines encourage using private sector for service deliveryFocus on establishment of voluntary counselling & testing centres Monthly reports to be compiledStates asked to take inputs from adoloescents

NEW DELHI: Union Health and Family Welfare Ministry has approved guidelines for implementation of a national strategy for Adolescent Reproductive and Sexual Health under the second phase of the Reproductive and Child Health (RCH-II) programme.

The strategy has been accepted by several States as part of their district RCH-II plans and will now be implemented in the primary health care setting for which the guidelines are expected to function as `programme managers.'

The document is drafted on the basis of the guidelines of the Health Ministry for RCH-II and the strategy is to be implemented within the framework of intersectoral convergence as emphasised by the National Rural Health Mission. The guidelines also encourage using the private sector for service delivery.

The strategy highlights the need for creating a supportive environment for adolescents to seek the health services they need. The public health system at the primary health care level will be reorganised to cater to the needs of adolescents and the focus will be on establishment of voluntary counselling and testing centres (VCTC) with appropriate referrals for HIV/AIDS and Reproductive Tract Infections (RTIs) and Sexually Transmitted Infections (STIs).

The Ministry believes that VCTC would be the gateway to prevention and care of HIV/AIDS and should have facilities for voluntary testing. In high prevalence States, these facilities are being located in CHCs while in other districts they are located in district hospitals. It is envisaged that in the third phase of the National AIDS Control Programme such facilities would be expanded to cover more peripheral facilities and VCTC sites could facilitate access to Anti-Retroviral Treatment, if required.

The essential packages of services to be provided at these `youth centres' would include focussed prenatal care, counselling and provision for emergency contraceptive pills, reversible contraceptives besides curative services for treatment of RTIs/STIs, counselling for menstrual disorders, sexual concerns for male and female adolescents.

Also, the monthly reports being received from all clinics would be compiled at the district level and the feedback given to the medical officers incharge of PHCs on the basis of trends in utilisation of services.

The mapping of essential actions, as envisaged in the guidelines, does not rule out scope for flexibility and further adaptation by the States and districts.

There is space for innovations and States have been encouraged to take input from adolescents and young people in implementing the strategy. This could be done by placing a question box outside the primary or community health centre and inputs taken from teenagers on identifying space for clinic, fixing timings and developing resource material.

The guidelines include a well-defined training module for the basic health functionaries who would be involved in the implementation of RCH-II.