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Consultant: Sudhir Tripathi 

Data theme: Entitlements 

Objective: Improve quality of Family Planning counselling offered at Village Health and Nutrition Days (VHND) for adolescents including counsellor outreach for block level and in remote areas, and for the addition of Lalitpur district as a peer educator district. 

Key Outcomes:  The intervention organised meetings with groups of adolescents in the five selected villages which resulted in adolescents visiting Village Health and Nutrition Days (VHND) and compiling a report with recommendations on the various activities available at the five VHNDs. 

The intervention also facilitated advocacy meetings between the adolescent groups and various officials and service providers, like district  and block health officials and frontline workers so the adolescents could present their findings and recommendations. The recommendations have been accepted but are yet to be implemented. 

The consultant also organised advocacy meetings with elected women representatives, and Panchayat election candidates. A few of the election candidates have agreed to make adolescent health a part of their campaigns. 

Process:  In the initial meetings, the adolescents discussed the UDAYA data, and the current status of counseling available to them. They also discussed various family planning methods currently available, the issues with access to family planning, and designed a community level monitoring exercise to collate local level information and data. 

An extensive survey was conducted by the adolescents, including visits for monitoring and documenting activities at five VHNDs in five villages. A report was compiled of their findings, and a letter requesting improved counselling and counsellor outreach was also drafted. Following this, the adolescent delegations met with various district and block level health staff, frontline health workers like service providers and counsellors. They also met with elected women representatives, and Panchayat election candidates. The delegations presented the UDAYA data, their report on the status of counseling at VHNDs, as well as their letter requesting improved counselling services. The delegations were very well received and their recommendations received and accepted by most of the officials. In fact, the meetings with the service providers and counsellors also noted the challenges they faced in providing service delivery and outreach, and these recommendations were included along with the adolescents’ recommendations. 

The adolescent delegations submitted their letters at the District Health Society meeting, as well as to the Chief Medical Officer (CMO), the Medical Officer In-Charge (MOIC) and the District Magistrate (DM). All these authorities have issued verbal commitments on ensuring better counselling services for adolescents. A few of the election candidates, too, have assured support towards this, and have promised to place improved counselling services and general improvement of adolescent health service delivery as a campaign commitment. 

COVID-19 and the subsequent lockdowns to be the biggest challenge for the intervention as all the health department staff were diverted towards COVID-19 management and relief work. Another huge effect of the lockdown was the massive spike in child marriage. According to community reports, the rates of early marriage nearly doubled. While schools remained shut, supplies of essentials like IFA tablets or sanitary napkins were not available. However, the adolescent delegations intend to follow up with block and district level officials to ensure better service delivery.