Lucknow, Uttar Pradesh 

Consultants: Raajni & Shraddha  

Data theme: Entitlements, Health and Nutrition

Objective:  Improve coverage of Rashtriya Kishor Swasthya Karyakram (RKSK) and ensure access to essential services and commodities for adolescents at Village Health and Nutrition Days (VHND) and Adolescent Friendly Health Clinics (AFHCs). 

Key Outcomes: This strategic intervention organised several meetings and workshops with the community, specifically local adolescents and shared insights and factsheets from the UDAYA survey, reaching out to more than 100 adolescents with information about Weekly Iron Folic Acid Supplementation (WIFS) and the importance of Iron Folic Acid tablets.

The intervention also facilitated adolescents visits to Adolescent Friendly Health Clinics (AFHCs); groups of 10-15 adolescents visited AFHCs three times to understand the quality of services. A letter demanding better service delivery of VHNDs and AFHCs with over 400 signatures from adolescents and members of the community was accepted by the Medical Officer In-Charge, Chief Medical Officer and the RKSK Nodal Officer. 

The intervention influenced local officials to organise five Adolescent Health Days, where over over 200 adolescents received information and entitlements as per the Rashtriya Kishor Swasthya Karyakram (RKSK) program.  

The consultant also organised meetings with the media, resulting in at least five media reports being published at the local level with information about the UDAYA study. 

Process: The meetings organised with adolescent groups and the wider community provided information and the subsequent discussions about the RKSK program implementation at local level culminated in a monitoring exercise on the status of RKSK implementation at the village level, as well as the condition and service delivery available at the AFHCs.  

The community monitoring exercise included visits by the adolescent girls to the Community Health Centre, Public Health Centre and anganwadis. This exercise revealed that while adolescents knew about the existence of frontline health workers (FLWs) like ANMs and ASHA workers, many had never met any in their area. Currently, the girls are regularly approaching the FLWs and are receiving regular vaccines, calcium tablets and anaemia screening.   

The girls also visited the AHFCs. There are currently two in Lucknow, at the Balrampur Hospital and Queen Mary’s Medical College. Neither AFHC had counselors available. The clinics are nearly 20 kilometers away from the areas the girls live in, and accessing the AFHCs easily, or discreetly, was a problem for the adolescents. The staff at the AFHCs were helpful,  supportive and participated in several meetings with the girls. Despite being understaffed and juggling multiple responsibilities, the AFHC staff have now organised a female counselor who now visits the adolescents in the community. 

Several community events were also conducted to raise awareness about RKSK program implementation in the wider community. The events included fun and engaging activities like street plays, slogan writing competitions, and competitions. A letter containing recommendations to strengthen service delivery of RKSK, VHNDs and AFHCs was drafted. Over 400 adolescents and parents were signatories. The letter was submitted to the District Program Officer and other relevant officials who had been invited to the events. 

The intervention also organised adolescent visits to different local and block level officials in charge of RKSK implementation. They presented the officials with the UDAYA data as well as the recommendation letter that was endorsed by the wider community. The recommendation letter has been accepted by the Medical Officer In-Charge, Chief Medical Officer and the RKSK Nodal Officer.

COVID-19 and the subsequent lockdowns was one of the greatest barriers in availability of provisions and service delivery. One of the immediate effects of the lockdowns had been a larger gap in procurement of supplies and availability of staff. For example, there hasn’t been any provision of IFA tablets, deworming tablets, sanitary napkins or anaemia screening for nearly two years. However, this intervention has motivated the local adolescents and district authorities to work closely with the local service delivery providers in the near future to assess and improve VHNDs and make them more adolescent friendly.