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Vaishali, Bihar

Consultant: Akhtari

Data theme: Health and Nutrition, Entitlements, Agency Community and Citizenship


  1. Improve quality of adolescent health services at Adolescent Friendly Health Clinics (AFHCs) and Village Health and Nutrition Days (VHND) 
  2. Increase in budget allocation for Information Education Communication/Behavior Change Communication for AFHC services

Key Outcomes: This project focused on 10 panchayats in Bhagwanpur block.  

A survey was undertaken with 50 frontline workers from the 10 panchayats to understand what they know about adolescent health issues and schemes. The findings highlighted that no Adolescent Friendly Health Clinics were being run and no health days being organized. These were mapped against findings from the UDAYA study and shared with frontline workers. Based on this, frontline workers in 10 panchayats organized kishori swasthya camps (adolescent girls health camps) in their panchayat anganwadi centers. Here they conducted a health screening of the girls including checking weight, oxygen levels; shared information about menstrual hygiene; and distributed IFA tablets.

A series of advocacy workshops were organized with adolescent girls across the 10 panchayats, where the UDAYA data was shared with them and they were made aware of their entitlements under the Rashtriya Kishor Swasthya Karyakram. From this group, 55 girls drafted a list of recommendations and signed a demand letter. They asked for more information dissemination about RKSK and schemes related to their health; and also for ASHAs and ANMs to be trained to provide adolescents the health support they need. The letter was presented to block level health officials at the primary healthcare center on the day of a health camp. 

The District Health Society has accepted these recommendations and issued a letter to regularize Adolescent Friendly Health Clinics at the primary healthcare center. Currently it has started opening once a month, and an ANM sits there as a counselor.

Process: The project used two main data points. One was the status and implementation of the RKSK programme, especially AFHC clinics. The second point was the implementation of the Scheme for Adolescent Girls, especially the delivery of Weekly Iron Folic Supplements (WIFS). These data points were chosen because they reflected that adolescents did not have access to critical SRH information and services. For instance, there were no AFHCs being run and no health days being organized. The intervention prioritized the perspective of adolescent girls.

The data were used to start conversations with frontline workers like ASHAs and ANMs; with block level health officials and with adolescent girls themselves. For the frontline workers and block level health officials, looking at this data helped them see the gaps in the service delivery, and indeed the acknowledgment that they had missed out on providing vital services to adolescents. They were receptive to the data and were eager to address gaps in service delivery. Frontline workers especially reflected that they had been very focused on providing services to pregnant women and new mothers, letting adolescent health fall behind. At various meetings, data from the UDAYA study was used by simplifying it by illustrating it with local examples that the community could relate to.

 The project mapped UDAYA’s findings, especially those that highlighted adolescents’ perspectives, against what frontline workers said. A small survey was undertaken with 50 frontline workers from the 10 panchayats to understand what they know about adolescent health issues and schemes. Then at a meeting for frontline workers, findings from this survey and UDAYA data were shown and it helped them realize that indeed there were many gaps in services related to adolescent health.. This process encouraged each of the frontline workers to make a plan in their panchayat and organize kishori swasthya camps (adolescent girls health camps) in their panchayat anganwadi centers.

Simultaneously, workshops were organized with adolescent girls to map their levels of knowledge about services through RKSK. The girls largely only knew about the fact that they should be given IFA tablets; they said these had stopped during COVID-19. They didn’t know about any other services they are entitled to and said that neither their parents, nor frontline workers share information about healthcare or sexual and reproductive health. These adolescent girls rarely sought healthcare services at the primary healthcare center (PHC) because people often treat going to the hospital with great curiosity or shame. Especially for young girls, it involves community members casting aspersions on their behavior. After the workshops the girls resolved that they would start going to the PHC, and also talk to ANMs and ASHAs when they needed information or services. The kishori swasthya camps also presented an opportunity to start these conversations and connections between frontline workers and adolescent girls.

The third step in the project was to bring the adolescent girls to the PHC. The health officials had organized a day’s health programme after seeing the UDAYA data. The health officials at the PHC were truly excited to be conducting the event. They made sure that all the girls got a health screening done; some even got a COVID test and vaccine.