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National Health Mission

Ministry of Health and Family Welfare, Government of India

Adolescent Friendly Health Clinics (AFHCs)

Rashtriya Kishor Swasthya Karyakram (RKSK) highlights the need for strengthening Adolescent Friendly Health Clinics (AFHC) under its facility based approach. This approach was initiated in 2006 under RCH II in the form of Adolescent Reproductive Sexual Health (ARSH) Clinic to provide counselling on sexual & reproductive health issues.

Now under RKSK, AFHC entails a whole gamut of clinical and counselling services on diverse adolescent health issues ranging from Sexual and Reproductive Health (SRH) to Nutrition, Substance abuse, Injuries and Violence (including Gender based violence, Non Communicable Diseases and Mental Health. Adolescent Friendly Health Services are delivered through trained service providers- MO, ANM and Counsellors at AFHCs located at Primary Health Centers (PHCs), Community Health Centers (CHCs) and District Hospitals (DHs) and Medical Colleges

The key ‘friendly’ component of AFHC mandates facility-based clinical and counselling services for adolescents, which are:

  • Equitable—services are provided to all adolescents who need them.
  • Accessible—ready accessibility to AFHCs by adolescents i.e. AFHC should be established where adolescents can go without hesitation for example: it should not be placed near labour rooms, integrated counselling and treatment centres, Sexual and Reproductive Transmitted Infections (STI/RTI) centre etc.
  • Acceptable—health providers meet the expectation of adolescents who use the services.
  • Appropriate—the required care is provided and any unnecessary and harmful practices are avoided.
  • Effective—healthcare produces positive change in the status of the adolescents; services are efficient and have high quality. The right health services are provided in the right way, and make a positive contribution to their health.
  • Comprehensive—care provision covers promotive, preventive and curative aspects.

 

Benchmark for AFHC

  • Infrastructure- clean, bright and colorful
  • Can be easily accessed by the adolescents (distance and convenient working hours)
  • Awareness about the clinic and range of service it provides (IEC, Proper Sinages)
  • Non judgmental and competent health service providers
  • Maintains privacy and confidentiality
  • Community members are aware of the services provided and understand the need of the same.
  • Referral from the periphery/community and further referral linkages with the higher facilities and specialty clinics.

 

Adolescent Friendly Health Clinics (AFHCs) at District level will be designated as Adolescent Health Resource Centre (A-HRC). These centres apart from providing the full complement of services envisioned for AFHC will also act as resource centre for capacity building of health care providers and repository for Information, Education and Communication materials on Adolescent Health such as posters, banners, pamphlets, audio-video materials.

Counselorsplay a crucial role in operationalization of Adolescent Friendly Health Clinics (AFHCs). They Inform, educate and counsel clients on Adolescent Health issues and refer clients to health facilities, or other service delivery points such as Integrated Counselling Testing Centre (ICTC), de-addiction centre, Non Communicable Diseases clinics etc. Besides this, outreach services by counsellors are carried out at schools, colleges, youth clubs and in community at least twice a week to sensitize the adolescents, caregivers and influencers on various adolescent health issues and apprise them of various available adolescent friendly health services.

It is important to recognise that AFHCs is a part of a wider package of adolescent healthservices. Adolescent Friendly Health Clinics will have strong linkages with Peer Education Programme. Adolescent Health Day and Adolescent Friendly Clubs will work as a platform for referral of clients to the Adolescent Friendly Health Clinics.