Adolescent Reproductive Sexual Health(ARSH)

AAdolescent Reproductive Sexual Health(ARSH)

1. Introduction ADOLESCENT REPRODUCTIVE SEXUAL HEALTH (ARSH)RCH II GROUP-5 1. AMIT TRIPATHI 4. RASHI GUPTA 2. NEHA DANG 5.SANA AMREEN 3. POOJA DAHHIYA 6.SHRAVARI UBALE 7.SHRUTI GOYAL 8.TARUN DESHMUKH 9. VAISHALI TALANI

2. INTRODUCTION

3. The term adolescence is derived from the Latin word “ adolescere ” meaning to grow, to mature. It is a time of physical and emotional change as the body matures and the mind becomes more questioning and independent. These are the formative years of life of an individual when major physical, psychological & behavioural changes takes place. Period of preparation for undertaking greater responsibilities including healthy responsible parenthood.

4. SOME FACTS • 225 million adolescent comprise 22% of India’s total population. • Of this 12%-10-14year age group 10 %-15-19 year age group • Female comprise 47% of adol.population • About 20% of total adol.female population are married before the age of 15 years are already mother.

5. >70% girls between 10-19 year age group suffer from severe or moderate anemia. • Mortality rate is higher in 15-19 year then 10-14 year age group. • Unmet need of contraception is much higher in this age group. • Over 35%of all reported HIV infection occur among 15-24 years age group. • Indicating young people are highly vulnerable and majority of them infected by unprotected sex.

6. Adolescence: 10 – 19 years Early Adolescence: 10 – 13 years Middle adolescence: 14 – 16 years Late adolescence: 17 – 19 years Youth: 15 – 24 years Young people: 10 - 24 years Definitions:

7. Characteristics: A – Aggressive, Anemic, Abortion D – Dynamic, Developing, Depressed O – Overconfident, Overindulging, Obese L – Loud but lonely & Lack information E – Enthusiastic, Explorative & Experimenting S – Social, Sexual, & Spiritual C – Courageous, Cheerful, & Concern E – Emotional, Eager & Emulating N – Nervous, Never say no to peers T – Temperamental, Teenage pregnancy

8. Investments in young people will yield dividents in term of delaying age of marriage, reducing incidence of pregnancies meeting unmet needs of contraception and reducing incidence of STI/HIV/AIDS Why invest?????? CATCH THEM YOUNG

9. 10 -19 years a critical phase Risks Inadequately prepared for life Enter adult hood in poor health Unintended unwanted pregnancy/unsafe abortion Maternal mortality higher for young women Infant mortality higher for young mothers Sexual abuse /violence and unwanted sexual activity STIS including HIV/AIDS 10-19 YEARS CRITICAL PHASE

10. Reproductive and Child Health-II Adolescent Reproductive and Sexual Health(ARSH)

11. Package of services Promotive services: Focused care during antenatal period Counselling & provision of emergency contraceptives Counselling & provision of reversible contraceptives Information/advice on SRH services Preventive services: Services for TT and prophylaxsis against nutritional anemia Nutritional counselling Services for early and safe termination of pregnancy and management of post abortion complications

12. 3.Curative services : Treatment for common RTI/STIs Treatment & counselling of menstrual disorders sexual concerns of males and female adolescents 4. Referral services : Integrated Counselling and Testing Centre Prevention of Parent to Child Transmission 5 . Outreach services : Periodic health checkups and community camps Periodic health education activities Co-curricular activities

13. Level of care Service provider Target group Flow of service delivery activities Services Sub-centre HW(F) Unmarried male& female Married male& female During routine subcentre clinic Enrolement of newly married couples Provision of spacing methods Routine ANC care & institutional deliveries Referral for early & safe abortion Education on prevention of RTI/STIs Nutritional counselling on anemia prevention & menstrual hygeine Immunization for pregnant adolescent mothers

14. Level of care Service provider Target group Flow of service delivery activities Services PHC/CHC/DH HA(F)LHV or MO Unmarried male& female Once a wk teen clinic at PHC for 2hrs Contraceptive condom programming Management of menstrual disorders Education on prevention of RTI/STIs and their management Counselling & services for pregnancy termination Nutritional counselling & counselling for sexual problems Immunization for pregnant adolescent mothers

15. NRHM - ARSH Vision Improve availability of quality healthcare in rural areas Synergy between health and determinants of good health Community ownership of health facilities Undertake architectural corrections of the health system Expected outcomes by 2012 IMR -30/1000 live births MMR – 100/1000 live births TFR -2.1 NRHM ARSH

16. ARSH Strategy Objective is to contribute to RCH II goals of reduction of IMR,MMR,and TFR by: Reducing teenage pregnancies Meeting unmet contraceptive needs Reducing number of teenage maternal deaths Reducing incidence of STIs Reducing proportion of HIV positive in 10 – 19 years age group ARSH STRATEGY

17. Interventions by ARSH Services for adolescents to cover preventive , promotive , curative and counseling services Capacity building of on meeting needs of adolescents Communication activities to be undertaken MIS indicators identified as per specific objectives Inter- sectoral linkages with NACP and NRHM

18. Training package Orientation programme for MOs and ANMs(AWW and counselors) “ How to treat differentially a client who is 16 not 6 or 26 Developing sensitivity towards adolescent clients Non judgmental, friendly, competent provider How to deliver friendly services within “public health system” Training of ASHA - adolescent health included

19. Implementation guide Part 1:Background - purpose of implementation guide -ARSH in RCH II Part 2: What to implement? - standards for adolescent friendly reproductive and sexual health services Part 3:How to implement? Service delivery package Organizing effective services Conducive environment at health facilities Capacity building of providers Environment building Communication with adolescents Monitoring and supervision Sample implementation Part 4 moving ahead Conclusion

20. Convergence between ARSH and HIV Addressing common challenges Understanding the need to address common risk factors Utilizing capacity for optimum utilization of resources Pro active participation of key stake holders to mainstream programme with public health system Common communication strategy for access to services Preventing overlap of interventions- avoid duplication

21. Establishing linkages with regard to services Institutional linkages critical for roll out Preventing overlap of interventions with regard to target groups and services Balancing the preventive and care strategies in both programme

22. Next steps Strengthen RCH MIS frame work Communication strategy for ARSH Establishing / strengthening inter sectoral convergence Quality assurance of framework Developing institutional and service linkages within ARSH framework to address HIV concerns

23. A = Adoption of healthy life style D = Develop appropriate i.e. strategy discourage early marriage and teenage pregnancy O = Organize adolescent/ youth friendly clinic L = Life skill training, legal support, liasion with peers, parents E = Educate about sexuality, safe sex, spirituality, responsible parenthood S =Safe , secure and supportive environment to be provided C = Counseling / curriculum in school inclusive of family life education E = Enable & empower for responsible citizenship N = Networking for experience sharing T =Training for income generation, teen clubs Strategies for promotion of adolescent health