Professional Documents
Culture Documents
By
Dr. Anil Kumar Gupta
Additional Project Director cum Technical lead
Delhi State AIDS Control Society
Department of Health & Family welfare
Govt. of Delhi
Preface
Young people aged between 10 and 24 years represent 30% of Indias total
population. They represent a resource for the future whose potential can
either be wasted or nurtured in a positive manner. Sexual and reproductive ill
health is one of the major causes of morbidity and mortality in young people.
In a conservative society where reproductive and sexual health related issues
are taboo for discussion, young people are hindered from actively seeking
counsel for their needs.
Even though programs and policies directed towards improvement of
adolescent reproductive health exist, under ARSH subcomponent of RCH-II
programme, there is a paucity of Adolescent /Youth Friendly Health Services
(AFHS/YFHS) in the country. The significant features of an Adolescent/Youth
Friendly Health Centre encompass provision of reproductive sexual & health
services, nutritional counseling and life skills education. It is a kind of 'onestop' shopping approach which means that the different needs of adolescents
can be met under one roof, by a team of professionals who understand their
needs and are trained to address them effectively.
I congratulate the officers of Jamia Millia Islamia, Directorate of Family
Welfare, Integrated District Health Society (South District) and Delhi State
Health Mission for enabling DSACS set up this facility for the first time in Delhi
as a youth centre based model and a noble example of integration of NRHM
and NACP III.
Faizi O Hashmi
Project Director, DSACS
Acknowledgement
DSACS is thankful to Dr. Sunil Mehra, Executive Director, Dr. Deepti
Aggarwal, Deputy Director & Dr P.K. Goswami Senior Advisor, MAMTA Health
Institute of Mother
prepare the basic framework for Standard Operative Procedure for YFHC,
Jamia Millia Islamia. DSACS is also grateful to following officers from Jamia
Millia Islamia, Department of Health & Family Welfare, Govt. of NCT of Delhi
for attending consultation meeting to finalize the document: :
1. Dr. Keerti Bhushan, OSD (RCH), Dte.of Family Welfare, Govt. of Delhi
2. Dr. Meera, CDMO (South District), Govt. of Delhi
3. Prof. A.S.Kohli, Department of Social Works & NSS Coordinator, Jamia
Millia Islamia
4. Dr.Lily Chopra, Additional CDMO (South District), Govt. of Delhi
5. Dr. Rajni Chakravarty, CMO (NFG),Programme Officer RCH (South
District), Govt of Delhi
6. Dr. M.Y. Shareef, CMO, Ansari Health Centre, Jamia Millia Islamia
7. Dr. Shaista Farhien, M.O. Ansari Health Centre, Jamia Millia Islamia
8. Prof. Anjali Gandhi, HOD, Department of Social Works,
Jamia Millia
Islamia
9. Prof. Dr Waheeda Khan, HOD, Department of Psychology, Jamia Millia
Islamia
10. Prof Dr. Aizaz HOD, Physiotherapy, Jamia Millia Islamia
11. Prof Viquar H Siddiqui, Faculty of fine Arts, Jamia Millia Islamia
12. Dr. K.K.Kaushik,Deputy NSS Coordinator, Jamia Millia Islamia
13. Dr. Abid, Counselor, ICTC/ YFHC, Jamia Millia Islamia
Contents
S.No
Topic
Page No.
5
Govt. of India
2. Vulnerability of Young people of India (NFHS -3)
6-9
10-12
13
14
6. Service Package
15
7. Facility Characteristics
16-17
18-19
20-27
26-28
29
More than 49 lakhs of adolescents under the age of 18 years are marriedApproximately 21% of boys and 28% of girls still get married below the
legal age of marriage.
Nearly 20 percent of the 1.5 million girls married under the age of 15 years
are already mothers.
11 million abortions take place annually and around 20,000 women die
every year due to abortion related complications.
3. Malnutrition
More than 70 percent girls in the age group of 10-19 years suffer from
severe or moderate anemia.
Young people have a high rate of self-harm and suicide is a leading cause
of death in young people.
5. Crime
In 50% of cases, the abusers were either known or in the position of trust
and responsibility and most children do not report the matter to anyone
Most rape victims are in the age group of 14-18 years. In 82 percent of
rape cases, the victims knew the offenders and 32 percent were
neighbors.
Among youth aware about HIV/AIDS, only two-thirds reported that the
disease can be prevented by consistent condom use and by having one
faithful uninfected sex partner.
The prevalence among men aged 15-24 years is 0.09% and 0.11% among
women (NFHS-3).
Among young women HIV prevalence is higher for those whose first
sexual partner was more than 10 years older.
The proportion of women (15-24 years) who have heard of HIV/ AIDS and
those who know how to prevent HIV has increased significantly over time
(from NFHS-2 to NFHS-3).
one in four pregnant women did not receive at least three antenatal care
visits for their last birth The percentage of institutional births in the three
years preceding the survey increased from 45 percent in NFHS-1 and 59
percent in NFHS-2 to 61 percent in NFHS-3. Only 48 percent of women
and 62 percent of men have comprehensive knowledge of HIV/AIDS.
Aged
15-19
yrs-
any method-
24.7%,any
modern
method-18%,
12.
Marital status of Youth - 8.6% married girls between 15-19 yrs age,
52.3% married b/w 20-24 yrs age.
13
Anemia- Girls 15-19 years - 49.7%, 20-24 years- 44.4%, Boys both age
groups -18%
Body Image.
Menstruation.
Teenage Pregnancy.
Abortion.
Personal Relationship.
2. Diet
Balanced diet
Junk Food.
3. Substance Abuse
Pear Pressure.
Family Background.
Lack of knowledge.
5. Violence
Domestic violence
Sexual Violence
6. Stress
Studies.
Family Pressure.
7. Mental Health
Anxiety
Depression
Mania
8. Others
generation
activities-Publicity, outreach
and
community
participation activities
Service Package
Capacity Building & Peer Education Programme
IEC on ARSH, RTI/STI & HIV/AIDS
Adolescent Health
Information on Healthy Life style, balanced diet & Yoga
Counseling on Reproductive & Sexual Health issues
Integrated Counseling & Testing Services (ICTC)
Advice on Contraception/ Emergency Contraception/unwanted pregnancy/
Psychosocial support & PEP in sexual assaults
Information on Family Planning methods
Promotion of Voluntary Blood Donations
Counseling on Substance and Drug abuse
Mental Health
Diagnosis & treatment of Sexually Transmitted Infections
Promoting outreach activities through RRCs
Referral Linkages with Health Centre, JAMIA MILLIA ISLAMIA; Red
Ribbon Clubs; NGOs
Service Facility Characteristics
in the Health centre, JAMIA MILLIA ISLAMIA have been linked to YHFC.
The services not available in JAMIA MILLIA ISLAMIA shall be arranged
through the CDMO, Integrated District Health Society (South District) by
linkage with Govt, facilities.
11. Utilizing available Toll Free help lines- Youth can call toll free 1800-11-
system has been prepared by DSACS with help of NGO MAMTA and is
being shared with the service providers for its implementation.
Components of the PackageYFHC will provide following package of health services that adolescents/
youth need:
a. Promotive services
b. Preventive services
ICTC services
Condom promotion
Nutrition counseling
Counseling & referral linkage for early & safe termination of pregnancy
c. Curative services
Counseling & referral linkage for cases of sexual abuse among girls:
d. Referral Services:
e. Outreach services:
Peer educators
15-24 years boys & girls, however, no client outside this age group
shall be denied services.
Present at the centre full time (female counselor & male counselor)
Screening all first-visit clients for psychological / behavioral / social / SRHrelated problems and concerns
Filling in counselors data collection form and logbook for each client
4. Laboratory assistant
5. Doctors
adolescent
Attending,
and
treating
SRHproblems
and
concerns
including
3. The forms which contain any identity information (such as name, address
etc.) about the client will be kept separately in a locked place and only the
receptionist will have access to these forms. All the other forms and all the
registers will only contain the serial number and ID number as means of
identification.
4. The data collected during the client's visits to the centre will be handled
confidentially, i.e. not disclosed to persons not working at the centre without
the client's consent. Before using a client's data for research purposes, the
client's permission has to be obtained in a form of a signed informed consent.
5. While the client is consulting the doctor or counselor, measures have to be
taken so that outsiders can not overhear the conversation. These include:
- Keep the door of the consultation room closed
- Ensure nobody is sitting outside the consultation room (because of lack of
space the laboratory assistant/pharmacist has to sit outside doctor's
consultation room, but he is bound by the professional confidentiality
mentioned in point 2)
- Nobody (including the staff) is allowed to enter the room during consultation
without the consent of the client
- If the client comes with an accompanying person and insists that s/he
should be present in the consultation, the counselor/doctor should still get
some time with the client alone (i.e. first discuss with both in the room, then
ask the accompanying person to wait while discussing with the client).
6. While the receptionist, community worker or programme manager / officer
is interviewing the client for identity/background information or exit interview,
measures are taken to ensure maximum possible privacy. Because of lack of
space it is usually not possible to interview the client in a separate room but
other measures can be taken such as:
- In case a separate room is empty, it should always be used
- Only one client at a time should be discussing with the receptionist in the
reception area
- If the interview has to take place in a space where other clients are also
seated (for example in the waiting room), the interview should be conducted
as far away as possible from the others and with a low voice.
7. These guidelines have to be made visible and discussed with every client
so that they are aware of their right to privacy and confidentiality. These are
also discussed during outreach when informing the community about the
centre.
8. Ways of assessing whether these guidelines are followed include:
- Constant monitoring by the project staff
- Regular monitoring observations
- Results of exit interviews (which includes a question about privacy and
confidentiality
or
Iron Folic acid, calcium tablets & STI /RTI drugs to be provided by the
NRHM /Ansari Health Centre
Form O (consent form with name & address of the client) to be stored by
the clerk.
References
1. Report of National Family Health Survey (NFHS-3) India, 2005-06,
Delhi published by Ministry of Health & family welfare, Govt. of India,
Feb 2009
2. National Standards and Implementation Guide for Youth Friendly
Health services, Ministry of Health Bhutan,
3. Friends A Youth-Friendly Health Services Project in Tigri slum, New
Delhi, India
4. National Guidelines for provision of Adolescent Youth Friendly Services
(YFS) in Kenya, Ministry of Health, Division of Reproductive Health,
Nairobi, Kenya , July 2005