Arsh programme
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The document provides information on adolescent health programs in India. It begins with introducing adolescence and defining the age groups. It then discusses why adolescent health is important in order to reduce disease burden and mortality. Some key health issues faced by adolescents are malnutrition, mental health problems, early and unprotected sex. The document outlines two main adolescent health programs in India - ARSH (Adolescent Reproductive and Sexual Health) and RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health). ARSH aims to address issues like teenage pregnancies, STIs, HIV, and maternal deaths. RMNCH+A is a comprehensive strategy that takes a continuum of care approach to
Arsh programme
- 2. PRESENTATION : INCLUDE • Introduction • Characteristics • Why pay attention to the health of adolescents? • Health problems of adolescents • ARSH – PROGRAMME (Main) • RMNCH+A - PROGRAMME
- 3. INTRODUCTION: • 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 & behavioral changes takes place. • Period of preparation for undertaking greater responsibilities including healthy responsible parenthood. • Adolescents (10-19 years) constitute about one fourth of India's population and young people (10-24 years) about one third of the population
- 4. DEFINITIONS: • 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
- 5. CHARACTERISTICS: • A – Aggressive, Anaemic, 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
- 6. WHY PAY ATTENTION TO THE HEALTH OF ADOLESCENTS? • To reduce death and disease in adolescents: • An estimated 1.7 million young people aged from 10 to 19 die each year due to accidents, violence, pregnancy related problems or illnesses. • To reduce the burden of disease in later life: • Malnutrition in adolescence can lead to lifelong health problems • Failure to care for the health needs of young pregnant women damage their own health and that of their babies. • Some of the highest infection rates for sexually transmitted infections are in adolescents. • Diseases of late middle age, such as lung cancer, bronchitis and heart disease, are strongly associated with smoking habit.
- 7. HEALTH PROBLEMS OF ADOLESCENTS: General health problems • Adolescent never recognize symptoms, and mostly underestimate their problems and they do not know where to go for help. • As a result adolescents are the least likely section of the population to go for early treatment. • They may leave diseases untreated because they are afraid of the outcome, worried about the stigma. Malnutrition: • Inadequate diet can delay or impair healthy development. Stunting during adolescence. • Anemia is also one of the most important problem among adolescents due to malnutrition • Obesity and eating disorders exist along side malnutrition.
- 8. Mental health problems: • Depression is common, especially for young people who have low self-esteem • Depression can also lead to the ultimate tragedy — almost 90,000 young people commit suicide each year across the world Early & unprotected sex: • Many young people become sexually active without planning the sexual relationship or thinking about the consequences. • This results into the high number of unwanted pregnancies and unsafe abortions and the steep rise in HIV infection.
- 11. 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
- 12. 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 •Enrollment 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 hygiene •Immunization for pregnant adolescent mothers
- 13. 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
- 14. • 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 IMR -30/1000 live births MMR – 100/1000 live births TFR -2.1
- 15. 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
- 16. • Services for adolescents to cover preventive , promotive ,curative and counseling services • Capacity building of on meeting needs of adolescents • Communication activities to be undertaken • Inter-sectoral linkages with NACP and NRHM
- 18. 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. Strengthen RCH 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
- 20. RMNCH+A 1. This is a comprehensive strategy for improving the maternal and child health outcomes , under NRHM 2. It is based on the evidence that maternal and child health cannot be improved in isolation as adolescent health and family planning have an important bearing on the outcomes. 3. This strategy encompasses various high impact interventions across the life cycle. 4. The strategy is based on the concept of ‘CONTINUUM OF CARE’ What is RMNCH+A Strategic approach?
- 21. PLUS DENOTES (1) Inclusion of adolescence as a distinct ‘life stage’ (2) Linking of Maternal and Child Health to Reproductive Health and other components like family planning. (3) Linking of community and facility-based care as well as referrals between various levels of health care system.
- 22. WHAT DOES RMNCH+A STANDS FOR • Reproductive, Maternal, New- born, Child & Adolescent Health : Links maternal and child survival to other components (family planning , adolescent health, gender & PC & PNDT) • Plus denotes • inclusion of adolescence as a distinct ‘life stage’ in the overall strategy • Links community and facility based care as well as referrals between various levels of health care system Under five child health pacakge