Even in six years of existence, the adolescent health programme for its over 243 million young population launched by the government has not been able to take off.
Study done across seven states shows that the Adolescent Reproductive and Sexual Health (ARSH, 2006) programme under National Rural Health Mission has failed in its very purpose of addressing non-clinical problems like depression, marriage delays, under-age pregnancies, reducing sexually transmitted diseases to name a few.
The qualitative study conducted by Trios, a social organization, based primarily on interviews and group discussions shows that most of these adolescent centres primarily function as clinics and offer little privacy to its users.
The study covered Bihar, Jharkhand, Maharastra, Rajasthan, Tamil Nadu, Gujrat and Orissa.
The study found that among the main reasons for failure of this programme, besides miniscule numbers of clinics, was lack of effective monitoring systems – so in most places one is not sure if these clinics function at all.
There were only 55 clinics across 28 districts of Gujrat, whereas the actual need is at least five times over. Bihar stood worst with just one adolescent clinic.
"The idea of this programme was to address the unmet needs of adolescents through provision of adolescent friendly health services, which was to be made available to all boys and girls through promotive, preventive and curative means," said Dr. S Ramanathan, director, Trios.
"What we increasing found on ground was that the focus was mainly on curative needs. And moreover, all these facilities were provided to people at fixed hours, which meant that at most hours it was shut and hence inaccessible," he said.
"Most of these clinics were enclosures made of cloth, where one could come and discuss health problems. It is most essential to re-christen the 'clinics to 'centres.' The name change alone would alter the nature of these centres, making them more like places for discussion, understanding and knowledge sharing," said Renu Khanna, with Sahaj, society for health alternatives.
"So far, there is a lot of skepticism among girls, who feel that they might be ostracized if they went in for consultation. If these were centres, with full-time experts or psychologists and clinicians offering advice, who also assured confidentiality one would feel more at ease in going to these centres," she said.
The researchers felt that the government should also initiate steps to include more youth participation by way of peer educators and knowledge givers.
"The programme is like a sick baby trying to come out of neo-natal unit. A lot of sensitive handling and nurturing is required before the it grows into proving useful for the community," said Ramanathan.