How to make services adolescent friendly? A cross-sectional study on awareness of adolescent friendly health clinics in Central India

BACKGROUND: India’s flagship program on adolescent health – Rashtriya Kishor Swasthya Karyakram (RKSK) emphasises the importance of strengthening Adolescent Friendly Health Clinics (AFHCs) under its facility-based approach for improving the health of adolescents. AFHCs are intended to provide targeted intervention in six domains – nutrition, injuries & violence (including gender-based violence), mental health, sexual & reproductive health, substance abuse and noncommunicable diseases. OBJECTIVE: The current study was conducted to assess the determinants of awareness and utilisation of AFHC services in districts with RKSK services in Madhya Pradesh. SUBJECTS: In total, 1605 adolescents (both males and females) within the age group of 10–19 years were included in the study. METHODS: Multistage stratified random sampling was employed to enrol participants from three districts of Madhya Pradesh, where AFHC services have been launched. RESULTS: The mean age of the participants was 15.07 ± 2.32 years. Only 153 (9.5%) adolescents were aware of AFHC services. On multivariate logistic regression, awareness of AFHC was seen to be associated with being aware of RKSK, being a part of the peer educator-led peer group, having had adolescent health days organised in the village and belonging from one of the financially better off districts. Utilisation rate of AFHC services was lower still – at 2.74%. CONCLUSION: Both awareness and utilisation of AFHC services remain very low among adolescents. There is a pressing need to focus on awareness generation campaigns – via mass media, but more importantly, through community health workers and peer educators – in order to sensitise target beneficiaries about the available services.