The first health clinic specifically for adolescents has been established in Mongolpuri as part of the Young Health Programme in India. Previously, if a young person needed to access health services, they would have to attend a clinic to be diagnosed by the doctor in front of elderly women and other community members. This deterred some young people from using the available health services whilst others who did try to access them could often find themselves feeling too shy to open up about their real health needs.
Mongolpuri is a resettlement community based in west Delhi. It is a very orthodox and traditional community, where talking about sexual and reproductive health problems are taboo. The Young Health Programme began in Mongolpuri in 2010. At the outset of the programme the health of many adolescents in the community was very poor. For example, many girls experienced reproductive health problems but due to the social taboos, did not seek help to deal with them and just lived with the situation. An additional barrier was the concern adolescent girls felt about asking to see a gynaecologist in case this generated speculation in the community that she might be pregnant outside of marriage – an unacceptable situation in this community. A lack of awareness and information among the adult population of the community also meant it was difficult for parents to provide sensitive and effective support for their children as they experienced these adolescent issues.
The clinics started operating in January 2012 and have been extremely popular among young people who are now able to access services in the privacy of just their peers. This has enabled them to feel more comfortable and confident in seeking health information, check-ups and treatment. The young people are referred to the clinic through the Health Information Centre (HIC) and peer educators. It runs for two hours on Saturdays which was decided to be the best time for young people who are often at school Monday to Friday.
’The Young Health Program is bliss for me and for my other friends. Now there is a separate time for us to go for treatment and doctors also take proper care of us.’’
To achieve good health amongst young people is a challenge, but it is not impossible.
The successful establishment of the clinic is a result of a dedicated and collaborative effort from government health workers and the YHP project team involving the following activities:
Over 250 young people (124 boys and 127 girls) were trained as part of the YHP as Peer Educators. Two public rallies were held to create community awareness about issues related to young people’s health and to encourage young people to develop positive health-seeking behaviours including taking preventative action against diseases by making prompt referrals to the healthcare services through the Peer Educators and Health Information Centre (HIC).
At the same time, the YHP team also worked with government health service providers like Auxiliary Nurse Midwifes (ANM), Medical Officers (MOs), Aganwadi Workers (AWW) and Accredited Social Health Activists (ASHA) to ensure that once referrals were received, they would be effectively and appropriately responded to by the health care providers.
On the advocacy front, the YHP worked closely with Municipal Cooperation of Delhi (MCD) who are responsible for running the primary health centres in the project region. Monthly convergence meetings were held with representatives from two critical government departments – the Health Department and the Women and Child Development Department. These meetings included doctors, supervisors, and front line workers from both departments and focused on discussing collaborative responsibilities towards adolescent health.
‘’The Young Health Program has made us more sensitive and responsible towards the need of young people and they played a remarkable role in breaking the taboos associated with reproductive health. But they have increased our workload too!’’
Following the success of the clinic in Mongolpuri, the Young Health Programme is now planning to replicate the model in other MCD Dispensaries in Delhi. The programme is also in the process of creating a referral system through Peer Educators and the Health Information Centre. This system will enable Peer Educators to provide adolescents with referral slips to refer them to the health centre when they become aware of health needs. YHP is continuing to work with MDC and is now advocating for the health centre to be converted into an adolescent-friendly clinic.