Rashtriya Kishor Swasthya Karyakram

Rashtriya Kishor Swasthya Karyakram

Rashtriya Kishor Swasthya Karyakram is a health program that has been designed by Union Government’s Health & Family Welfare Ministry. This scheme is targeted for adolescents in the country. The target group belongs to the age group – 10 years to 19 years. The primary objectives of the scheme or the programs is to focus on several factors that impact the health of adolescents in India. Some of those factors include:

• Substance abuse
• Reproductive health
• Nutrition
• Gender violence
• Mental health
• Non-communicable diseases etc.

Starting with some facts

The question that you might naturally be inclined to ask is, “why was Rashtriya Kishor Swasthya Karyakram introduced in the first place?” To answer this question, the best approach will be to look at some facts – some of which will amaze us and some of which will make us feel disturbed if we have slightest of humanity left within us. So, let us start with the facts in order to answer that question:

• 21% of total population of India is made of adolescent people. There are 24.3 crore adolescents in India.
• Currently, of all married women in India who belong to the age group of 20 to 24, a whopping 47% of girls were pushed into marriage prior to the achievement of age of 18 years, that is, before they even turned adults!
• 1 out of every 5 married women who belong to this age group of 20 to 24 years, actually became a mother before attaining the age of 18 or when they reached the age of 18 years.
• Of all adolescents in India, only 35% of males and 19% of females have proper knowledge of the Sexually Transmitted Disease called HIV / AIDS.
• When the age group is refined and population size is reduced to people belonging to the group of 15 years to 19 years old, it is found that 30% of males and a whopping 56% of females suffer from anemia.
• 58% of all adolescent boys (that is, 3/5^th of all adolescent boys) and 47% of all adolescent girls (that is nearly ½ of all adolescent girls) are found to be thin.
• About 3.35 lakh adolescents belonging to the age group of 15-29 years, die every year in India because of road accidents!
• 34% of adolescent girls who fall in the category of ever-married have reported that they have experienced sexual violence, emotional abuse and physical abuse.
• Of all suicides in India, 13% of dead actually belong to the 15-29 years of age group.

Survey leads to formulation

The facts stated above were found after a survey was conducted in year 2011-2012. A similar study was also conducted specifically for the state of Odisha where similar disturbing facts popped up. Based on the facts gather, the Union Government came up with the Rashtriya Kishor Swasthya Karyakram. The program was formally inaugurated on January 7^th, 2014.

To be honest, Rashtriya Kishor Swasthya Karyakram was not what was initially formulated. The program already existed and there was another name for the program. It was called the ARSH or Adolescent Reproductive and Sexual Health. The program was later renamed and the scope of the program was increased significantly.

The primary principle or the driving force behind this formulation was ensure that the participation as well as the leadership of the adolescents in India can be increased. Gender equity and inclusion were also among the primary objectives of the program.

The program wanted to make sure that Indian adolescents reach their full potential are stay fully aware of well-being and health and that they should have proper access to support, services and knowledge they would need to make decisions that are responsible and well-informed.

Core objectives of Rashtriya Kishor Swasthya Karyakram

The Rashtriya Kishor Swasthya Karyakram had the core objectives clearly defined. The objectives of the program included:

Nutrition Improvement

• Reduction of malnutrition that is present among both genders of the adolescent population of India.
• Reduction of anemia (iron deficiency) among both genders of the adolescent population of India.

Reproductive and Sexual Health Improvement

• To improve behavior of adolescents, their attitude and their knowledge when it comes to Reproductive and Sexual Health.
• Reduce the total number of instances where teens become pregnant.
• Improve the preparedness for birth and increase the readiness for complications that may arise out of birth.
• Arranging for provisions for early parenting support in case of those parents who are still in their adolescence.

Mental Health Enhancement

• Many Indian adolescents are struck by mental health problems. The Rashtriya Kishor Swasthya Karyakram looks forward to address all concerns that are related to mental health among the adolescent population of India.

Violence and Injuries Prevention

• Promotion of attitude towards prevention of violence and injuries or any kind and this also includes Gender Based Violence or GBV.

Substance Abuse Prevention

• Substance abuse (alcohol, drugs etc.) being one of the major problems, the Rashtriya Kishor Swasthya Karyakram aims towards promotion of knowledge that would help adolescents in India understand the adverse effects they will have to face in case they decide to abuse substances. Thus, substance abuse prevention is one of the core objectives of the program.

Properly Addressing Non-Communicable Diseases

• Non-communicable diseases are a major problem everywhere in India and the Rashtriya Kishor Swasthya Karyakram aims towards promotion of changes in adolescents’ behavior to that such diseases of the likes of cardio-vascular diseases, stroke, hypertension and diabetes can be prevented.

Who are the target groups of the Rashtriya Kishor Swasthya Karyakram?

It has already been mentioned that the Rashtriya Kishor Swasthya Karyakram is targeted towards the adolescents. However, here is the clear definition of the target group:

Age Group:

The following age groups are targeted under the program:

• 10 years to 14 years
• 15 years to 19 years

Coverage: Universal

The Rashtriya Kishor Swasthya Karyakram goes for universal coverage. This means that adolescents belonging to the following groups will be covered under the program:

• Females adolescents
• Males adolescents
• Urban adolescents
• Rural adolescents
• In-school adolescents
• Out-of-school adolescents
• Married adolescents
• Unmarried adolescents
• Vulnerable adolescents
• Under-served adolescents

Rashtriya Kishor Swasthya Karyakram in a nutshell

The Rashtriya Kishor Swasthya Karyakram can all be summed up in a nutshell. We will like to do so before we go into the details of the strategies of the program. This will help you to get a good grasp over the whole program idea. Let’s start…

• Focus group: 243 million or 24.3 crore Indian adolescents.
• Approach: Instead of being doctor-driven, the approach will be participative and holistic.
• Strategy:Reproductive, Maternal, New born, Child Health + Adolescent (abbreviated as RMNCH+A).
• Dimensions included: Substance abuse, nutrition, non-communicable diseases, mental health, sexual health and gender based violence.
• Intervention style: Community based. Usage of peer educators with State and Central Ministries’ collaboration through research and knowledge partners.
• Objective: Making adolescents aware of problems or diseases well before they actually arise. This will help to ensure that the target group can make decisions that are informed and that they are aware of their choices.
• Aiding factors: The program will be implemented via platforms of social media as well as new technologies so that the adolescents can be reached effectively without pulling them out of their own comfort space. Peers and communities will play an important role in the same.

That’s the whole program in a nutshell. It is time that we take a detailed look at the strategies of the program.

Rashtriya Kishor Swasthya Karyakram strategies

When we speak of the strategies of the Rashtriya Kishor Swasthya Karyakram, we actually mean how the program aims towards achieving the core objectives that were laid down. For this, a number of strategies have been formulated. Interestingly, these strategies are not alternatives. They are actually interdependent and interwoven. So, let us take a quick look at the strategies of the program.

Strategy 1: Interventions (for objective achievement)

The whole program has broad objectives and achieving the same requires several interventions, which can be classified as:

• CBIs or Community-Based Interventions.
• PE or Peer Education.
• Quarterly AHD or Adolescent Health Day.
• WIFS or Weekly Iron and Folic Acid Supplement Programme.
• MHS or Menstrual Hygiene Scheme.

Strategy 2: Clinics and Facilities

• Strengthening AFHCs or Adolescent Friendly Health Clinics.

Strategy 3: Convergence

The program can work properly only and only when various government ministries and their existing health-related programs are all converged into a singular entity. The various existing programs that are envisaged to be converged under Rashtriya Kishor Swasthya Karyakram include:

• National Programme for Non-Communicable Diseases (NCDs)
• National Mental Health Programme (NMHP)
• National Tobacco Control Programme (NTCP)
• National AIDS Control Programme (NACP)
• Child Health (CH)
• Family Planning (FP)
• Maternal Health (MH)
• Rashtriya Bal Swasthya Karyakram (RBSK)

The various ministries that are envisaged to converge under the Rashtriya Kishor Swasthya Karyakram include:

• MoYAS or Ministry of Youth Affairs and Sports.
• MSJE or Ministry or Social Justice and Empowerment.
• MoLE or Ministry of Labour and Employment.
• MWCD or Ministry of Women and Child Development.
• MHRD or Ministry of Human Resource Development.

The question here is, “why convergence?” The answer to this question can be given with the following points:

• Convergence of allied ministries, stakeholders and departments will ensure that all linkages become very strong.
• Such convergence will ensure that fresh partnership opportunities are generated.
• Such convergence will also ensure that duplication doesn’t take place.
• Such convergence will also:
  • Effects are maximized at every end.
  • Resources are utilized efficiently.
  • A review mechanism is established and it is comprehensive.

Strategy 4: Communication

With special focus on IPC or Inter-Personal Communication, communication about behavior as well as social change is of paramount importance to the effective implementation of the Rashtriya Kishor Swasthya Karyakram.

7Cs of Rashtriya Kishor Swasthya Karyakram

While we have only moderately touched the strategies, we didn’t go into extreme details, However, while we are still on the strategies, it is worth stating that the whole strategy framework has been designed to have 7 pillars. Those pillars are known as the 7Cs of Rashtriya Kishor Swasthya Karyakram strategy. Those pillars or 7Cs are:

1. Coverage
2. Content
3. Communities
4. Clinics
5. Counselling
6. Communication
7. Convergence

What really is Coverage?

Coverage simply refers to the target group of the program. Check the target group section mentioned above in this article.

What really is Content?

Content simply refers to the key priorities or objectives of the program. These have already been mentioned earlier but we can always give a summary again in bullet point format.

• Nutrition
• Violence (including Gender Based Violence)
• Substance Abuse
• Mental Health
• Non-Communicable Diseases
• Sexual Health and Reproductive Health

These are the core or key priorities that the program wants to deal with and are referred to as the Content of the program in the context of strategy framework.

What are Communities?

Communities refer to the places that can be used for reaching out to the target group. Basically, they are places where workers of the front line, service providers, communities (basically societies) as well as adolescent people (the target group) can interact with each other. The target of the program is consistent outreach.

What are Clinics?

These are not just any clinic. They are designed specifically for adolescents and for providing:

• Information about various health related problems (can be anything ranging from anemia to pregnancy complications etc.)
• Material such as sanitary napkins, tablets of folic acid and iron, contraception that are non-clinical etc.
• Para-medical and medical services specially for adolescents.
• Counselling for adolescents.

These are called Adolescent Friendly Health Clinics and they will ensure confidentiality and privacy of the adolescents who visit such clinics.

What is Counselling?

This basically refers to the provisions for providing correct knowledge to adolescents related to their health. Such information will be provided by medical officers, staff nurses, ANM (Auxiliary Nursing and Midwifery), male multipurpose health workers, AWW (Anganwadi Workers), ASHA (organization that provides health services at ground level), peers, nodal teachers and school teachers. There will also be Adolescent Health Counsellors to provide such knowledge and counselling so that adolescent people can make informed decisions. These people listed above will also help the adolescents to resolve various issues related to health that they face from time to time.

What is Communication?

Communications is definitely one of the most important pillars of the program. It is absolutely necessary to reach out to the target group. If that fails, the whole program will fall apart. So, it is not only necessary to reach out to and communicate with adolescents but also to and with those people who influence the adolescents. This can be achieved via IPC (Inter-Personal Communication), which is considered as communication at entry level. Communication can also take place through mass media and mid-media. Health professionals will be the ones who will communicate with adolescents, their caretakers or parents and use relevant information that is based on evidences and is totally up-to-date. Also, health professionals will have the freedom of selecting the language and mode of communication for interacting directly with the adolescents. Language freedom is of utmost important because there’s no standard language that is spoken across India and linguistic barriers can destroy the whole purpose of the program.

What is Convergence?

We have already discussed this in details above and repeating the same will be useless. Feel free to go through the Convergence section discussed above.

Conclusion

India is a country which has the highest number of young people. This gives India unmatched edge over every other country in this world. This treasure trove of young talents can be harnessed by India in near future to become intellectual and economic powerhouse or superpower. So, the Rashtriya Kishor Swasthya Karyakram actually makes sense because it is aimed towards betterment and improvement of this precious treasure that India has. We all need to work towards the success of this program so that tomorrow India becomes the brightest spot on world map – the state that India enjoyed in antiquity.

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