, Ahmedabad, India.
, Singapore, Singapore.
Reprod Health. 2020 Jun 3;17(1):87. doi: 10.1186/s12978-020-00929-4.
Recognizing the potential of the country's large youth population and the importance of protecting and supporting its health and well-being, the Government of India committed to strengthening its programmes and systems for adolescents, initially through the Adolescent Reproductive and Sexual Health Strategy (ARSH) launched in 2005 and, subsequently, through the National Adolescent Health Programme (Rashtriya Kishore Swaasthya Karyakram or RKSK) launched in 2014. In 2016, in response to a request from the Government of India, the World Health Organisation undertook a rapid programme review of ARSH and RKSK at the national level and in four states (Haryana, Madhya Pradesh, Maharashtra and Uttarakhand) to identify and document lessons learnt in relation to four domains of the programmes (governance, implementation, monitoring and linkages) that could be used to enhance current and future adolescent health programming in India.
A rapid programme review methodology was utilised to gain an overview of the successes and challenges of the two adolescent health programmes. A desk review of policy statements, Program Implementation Plans (PIPs) (Program Implementation Plan (PIP) is an annual process of planning, approval and allocation of budgets of various programmes under the National Health Mission (NHM). It is also used for monitoring of physical and financial progress made against the approved activities and budget. ), reports and data provided by the four State governments was conducted alongside 70 semi-structured interviews with health, education and NGO officials at national, state, district and block levels. Data showed that the ARSH Strategy put adolescent health on the agenda for the first time in India, though insufficient human and financial resources were mobilised to ensure maximum impact. Further, the Strategy's focus on clinical service provision in a limited number of health facilities with a complementary focus on promoting community support and adolescent demand for them meant that services were not as easily accessible to adolescents in their communities, and in addition many were not even aware of them. Under RKSK, significant investment has been made in adequate management structures, as well as in community engagement and clinical service delivery at all levels of the health system. Monitoring the quality of service delivery remains a challenge in all four of the states, as does training of counsellors, nodal officers and other implementing partners. Additionally, further thought and action are required to ensure that peer educators are properly trained, supported and retained for the programme.
India's RKSK clearly integrated learning from the earlier ARSH Strategy. The findings of this review present an opportunity for the government and its partners to ensure that future investment in adolescent health programming continues to be framed around lessons learnt across India.
认识到国家庞大的青年人口的潜力以及保护和支持其健康和福祉的重要性，印度政府承诺加强其青少年方案和系统，最初是通过 2005 年推出的青少年生殖和性健康战略，随后是通过 2014 年推出的国家青少年健康方案（Rashtriya Kishore Swaasthya Karyakram 或 RKSK）。2016 年，应印度政府的要求，世界卫生组织在国家一级和四个邦（哈里亚纳邦、中央邦、马哈拉施特拉邦和北阿坎德邦）对 ARSH 和 RKSK 进行了快速方案审查，以确定和记录与方案的四个领域（治理、实施、监测和联系）有关的经验教训，这些经验教训可用于加强印度当前和未来的青少年健康方案。
利用快速方案审查方法，概述了两个青少年健康方案的成功和挑战。对政策声明、方案实施计划（PIP）（方案实施计划（PIP）是国家健康使命（NHM）下各项方案的年度规划、批准和预算分配过程。它还用于监测已批准活动和预算的实际进展和财务进展。）、四个邦政府提供的报告和数据进行了案头审查，并与国家、邦、区和街区各级的卫生、教育和非政府组织官员进行了 70 次半结构化访谈。数据显示，ARSH 战略首次将青少年健康纳入印度的议程，但未能调动足够的人力和财力来确保最大的影响。此外，该战略侧重于在少数卫生设施提供临床服务，并辅以促进社区支持和青少年对这些服务的需求，这意味着服务在社区中对青少年的可及性较差，而且许多人甚至不知道这些服务。在 RKSK 下，对适当的管理结构以及社区参与和各级卫生系统的临床服务提供进行了大量投资。在所有四个邦，监测服务提供质量仍然是一个挑战，顾问、协调人和其他执行伙伴的培训也是如此。此外，还需要进一步思考和采取行动，确保同伴教育者接受适当的培训、支持和保留，以开展方案。
印度的 RKSK 显然借鉴了早期 ARSH 战略的经验。本次审查的结果为政府及其合作伙伴提供了一个机会，以确保未来对青少年健康方案的投资继续围绕印度各地的经验教训展开。
