Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India.
Ministry of Health and Family Welfare, Nirman Bhavan, Government of India, New Delhi, India.
Front Public Health. 2024 Nov 1;12:1434959. doi: 10.3389/fpubh.2024.1434959. eCollection 2024.
Each Indian state can select one of the two implementation models under India's National Adolescent Health Strategy, i.e., Rashtriya Kishor Swasthya Karyakram, either direct implementation through the existing State Health Department and systems, or the Non-Governmental Organisation (NGOs) implementation model, which involves partnering with one or more field-level NGOs to provide the services and personnel.
To compare and comprehend the implementation strategies of the Peer Education programme under the Direct and NGO implementation models within India's National Adolescent Health Strategy, and to document factors facilitating and hindering the adoption and implementation of the programme across two Indian states, using a qualitative approach.
Variations and similarities were seen across the two models. Employing a multi-level selection process, Madhya Pradesh selected two peer educators (PEs), while Maharashtra had four. Criteria included adolescents aged 15 and above in Madhya Pradesh and younger (10-14 years) and older (15-19 years) in Maharashtra. Madhya Pradesh selected Shadow Peers (10-14 years) to address attrition. Training in Madhya Pradesh spanned over 6 days, structured, led by NGO Mentors, utilising standardised, interactive resources with participatory methods. Maharashtra's training, facilitated by Auxiliary Nurse Midwife or Medical Officer, followed traditional approaches and relied on the trainer's expertise. PE session frequency and duration varied from monthly to quarterly. PEs were comfortable in handling issues like nutrition and non-communicable diseases but faced hesitancy in handling sexual and reproductive health issues. Regular Adolescent Friendly Clubs supported peer educators (PEs). In Madhya Pradesh, Adolescent Health and Wellness Days were suspended due to the pandemic, which led to decreased awareness of adolescent health services. Maharashtra resumed Adolescent Health and Wellness Days albeit on a limited scale.
The study identified various similarities and deviations from operational guidelines for the implementation of the peer education programme, offering valuable guidance for policymakers, practitioners, and stakeholders involved in RKSK's planning and implementation. It presents actionable strategies to strengthen peer education interventions within national adolescent health programmes, regionally and globally.
印度的国家青少年健康战略为每个邦提供了两种实施模式，邦可以从中选择其一，这两种模式分别是：Rashtriya Kishor Swasthya Karyakram（RKSK），直接由邦卫生部门和系统实施，或者非政府组织（NGO）实施模式，涉及与一个或多个实地一级的非政府组织合作，提供服务和人员。
为了比较和理解印度国家青少年健康战略下直接实施模式和非政府组织实施模式下同伴教育方案的实施策略，并记录在印度的两个邦采用和实施该方案的促进和阻碍因素，本研究采用了定性方法。
在两种模式下，都发现了差异和相似之处。中央邦通过多层次选择程序，选出了两名同伴教育者（PEs），而马哈拉施特拉邦则选出了四名。标准包括中央邦的 15 岁及以上青少年和马哈拉施特拉邦的 10-14 岁和 15-19 岁青少年。中央邦选择影子同伴（10-14 岁）来解决流失问题。中央邦的培训持续了 6 天，结构合理，由 NGO 导师领导，利用标准化、互动资源和参与性方法。马哈拉施特拉邦的培训由辅助护士助产士或医疗官提供，采用传统方法，依赖培训师的专业知识。同伴教育者的培训频率和持续时间从每月到每季度不等。同伴教育者在处理营养和非传染性疾病等问题方面感到舒适，但在处理性和生殖健康问题方面则犹豫不决。定期的青少年友好俱乐部支持同伴教育者。在中央邦，由于疫情，青少年健康和保健日暂停，导致青少年对卫生服务的认识减少。马哈拉施特拉邦恢复了青少年健康和保健日，但规模有限。
本研究确定了实施同伴教育方案在操作指南方面的各种相似之处和偏差，为 RKSK 的规划和实施涉及的政策制定者、实践者和利益相关者提供了宝贵的指导。它为加强国家青少年健康方案中的同伴教育干预措施提供了可操作的策略，无论是在区域内还是全球范围内。
