Adolescent Friendly Center Medical College Vadodara A Model Presentation at IAPSM National Conference 2004 28th February 2004, Chandigarh By Dr. Prakash V. Kotecha Professor and Head, Preventive and Social Medicine Medical College Vadodara, Gujarat Technical and Financial Assistance W. H. O. India Office

Medical College Vadodara

Adolescent Friendly Center Background Medical College Vadodara is having a unique model unit for adolescent anemia project (UNICEF Supported) where for the entire district once a week IFA tablet is given With the good rapport and contacts with adolescent we realized their needs beyond anemia in various spheres. In WHO Regional Workshop for adolescent nutrition in 2002 the concept of AFC was proposed to and accepted by Medical College Vadodara 12/1/2018 Dr. Prakash V. Kotecha

12/1/2018 Dr. Prakash V. Kotecha

INTRODUCTION Gujarat with 5 crore population has about 1 crore adolescents in the state Vadodara city with 15 lakh population has about 3 lakh adolescents Their unique needs remain largely unmet…. 12/1/2018 Dr. Prakash V. Kotecha

What are the needs of adolescents? Are Unique and invisible They are relatively healthy compared to other lifecycle groups with similar morbidity and mortality as adults Adolescents are an in-between group, with some problem commonalties with children, and with adults. 12/1/2018 Dr. Prakash V. Kotecha

What are the needs of adolescents? However this group passes through very important phase of life and very fast growing phase of life. Consequences of the effects on adolescent growth are far reaching and affects the whole generation.. So the need assessment study 12/1/2018 Dr. Prakash V. Kotecha

Adolescent Friendly Center As we envisage… A special package of care and counseling based on their needs Provide a nodal agency for networking with other departments and specialties working towards common goal of a well adjusted healthy adolescence for our population. Create environment to facilitate more easy approach for adolescents to their need through school/ngo involvement 12/1/2018 Dr. Prakash V. Kotecha

Adolescent Friendly Center Medical College Departments DEO, M. S. University Social Science Departments NGOs Health Dept Dept of P and SM WHO Country Office Advisory Committee Implementation Core Members + Project Staff 177 Urban Schools With 2000 teachers and 80000 Adolescents Students Out of school Adolescents in the city 193 Rural Schools 56 Tribal Schools Beneficiaries More than 130000 Adolescents 12/1/2018 Dr. Prakash V. Kotecha

What did AFC do? Needs Assessment Forum for Advocacy and linkages Study Dissemination of the study Forum for Advocacy and linkages Other departments in the university: within the institution and Out side the institution School Management Non Government Organizations Health functionaries 12/1/2018 Dr. Prakash V. Kotecha

What Young People have to say? Self revelation of fears   N=1440 % Parents Exams No Fears Gods curse Teachers Animals 307 255 206 156 119 103 21.3 17.7 14.3 10.8 8.3 7.2 * multiple responses 12/1/2018 Dr. Prakash V. Kotecha

Age Wise Fear of Parents Among Adolescent Boys and Girls Difference is statistically highly significant 12/1/2018 Dr. Prakash V. Kotecha

Perceptions of the adolescents regarding their height and weight with the BMI grades Perception about height and weight Boys N=479 Girls N=474 Below Normal Normal Above Normal N % Less More 24 20 6 48.0 40.0 12.0 176 80 42 59.0 26.8 14.0 76 13 58. 9.9 32. 12 70.0 20.0 10.0 186 32 62.4 10.7 22.9 37 17 62 31.9 14.6 53.4 Total 50 10.4 298 62.2 131 27.3 60 12.6 62.9 116 24.5 12/1/2018 Percentiles: < 5th=Below Normal , 5th – 85th: Normal and >85th= Above Normal Dr. Prakash V. Kotecha

What did AFC do? Out Reach to the schools Need based, Family Life Education, Psychosocial and Behavioral, Nutrition, Growth and Development, Reproductive It is a student-centered, participatory process of learning and applying new skills in a supportive classroom environment A Huge and Interesting Question Bank generated At the Adolescent Friendly Clinic Service Unit (Counseling + Care) Anonymous Service on emails and phone.. 12/1/2018 Dr. Prakash V. Kotecha

What did AFC do? Teachers’ Training for Empowerment Teachers from English and Gujarati Medium of instruction selected. 2 day highly interactive training program for them Counseling material developed and shared with them to train other teachers in the school Training material in vernacular language is under preparation 12/1/2018 Dr. Prakash V. Kotecha

Focused Group Discussion With Students and Teachers 12/1/2018 Dr. Prakash V. Kotecha

Needs Assessment Study With Boys and Girls 12/1/2018 Dr. Prakash V. Kotecha

Students for Need Based Group Discussion Students for Need Based Counseling 12/1/2018 Dr. Prakash V. Kotecha

12/1/2018 Dr. Prakash V. Kotecha

12/1/2018 Dr. Prakash V. Kotecha

12/1/2018 Dr. Prakash V. Kotecha

12/1/2018 Dr. Prakash V. Kotecha

Lessons Learnt Adolescents have large number of questions and issues for which they do not have places to approach and AFC is one the best option Majority of the needs are better addressed in school and group environment Body Image, School performance, Reproductive Issues, Emotional turmoil and Career Guidance are forefront issues 12/1/2018 Dr. Prakash V. Kotecha

Lessons Learnt School based services are so much more in demand Clinic based services are less utilized Teachers (and Parents) training is as much important as the adolescents counseling to address the issues of adolescents… 12/1/2018 Dr. Prakash V. Kotecha

Future of the AFC Continue with the urban services Expanding the services to rural areas by extension activities to the rural schools and rural based NGO Initiating the training to rural areas and continue with training in urban areas Explore the possibility of main-streaming the adolescent center 12/1/2018 Dr. Prakash V. Kotecha

Questions? Thanks 12/1/2018 Dr. Prakash V. Kotecha