In order to ensure holistic development of adolescent population, the Ministry of Health and Family Welfare launched Rashtriya Kishor Swasthya Karyakram (RKSK) on 7th January 2014 to reach out to 253 million adolescents - male and female, rural and urban, married and unmarried, in and out-of-school adolescents with special focus on marginalized and undeserved groups . The programme expands the scope of adolescent health programming in India - from being limited to sexual and reproductive health, it now includes in its ambit nutrition, injuries and violence (including gender based violence), non-communicable diseases, mental health and substance misuse. The strength of the program is its health promotion approach. It is a paradigm shift from the existing clinic-based services to promotion and prevention and reaching adolescents in their own environment, such as in schools, families and communities. Key drivers of the program are community based interventions like, outreach by counselors; facility based counselling; Social and Behavior Change Communication; and strengthening of Adolescent Friendly Health Clinics across levels of care. Adolescent often do not have the autonomy or the agency to make their own decision. RKSK takes cognizance of this and involves parents and community. Focus is on reorganizing the existing public health system in order to meet the service needs of adolescents. Under this a core package of services includes preventive, promotive, curative and counselling services, routine check-ups at primary, secondary and tertiary levels of care is provided regularly to adolescents, married and unmarried, girls and boys during the clinic sessions.

Through Adolescent Friendly Health Clinics (AFHCs), counselling and curative services are provided at primary, secondary and tertiary levels of care on fixed days and fixed time with due referral linkages. Commodities such as Iron & Folic Acid tablets and non-clinical contraceptives are also made available in the clinics for the adolescents. Capacity building of service providers in the six thematic areas is vital for effective and successful implementation of RKSK. Counselling services for adolescent on important health areas such as nutrition, puberty, RTI/STI prevention and contraception and delaying marriage and child bearing are being provided through recruitment and training of dedicated counsellors.

• Weekly Iron & Folic Acid Supplementation & Albendazole
• Sanitary napkins
• Contraceptives

• Counselling on nutrition, menstrual disorders, personal hygiene, menstrual hygiene, use of sanitary napkins, use of contraceptives, sexual concerns, depression, sexual abuse, gender violence, substance misuse and promoting healthy behavior to prevent non communicable diseases
• Posters/booklets/pamphlets, wall writing and visuals

• Treatment of severe malnutrition
• Treatment of common RTI/STI problems
• Treatmentof menstrual disorders
• Treatment for sexual concerns of males and female
• Mental health service/management of depression • Treatment of non-communicable diseases and other common ailments
• Management of injuries related to accidents and violence
• Management of substance misuse
• Treatment of non-communicable diseases like hypertension, stroke, cardio-vascular diseases and diabetes

• To delay first pregnancy, decrease teenage pregnancies and meet contraceptive needs of adolescents is an important mandate of the Adolescent Health Programme. Counselling on contraception and provision for emergency contraceptives and reversible contraceptives to prevent unwanted pregnancy and to delay teenage pregnancy will be provided at the AFHC. The pregnant adolescents are guided for early antenatal registration and ensure institutional delivery in order to prevent antenatal and postnatal complications. Outreach activities on Village Health and Nutrition day and health education sessions in school and community on appropriate age of marriage and adverse health consequences of teenage pregnancy are also organized. - Reduction in maternal deaths among adolescent girls- AFHCs provide management of anemia through iron supplementation and nutritional counselling. Through appropriate health facility referrals, early and safe abortion services are provided to adolescents.
• Reduction in incidence of sexually transmitted diseases and proportion of HIV positive cases in adolescents- Trained Medical officers at AFHC provide early treatment of common Reproductive tract infections / sexually transmitted infections. The health functionaries will ensure confidentiality, treatment compliance, partner management and follow-up. Linkage and referral to ICTC facilities is established to prevent HIV infections. Management of menstrual disorders, addressing sexual concerns of adolescence is ensured at appropriate level of facility.