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Adolescents Reproductive & Sexual Health (ARSH) has been identified as one of the four strategies under RCH-II and implementing context – sensitive ARSH intervention in the state is now over three years old. In the year 2008, the ARSH intervention was initiated through a pilot project in the state of state of Uttarakhand with the external support of USAID under Innovations in Family Planning Services (IFPS) grant. The branding of the ARSH program in the state was done as “UDAAN – Understanding, Delivering and Addressing Adolescent Needs”. However, prior to this pilot few other intervention programs like KISHORI UTTHAN PARIYOJANA and others were also implemented in the state. In the year 2008 UKHFWS decided to initiate the pilot project, through USAID’s IFPS mechanism, in eight blocks of the four districts namely Dehradun, Haridwar, Udham Singh Nagar and Nainital. A midline assessment of the impact of UDAAN services in these pilot blocks was undertaken by UKHFWS through IFPS funds in the year 2010—11. Some of the key findings are being listed here:

Awareness of services was 51.2 % in males and 48.8 % in females.
Awareness of health camps was relatively higher compared to other activities. Being highest in Dehradun ( 41.9%) in males and in Nainital(40.6 %) was highest in females.
Awareness and utilization of Udaan services was found higher among school going adolescent as compared to non-school going adolescent.
Over Four –Fifths reported satisfaction with services, who utilized at least one service by UDAAN program.
Regarding Location of Health Services for adolescents, 44% male adolescents stated that it should be within village and 27% female adolescents stated that sub-centres would be convenient.
A higher proportion of users 21.5% reported having ever heard of RTI, compared to non-users 10.2% of Udaan services.
A higher proportion of users (76.6%) reported having ever heard of HIV/AIDS, compared to non-users (61%) of Udaan services.
A much higher proportion of users (94.1%) perceived ideal number of children as one or two, compared to non-users (10.4%) of Udaan services.
A higher proportion of users (76.2%) perceive problems arising from early pregnancy, compared to non-users (63.7%) of Udaan services.
Awareness about minimum legal age at marriage for girls being 18 yrs, was observed among a higher proportion of users (90.1%) compared to non-users (84.5%) of Udaan services.
Awareness about minimum legal age at marriage for boys being 21 years, was observed among a higher proportion of users(77.2%), compared to non-users(71.4%) of Udaan services.
Parents reported their satisfaction by stating that ,the adolescent are engaged gainfully due to program initiatives, participation in the program made adolescent more aware and adolescents also tend to learn on a variety of new and useful life aspects.

In the subsequent year, UKHFWS expanded the ARSH – UDAAN project which is now running in 27 blocks of the state. A State Nodal Agency, CSHCS &SAMARPAN was also selected to provide the technical assistance to the UKHFWS on ARSH issues in terms of undertaking all the activities as envisaged in the concept note of ARSH – UDAAN project under the guidance of Programme officer RCH and state has decided to continue with the same agency as SNA in the year 2012-13.

Services under UDAAN
The comprehensive package of services was designed to respond to the diverse needs of different adolescents and includes promotive, preventive and curative services. The package also include services which may be beyond the purview of health per se, but are indirect determinants of the physical, social and mental well-being of adolescents.

Promotive Services like counselling for unmet need of contraception, information on RTI/STI , menstruation and other sexual concerns.
Preventive Services like nutritional counselling, supplement for nutritional anaemia , T.T. Immunization and focused antenatal care.
Curative Services viz; treatment for RTI/STI, Anaemia, acne, cornice infection etc.
Miscellaneous Services like life skills education, career counselling and co-curricular activities.

Multi Stakeholder Participation
The UKHFWS and state department of health and family welfare has the key responsibility of delivering adolescent health services. However, there are many stakeholders who can be involved in reaching out to the adolescents – ICTC, ICDS, Department of Education, Youth Affairs and Sports - Nehru Yuva Kendras (NYK) and National Security Services (NSS), NGOs, civil societies, professional bodies like IAP, medical colleges, and PRIs etc.

District-wise Report

Udhamsingh Nagar

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