Young people and their health needs are reflected in various national policies in India.
However curative health care being the primary focus, preventive
care often took a back seat. Review of health systems in India
and in South Asia shows that young people faced many barriers in the utilization of public health facilities.
In order to learn more about 'what makes services youth friendly'
and 'attracts young people to health services' MAMTA established a Youth Friendly Centre – ‘Friends’, in a resettlement colony Tigri in New Delhi, as community-based drop-in facility. The centre started
functioning in February, 2006. A defined package of services focusing on promotive, preventive and curative health care and youth information
was evolved through participation of young people from the local
community. The center served young people, aged 10-24 years, married and unmarried, male and female (clients outside this age range were referred to another nearby health centre, run by MAMTA). The centre addressed young peoples’ health needs and concerns, including Sexual and Reproductive Health (SRH) concerns through medical and counselling services, basic laboratory facilities, drug dispensary and referrals to secondary/tertiary health care facilities in the vicinity. A token user fee of INR 5/- only, was charged.
The intervention had three components:
Intervention covered 11 blocks of Tigri slum spread over 4 square km covering a total population of more than 50,000 from around 7,000 households.
- Youth Friendly Health Centre, providing Clinical and Information services
- Outreach activities to raise awareness about SRH issues and about the clinical services, and
- Research activities to determine the dynamics of youth friendly services and the know-how to attract the target group
Combination of approaches was used to position the centre not only as a health facility, but also as a center providing health information and recreation facilities. Peer Educators were identified, trained and encouraged to hold small meetings with their peers to encourage utilization of services available at the centre. Information, advice and contraceptives were made available on all days. Written material on different health issues as well as educational documentaries / films were available. Carry-home material was also provided.
The outreach activities in the community focused on raising awareness about young people’s health issues and about the services provided by the centre and reduced barriers to services. Meetings with CBO-members, parents and key gatekeepers to create an enabling environment and to reduce barriers for young people to visit the centre were part of the regular outreach.
Standard Operating Procedures (SOPs) were created in order to standardize and ensure quality of services and activities of the centre. Quality of services was monitored through exit interviews, FGDs and IDIs.
During the initial period, most of the clients attending the clinic
were informed about the center by the outreach staff and through
activities taking place in the community. However, peers and
relatives (‘word of mouth’) subsequently became important sources of
information about the center.