NEW DELHI: India’s Adolescent Friendly Health Centres (AFHCs), which provide clinical and counselling services on adolescent health, ranging from sexual and reproductive health (SRH) to nutrition, substance abuse, injuries and violence, including gender-based violence, have overburdened staff and need dedicated medical officers (MOs) and full-time adolescent health (AH) counsellors, an assessment by UNICEF has found.
Carried out under the guidance of the Health Ministry in 45 health facilities—30 Model-AFHC and 15 AFHC—spread in 15 states, the assessment also pointed out that in some facilities, counselling rooms are located within hospital premises near OPDs, where staff movement compromises privacy.
The AFHCs’ assessment report also highlighted that increased workload from Model-AFHC upgrades is impacting service depth and consistency.
Released recently at an event organised by the ministry, UNICEF, and other partners on mental health and well-being for youths and adolescents, the report said that inter-district collaboration and learning opportunities are minimal.
It also highlighted the need for more support from schools and communities to enhance reach and engagement.
“Address workload issues by ensuring adequate staffing and support to sustain service quality. Deploy dedicated MOs for adolescent health services and appoint full-time AH counsellors at all facilities,” the report recommended.
However, despite challenges, the report also found through in-depth interviews with counsellors that the transition from AFHC to Model AFHC has brought positive changes. Till January 2025, there were 150 M-AFHC in the country.
“The upgraded centres are now more spacious and exclusively dedicated to adolescents, creating a welcoming and non-judgemental environment that encourages adolescents to seek care with confidence. Counsellors also highlighted the availability of enhanced resources, which have improved their ability to engage and support adolescent clients effectively. However, they also acknowledged that the transition has resulted in a heavier workload,” the report added.
The UNICEF-led assessment, which was conducted last year and also evaluated the centre’s status, their readiness and functionality, service delivery and comparison of services and quality between AFHCs and M-AFHCs, also recommended making provision of dedicated, well-ventilated and adequately sized counselling rooms as “essential to ensure privacy and enhance the quality of care delivered to adolescents”. It also suggested that the government should “maximise M-AFHCs’ potential as centres of excellence, focus on inter-district collaboration through peer learning and joint training.”
Emphasis was also placed on regular refresher training for counsellors, nurses, and Community Health Officers on adolescent-specific issues such as mental health, gender sensitivity, and inclusive care.
Facilites conceptualised to offer specialised care
In 2022, Model-AFHCs were introduced by the Union Ministry of Health. These health facilities offered upgraded services with better infrastructure, increased human resources (HR), and expanded service delivery with the aim to provide specialised care across all districts of India for India’s youth. These model centres were integrated into existing AFHCs at district hospitals, with additional components added to strengthen service delivery.