NEW DELHI: India’s Adolescent Friendly Health Centres (AFHCs), which provide clinical and counselling services on adolescent health, are facing staff shortages and privacy concerns, a UNICEF assessment has found.
The assessment, conducted under the guidance of the Union Health Ministry in 45 health facilities — 30 Model-AFHCs and 15 AFHCs across 15 states — found that many centres have overburdened staff and need dedicated medical officers (MOs) and full-time adolescent health (AH) counsellors.
It also pointed out that in some facilities, counselling rooms are located near OPDs inside hospital premises, where staff movement compromises privacy.
The Adolescent-Friendly Health Centre assessment report said the increased workload following the upgrade to Model-AFHCs is affecting service depth and consistency. It also noted that inter-district collaboration and structured learning opportunities remain limited.
The report highlighted the need for greater support from schools and communities to improve outreach 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.
The report, released recently at an event organised by the Union Health Ministry, UNICEF and other partners on mental health and well-being for youths and adolescents, said counsellors reported positive changes after the transition from AFHCs to Model-AFHCs. Till January 2025, there were 150 Model-AFHCs 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, conducted last year, recommended dedicated, well-ventilated and adequately sized counselling rooms to ensure privacy and improve the quality of care.
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.”
The report stressed the need for regular refresher training for counsellors, nurses and Community Health Officers (CHOs) on adolescent mental health, gender sensitivity and inclusive care.|
The UN agency also recommended a youth-friendly feedback system, including suggestion boxes, digital forms or helplines, to allow adolescents to anonymously share concerns and suggestions.
“Propose creation of a platform for cross-state learning and sharing of best practices to encourage states with emerging M-AFHCs to adopt successful models,” it added.
The report found that most facilities addressed a broad range of adolescent health concerns.
“Over 90% of the facilities reported that they provide care for skin problems, menstrual problems, antenatal care (ANC) check-ups, emergency contraceptive pills, and immunisation; and provision of these services is slightly higher among M-AFHC facilities than the AFHC facilities. 93% of the adolescents coming to M-AFHC are referred from schools and communities,” the report said.
Demand for counselling was mainly related to Reproductive Tract Infections (RTIs), Sexually Transmitted Infections (STIs), immunisation and Body Mass Index (BMI) screening. Demand for counselling on non-communicable diseases (NCDs) and nutrition also increased.
The report said the comprehensive services offered by Model-AFHCs enabled many adolescents to access additional care beyond their initial needs, improving their overall experience.
The Union Health Ministry launched the Rashtriya Kishor Swasthya Karyakram (RKSK) in 2014 to address adolescent health and development needs. Under the programme, AFHCs were established across the country to provide services related to sexual and reproductive health, mental well-being, nutrition, substance misuse prevention, injuries, violence and non-communicable diseases.
Facilites conceptualised to offer specialised care
In 2022, the ministry introduced Model-AFHCs with upgraded infrastructure, additional human resources and expanded services to provide specialised adolescent healthcare across districts.
