NCERT Textbook: Adolescent Friendly Health Services (AFHS) | Physical Education for Grade 9 PDF Download

 Page 1


14.1  IntroductIon India is the second most populous country 
in the world with a total population of over 
1.21 billion according to the 2011 Census. 
Adolescents (10–19 years) constitute over 
one-fifth of the total population, and their 
number is estimated to be about 243 
million. They represent a resource for the 
future whose potential needs to be nurtured 
in a positive manner. The adolescents are 
considered to be healthy as a group; however, 
they do have a range of health problems that 
cause a lot of morbidity as well as mortality. 
In spite of specific health problems, it is  
a common observation that the existing 
health services do not cater to the specific 
problems of adolescents. Moreover, it is a 
challenge for the health sector to respond to 
their needs adequately by offering services 
in a friendly manner in a non-threatening environment. In 
this chapter, an attempt has been made to discuss the health 
needs of adolescents, the status of existing adolescent friendly 
health services and the manner in which these services can be 
made available to adolescents so that these can be adequately 
utilised by them. 
14.2 HealtH n eeds of a dolescents As you have realised while going through the chapters ‘Growing 
up with Confidence’ and ‘Diet for Healthy Living’, adolescence 
is the most significant period in the life of human beings. 
It is imperative, therefore, that the needs of adolescents be 
recognised and met  adequately. Their health needs are 
mentioned below.
 (i) Nutritional Needs: as discussed in the previous 
chapters, many boys and girls enter adolescence 
undernourished, making them more vulnerable to 
diseases. The findings of the National Family Health 
Survey 3 (NFHS 3) indicate high percentage of anaemia 
(56 per cent of females and 25 per cent of males in  
15–24 age group were anaemic). Anaemia affects physical 
Adolescent Friendly 
Health Services (AFHS)
14
Fig. 14.1 : Visit to AFHS
Page 2


14.1  IntroductIon India is the second most populous country 
in the world with a total population of over 
1.21 billion according to the 2011 Census. 
Adolescents (10–19 years) constitute over 
one-fifth of the total population, and their 
number is estimated to be about 243 
million. They represent a resource for the 
future whose potential needs to be nurtured 
in a positive manner. The adolescents are 
considered to be healthy as a group; however, 
they do have a range of health problems that 
cause a lot of morbidity as well as mortality. 
In spite of specific health problems, it is  
a common observation that the existing 
health services do not cater to the specific 
problems of adolescents. Moreover, it is a 
challenge for the health sector to respond to 
their needs adequately by offering services 
in a friendly manner in a non-threatening environment. In 
this chapter, an attempt has been made to discuss the health 
needs of adolescents, the status of existing adolescent friendly 
health services and the manner in which these services can be 
made available to adolescents so that these can be adequately 
utilised by them. 
14.2 HealtH n eeds of a dolescents As you have realised while going through the chapters ‘Growing 
up with Confidence’ and ‘Diet for Healthy Living’, adolescence 
is the most significant period in the life of human beings. 
It is imperative, therefore, that the needs of adolescents be 
recognised and met  adequately. Their health needs are 
mentioned below.
 (i) Nutritional Needs: as discussed in the previous 
chapters, many boys and girls enter adolescence 
undernourished, making them more vulnerable to 
diseases. The findings of the National Family Health 
Survey 3 (NFHS 3) indicate high percentage of anaemia 
(56 per cent of females and 25 per cent of males in  
15–24 age group were anaemic). Anaemia affects physical 
Adolescent Friendly 
Health Services (AFHS)
14
Fig. 14.1 : Visit to AFHS
Adolescent Friendly Health Services 
growth, cognitive development and performance in 
school and at work in later years. Anaemic women are 
more prone to give birth to malnourished children, with 
significant morbidity and mortality associated with both 
mother and child. Adequate nutrition and healthy eating 
habits and physical exercise at this age are foundations 
for good health in adulthood.
 (ii) Reproductive and Sexual Health Needs: the adolescents 
confront a number of reproductive and sexual health 
problems. They hesitate to seek information from 
authentic sources as such issues are considered taboo 
in our society. There is always a possibility of their 
practising risky behaviour, thereby acquiring HIV and 
other sexually transmitted infections. According to 
National AIDS Control Organisation, almost 50 per cent 
of new HIV infections are taking place in 15–24 years 
age group (NACO 2005). The adolescent girls suffer due 
to a number of myths related to menstruation. Early 
marriage is still a serious problem in many parts of 
the country. A substantial number of adolescent girls, 
mostly married girls, become pregnant and give birth 
to children below the legal age of marriage which is 18 
years. According to NFHS 3, twelve per cent of married 
young women aged 15–19 have become mothers and 4 
per cent of women ages 15–19 are currently pregnant 
with their first child. This means that one in six women 
in the age group.  15–19 years begun child bearing. This 
phenomenon of early pregnancy adversely affects the 
health of both mothers and children and is the cause of 
mortality and morbidity among them. 
      Sexual harassment in public places, institutions  
  of education, in and around neighbourhood and at the  
  workplace is a well established fact.  Child abuse,  
  bullying and ragging are also common, more so among  
  boys.  
 (iii) Mental Health Concerns: it is estimated that at least 
20 per cent of youth experience some form of mental 
problems such as depression, mood disturbances, 
substance abuse, suicidal behaviour, eating disorders, 
aggression, violence. Among 15–19 year olds, suicide is 
the second leading cause of death, followed by violence 
in the family and community. In fact, effective and 
sensitive care of adolescent victims of violence is needed 
as one of the priority measures. 
 (iv) Substance Abuse: tobacco and alcohol use among 
young people is emerging as a matter of concern. The 
projected number of drug abusers in India is about three 
Page 3


14.1  IntroductIon India is the second most populous country 
in the world with a total population of over 
1.21 billion according to the 2011 Census. 
Adolescents (10–19 years) constitute over 
one-fifth of the total population, and their 
number is estimated to be about 243 
million. They represent a resource for the 
future whose potential needs to be nurtured 
in a positive manner. The adolescents are 
considered to be healthy as a group; however, 
they do have a range of health problems that 
cause a lot of morbidity as well as mortality. 
In spite of specific health problems, it is  
a common observation that the existing 
health services do not cater to the specific 
problems of adolescents. Moreover, it is a 
challenge for the health sector to respond to 
their needs adequately by offering services 
in a friendly manner in a non-threatening environment. In 
this chapter, an attempt has been made to discuss the health 
needs of adolescents, the status of existing adolescent friendly 
health services and the manner in which these services can be 
made available to adolescents so that these can be adequately 
utilised by them. 
14.2 HealtH n eeds of a dolescents As you have realised while going through the chapters ‘Growing 
up with Confidence’ and ‘Diet for Healthy Living’, adolescence 
is the most significant period in the life of human beings. 
It is imperative, therefore, that the needs of adolescents be 
recognised and met  adequately. Their health needs are 
mentioned below.
 (i) Nutritional Needs: as discussed in the previous 
chapters, many boys and girls enter adolescence 
undernourished, making them more vulnerable to 
diseases. The findings of the National Family Health 
Survey 3 (NFHS 3) indicate high percentage of anaemia 
(56 per cent of females and 25 per cent of males in  
15–24 age group were anaemic). Anaemia affects physical 
Adolescent Friendly 
Health Services (AFHS)
14
Fig. 14.1 : Visit to AFHS
Adolescent Friendly Health Services 
growth, cognitive development and performance in 
school and at work in later years. Anaemic women are 
more prone to give birth to malnourished children, with 
significant morbidity and mortality associated with both 
mother and child. Adequate nutrition and healthy eating 
habits and physical exercise at this age are foundations 
for good health in adulthood.
 (ii) Reproductive and Sexual Health Needs: the adolescents 
confront a number of reproductive and sexual health 
problems. They hesitate to seek information from 
authentic sources as such issues are considered taboo 
in our society. There is always a possibility of their 
practising risky behaviour, thereby acquiring HIV and 
other sexually transmitted infections. According to 
National AIDS Control Organisation, almost 50 per cent 
of new HIV infections are taking place in 15–24 years 
age group (NACO 2005). The adolescent girls suffer due 
to a number of myths related to menstruation. Early 
marriage is still a serious problem in many parts of 
the country. A substantial number of adolescent girls, 
mostly married girls, become pregnant and give birth 
to children below the legal age of marriage which is 18 
years. According to NFHS 3, twelve per cent of married 
young women aged 15–19 have become mothers and 4 
per cent of women ages 15–19 are currently pregnant 
with their first child. This means that one in six women 
in the age group.  15–19 years begun child bearing. This 
phenomenon of early pregnancy adversely affects the 
health of both mothers and children and is the cause of 
mortality and morbidity among them. 
      Sexual harassment in public places, institutions  
  of education, in and around neighbourhood and at the  
  workplace is a well established fact.  Child abuse,  
  bullying and ragging are also common, more so among  
  boys.  
 (iii) Mental Health Concerns: it is estimated that at least 
20 per cent of youth experience some form of mental 
problems such as depression, mood disturbances, 
substance abuse, suicidal behaviour, eating disorders, 
aggression, violence. Among 15–19 year olds, suicide is 
the second leading cause of death, followed by violence 
in the family and community. In fact, effective and 
sensitive care of adolescent victims of violence is needed 
as one of the priority measures. 
 (iv) Substance Abuse: tobacco and alcohol use among 
young people is emerging as a matter of concern. The 
projected number of drug abusers in India is about three 
 Health and Physical Education — Class IX
million, and most are in the age group of 16–35 years 
(UNODC, 2003).  Nearly 11 per cent were introduced 
to cannabis before the age of 15 years and about 26 
per cent between the age of 16-20 years (UNODC and 
Ministry of Social Justice and Empowerment, 2004). 
Findings of NFHS 3 show that in the age group of 15–
19 years, 3.5 per cent women and 28.6 per cent men 
were using some kind of tabacco. Similarly, in this age 
group 1 per cent of women and 11 per cent of men were 
consuming alcohol. Further, 6.8 per cent women and 
18.3 per cent men were drinking about once a week. 
(v)  Accidental Injuries: accidental injuries are a leading 
cause of death and disability in adolescents, of which 
road traffic injuries, drowning and burns are the most 
common. Injury rates among adolescents 
are the highest. Public education targeted 
at young people on how to avoid accidental 
injuries during driving and using road, 
drowning, burns and falls can reduce 
injuries.
 In order to address the above needs, 
adolescent friendly health services have 
been developed. These adolescent friendly 
health services have been designed 
specifically to attract them, meet their 
needs conveniently and retain them for 
continuing care. We have to take note of an 
important fact that adolescents are not a 
homogeneous group. Their situation varies 
with respect to age, sex, marital status, class, region 
and cultural context. This calls for interventions that 
are flexible and responsive to their needs.
14.3 a dolescent f rIendly HealtH s ervIces (afHs): 
WHat does tHIs mean ? 
As we have seen, the health needs of young people are special 
in many respects. Therefore, there is a need to establish special 
services for them. These services are called “Adolescent Friendly 
Health Services” (AFHS). They have a specialised approach for 
giving adolescents preventive, promotive and curative health 
care. These services are mostly run by the government and 
in them diagnostic, treatment, counselling and other facilities 
related to health are offered for free or at a very minimal charge. 
14.4 n eed for afHs Specialised services are needed for adolescents because they 
are still in the developmental stage. They have a lot of concerns, 
a ctIvIty 14.1
Talk to your friends or classmates and 
make a report.
• if they are aware of adolescent friendly 
health services and if they have ever 
visited the place where such services 
are available.
• if they have visited, what has been 
their experience, and if they have not 
visited any, what are the reasons for 
not doing so.
Page 4


14.1  IntroductIon India is the second most populous country 
in the world with a total population of over 
1.21 billion according to the 2011 Census. 
Adolescents (10–19 years) constitute over 
one-fifth of the total population, and their 
number is estimated to be about 243 
million. They represent a resource for the 
future whose potential needs to be nurtured 
in a positive manner. The adolescents are 
considered to be healthy as a group; however, 
they do have a range of health problems that 
cause a lot of morbidity as well as mortality. 
In spite of specific health problems, it is  
a common observation that the existing 
health services do not cater to the specific 
problems of adolescents. Moreover, it is a 
challenge for the health sector to respond to 
their needs adequately by offering services 
in a friendly manner in a non-threatening environment. In 
this chapter, an attempt has been made to discuss the health 
needs of adolescents, the status of existing adolescent friendly 
health services and the manner in which these services can be 
made available to adolescents so that these can be adequately 
utilised by them. 
14.2 HealtH n eeds of a dolescents As you have realised while going through the chapters ‘Growing 
up with Confidence’ and ‘Diet for Healthy Living’, adolescence 
is the most significant period in the life of human beings. 
It is imperative, therefore, that the needs of adolescents be 
recognised and met  adequately. Their health needs are 
mentioned below.
 (i) Nutritional Needs: as discussed in the previous 
chapters, many boys and girls enter adolescence 
undernourished, making them more vulnerable to 
diseases. The findings of the National Family Health 
Survey 3 (NFHS 3) indicate high percentage of anaemia 
(56 per cent of females and 25 per cent of males in  
15–24 age group were anaemic). Anaemia affects physical 
Adolescent Friendly 
Health Services (AFHS)
14
Fig. 14.1 : Visit to AFHS
Adolescent Friendly Health Services 
growth, cognitive development and performance in 
school and at work in later years. Anaemic women are 
more prone to give birth to malnourished children, with 
significant morbidity and mortality associated with both 
mother and child. Adequate nutrition and healthy eating 
habits and physical exercise at this age are foundations 
for good health in adulthood.
 (ii) Reproductive and Sexual Health Needs: the adolescents 
confront a number of reproductive and sexual health 
problems. They hesitate to seek information from 
authentic sources as such issues are considered taboo 
in our society. There is always a possibility of their 
practising risky behaviour, thereby acquiring HIV and 
other sexually transmitted infections. According to 
National AIDS Control Organisation, almost 50 per cent 
of new HIV infections are taking place in 15–24 years 
age group (NACO 2005). The adolescent girls suffer due 
to a number of myths related to menstruation. Early 
marriage is still a serious problem in many parts of 
the country. A substantial number of adolescent girls, 
mostly married girls, become pregnant and give birth 
to children below the legal age of marriage which is 18 
years. According to NFHS 3, twelve per cent of married 
young women aged 15–19 have become mothers and 4 
per cent of women ages 15–19 are currently pregnant 
with their first child. This means that one in six women 
in the age group.  15–19 years begun child bearing. This 
phenomenon of early pregnancy adversely affects the 
health of both mothers and children and is the cause of 
mortality and morbidity among them. 
      Sexual harassment in public places, institutions  
  of education, in and around neighbourhood and at the  
  workplace is a well established fact.  Child abuse,  
  bullying and ragging are also common, more so among  
  boys.  
 (iii) Mental Health Concerns: it is estimated that at least 
20 per cent of youth experience some form of mental 
problems such as depression, mood disturbances, 
substance abuse, suicidal behaviour, eating disorders, 
aggression, violence. Among 15–19 year olds, suicide is 
the second leading cause of death, followed by violence 
in the family and community. In fact, effective and 
sensitive care of adolescent victims of violence is needed 
as one of the priority measures. 
 (iv) Substance Abuse: tobacco and alcohol use among 
young people is emerging as a matter of concern. The 
projected number of drug abusers in India is about three 
 Health and Physical Education — Class IX
million, and most are in the age group of 16–35 years 
(UNODC, 2003).  Nearly 11 per cent were introduced 
to cannabis before the age of 15 years and about 26 
per cent between the age of 16-20 years (UNODC and 
Ministry of Social Justice and Empowerment, 2004). 
Findings of NFHS 3 show that in the age group of 15–
19 years, 3.5 per cent women and 28.6 per cent men 
were using some kind of tabacco. Similarly, in this age 
group 1 per cent of women and 11 per cent of men were 
consuming alcohol. Further, 6.8 per cent women and 
18.3 per cent men were drinking about once a week. 
(v)  Accidental Injuries: accidental injuries are a leading 
cause of death and disability in adolescents, of which 
road traffic injuries, drowning and burns are the most 
common. Injury rates among adolescents 
are the highest. Public education targeted 
at young people on how to avoid accidental 
injuries during driving and using road, 
drowning, burns and falls can reduce 
injuries.
 In order to address the above needs, 
adolescent friendly health services have 
been developed. These adolescent friendly 
health services have been designed 
specifically to attract them, meet their 
needs conveniently and retain them for 
continuing care. We have to take note of an 
important fact that adolescents are not a 
homogeneous group. Their situation varies 
with respect to age, sex, marital status, class, region 
and cultural context. This calls for interventions that 
are flexible and responsive to their needs.
14.3 a dolescent f rIendly HealtH s ervIces (afHs): 
WHat does tHIs mean ? 
As we have seen, the health needs of young people are special 
in many respects. Therefore, there is a need to establish special 
services for them. These services are called “Adolescent Friendly 
Health Services” (AFHS). They have a specialised approach for 
giving adolescents preventive, promotive and curative health 
care. These services are mostly run by the government and 
in them diagnostic, treatment, counselling and other facilities 
related to health are offered for free or at a very minimal charge. 
14.4 n eed for afHs Specialised services are needed for adolescents because they 
are still in the developmental stage. They have a lot of concerns, 
a ctIvIty 14.1
Talk to your friends or classmates and 
make a report.
• if they are aware of adolescent friendly 
health services and if they have ever 
visited the place where such services 
are available.
• if they have visited, what has been 
their experience, and if they have not 
visited any, what are the reasons for 
not doing so.
Adolescent Friendly Health Services 
apprehensions and lack of understanding regarding their own 
needs. The adolescents feel shy, embarrassed and hesitant in 
talking to adults, especially regarding matters that are personal. 
Most adolescents avoid seeking care and guidance. They feel 
more comfortable in discussing their problems and concerns 
with their peers who also do not have scientific knowledge. In 
view of this, separate adolescent friendly health services need 
to be provided. Such special clinics can take care of all the 
concerns of the adolescents in an ambience in which they can 
utilise services without any hesitation. 
14.5 WHy do a dolescents HesItate In u tIlIsIng HealtH 
s ervIces ?
In additon to some of the reasons cited above, think of the 
reasons as to why the adolescents do not avail the health 
services. In fact, they face constraints in seeking services due 
to barriers such as: 
 (i) Myths and misconceptions related to the development 
of sexual and reproductive organs.
 (ii) Lack of knowledge of the location of the health services 
or the kinds of services offered by them.
 (iii) Adolescents are not able to go to clinics as their timings 
do not match their schedule. They cannot miss school 
and college classes to visit these clinics. 
 (iv) Lack of privacy and confidentiality in health clinics.
 (v) Long waiting period in the public health clinics.
 (vi) Cannot afford the fees of the private set up. 
 (vii) No transport or means to go to these clinics, specially in 
rural areas. Moreover, they are unable to afford the cost 
of visiting these clinics.
 (viii) Negative attitudes or judgemental behaviour of nurse/
doctor. 
 (ix) The routine hospitals do not entertain adolescents 
coming alone, especially when they have issues 
regarding sexual and reproductive health. Most 
hospitals require the parent to accompany them and/
or to give permission for any procedure or testing as per 
the legal requirement. 
14.6 WHere are afHs l ocated ?
Adolescent Friendly Health Services are located at various 
places, in hospitals and health centres or at other places. 
There are three major models of the location of such services:  
Fixed Site Models
1. Hospitals, both public and private in urban areas. 
2. Clinics and Health centres in cities.
a ctIvIty 14.2
Visit an Adolescent 
Friendly Health 
Service Centre. 
Discuss with 
the  nurse/doctor 
the myths and  
misconceptions 
usually experienced 
by adolescents.
Page 5


14.1  IntroductIon India is the second most populous country 
in the world with a total population of over 
1.21 billion according to the 2011 Census. 
Adolescents (10–19 years) constitute over 
one-fifth of the total population, and their 
number is estimated to be about 243 
million. They represent a resource for the 
future whose potential needs to be nurtured 
in a positive manner. The adolescents are 
considered to be healthy as a group; however, 
they do have a range of health problems that 
cause a lot of morbidity as well as mortality. 
In spite of specific health problems, it is  
a common observation that the existing 
health services do not cater to the specific 
problems of adolescents. Moreover, it is a 
challenge for the health sector to respond to 
their needs adequately by offering services 
in a friendly manner in a non-threatening environment. In 
this chapter, an attempt has been made to discuss the health 
needs of adolescents, the status of existing adolescent friendly 
health services and the manner in which these services can be 
made available to adolescents so that these can be adequately 
utilised by them. 
14.2 HealtH n eeds of a dolescents As you have realised while going through the chapters ‘Growing 
up with Confidence’ and ‘Diet for Healthy Living’, adolescence 
is the most significant period in the life of human beings. 
It is imperative, therefore, that the needs of adolescents be 
recognised and met  adequately. Their health needs are 
mentioned below.
 (i) Nutritional Needs: as discussed in the previous 
chapters, many boys and girls enter adolescence 
undernourished, making them more vulnerable to 
diseases. The findings of the National Family Health 
Survey 3 (NFHS 3) indicate high percentage of anaemia 
(56 per cent of females and 25 per cent of males in  
15–24 age group were anaemic). Anaemia affects physical 
Adolescent Friendly 
Health Services (AFHS)
14
Fig. 14.1 : Visit to AFHS
Adolescent Friendly Health Services 
growth, cognitive development and performance in 
school and at work in later years. Anaemic women are 
more prone to give birth to malnourished children, with 
significant morbidity and mortality associated with both 
mother and child. Adequate nutrition and healthy eating 
habits and physical exercise at this age are foundations 
for good health in adulthood.
 (ii) Reproductive and Sexual Health Needs: the adolescents 
confront a number of reproductive and sexual health 
problems. They hesitate to seek information from 
authentic sources as such issues are considered taboo 
in our society. There is always a possibility of their 
practising risky behaviour, thereby acquiring HIV and 
other sexually transmitted infections. According to 
National AIDS Control Organisation, almost 50 per cent 
of new HIV infections are taking place in 15–24 years 
age group (NACO 2005). The adolescent girls suffer due 
to a number of myths related to menstruation. Early 
marriage is still a serious problem in many parts of 
the country. A substantial number of adolescent girls, 
mostly married girls, become pregnant and give birth 
to children below the legal age of marriage which is 18 
years. According to NFHS 3, twelve per cent of married 
young women aged 15–19 have become mothers and 4 
per cent of women ages 15–19 are currently pregnant 
with their first child. This means that one in six women 
in the age group.  15–19 years begun child bearing. This 
phenomenon of early pregnancy adversely affects the 
health of both mothers and children and is the cause of 
mortality and morbidity among them. 
      Sexual harassment in public places, institutions  
  of education, in and around neighbourhood and at the  
  workplace is a well established fact.  Child abuse,  
  bullying and ragging are also common, more so among  
  boys.  
 (iii) Mental Health Concerns: it is estimated that at least 
20 per cent of youth experience some form of mental 
problems such as depression, mood disturbances, 
substance abuse, suicidal behaviour, eating disorders, 
aggression, violence. Among 15–19 year olds, suicide is 
the second leading cause of death, followed by violence 
in the family and community. In fact, effective and 
sensitive care of adolescent victims of violence is needed 
as one of the priority measures. 
 (iv) Substance Abuse: tobacco and alcohol use among 
young people is emerging as a matter of concern. The 
projected number of drug abusers in India is about three 
 Health and Physical Education — Class IX
million, and most are in the age group of 16–35 years 
(UNODC, 2003).  Nearly 11 per cent were introduced 
to cannabis before the age of 15 years and about 26 
per cent between the age of 16-20 years (UNODC and 
Ministry of Social Justice and Empowerment, 2004). 
Findings of NFHS 3 show that in the age group of 15–
19 years, 3.5 per cent women and 28.6 per cent men 
were using some kind of tabacco. Similarly, in this age 
group 1 per cent of women and 11 per cent of men were 
consuming alcohol. Further, 6.8 per cent women and 
18.3 per cent men were drinking about once a week. 
(v)  Accidental Injuries: accidental injuries are a leading 
cause of death and disability in adolescents, of which 
road traffic injuries, drowning and burns are the most 
common. Injury rates among adolescents 
are the highest. Public education targeted 
at young people on how to avoid accidental 
injuries during driving and using road, 
drowning, burns and falls can reduce 
injuries.
 In order to address the above needs, 
adolescent friendly health services have 
been developed. These adolescent friendly 
health services have been designed 
specifically to attract them, meet their 
needs conveniently and retain them for 
continuing care. We have to take note of an 
important fact that adolescents are not a 
homogeneous group. Their situation varies 
with respect to age, sex, marital status, class, region 
and cultural context. This calls for interventions that 
are flexible and responsive to their needs.
14.3 a dolescent f rIendly HealtH s ervIces (afHs): 
WHat does tHIs mean ? 
As we have seen, the health needs of young people are special 
in many respects. Therefore, there is a need to establish special 
services for them. These services are called “Adolescent Friendly 
Health Services” (AFHS). They have a specialised approach for 
giving adolescents preventive, promotive and curative health 
care. These services are mostly run by the government and 
in them diagnostic, treatment, counselling and other facilities 
related to health are offered for free or at a very minimal charge. 
14.4 n eed for afHs Specialised services are needed for adolescents because they 
are still in the developmental stage. They have a lot of concerns, 
a ctIvIty 14.1
Talk to your friends or classmates and 
make a report.
• if they are aware of adolescent friendly 
health services and if they have ever 
visited the place where such services 
are available.
• if they have visited, what has been 
their experience, and if they have not 
visited any, what are the reasons for 
not doing so.
Adolescent Friendly Health Services 
apprehensions and lack of understanding regarding their own 
needs. The adolescents feel shy, embarrassed and hesitant in 
talking to adults, especially regarding matters that are personal. 
Most adolescents avoid seeking care and guidance. They feel 
more comfortable in discussing their problems and concerns 
with their peers who also do not have scientific knowledge. In 
view of this, separate adolescent friendly health services need 
to be provided. Such special clinics can take care of all the 
concerns of the adolescents in an ambience in which they can 
utilise services without any hesitation. 
14.5 WHy do a dolescents HesItate In u tIlIsIng HealtH 
s ervIces ?
In additon to some of the reasons cited above, think of the 
reasons as to why the adolescents do not avail the health 
services. In fact, they face constraints in seeking services due 
to barriers such as: 
 (i) Myths and misconceptions related to the development 
of sexual and reproductive organs.
 (ii) Lack of knowledge of the location of the health services 
or the kinds of services offered by them.
 (iii) Adolescents are not able to go to clinics as their timings 
do not match their schedule. They cannot miss school 
and college classes to visit these clinics. 
 (iv) Lack of privacy and confidentiality in health clinics.
 (v) Long waiting period in the public health clinics.
 (vi) Cannot afford the fees of the private set up. 
 (vii) No transport or means to go to these clinics, specially in 
rural areas. Moreover, they are unable to afford the cost 
of visiting these clinics.
 (viii) Negative attitudes or judgemental behaviour of nurse/
doctor. 
 (ix) The routine hospitals do not entertain adolescents 
coming alone, especially when they have issues 
regarding sexual and reproductive health. Most 
hospitals require the parent to accompany them and/
or to give permission for any procedure or testing as per 
the legal requirement. 
14.6 WHere are afHs l ocated ?
Adolescent Friendly Health Services are located at various 
places, in hospitals and health centres or at other places. 
There are three major models of the location of such services:  
Fixed Site Models
1. Hospitals, both public and private in urban areas. 
2. Clinics and Health centres in cities.
a ctIvIty 14.2
Visit an Adolescent 
Friendly Health 
Service Centre. 
Discuss with 
the  nurse/doctor 
the myths and  
misconceptions 
usually experienced 
by adolescents.
 Health and Physical Education — Class IX
3. Primary Health Centres and other Rural Health 
Centres, specially under NRHM (National Rural Health 
Mission) by the Ministry of Health and Family Welfare, 
Government of India. 
Outreach Models 
1. School based or linked clinics 
2. Workplace clinics  
3. Satellite clinics 
4. Mobile clinics 
5. Departments associated with Ministry of Health and 
Family Welfare like National AIDs Control Organisation 
(NACO) and Ministry of Youth Affair and Sports like 
Nehru Yuva Kendra (NYK).  
Adolescent services can also be delivered by
1. Telephone helplines which have toll free (no charge) 
numbers 
2. Call-in radio talks
3. Websites that answer questions by email and 
4. Partnering with existing agencies that serve youth, 
like National Scout Association, (NSS) National Service 
Scheme, etc.
14.7 c HaracterIstIcs of afHs 14.7.1 Role of the staff working in the AFHS
The Ministry of Health and Family Welfare (MoHFW), GOI, is 
making efforts to train the staff at health care centres to deal 
with adolescents. In case you or any of your friends has any 
problem or is concerned about any issue, you should visit the 
AFHS centre and discuss the same with the nurse or doctor 
available. The staff has now been adequately trained to handle 
adolescence issues through discussion and counselling. The 
staff of adolescent friendly health centres is expected to: 
•  Show respect for adolescents: the staff need to be non-
judgmental and non-critical of the issues an adolescent 
comes to the clinic with, including issues regarding 
sexual and reproductive health.
•	 Know importance of privacy and confidentiality: 
the trained staff should provide privacy in physical 
examination without any embarrassment. The doctors, 
nurses and other staff should not divulge information 
about the adolescent patient to the parents or 
acquaintances, about what they came to the clinic for. 
They will need to tell parents only after informing the 
adolescent about the legal need or in view of protecting 
life and health of the adolescent. 
a ctIvIty 14.3
Box 14.1
Find out the AFHS 
centres that are 
located near your 
school or home 
or in the district. 
Make a list of their 
addresses and 
contact numbers 
which can be useful 
to yourself and to 
your friends. Display 
this list on the board 
for the benefit of all.
Visit a website 
aeparc.org for 
information related 
to adolescence.