Adolescent Friendly Health Services Class 9 HPE NCERT

QWho are considered adolescents in this chapter, and why is this group important in India?

In this chapter, adolescents are defined as young people aged 10–19 years. India has a very large adolescent population—over one-fifth of the total population, estimated at about 243 million (Census 2011). This group is described as a resource for the future whose potential needs to be nurtured positively. Even though adolescents are often considered healthy as a group, they face a range of health problems that can lead to significant illness (morbidity) and even death (mortality). This makes focused attention on adolescent health essential.

QIf adolescents are generally considered healthy, why do they still need special health services?

Adolescents are often considered healthy overall, but the chapter explains that they still experience many health problems that cause significant morbidity and mortality. A key issue is that existing health services usually do not cater to the specific problems of adolescents. Another challenge is that the health sector must respond in a friendly manner and provide a non-threatening environment so adolescents feel safe seeking help. Because adolescence is a developmental stage with many concerns, specialised services are needed to address their unique needs effectively.

QWhat are Adolescent Friendly Health Services (AFHS) in simple terms?

Adolescent Friendly Health Services (AFHS) are special health services created specifically for adolescents because their health needs are different in many ways. AFHS use a specialised approach to provide preventive, promotive, and curative health care to young people. The chapter notes that these services are mostly run by the government and offer facilities such as diagnosis, treatment, counselling, and other health-related support either free or at a very minimal charge. The goal is to make care easier to access and more comfortable for adolescents.

QWhat types of care do AFHS provide: preventive, promotive, and curative—what do these mean here?

The chapter states that AFHS provide preventive, promotive, and curative care through a specialised approach. Preventive care aims to stop health problems before they start, such as guidance to avoid risky behaviour or accidents. Promotive care supports healthy growth and habits, like encouraging good nutrition, healthy eating habits, and physical exercise. Curative care focuses on treating existing problems through diagnostic services, treatment, and counselling. AFHS combine these types of care so adolescents can get help for current concerns while also learning how to stay healthy.

QWhy does the chapter emphasise a “friendly” and “non-threatening” environment for adolescents?

The chapter explains that a major challenge for the health sector is to respond to adolescent needs by offering services in a friendly manner in a non-threatening environment. Many adolescent concerns—especially reproductive and sexual health—may be difficult to discuss due to taboos. If the environment feels judgmental, scary, or unsafe, adolescents may avoid seeking care even when they need it. AFHS are designed to attract adolescents, meet their needs conveniently, and retain them for continuing care, which depends heavily on adolescents feeling respected and comfortable.

QWhat are the main health needs of adolescents listed in this chapter?

The chapter lists five major health needs of adolescents. These are: (1) nutritional needs, including concerns like undernutrition and anaemia; (2) reproductive and sexual health needs, including taboos, menstrual myths, HIV and other infections, early marriage and early pregnancy, and issues like harassment and abuse; (3) mental health concerns such as depression, mood disturbances, substance abuse, suicidal behaviour, eating disorders, aggression, and violence; (4) substance abuse involving tobacco, alcohol, and drugs; and (5) accidental injuries, especially road traffic injuries, drowning, and burns.

QWhat nutritional problems are common in adolescence according to the chapter?

The chapter notes that many boys and girls enter adolescence undernourished, which makes them more vulnerable to diseases. It highlights anaemia as a major problem using NFHS-3 findings: 56% of females and 25% of males in the 15–24 age group were anaemic. Anaemia can affect physical growth, cognitive development, and performance in school and later at work. The chapter stresses that adequate nutrition, healthy eating habits, and physical exercise during adolescence lay the foundation for good health in adulthood.

QHow does anaemia affect adolescents and their future according to the chapter?

According to the chapter, anaemia affects adolescents’ physical growth, cognitive development, and performance in school, and it can also affect work performance in later years. It also points out long-term impacts for women: anaemic women are more likely to give birth to malnourished children, and there can be significant illness and death associated with both mother and child. This is why meeting nutritional needs in adolescence is described as imperative, and why healthy eating habits and physical exercise are emphasised as foundations for adult health.

QWhy are sexual and reproductive health needs especially challenging for adolescents in society?

The chapter explains that adolescents face reproductive and sexual health problems but hesitate to seek information from authentic sources because such issues are considered taboo in society. This hesitation can increase the possibility of risky behaviour, which may lead to HIV and other sexually transmitted infections. The chapter also notes that adolescent girls suffer due to myths related to menstruation. In addition, problems like early marriage and early pregnancy continue in many areas, increasing health risks for young mothers and children and contributing to morbidity and mortality.

QWhat does the chapter say about HIV risk among young people?

The chapter states that there is a possibility of adolescents practicing risky behaviour and acquiring HIV and other sexually transmitted infections. It cites the National AIDS Control Organisation (NACO 2005), noting that almost 50% of new HIV infections are occurring in the 15–24 years age group. This highlights why adolescents need accurate information and supportive services. AFHS can contribute by offering counselling, diagnosis, and treatment-related facilities in a setting that adolescents find approachable and non-threatening.

QWhat myths or issues related to menstruation are mentioned, and why do they matter?

The chapter notes that adolescent girls suffer due to a number of myths related to menstruation. While it does not list the myths in detail, it clearly indicates that misinformation and social taboos create confusion and distress for girls. Because reproductive and sexual health topics are often considered taboo, adolescents may not seek authentic information. This can lead to poor health practices and anxiety. AFHS, with counselling and supportive care, are meant to provide reliable guidance in a friendly environment where adolescents can ask questions safely.

QHow is early marriage connected to adolescent health problems in the chapter?

The chapter describes early marriage as a serious problem in many parts of India. It explains that many adolescent girls—mostly married girls—become pregnant and give birth to children below the legal age of marriage, which is 18 years. It uses NFHS-3 data: 12% of married young women aged 15–19 have become mothers, and 4% are currently pregnant with their first child. Early pregnancy adversely affects the health of both mothers and children and contributes to illness and death.

QWhat NFHS-3 figures does the chapter provide about teenage pregnancy and childbirth?

The chapter provides specific NFHS-3 statistics about early childbearing among adolescents. It states that 12% of married young women aged 15–19 have become mothers, and 4% of women aged 15–19 are currently pregnant with their first child. It interprets this as meaning that one in six women in the age group 15–19 has begun childbearing. The chapter emphasises that early pregnancy negatively affects the health of both mothers and children and contributes to morbidity and mortality.

QWhat forms of violence and abuse affecting adolescents are mentioned in the chapter?

The chapter states that sexual harassment in public places, educational institutions, in and around neighbourhoods, and at workplaces is a well-established fact. It also notes that child abuse, bullying, and ragging are common, more so among boys. These experiences can harm both physical and mental health and may require sensitive support. The chapter highlights that effective and sensitive care of adolescent victims of violence is needed as a priority measure, showing why specialised adolescent-focused services are important.

QWhat mental health concerns are highlighted for adolescents?

The chapter estimates that at least 20% of youth experience some form of mental health problem. It lists examples such as depression, mood disturbances, substance abuse, suicidal behaviour, eating disorders, aggression, and violence. It also points out the seriousness of suicide among adolescents: among 15–19 year olds, suicide is described as the second leading cause of death, followed by violence in the family and community. These facts underline the need for sensitive counselling and care as part of adolescent-friendly services.

QWhat does the chapter say about suicide and violence among 15–19 year olds?

The chapter highlights suicide as a major concern, stating that among 15–19 year olds, suicide is the second leading cause of death. It adds that this is followed by violence in the family and community. Because of these risks, the chapter stresses that effective and sensitive care of adolescent victims of violence is needed as one of the priority measures. This connects directly to the purpose of AFHS, which include counselling and supportive care aimed at addressing serious mental health and safety issues.

QWhy is substance abuse an emerging concern among young people in this chapter?

The chapter describes tobacco and alcohol use among young people as emerging concerns and also mentions drug abuse. It notes that the projected number of drug abusers in India is about three million, with most in the 16–35 age group (UNODC, 2003). It also provides data on early exposure to cannabis and patterns of tobacco and alcohol use among 15–19 year olds. These trends show that risky substance use can begin during adolescence, making early prevention and counselling crucial.

QWhat does the chapter report about early cannabis exposure among young people?

The chapter cites findings (UNODC and Ministry of Social Justice and Empowerment, 2004) that nearly 11% of individuals were introduced to cannabis before the age of 15 years, and about 26% between the ages of 16–20 years. These figures indicate that exposure to drugs can begin quite early, even before mid-adolescence. This supports the chapter’s broader message that adolescents have specific vulnerabilities and concerns, and that adolescent-friendly health services should include prevention and counselling to address substance use risks.

QWhat NFHS-3 data does the chapter give about tobacco use among 15–19 year olds?

Using NFHS-3 findings, the chapter reports that in the 15–19 years age group, 3.5% of women and 28.6% of men were using some kind of tobacco. This large gender difference still indicates that tobacco use is present among both girls and boys. Because adolescence is a developmental stage, such habits can become long-term health risks. AFHS, with counselling and health education, can help adolescents understand harms and support healthier decisions in a non-threatening setting.

QWhat does the chapter say about alcohol use patterns in the 15–19 age group?

The chapter provides NFHS-3 data showing that in the 15–19 age group, 1% of women and 11% of men were consuming alcohol. It further states that 6.8% of women and 18.3% of men were drinking about once a week. These figures suggest that regular drinking exists among some adolescents, especially boys. Since substance use is linked to health risks and other harmful behaviours, adolescent-friendly services that offer counselling and education can play an important role in prevention and early support.

QWhich accidental injuries are most common among adolescents according to the chapter?

The chapter states that accidental injuries are a leading cause of death and disability in adolescents and that injury rates among adolescents are the highest. It identifies road traffic injuries, drowning, and burns as the most common types. The chapter also suggests that public education targeted at young people on avoiding injuries during driving and road use, as well as preventing drowning, burns, and falls, can reduce injury rates. This places injury prevention as an important adolescent health need.

QHow can education help reduce accidental injuries among adolescents?

According to the chapter, public education targeted at young people can reduce injuries by teaching how to avoid accidental injuries during driving and using the road, and by promoting awareness about drowning, burns, and falls. Since adolescents have the highest injury rates and accidental injuries are a leading cause of death and disability, learning safe behaviours is essential. While the chapter does not list detailed safety rules, it clearly supports prevention through awareness and guidance, which aligns with the preventive and promotive role of adolescent-friendly health services.

QWhy are existing health services often not enough for adolescent needs?

The chapter notes a common observation that existing health services do not cater to the specific problems of adolescents. Adolescents have unique concerns—nutritional issues like anaemia, sexual and reproductive health questions in a taboo environment, mental health challenges including suicidal behaviour, substance use, and high injury risk. Traditional services may not provide a welcoming space or tailored counselling for these topics. Therefore, it is a challenge for the health sector to respond adequately and offer services in a friendly, non-threatening environment designed for adolescents.

QHow are AFHS designed to improve service use by adolescents?

The chapter explains that adolescent-friendly health services are designed specifically to attract adolescents, meet their needs conveniently, and retain them for continuing care. This means AFHS are intended not just for one-time visits but for ongoing support when needed. AFHS provide preventive, promotive, and curative care and include diagnostics, treatment, counselling, and other health-related facilities. Because cost can be a barrier, the chapter also notes that these services are mostly government-run and offered free or at a very minimal charge.

QAre AFHS expensive, and who usually runs them?

The chapter states that AFHS are mostly run by the government. It also explains that in these services, diagnostic, treatment, counselling, and other health facilities are offered for free or at a very minimal charge. This low-cost or free structure is important because adolescents may not have independent income and may hesitate to involve adults for financial reasons. By reducing cost barriers and providing a specialised, friendly approach, AFHS aim to increase access and encourage adolescents to seek help for important health concerns.

QWhy does the chapter say adolescents are not a homogeneous group?

The chapter emphasises that adolescents are not a homogeneous (uniform) group because their situations vary by age, sex, marital status, class, region, and cultural context. These differences affect their health risks, their access to information, and whether they can use services comfortably. For example, married adolescent girls may face early pregnancy risks, while others may face different mental health or injury-related challenges. Because of this diversity, the chapter calls for interventions that are flexible and responsive so adolescent-friendly services can meet varied needs effectively.

QWhat is Activity 14.1 asking students to find out about AFHS?

Activity 14.1 asks students to talk to friends or classmates and prepare a report on adolescent-friendly health services. Specifically, it asks whether they are aware of AFHS and whether they have ever visited a place where such services are available. If they have visited, students should note their experience. If they have not visited, they should record the reasons for not going. This activity connects learning to real-life awareness and helps identify barriers that may prevent adolescents from using health services even when they are available.

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