1. THE OBSTETRICIAN AND
THE COMMUNITY
MINI SOOD

2. ROLE
1. Pediatric age-
2. Adolescent care
3. Reproductive age group
4. Delivery and postpartum
5. Contraceptive services
6. Menopausal care
7. Cancer screening
8. Care of elderly

3. CHALLENGES
• Family life education
• Making curriculum interesting
• Incorporation of life skills
• Involvement of teacher
• Sustainability
• Program for non school going girls
• Acceptance of adolescent leaders by the community
• Active role of young leaders in community
• Building new leaders

4. MAJOR PROBLEMS
1. Why women do not seek help for conditions in time?
Constraints such as financial, transport, abusive families, too many children to be taken care of.
Lack of adequate health care services
2. What are the main differences in women in the community as compared to women in urban areas?
Women in urban areas may be better educated or have an access to media and therefore be better
informed, more availability of health services

5. Scope of Health Services that can be offered
Girls
General health check-ups and referrals
(general examination, height, weight, BP)
Hemoglobin estimation
De-worming
Iron Folate supplementation (for 3 months)
3 doses of injection tetanus toxoid for
pregnant women
For married adolescents:
Contraceptive counseling and supply
(boys and girls)
ANC care at doorstep, breastfeeding
counseling, and spacing advice

6. • Boys
• General health check-ups and referrals
• Contraception counseling
• Protection from STI’S AND Early detection
• Protection from HIV
• Protection from drug abuse and substance abuse

7. Health Services Providers
Part-time doctors, nurses and
lab technicians hired by
the NGO partners.
Lady doctors for adolescent girls
Staff trained to do hemoglobin
estimation
Supplies of IFA tablets,
contraceptives and Inj. Tetanus
Toxoid.

8. The Adolescent-Friendly Reproductive Health
Services Project
(July 2001 – Dec 2002)
USAID-funded ENABLE Project helped to
Build the capacity of four NGO
partners
to effectively implement CEDPA’s BLP
using the Choose a Future! training
guide
for facilitators
Provide adolescent-friendly reproductive
health services to program participants

9. Strategies for Implementing the service provision
Long term approach (3-6 months):
services can be integrated into vocational
training
classes, remedial coaching classes,
recreational clubs, gym and sports clubs
Camp approach (10-14 days):
imparted through intensive training camps
of short duration
School approach:
imparted in the classroom where many
students can be reached out to.

10. Health Problems of Adolescents
Girls:
RTIs/STI’s
Concerns about
puberty and
menstruation
Contraception
Tuberculosis
Boys:
Substance/
alcohol abuse
Effects of
risky behaviors
Contraceptives
HIV/AIDS
Diseases identified:
Tuberculosis
RTIs
Skin diseases
Respiratory tract infections
Diarrhea
Refractive errors

11. Knowledge about Contraception
25.8 24.5
2.3
22.2
2.2
26.1
60.4
49.5
8.6
59.8
17.3
53.8
0
10
20
30
40
50
60
70
Condoms IUCD Injectables Sterilization Natural
methods
Condoms for
Dual
Protection
Percentage
Pre Prog
Post Prog

12. Knowledge of Ante Natal Care
30.8 30.6
25.4
17.7
56.2
51.7
49.2
33.4
0
10
20
30
40
50
60
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A
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Percentage
Pre Prog
Post Prog

13. LESSONS
LEARNED
• A health services component integrated into the
empowerment model results in significant
improvement in health status as well as impacts
on knowledge on issues related to health, RH, and
HIV/AIDS
• RH services should be provided to adolescents in
the context of general health services
• Services have to be brought to where the
adolescents lived or visited
• Getting qualified medical professionals and lab
technicians to go to the field was a challenge
• Maintaining a steady supply of IFA difficult

14. VOICES FROM
THE FIELD
• “Earlier I did not know whether I was of
‘normal’ shape or not. Now I know that
there is nothing abnormal in life, it is only
one’s perception”
• …adolescent girl
• “She who does not get married till 18,
is a fortunate one”
• …. adolescent girl
• “Before the training, we thought that
having nightfall and masturbating was
‘abnormal’. Now we know that these are
normal functions of the body”
…adolescent boy

15. OTHER CHANGES IN BELIEFS
“I spoke to my older sister-in-law about contraceptive methods; something I couldn’t think of doing earlier” ..
adolescent girl
“I shall share this information with my husband and then decide on what family planning method to adopt…..of
course, I shall discuss this with him only when he is in a good mood” …married adolescent girl
“This is the first time I saw a condom. Now I know how to use it too!”
…adolescent boy
“AIDS is just another disease; one should not hate the sick, but talk to him kindly and help him” …adolescent boy

16. FAMILY LIFE
EDUCATION
• Training workshop for teachers
• Family life education through schools
• Schools Target – grades 9th &
11th
• 30 hours curriculum to Impart
life skills
• Innovative ideas: Poster &
competition, Exhibitions
• Family life education at village level

17. ACTIVITIES
HIV/ AIDS: rally and workshops

18. METHODS AND GOALS
Activities
No Tobacco
Day
celebration

19. ACTIVITIES Slogans
Slogan competition

20. THANK YOU