A primary care approach for adolescent care and counseling services.

OBJECTIVE: Adolescents can have mental, emotional, and behavior problems that are a source of stress for the child as well as the family, school and community. These may disrupt the adolescent's ability to function normally. Adolescents also have reproductive concerns especially at menarche. Considering the extent of problems of adolescents and the lack of adolescent care and counseling services, it was felt that community adolescent care counseling services should be made available. This article describes the steps involved in the setting up of Taluk model of adolescent care and counseling services. METHODS: Following steps were involved in setting up a Taluk model of adolescent care counseling service delivery system. Step I: Focus Group Discussions (FGDs) among Stakeholders. Step II: Conceptualization and Strategy planning for service delivery. III: Finalization of service delivery model Step IV: Workshops for finalization of TSQ-T 2008 version the tool to be used for assessing the adolescents in the ARSH clinics. Step V: Training Programme for Medical/Paramedical health staff. Step VI: Awareness programs for mothers of adolescents. Step VII: Setting up of ACS/ARSH clinics at Taluk hospitals. Step VIII: Evaluation of the utilization of services at Taluk hospitals. The clinic has been well utilized with 1,588 adolescents being seen in 2 years. RESULTS: Medical and Reproductive problems among adolescent girls were anemia, underweight, dysmenorrhoea, menstrual irregularities and symptoms of Polycystic Ovarian Syndrome, whereas among boys problems were mostly related to concerns about masturbation and its perceived ill effects. The psychosocial problems ranged from minor anxieties, sadness and adjustment problems to psychiatric disorders. Scholastic problems included poor concentration, poor study habits and low intelligence quotient. CONCLUSIONS: The success of the clinics in these five hospitals can be replicated in other parts of the state as well as the country. These will go a long way to ameliorate the morbidity of adolescents.

Effectiveness of a community oral health awareness program.

OBJECTIVE: To evaluate the effectiveness of a community oral health awareness program given to mothers through trained community level workers (Junior Public Health Nurses (JPHNs) and Anganwadi workers (AWWs). METHODS: Oral health education materials were prepared based on the findings of a knowledge survey among community workers and mothers of children (0-6 years) in a selected block panchayat in Kerala. Using this material, classes were held for health workers and through them for the mothers. Post evaluation for both the groups was done using the same questionnaire. RESULTS: The post intervention survey among both the community workers and the mothers showed statistically significant improvement in knowledge regarding oral hygiene habits, importance of milk teeth, causes of dental diseases, prevention of dental diseases, and treatment of certain dental conditions. CONCLUSION: A community health awareness program has a positive effect on knowledge of community workers and thereby in the mothers. The feasibility of integrating oral health education in the existing primary healthcare activities needs to be explored.