Adolescent-Friendly Health Services in India: Bridging the Gap Between Policy and Practice

Abstract

Adolescents in India, comprising nearly one-fifth of the population, face a complex mix of health challenges spanning sexual and reproductive health, mental well-being, nutrition, substance use, non-communicable diseases, and injuries. Despite the introduction of dedicated policies such as the Adolescent Reproductive and Sexual Health strategy (2005) and the more holistic Rashtriya Kishor Swasthya Karyakram (2014), and the establishment of Adolescent-Friendly Health Clinics (AFHCs), a persistent gap remains between policy intent and actual service delivery. Evidence shows low awareness and utilization of AFHCs, particularly among boys, with access largely restricted to basic services like sanitary napkin distribution. Structural and human resource deficiencies, including lack of privacy, inadequate infrastructure, and insufficiently trained or sensitized providers, further deter adolescents from seeking care. Regional disparities are stark, with some states demonstrating well-functioning models while others struggle to establish even basic facilities. Stigma, around sexual health, menstruation, and mental health, remains a major barrier, silencing adolescents and pushing them toward unreliable sources of information. Policy evaluations suggest that solutions lie less in creating new frameworks than in strengthening existing ones through better training, accountability, and adolescent engagement. Expanding the role of peer educators, ensuring privacy and confidentiality in every clinic, and involving adolescents in governance are critical steps toward improving trust and utilization. Equally important is engaging schools, families, and communities to normalize health discussions and reduce stigma. Testimonies from adolescents highlight that respectful, confidential, and non-judgmental services are valued more than the mere availability of clinics or staff. India stands at a crossroads where adolescent health must be reframed as a societal investment rather than a programmatic obligation. By embedding equity, confidentiality, and youth participation at the core of implementation, India can convert its policy commitments into tangible outcomes, ensuring that adolescents grow into healthier, empowered adults and laying a stronger foundation for national progress.