Evaluating the implementation of the Peer Educator Intervention for improving adolescent health in India's National Adolescent Health Programme
Lead Research Organisation:
Public Health Foundation of India
Department Name: Grants Administration
Abstract
India is home to 243 million adolescents, yet there is a lack of data on several health indicators and no national data on current levels of knowledge, perceptions and practices of adolescents. In 2014, the Ministry of Health and Family Welfare (MOHFW), Government of India (GOI) launched a comprehensive National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK), to emphasize on community-based health promotion and strengthening preventive, diagnostic and curative service across health system related to 6 strategic priorities. RKSK interventions, which include a Peer Educator (PE) Programme component, are being implemented in a phased manner; the first phase targets 213 selected High Priority Districts in 28 states of India. The PE programme, rolling out in 2016, is designed to provide life-skills, increase knowledge and awareness among PEs and adolescents of: their needs under six strategic priorities and the availability of services and care at Adolescent Friendly Health Clinics (AFHC), which should lead to increased adolescents' attendance at AFHCs.
The proposed research aims to undertake impact and process evaluation of PE Intervention in 2 selected States of India. This implementation research will focus on evaluating impact and process of implementing PE programme. Process evaluation will aid in understanding implementation, causal mechanisms and the factors that shape desired outcomes. Surveys will study equitable coverage and implementation cost of PE intervention and these data will be summed up to develop vertical and horizontal scale up strategy to expand PE intervention at National and regional level. The outcomes of this implementation research will provide vital insights on effective components, processes and context that maximize the potential of PE Intervention and that need to be scaled up at all India level. They will also inform the field of implementation science for adolescent health and fill the evidence gap of 'What works in PE intervention-for whom, why and under what circumstances'?
Project aims:
1) Evaluate the Process of PE intervention to understand implementation, causal mechanisms and context of the PE programme of the RKSK in two Indian states.
2) Evaluate the effect of the PE intervention on primary outcomes at adolescent (knowledge, attitudes, life skills, practices) and parental levels (attitudes, communication skills) and impacts on PE (leadership and communication skills) and on AFHCS (trends in attendance numbers).
3) Provide specific guidance to MoHFW, GOI, and more generic guidance to other countries, on modifying, scaling up and sustaining the PE intervention.
This project aim has 2 sub questions:
i.What were the costs of implementing the PE intervention and how did costs associate with the quality of the intervention and its outcomes?
ii.What PE intervention components need to be prioritised for horizontal and vertical scale up at state and national level?
The evaluation will be guided by MRC's framework for conducting process evaluations. A mixed-methods design will be used to investigate implementation, mechanisms of impact and context and to assess impact of this intervention. Data will be collected through adolescent, PE and parent surveys, process measures and qualitative data collection methods along with routine RKSK data. The outcomes of the study will be presented at state scale up, national and regional dissemination workshops to various stakeholders including researchers, public health practitioners, programme managers, academicians, policy makers and state-level programme functionaries to highlight barriers to be addressed as well as opportunistic use of enablers in various settings to reach desired adolescent health outcomes. Apart from its applicability in India, the outcomes will be of relevance to other countries in the South East Asia Region, as several are adopting the GOI's RKSK framework to design their adolescent health programmes.
The proposed research aims to undertake impact and process evaluation of PE Intervention in 2 selected States of India. This implementation research will focus on evaluating impact and process of implementing PE programme. Process evaluation will aid in understanding implementation, causal mechanisms and the factors that shape desired outcomes. Surveys will study equitable coverage and implementation cost of PE intervention and these data will be summed up to develop vertical and horizontal scale up strategy to expand PE intervention at National and regional level. The outcomes of this implementation research will provide vital insights on effective components, processes and context that maximize the potential of PE Intervention and that need to be scaled up at all India level. They will also inform the field of implementation science for adolescent health and fill the evidence gap of 'What works in PE intervention-for whom, why and under what circumstances'?
Project aims:
1) Evaluate the Process of PE intervention to understand implementation, causal mechanisms and context of the PE programme of the RKSK in two Indian states.
2) Evaluate the effect of the PE intervention on primary outcomes at adolescent (knowledge, attitudes, life skills, practices) and parental levels (attitudes, communication skills) and impacts on PE (leadership and communication skills) and on AFHCS (trends in attendance numbers).
3) Provide specific guidance to MoHFW, GOI, and more generic guidance to other countries, on modifying, scaling up and sustaining the PE intervention.
This project aim has 2 sub questions:
i.What were the costs of implementing the PE intervention and how did costs associate with the quality of the intervention and its outcomes?
ii.What PE intervention components need to be prioritised for horizontal and vertical scale up at state and national level?
The evaluation will be guided by MRC's framework for conducting process evaluations. A mixed-methods design will be used to investigate implementation, mechanisms of impact and context and to assess impact of this intervention. Data will be collected through adolescent, PE and parent surveys, process measures and qualitative data collection methods along with routine RKSK data. The outcomes of the study will be presented at state scale up, national and regional dissemination workshops to various stakeholders including researchers, public health practitioners, programme managers, academicians, policy makers and state-level programme functionaries to highlight barriers to be addressed as well as opportunistic use of enablers in various settings to reach desired adolescent health outcomes. Apart from its applicability in India, the outcomes will be of relevance to other countries in the South East Asia Region, as several are adopting the GOI's RKSK framework to design their adolescent health programmes.
Technical Summary
India is home to 243 million adolescents, yet they remain an understudied population in India with lack of data on the health indicators for this age group and current levels of knowledge on adolescent health issues and effective approaches on reaching marginalized adolescents. In 2014, the Ministry of Health and Family Welfare (MOHFW), Government of India launched a comprehensive National Adolescent Health Programme (Rashtriya Kishor Swasthya Karyakram-RKSK), to emphasize on community-based health promotion and strengthening preventive, diagnostic and curative service across health system related to 6 strategic health priorities. RKSK includes a peer educator (PE) programme, which seeks to ensure that adolescents benefit from sustained peer education and is expected to improve knowledge, attitudes and life skills of adolescents. The PE programme is also expected to change parental and community norms towards the need for adolescent friendly health services, leading to increased attendance to Adolescent Friendly Health Clinics (AFHCs) and subsequently positive adolescent health outcomes. This study will evaluate the impact and process of PE intervention as an integrated component of the RKSK and also explore its interaction with other RKSK components. It will further undertake economic analysis of costs related to implementing PE intervention for guiding scale up. This implementation research will be conducted in 4 high priority districts of 2 Indian states (2 each in Madhya Pradesh & Andhra Pradesh). Mixed methods approach will evaluate the process of the PE programme and its effects on primary outcomes at the adolescent (knowledge, attitudes, life skills, practices) and parental (attitudes, communication) levels as well as impact on PE skills and attendance at AFHCs. The research project also aims to provide guidance to MoHFW on modifying, scaling up and sustaining the PE programme and share findings with countries adapting RKSK.
Planned Impact
This study will evaluate the implementation of the Peer Educator programme under India's National Adolescent Health Programme - Rashtriya Kishor Swasthya Karyakram (RKSK) through feedback on quality improvement, delivery costs, health seeking behavior outcomes and issues of equity. Since the Ministry of Health and Family Welfare (MoHFW), Government of India (GOI) is implementing RKSK, which is an evolving programme, and is implementing partner on this research, the outcomes of this research is expected to provide a basis for MOHFW to develop a National Scale up strategy for improved PE programme within RKSK, to reach a larger number of adolescents, more equitably and in a sustainable manner. It will further provide a more generic guidance to other countries, on modifying, scaling up and sustaining the PE intervention.
The timelines of this study coincide with the roll out of the PE programme under RKSK in 2016 and provides an excellent opportunity to assess the PE programme to provide important lessons for decision makers in India and similar interventions in other low-and middle-income countries.
MoHFW-GOI has been involved in these research discussions from the inception of this study. As a partner in this research, they will also be ultimate users of research outcomes. Vertical and horizontal scale up strategy developed as part of this study will be easily adopted by government for expanding PE programme in other non RKSK districts and remaining states of India. Principal Investigators of this study are appropriately positioned as members of MoHFW's Technical Review Group (TRG) for RKSK to disseminate outcomes of this research with other experts on the TRG and will work with the government for any proposed midcourse corrections necessary for RKSK scale up.
This evaluation provides a unique opportunity to understand impact of peer educators beyond its traditional utilization in the area of sexual and reproductive health to broader issues for adolescent health as enlisted under RKSK priorities and to understand interactions of PE intervention with other components of RKSK. Given that the PE programme under RKSK is a community-based intervention led by adolescents and intended for adolescents, the proposed research will assess adolescents as both beneficiaries and implementers. Therefore, the project will offer relevant community engagement and involve the intended beneficiaries on both the community and systems ends. To maximize the impact of PE intervention, a Community Advisory Board (CAB) at each study site will be formed. CAB will include adolescents, PEs, parents and community members, to ensure smooth implementation of intervention, enhance acceptance of RKSK and AFHCs and aid in scale up of PE intervention.
The results and outcomes of this implementation research will also be disseminated to multiple stakeholders including the participants of this study, public health scientists and practitioners, programme managers, academicians, policy makers and state-level programme functionaries. The outcomes of this research are expected to inform global adolescent health science and provide evidence informed programme and policy recommendations for improving adolescent health.
The timelines of this study coincide with the roll out of the PE programme under RKSK in 2016 and provides an excellent opportunity to assess the PE programme to provide important lessons for decision makers in India and similar interventions in other low-and middle-income countries.
MoHFW-GOI has been involved in these research discussions from the inception of this study. As a partner in this research, they will also be ultimate users of research outcomes. Vertical and horizontal scale up strategy developed as part of this study will be easily adopted by government for expanding PE programme in other non RKSK districts and remaining states of India. Principal Investigators of this study are appropriately positioned as members of MoHFW's Technical Review Group (TRG) for RKSK to disseminate outcomes of this research with other experts on the TRG and will work with the government for any proposed midcourse corrections necessary for RKSK scale up.
This evaluation provides a unique opportunity to understand impact of peer educators beyond its traditional utilization in the area of sexual and reproductive health to broader issues for adolescent health as enlisted under RKSK priorities and to understand interactions of PE intervention with other components of RKSK. Given that the PE programme under RKSK is a community-based intervention led by adolescents and intended for adolescents, the proposed research will assess adolescents as both beneficiaries and implementers. Therefore, the project will offer relevant community engagement and involve the intended beneficiaries on both the community and systems ends. To maximize the impact of PE intervention, a Community Advisory Board (CAB) at each study site will be formed. CAB will include adolescents, PEs, parents and community members, to ensure smooth implementation of intervention, enhance acceptance of RKSK and AFHCs and aid in scale up of PE intervention.
The results and outcomes of this implementation research will also be disseminated to multiple stakeholders including the participants of this study, public health scientists and practitioners, programme managers, academicians, policy makers and state-level programme functionaries. The outcomes of this research are expected to inform global adolescent health science and provide evidence informed programme and policy recommendations for improving adolescent health.
Publications
Amanda Mason-Jones
(2017)
Peer-based interventions to improve adolescent health: an overview of systematic reviews.
in PROSPERO
Bahl D
(2023)
Adolescent Friendly Health Clinics (AFHCS) in India and their compliance with government benchmarks: A scoping review
in F1000Research
Bahl D
(2023)
Adolescent Friendly Health Clinics (AFHCS) in India and their compliance with government benchmarks: A scoping review
in F1000Research
Deepika Bahl
(2021)
Observer research foundation (ORF)
| Description | Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Contribution to a national consultation/review |
| Description | National level Training of State Master Trainers on Rashtriya Kishor Swasthya Karyakram (RKSK) |
| Geographic Reach | National |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Description | Planning Group to synthesize a research and programming involving Very Young Adolescents (VYA) |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Contribution to a national consultation/review |
| Description | State Level Dissemination and Validation Workshop |
| Geographic Reach | National |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | The study identified the need to provide audio-visual resources to peer educators for conducting sessions with adolescents on Sexual and Reproductive Health issues and other issues, they were not confident and comfortable in handling in a group setting including, child marriage, teenage pregnancy, menstruation, nightfall, etc. It was also highlighted that the non-standardized training of PEs and deviation from the prescribed number of days and timings of training as well as sequencing of health themes adversely impacted PE learning. Additionally, lack of printed resources/materials made available to PEs hindered the effective implementation of sessions by PEs with adolescents, especially on sensitive topics like SRH were also identified as other challenges through this research award. The state level dissemination and validation workshop provided an opportunity to communicate the findings of this research award to the highest level of the decision-making at the centre (i.e Ministry of Health and Family Welfare-Government of India) and State (State Family Welfare Bureau, Pune) for relevant changes for strengthening the programme implementation. All the high-level dignitaries in the government agreed with the study recommendations. |
| Title | i-Saathiya |
| Description | The research design is a mixed methods cross-sectional study involving range of methods including process evaluation, qualitative methods (Focus Group Discussions with adolescents, In-depth interviews with ASHA, ASHA facilitator, Peer Educators, Parent of Peer Educators, Parents of Adolescents, School teachers, AFHC Counsellors, Medical Officer, NGO representative, NGO mentor, Faculty Training, structured observations of Peer Educator Trainings, Peer Educator sessions, Adolescent Friendly Club meetings, Adolescent Friendly Health Clinics, Adolescent Health and Wellness days), Out of Pocket Expenditure Survey for Parents of Adolescents and cross-sectional survey with PEs and adolescents to: describe the process of implementation, and context of PE programme during COVID-19; assess PE engagement during COVID-19 pandemic, access to community activities and health services by adolescents during the pandemic; understand resource use and implementation cost of peer educator programme and whether there are any changes in costs of implementation of PE during COVID-19. |
| Type Of Material | Improvements to research infrastructure |
| Year Produced | 2021 |
| Provided To Others? | No |
| Impact | The findings from the situational analysis conducted in both the study states revealed interesting insights about Peer Educators' engagement to meet adolescents' needs during COVID-19. Hence, our situational analysis publication emphasized the need of institutionalizing PEs as other frontline workforce. The research focuses on studying implementation of the PE programme and adaptations undertaken in COVID-19 context in the two study states. The study findings would also help to understand engagement of PEs during COVID-19 pandemic for meeting the needs of adolescents and adolescents' response to PE engagement in community activities (Footfall in AHDs) and accessing the health services (footfall in AFHCs). The research would also help to understand the knowledge and practices of the adolescents and PEs related to six themes of RKSK and COVID-19 information in both study districts. |
| Title | i-Saathiya |
| Description | The research design is a mixed methods cross-sectional study involving range of methods including process evaluation, qualitative methods (Focus Group Discussions with adolescents, In-depth interviews with ASHA, ASHA facilitator, Peer Educators, Parent of Peer Educators, Parents of Adolescents, School teachers, AFHC Counsellors, Medical Officer, NGO representative, NGO mentor, Faculty Training, structured observations of Peer Educator Trainings, Peer Educator sessions, Adolescent Friendly Club meetings, Adolescent Friendly Health Clinics, Adolescent Health and Wellness days), Out of Pocket Expenditure Survey for Parents of Adolescents and cross-sectional survey with PEs and adolescents to: describe the process of implementation, and context of PE programme during COVID-19; assess PE engagement during COVID-19 pandemic, access to community activities and health services by adolescents during the pandemic; understand resource use and implementation cost of peer educator programme and whether there are any changes in costs of implementation of PE during COVID-19. |
| Type Of Material | Improvements to research infrastructure |
| Year Produced | 2021 |
| Provided To Others? | No |
| Impact | The findings from the situational analysis conducted in both the study states revealed interesting insights about Peer Educators' engagement to meet adolescents' needs during COVID-19. Hence, our situational analysis publication emphasized the need of institutionalising PEs as other frontline workforce. The research focuses on studying implementation of the PE programme and adaptations undertaken in COVID-19 context in the two study states. The study findings would also help to understand engagement of PEs during COVID-19 pandemic for meeting the needs of adolescents and adolescents' response to PE engagement in community activities (Footfall in AHDs) and accessing the health services (footfall in AFHCs). The research would also help to understand the knowledge and practices of the adolescents and PEs related to six themes of RKSK and COVID-19 information in both study districts. The study identified the need to provide Audio-visual resources to PEs for conducting sessions with adolescents on Sexual and Reproductive Health issues and other issues, they were not confident and comfortable in handling in a group setting including child marriage, teenage pregnancy, menstruation, nightfall, etc. Hence, PEs and adolescents can be engaged meaningful in the co-creation of resources like digital modules to build ownership and retain the interest of PEs and adolescents in the programme activities as well as to address the hesitancy of parents. |
| Description | Collaborations and partnerships were established for implementing this study in two Indian states (Maharashtra and Madhya Pradesh) with Public Health Foundation of India (PHFI), Indian Institute of Public Health- Bhubaneswar, Ministry of Health and Family Welfare-Government of India (MoHFW-GoI), National Health Mission, Directorate of Health Services, Madhya Pradesh, State Family Welfare Bureau Pune, Government of Maharashtra and University of York, UK |
| Organisation | Government of India |
| Department | Ministry of Health and Family Welfare |
| Country | India |
| Sector | Public |
| PI Contribution | The study involves a multi-disciplinary team of established public health researchers and epidemiologists from India and UK, who are research active, with expertise in epidemiology, implementation science, Adolescent health, health economics and social sciences. Dr Amanda J. Mason-Jones, co-investigator from the University of York on this study and a member of the Independent Project Steering Committee (IPSC). She is guiding the Overview of Systematic Review component of the study, including: Training study team on data extraction, quality assessment, inputs on SR protocol and supervising the MPH student from the University of York and the team member from PHFI (Ms. Tina Rawal, voluntary contribution) for conducting the overview of a systematic review and writing overview manuscripts. She led the development of a manuscript from the Overview of Systematic Review component entitled "Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews" which was submitted to the Journal of Adolescent Health and is currently under review. The development of the second manuscript from this review entitled "Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews" is in progress. Dr. Stefanie Dringus is guiding the qualitative component of the study and also contributing to manuscript writing from the qualitative study component. Dr. Ambarish Dutta, Additional Professor - Epidemiology at the Indian Institute of Public Health, Bhubaneswar is leading the quantitative component of the study and Dr Sarit Kumar Rout, Additional Professor at Indian Institute of Public Health, Bhubaneswar is leading the cost component of the study. Dr. Dutta and Dr. Rout are also contributing to the manuscript writing from the study components they are leading. Dr. Monika Arora as PI has been guiding overall research conduction, ethics approvals and coordinating with lead of all research questions as advised by the IPSC. She has led development of research protocols, analysis plan and finalized manuscripts being written by research teams currently. The study also helped to build the capacity of young researchers (Ms. Heeya Maity, Ms. Gayatri Naik, Ms. Priya Amrit). Under the guidance of PI (Dr. Monika Arora) and other senior team members and investigators on this study( Ms. Shalini Bassi, Senior Research Scientist at PHFI and Project Manager on this grant and Dr. Deepika Bahl, Senior Research Associate at PHFI and Qualitative Researcher on this study), they have been involved in the development of study tools, undertaking review of literature, conducting structured observations, quantitative surveys with adolescents, Peer Educators and parents, conducting indepth interviews with RKSK stakeholders. They were also trained to collect data virtually during the pandemic period and are also contributing to data analysis and manuscript writing. Ms. Tina Rawal was trained in Systematic Review as part of this study. Other partnership activities Dr. Monika Arora, Ms. Shalini Bassi and Dr. Deepika Bahl are the Resource Faculty for training the State Master Trainers on Rashtriya Kishor Swasthya Karyakram (RKSK), being organized by the Ministry of Health and Family Welfare-Government of India. These training sessions were held for the Master Trainers i.e Medical Officers and Counsellors from the RKSK programme to improve availability of Adolescent Friendly Services (AFHCs) across the country. During these training sessions, Dr. Monika Arora and Dr. Deepika Bahl led the sessions on Substance Misuse, Non-Communicable Diseases and Ms. Shalini Bassi on Prevention and Management of Non-Communicable Diseases risk factors, the key thematic areas of RKSK. Ms. Shalini Bassi is also a Master Trainer for National and State Resource Group (SRG and NRG) on School Health Program under Ayushman Bharat organized by Ministry of Health and Family Welfare and the Ministry of HRD, Government of India. She led the session on Prevention and Management of Substance Misuse. Ms. Shalini Bassi and Dr. Deepika Bahl (member of study team) under the guidance of Dr. Monika Arora, contributed for a Review. The objective of this study was to review the overall planning, implementation and monitoring of adolescent and school health programmes currently implemented in India and determine if they are in alignment with the indicators for achieving universal health coverage for adolescents in India. This was published in BMJ Open (Jain N, Bahl D, Mehta R, et al. Progress and challenges in implementing adolescent and school health programmes in India: a rapid review BMJ Open 2022; 12: e047435. doi: 10.1136/bmjopen-2020-047435). Dr. Monika Arora, Dr. Deepika Bahl and Ms. Shalini Bassi also undertook a Scoping Review on Adolescent Friendly Health Clinics (AFHCs) to understand the status of the AFHCs in India and compliance of these AFHCs with the benchmark proposed by the Ministry of Health and Family Welfare-Government of India (MoHFW-GoI) under India's National Adolescent Health Programme (i.e Rashtriya Kishor Swasthya Karyakram). This review has been accepted for publication in F1000 Research. Dr. Monika Arora shared the learnings from this study during the 1st Asian Congress on Adolescent Health ADOLESCON 2022 held in November 2022 with the larger Pediatric community and adolescent health practitioners from all over India and Asia. Based on the study findings, she presented the recommendations to develop evidence-based policy positions for health promotion among adolescents, in order to prioritise Adolescent Health at all levels, for the Pediatricians and Associations. During the Implementation Science and Research Methodology workshop organized for mid-career medical researchers from academic institutions, Dr. Monika Arora shared the research design and process evaluation framework of this ongoing research with the workshop participants during her session entitled "Stakeholder engagement and community-based participatory approaches". The workshop was organized collaboratively by Indian Society for Clinical Research (ISCR), Christian Medical College (Ludhiana), PHFI and St. John's Medical College and Research Institute (Bengaluru). The Government of India has developed (piloting phase) a mobile based App for peer educators to maintain the programme records (number of sessions conducted with adolescents by peer educators, themes on which session was undertaken, number of adolescents attended the session, number of adolescents referred to health facility like AFHCs and health and Wellness Centre). In this regard, a workshop was organized by Ministry of Health and Family Welfare-Government of India to roll out this App in selected states and districts of India. Ms. Shalini Bassi and Dr. Deepika Bahl also participated in this workshop and shared the evidence from the field for this new intervention being developed and also offered PHFI's support to evaluate the feasibility and acceptability of this app under the current award in the study states and districts. |
| Collaborator Contribution | A key element of this study is that the PHFI collaborated with MoHFW-GoI (as an implementation partner) right from the inception of this research study. The focus on studying Rashtriya Kishor Swasthya Karyakram's (RKSK's, India's National Adolescent Health Programme) Peer Educator (PE) program is at their expressed request. MoHFW-GOI and the State Health Departments (Madhya Pradesh and Maharashtra) are providing continuous leadership and guidance to this study, further reiterating the government's commitment at all levels to this evaluation. There has been continuous communication between PHFI, MoHFW (at Centre), State health departments for the implementation of the study activities as well as dissemination of the study findings. Representation from State Health Department and District RKSK officials during the training workshops organized for training the data collection teams to collect the qualitative and quantitative study data. The state health department and District RKSK officials and NGO implementing the PE Programme (in case of Madhya Pradesh) facilitated the qualitative, quantitative and routine RKSK programme data collection in four study districts. The list of villages, Peer Educators and Adolescents were sampled in their consultation. The District RKSK teams also shared the implementation plan for conducting the structured observations by the PHFI study team. The visits for conducting the structured observations of Peer Educator trainings, Peer Educator sessions, Adolescent Health, Wellness Day and Adolescent Friendly Club meetings and Adolescent Friendly Health Clinics were made in consultation with state and district RKSK teams. A meeting was also held with the Deputy Commissioner-Ministry of Health and Family Welfare-Government of India and Adolescent Health team to discuss the study findings, successes, identified gaps as well as provided recommendations for strengthening the implementation and scale-up of PE programme. As part of the dissemination component of the study, a one-day State Level Dissemination and Validation Workshop was held in Pune (Maharashtra) on 10th January 2023. This multi-stakeholder event engaged the participation of 60 stakeholders, including senior officials from the Ministry of Health and Family Welfare-Government of India, State Family Welfare Bureau, Pune and RKSK stakeholders from district, block and village levels. The discussions during the workshop provided an opportunity to present the study findings by the PHFI study team and deliberated with the Peer Educators, Frontline Health workers and other programme implementers on challenges and opportunities as identified through the i-Saathiya study. - The workshop provided an opportunity to communicate the findings of this research award to the highest level of the decision making at the centre (i.e Ministry of Health and Family Welfare-Government of India) and State (State Family Welfare Bureau, Pune) for relevant changes for strengthening the programme implementation. - All the high-level dignitaries in the government agreed with the study recommendations. - The workshop also provided an opportunity for the Peer Educators and adolescents to share their experiences, learnings and challenges with the PE programme and highlighted their contributions in COVID-19 pandemic response activities. - The discussions also explained reasons for successes, identified activities, and approaches for scale-up of PE programme in other non-RKSK districts in the state of Maharashtra and for consideration as best practice at the National level. The state-level workshop for Madhya Pradesh is yet to be scheduled in March 2023, in consultation with the National Health Mission-Madhya Pradesh. The National Level workshop will be organized in consultation with the Ministry of Health and Family Welfare-Government of India that will encompass recommendations from state-level dissemination and validation workshops. The national-level workshop will provide evidence for strengthening the Peer Education program at the state level for program implementation in other districts and learning from the states that can be taken at the national level to scale up the program. The Independent Project Steering Committee (IPSC) formulated as part of this study is providing continuous guidance to the research activities. This Committee includes independent academic members, representatives from senior officials from the Adolescent Health Division-MoHFW, GoI, adolescent health experts and key investigators from the study team. Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The manuscript titled "Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis" published in PLOS One was jointly developed by the Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators. |
| Impact | These outputs are the result of multi-disciplinary collaboration. o Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The IPSC Committee is a multi-disciplinary expert team, having membership from independent academic members (Prof. Robert Blum, Prof. David Ross and Dr. Harish K Pemde), representatives from senior official from the Adolescent Health Division-MoHFW, GoI (Dr. Zoya Rizvi), adolescent health experts (Prof. Vikram Patel) and key investigators from the study team (Dr. Monika Arora, Dr. Amanda J. Mason-Jones). o The multi-disciplinary study team from India and UK contributed for the development of study tools under the guidance of Principal Investigator (Dr. Monika Arora), who is an adolescent health expert. These included: 1) quantitative study tools (Survey for Peer Educators, Survey for Adolescents, Out of Pocket Expenditure Survey for Parents of Adolescents); 2) qualitative tools (Indepth interview guide for: ASHA, ASHA facilitator, Peer Educators, Parent of Peer Educators, Parents of Adolescents, School teachers, AFHC Counsellors, Medical Officer, NGO representative, NGO mentor, Faculty Training and Focus Group Discussion guide for Adolescents and structured observation checklists: Peer Educator Trainings, Peer Educator sessions, Adolescent Friendly Club meetings, Adolescent Friendly Health Clinics, Adolescent Health and Wellness days). The team members from India and UK extensively contributed to the development of these study tools and protocols: Dr. Stefanie Dringus (Global Health Consultant), Ms. Shalini Bassi (Nutritionist and public health researcher), Dr. Deepika Bahl (Nutritionist and public health researcher), Ms. Heeya Maity (young public health researcher), Dr. Smritima Lama (health researcher) contributed for the development of qualitative guides and structured observation checklists. Dr. Ambarish Dutta (Epidemiologist), Dr. Amanda J. Mason-Jones (public health specialist and epidemiologist), Dr. Deepika Bahl, Ms. Shalini Bassi, Ms. Heeya Maity contributed for the development of household level surveys for Peer Educators and Adolescents. Dr Sarit Kumar Rout (Health Economist) led the development of Out of Pocket Expenditure Survey for administration with parents of Adolescents. He was facilitated by Ms. Priya Amrit, who is a young researcher. The State level dissemination and validation workshop report developed and submitted to the MoHFW-GOI, State Family Welfare Bureau (SHFW) and IPSC is also an output of joint collaboration. The collaboration has resulted in a list of manuscripts that have either been published or are planned for publication in peer-reviewed journals, aiming to widely disseminate the findings of the study. Published Manuscripts 1. Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis was jointly developed by Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators and published in PLoS One (https://pubmed.ncbi.nlm.nih.gov/36129932/). 2. Amanda Mason-Jones, Marlon Freeman, Tina Rawal, Shalini Bassi, Theo Lorenc, Monika Arora. Peer-based interventions to improve adolescent health: an overview of systematic reviews. PROSPERO 2017 CRD42017076290 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017076290. 3. Bahl D, Bassi S, Arora M. The Impact of COVID-19 on children and adolescents: Early evidence in India. ORF Issue Brief No. 448, March 2021, Observer Research Foundation. Available at: https://www.orfonline.org/research/the-impact-of-covid-19-on-children-and-adolescents-early-evidence-in-india. 4. Bahl D, Bassi S, Manna S, Arora M. Adolescent Friendly Health Clinics (AFHCS) In India and its Compliance with Benchmarks: A Scoping review. (Accepted for publication in F1000 Research) Manuscripts under review 5. Amanda J. Mason-Jones, Marlon Freeman, Theo Lorenc, Tina Rawal, Shalini Bassi, Monika Arora. Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews (Under Review, Journal of Adolescent Health). 6. Gayatri Nayak, Deepika Bahl, Shalini Bassi, Heeya Meity, Amanda Mason-Jones, Stefanie Dringus, Monika Arora, Ambarish Dutta. Knowledge, Attitudes and Practices of the adolescents and PEs to various components of RKSK: Findings from a cross-sectional survey. Submitted to International Journal of Adolescent Medicine and Health. (Submitted in BMC Public Health). Manuscripts in the offing 7. Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews. 8. Do adolescents spend anything from their pocket to access health care services? Evidence from India. 9. Compliance of Adolescent Friendly Health Clinics (AFHCs) with National and International Standards 10. Role of peer educators from India's National Adolescent Health Programme for the COVID-19 pandemic response 11. Cost of providing RKSK services and its variations across districts of India 12. The dose-response relationship between peer-educator engagement and knowledge and practices of the adolescents of India, a report from two states 13. Delivery of PE programme during COVID-19 pandemic in Government and NGO led implementation model: Successes and Challenges 14. Impact of PE programme in improving Adolescent health and well-being 15. Identifying challenges in implementing PE programme in Adolescent Health and solutions for scale-up |
| Start Year | 2020 |
| Description | Collaborations and partnerships were established for implementing this study in two Indian states (Maharashtra and Madhya Pradesh) with Public Health Foundation of India (PHFI), Indian Institute of Public Health- Bhubaneswar, Ministry of Health and Family Welfare-Government of India (MoHFW-GoI), National Health Mission, Directorate of Health Services, Madhya Pradesh, State Family Welfare Bureau Pune, Government of Maharashtra and University of York, UK |
| Organisation | Government of India |
| Department | National Health Mission, Madhya Pradesh |
| Country | India |
| Sector | Public |
| PI Contribution | The study involves a multi-disciplinary team of established public health researchers and epidemiologists from India and UK, who are research active, with expertise in epidemiology, implementation science, Adolescent health, health economics and social sciences. Dr Amanda J. Mason-Jones, co-investigator from the University of York on this study and a member of the Independent Project Steering Committee (IPSC). She is guiding the Overview of Systematic Review component of the study, including: Training study team on data extraction, quality assessment, inputs on SR protocol and supervising the MPH student from the University of York and the team member from PHFI (Ms. Tina Rawal, voluntary contribution) for conducting the overview of a systematic review and writing overview manuscripts. She led the development of a manuscript from the Overview of Systematic Review component entitled "Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews" which was submitted to the Journal of Adolescent Health and is currently under review. The development of the second manuscript from this review entitled "Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews" is in progress. Dr. Stefanie Dringus is guiding the qualitative component of the study and also contributing to manuscript writing from the qualitative study component. Dr. Ambarish Dutta, Additional Professor - Epidemiology at the Indian Institute of Public Health, Bhubaneswar is leading the quantitative component of the study and Dr Sarit Kumar Rout, Additional Professor at Indian Institute of Public Health, Bhubaneswar is leading the cost component of the study. Dr. Dutta and Dr. Rout are also contributing to the manuscript writing from the study components they are leading. Dr. Monika Arora as PI has been guiding overall research conduction, ethics approvals and coordinating with lead of all research questions as advised by the IPSC. She has led development of research protocols, analysis plan and finalized manuscripts being written by research teams currently. The study also helped to build the capacity of young researchers (Ms. Heeya Maity, Ms. Gayatri Naik, Ms. Priya Amrit). Under the guidance of PI (Dr. Monika Arora) and other senior team members and investigators on this study( Ms. Shalini Bassi, Senior Research Scientist at PHFI and Project Manager on this grant and Dr. Deepika Bahl, Senior Research Associate at PHFI and Qualitative Researcher on this study), they have been involved in the development of study tools, undertaking review of literature, conducting structured observations, quantitative surveys with adolescents, Peer Educators and parents, conducting indepth interviews with RKSK stakeholders. They were also trained to collect data virtually during the pandemic period and are also contributing to data analysis and manuscript writing. Ms. Tina Rawal was trained in Systematic Review as part of this study. Other partnership activities Dr. Monika Arora, Ms. Shalini Bassi and Dr. Deepika Bahl are the Resource Faculty for training the State Master Trainers on Rashtriya Kishor Swasthya Karyakram (RKSK), being organized by the Ministry of Health and Family Welfare-Government of India. These training sessions were held for the Master Trainers i.e Medical Officers and Counsellors from the RKSK programme to improve availability of Adolescent Friendly Services (AFHCs) across the country. During these training sessions, Dr. Monika Arora and Dr. Deepika Bahl led the sessions on Substance Misuse, Non-Communicable Diseases and Ms. Shalini Bassi on Prevention and Management of Non-Communicable Diseases risk factors, the key thematic areas of RKSK. Ms. Shalini Bassi is also a Master Trainer for National and State Resource Group (SRG and NRG) on School Health Program under Ayushman Bharat organized by Ministry of Health and Family Welfare and the Ministry of HRD, Government of India. She led the session on Prevention and Management of Substance Misuse. Ms. Shalini Bassi and Dr. Deepika Bahl (member of study team) under the guidance of Dr. Monika Arora, contributed for a Review. The objective of this study was to review the overall planning, implementation and monitoring of adolescent and school health programmes currently implemented in India and determine if they are in alignment with the indicators for achieving universal health coverage for adolescents in India. This was published in BMJ Open (Jain N, Bahl D, Mehta R, et al. Progress and challenges in implementing adolescent and school health programmes in India: a rapid review BMJ Open 2022; 12: e047435. doi: 10.1136/bmjopen-2020-047435). Dr. Monika Arora, Dr. Deepika Bahl and Ms. Shalini Bassi also undertook a Scoping Review on Adolescent Friendly Health Clinics (AFHCs) to understand the status of the AFHCs in India and compliance of these AFHCs with the benchmark proposed by the Ministry of Health and Family Welfare-Government of India (MoHFW-GoI) under India's National Adolescent Health Programme (i.e Rashtriya Kishor Swasthya Karyakram). This review has been accepted for publication in F1000 Research. Dr. Monika Arora shared the learnings from this study during the 1st Asian Congress on Adolescent Health ADOLESCON 2022 held in November 2022 with the larger Pediatric community and adolescent health practitioners from all over India and Asia. Based on the study findings, she presented the recommendations to develop evidence-based policy positions for health promotion among adolescents, in order to prioritise Adolescent Health at all levels, for the Pediatricians and Associations. During the Implementation Science and Research Methodology workshop organized for mid-career medical researchers from academic institutions, Dr. Monika Arora shared the research design and process evaluation framework of this ongoing research with the workshop participants during her session entitled "Stakeholder engagement and community-based participatory approaches". The workshop was organized collaboratively by Indian Society for Clinical Research (ISCR), Christian Medical College (Ludhiana), PHFI and St. John's Medical College and Research Institute (Bengaluru). The Government of India has developed (piloting phase) a mobile based App for peer educators to maintain the programme records (number of sessions conducted with adolescents by peer educators, themes on which session was undertaken, number of adolescents attended the session, number of adolescents referred to health facility like AFHCs and health and Wellness Centre). In this regard, a workshop was organized by Ministry of Health and Family Welfare-Government of India to roll out this App in selected states and districts of India. Ms. Shalini Bassi and Dr. Deepika Bahl also participated in this workshop and shared the evidence from the field for this new intervention being developed and also offered PHFI's support to evaluate the feasibility and acceptability of this app under the current award in the study states and districts. |
| Collaborator Contribution | A key element of this study is that the PHFI collaborated with MoHFW-GoI (as an implementation partner) right from the inception of this research study. The focus on studying Rashtriya Kishor Swasthya Karyakram's (RKSK's, India's National Adolescent Health Programme) Peer Educator (PE) program is at their expressed request. MoHFW-GOI and the State Health Departments (Madhya Pradesh and Maharashtra) are providing continuous leadership and guidance to this study, further reiterating the government's commitment at all levels to this evaluation. There has been continuous communication between PHFI, MoHFW (at Centre), State health departments for the implementation of the study activities as well as dissemination of the study findings. Representation from State Health Department and District RKSK officials during the training workshops organized for training the data collection teams to collect the qualitative and quantitative study data. The state health department and District RKSK officials and NGO implementing the PE Programme (in case of Madhya Pradesh) facilitated the qualitative, quantitative and routine RKSK programme data collection in four study districts. The list of villages, Peer Educators and Adolescents were sampled in their consultation. The District RKSK teams also shared the implementation plan for conducting the structured observations by the PHFI study team. The visits for conducting the structured observations of Peer Educator trainings, Peer Educator sessions, Adolescent Health, Wellness Day and Adolescent Friendly Club meetings and Adolescent Friendly Health Clinics were made in consultation with state and district RKSK teams. A meeting was also held with the Deputy Commissioner-Ministry of Health and Family Welfare-Government of India and Adolescent Health team to discuss the study findings, successes, identified gaps as well as provided recommendations for strengthening the implementation and scale-up of PE programme. As part of the dissemination component of the study, a one-day State Level Dissemination and Validation Workshop was held in Pune (Maharashtra) on 10th January 2023. This multi-stakeholder event engaged the participation of 60 stakeholders, including senior officials from the Ministry of Health and Family Welfare-Government of India, State Family Welfare Bureau, Pune and RKSK stakeholders from district, block and village levels. The discussions during the workshop provided an opportunity to present the study findings by the PHFI study team and deliberated with the Peer Educators, Frontline Health workers and other programme implementers on challenges and opportunities as identified through the i-Saathiya study. - The workshop provided an opportunity to communicate the findings of this research award to the highest level of the decision making at the centre (i.e Ministry of Health and Family Welfare-Government of India) and State (State Family Welfare Bureau, Pune) for relevant changes for strengthening the programme implementation. - All the high-level dignitaries in the government agreed with the study recommendations. - The workshop also provided an opportunity for the Peer Educators and adolescents to share their experiences, learnings and challenges with the PE programme and highlighted their contributions in COVID-19 pandemic response activities. - The discussions also explained reasons for successes, identified activities, and approaches for scale-up of PE programme in other non-RKSK districts in the state of Maharashtra and for consideration as best practice at the National level. The state-level workshop for Madhya Pradesh is yet to be scheduled in March 2023, in consultation with the National Health Mission-Madhya Pradesh. The National Level workshop will be organized in consultation with the Ministry of Health and Family Welfare-Government of India that will encompass recommendations from state-level dissemination and validation workshops. The national-level workshop will provide evidence for strengthening the Peer Education program at the state level for program implementation in other districts and learning from the states that can be taken at the national level to scale up the program. The Independent Project Steering Committee (IPSC) formulated as part of this study is providing continuous guidance to the research activities. This Committee includes independent academic members, representatives from senior officials from the Adolescent Health Division-MoHFW, GoI, adolescent health experts and key investigators from the study team. Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The manuscript titled "Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis" published in PLOS One was jointly developed by the Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators. |
| Impact | These outputs are the result of multi-disciplinary collaboration. o Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The IPSC Committee is a multi-disciplinary expert team, having membership from independent academic members (Prof. Robert Blum, Prof. David Ross and Dr. Harish K Pemde), representatives from senior official from the Adolescent Health Division-MoHFW, GoI (Dr. Zoya Rizvi), adolescent health experts (Prof. Vikram Patel) and key investigators from the study team (Dr. Monika Arora, Dr. Amanda J. Mason-Jones). o The multi-disciplinary study team from India and UK contributed for the development of study tools under the guidance of Principal Investigator (Dr. Monika Arora), who is an adolescent health expert. These included: 1) quantitative study tools (Survey for Peer Educators, Survey for Adolescents, Out of Pocket Expenditure Survey for Parents of Adolescents); 2) qualitative tools (Indepth interview guide for: ASHA, ASHA facilitator, Peer Educators, Parent of Peer Educators, Parents of Adolescents, School teachers, AFHC Counsellors, Medical Officer, NGO representative, NGO mentor, Faculty Training and Focus Group Discussion guide for Adolescents and structured observation checklists: Peer Educator Trainings, Peer Educator sessions, Adolescent Friendly Club meetings, Adolescent Friendly Health Clinics, Adolescent Health and Wellness days). The team members from India and UK extensively contributed to the development of these study tools and protocols: Dr. Stefanie Dringus (Global Health Consultant), Ms. Shalini Bassi (Nutritionist and public health researcher), Dr. Deepika Bahl (Nutritionist and public health researcher), Ms. Heeya Maity (young public health researcher), Dr. Smritima Lama (health researcher) contributed for the development of qualitative guides and structured observation checklists. Dr. Ambarish Dutta (Epidemiologist), Dr. Amanda J. Mason-Jones (public health specialist and epidemiologist), Dr. Deepika Bahl, Ms. Shalini Bassi, Ms. Heeya Maity contributed for the development of household level surveys for Peer Educators and Adolescents. Dr Sarit Kumar Rout (Health Economist) led the development of Out of Pocket Expenditure Survey for administration with parents of Adolescents. He was facilitated by Ms. Priya Amrit, who is a young researcher. The State level dissemination and validation workshop report developed and submitted to the MoHFW-GOI, State Family Welfare Bureau (SHFW) and IPSC is also an output of joint collaboration. The collaboration has resulted in a list of manuscripts that have either been published or are planned for publication in peer-reviewed journals, aiming to widely disseminate the findings of the study. Published Manuscripts 1. Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis was jointly developed by Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators and published in PLoS One (https://pubmed.ncbi.nlm.nih.gov/36129932/). 2. Amanda Mason-Jones, Marlon Freeman, Tina Rawal, Shalini Bassi, Theo Lorenc, Monika Arora. Peer-based interventions to improve adolescent health: an overview of systematic reviews. PROSPERO 2017 CRD42017076290 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017076290. 3. Bahl D, Bassi S, Arora M. The Impact of COVID-19 on children and adolescents: Early evidence in India. ORF Issue Brief No. 448, March 2021, Observer Research Foundation. Available at: https://www.orfonline.org/research/the-impact-of-covid-19-on-children-and-adolescents-early-evidence-in-india. 4. Bahl D, Bassi S, Manna S, Arora M. Adolescent Friendly Health Clinics (AFHCS) In India and its Compliance with Benchmarks: A Scoping review. (Accepted for publication in F1000 Research) Manuscripts under review 5. Amanda J. Mason-Jones, Marlon Freeman, Theo Lorenc, Tina Rawal, Shalini Bassi, Monika Arora. Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews (Under Review, Journal of Adolescent Health). 6. Gayatri Nayak, Deepika Bahl, Shalini Bassi, Heeya Meity, Amanda Mason-Jones, Stefanie Dringus, Monika Arora, Ambarish Dutta. Knowledge, Attitudes and Practices of the adolescents and PEs to various components of RKSK: Findings from a cross-sectional survey. Submitted to International Journal of Adolescent Medicine and Health. (Submitted in BMC Public Health). Manuscripts in the offing 7. Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews. 8. Do adolescents spend anything from their pocket to access health care services? Evidence from India. 9. Compliance of Adolescent Friendly Health Clinics (AFHCs) with National and International Standards 10. Role of peer educators from India's National Adolescent Health Programme for the COVID-19 pandemic response 11. Cost of providing RKSK services and its variations across districts of India 12. The dose-response relationship between peer-educator engagement and knowledge and practices of the adolescents of India, a report from two states 13. Delivery of PE programme during COVID-19 pandemic in Government and NGO led implementation model: Successes and Challenges 14. Impact of PE programme in improving Adolescent health and well-being 15. Identifying challenges in implementing PE programme in Adolescent Health and solutions for scale-up |
| Start Year | 2020 |
| Description | Collaborations and partnerships were established for implementing this study in two Indian states (Maharashtra and Madhya Pradesh) with Public Health Foundation of India (PHFI), Indian Institute of Public Health- Bhubaneswar, Ministry of Health and Family Welfare-Government of India (MoHFW-GoI), National Health Mission, Directorate of Health Services, Madhya Pradesh, State Family Welfare Bureau Pune, Government of Maharashtra and University of York, UK |
| Organisation | Government of India |
| Department | National Health Mission, Madhya Pradesh |
| Country | India |
| Sector | Public |
| PI Contribution | The study involves a multi-disciplinary team of established public health researchers and epidemiologists from India and UK, who are research active, with expertise in epidemiology, implementation science, Adolescent health, health economics and social sciences. Dr Amanda J. Mason-Jones, co-investigator from the University of York on this study and a member of the Independent Project Steering Committee (IPSC). She is guiding the Overview of Systematic Review component of the study, including: Training study team on data extraction, quality assessment, inputs on SR protocol and supervising the MPH student from the University of York and the team member from PHFI (Ms. Tina Rawal, voluntary contribution) for conducting the overview of a systematic review and writing overview manuscripts. She led the development of a manuscript from the Overview of Systematic Review component entitled "Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews" which was submitted to the Journal of Adolescent Health and is currently under review. The development of the second manuscript from this review entitled "Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews" is in progress. Dr. Stefanie Dringus is guiding the qualitative component of the study and also contributing to manuscript writing from the qualitative study component. Dr. Ambarish Dutta, Additional Professor - Epidemiology at the Indian Institute of Public Health, Bhubaneswar is leading the quantitative component of the study and Dr Sarit Kumar Rout, Additional Professor at Indian Institute of Public Health, Bhubaneswar is leading the cost component of the study. Dr. Dutta and Dr. Rout are also contributing to the manuscript writing from the study components they are leading. Dr. Monika Arora as PI has been guiding overall research conduction, ethics approvals and coordinating with lead of all research questions as advised by the IPSC. She has led development of research protocols, analysis plan and finalized manuscripts being written by research teams currently. The study also helped to build the capacity of young researchers (Ms. Heeya Maity, Ms. Gayatri Naik, Ms. Priya Amrit). Under the guidance of PI (Dr. Monika Arora) and other senior team members and investigators on this study( Ms. Shalini Bassi, Senior Research Scientist at PHFI and Project Manager on this grant and Dr. Deepika Bahl, Senior Research Associate at PHFI and Qualitative Researcher on this study), they have been involved in the development of study tools, undertaking review of literature, conducting structured observations, quantitative surveys with adolescents, Peer Educators and parents, conducting indepth interviews with RKSK stakeholders. They were also trained to collect data virtually during the pandemic period and are also contributing to data analysis and manuscript writing. Ms. Tina Rawal was trained in Systematic Review as part of this study. Other partnership activities Dr. Monika Arora, Ms. Shalini Bassi and Dr. Deepika Bahl are the Resource Faculty for training the State Master Trainers on Rashtriya Kishor Swasthya Karyakram (RKSK), being organized by the Ministry of Health and Family Welfare-Government of India. These training sessions were held for the Master Trainers i.e Medical Officers and Counsellors from the RKSK programme to improve availability of Adolescent Friendly Services (AFHCs) across the country. During these training sessions, Dr. Monika Arora and Dr. Deepika Bahl led the sessions on Substance Misuse, Non-Communicable Diseases and Ms. Shalini Bassi on Prevention and Management of Non-Communicable Diseases risk factors, the key thematic areas of RKSK. Ms. Shalini Bassi is also a Master Trainer for National and State Resource Group (SRG and NRG) on School Health Program under Ayushman Bharat organized by Ministry of Health and Family Welfare and the Ministry of HRD, Government of India. She led the session on Prevention and Management of Substance Misuse. Ms. Shalini Bassi and Dr. Deepika Bahl (member of study team) under the guidance of Dr. Monika Arora, contributed for a Review. The objective of this study was to review the overall planning, implementation and monitoring of adolescent and school health programmes currently implemented in India and determine if they are in alignment with the indicators for achieving universal health coverage for adolescents in India. This was published in BMJ Open (Jain N, Bahl D, Mehta R, et al. Progress and challenges in implementing adolescent and school health programmes in India: a rapid review BMJ Open 2022; 12: e047435. doi: 10.1136/bmjopen-2020-047435). Dr. Monika Arora, Dr. Deepika Bahl and Ms. Shalini Bassi also undertook a Scoping Review on Adolescent Friendly Health Clinics (AFHCs) to understand the status of the AFHCs in India and compliance of these AFHCs with the benchmark proposed by the Ministry of Health and Family Welfare-Government of India (MoHFW-GoI) under India's National Adolescent Health Programme (i.e Rashtriya Kishor Swasthya Karyakram). This review has been accepted for publication in F1000 Research. Dr. Monika Arora shared the learnings from this study during the 1st Asian Congress on Adolescent Health ADOLESCON 2022 held in November 2022 with the larger Pediatric community and adolescent health practitioners from all over India and Asia. Based on the study findings, she presented the recommendations to develop evidence-based policy positions for health promotion among adolescents, in order to prioritise Adolescent Health at all levels, for the Pediatricians and Associations. During the Implementation Science and Research Methodology workshop organized for mid-career medical researchers from academic institutions, Dr. Monika Arora shared the research design and process evaluation framework of this ongoing research with the workshop participants during her session entitled "Stakeholder engagement and community-based participatory approaches". The workshop was organized collaboratively by Indian Society for Clinical Research (ISCR), Christian Medical College (Ludhiana), PHFI and St. John's Medical College and Research Institute (Bengaluru). The Government of India has developed (piloting phase) a mobile based App for peer educators to maintain the programme records (number of sessions conducted with adolescents by peer educators, themes on which session was undertaken, number of adolescents attended the session, number of adolescents referred to health facility like AFHCs and health and Wellness Centre). In this regard, a workshop was organized by Ministry of Health and Family Welfare-Government of India to roll out this App in selected states and districts of India. Ms. Shalini Bassi and Dr. Deepika Bahl also participated in this workshop and shared the evidence from the field for this new intervention being developed and also offered PHFI's support to evaluate the feasibility and acceptability of this app under the current award in the study states and districts. |
| Collaborator Contribution | A key element of this study is that the PHFI collaborated with MoHFW-GoI (as an implementation partner) right from the inception of this research study. The focus on studying Rashtriya Kishor Swasthya Karyakram's (RKSK's, India's National Adolescent Health Programme) Peer Educator (PE) program is at their expressed request. MoHFW-GOI and the State Health Departments (Madhya Pradesh and Maharashtra) are providing continuous leadership and guidance to this study, further reiterating the government's commitment at all levels to this evaluation. There has been continuous communication between PHFI, MoHFW (at Centre), State health departments for the implementation of the study activities as well as dissemination of the study findings. Representation from State Health Department and District RKSK officials during the training workshops organized for training the data collection teams to collect the qualitative and quantitative study data. The state health department and District RKSK officials and NGO implementing the PE Programme (in case of Madhya Pradesh) facilitated the qualitative, quantitative and routine RKSK programme data collection in four study districts. The list of villages, Peer Educators and Adolescents were sampled in their consultation. The District RKSK teams also shared the implementation plan for conducting the structured observations by the PHFI study team. The visits for conducting the structured observations of Peer Educator trainings, Peer Educator sessions, Adolescent Health, Wellness Day and Adolescent Friendly Club meetings and Adolescent Friendly Health Clinics were made in consultation with state and district RKSK teams. A meeting was also held with the Deputy Commissioner-Ministry of Health and Family Welfare-Government of India and Adolescent Health team to discuss the study findings, successes, identified gaps as well as provided recommendations for strengthening the implementation and scale-up of PE programme. As part of the dissemination component of the study, a one-day State Level Dissemination and Validation Workshop was held in Pune (Maharashtra) on 10th January 2023. This multi-stakeholder event engaged the participation of 60 stakeholders, including senior officials from the Ministry of Health and Family Welfare-Government of India, State Family Welfare Bureau, Pune and RKSK stakeholders from district, block and village levels. The discussions during the workshop provided an opportunity to present the study findings by the PHFI study team and deliberated with the Peer Educators, Frontline Health workers and other programme implementers on challenges and opportunities as identified through the i-Saathiya study. - The workshop provided an opportunity to communicate the findings of this research award to the highest level of the decision making at the centre (i.e Ministry of Health and Family Welfare-Government of India) and State (State Family Welfare Bureau, Pune) for relevant changes for strengthening the programme implementation. - All the high-level dignitaries in the government agreed with the study recommendations. - The workshop also provided an opportunity for the Peer Educators and adolescents to share their experiences, learnings and challenges with the PE programme and highlighted their contributions in COVID-19 pandemic response activities. - The discussions also explained reasons for successes, identified activities, and approaches for scale-up of PE programme in other non-RKSK districts in the state of Maharashtra and for consideration as best practice at the National level. The state-level workshop for Madhya Pradesh is yet to be scheduled in March 2023, in consultation with the National Health Mission-Madhya Pradesh. The National Level workshop will be organized in consultation with the Ministry of Health and Family Welfare-Government of India that will encompass recommendations from state-level dissemination and validation workshops. The national-level workshop will provide evidence for strengthening the Peer Education program at the state level for program implementation in other districts and learning from the states that can be taken at the national level to scale up the program. The Independent Project Steering Committee (IPSC) formulated as part of this study is providing continuous guidance to the research activities. This Committee includes independent academic members, representatives from senior officials from the Adolescent Health Division-MoHFW, GoI, adolescent health experts and key investigators from the study team. Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The manuscript titled "Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis" published in PLOS One was jointly developed by the Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators. |
| Impact | These outputs are the result of multi-disciplinary collaboration. o Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The IPSC Committee is a multi-disciplinary expert team, having membership from independent academic members (Prof. Robert Blum, Prof. David Ross and Dr. Harish K Pemde), representatives from senior official from the Adolescent Health Division-MoHFW, GoI (Dr. Zoya Rizvi), adolescent health experts (Prof. Vikram Patel) and key investigators from the study team (Dr. Monika Arora, Dr. Amanda J. Mason-Jones). o The multi-disciplinary study team from India and UK contributed for the development of study tools under the guidance of Principal Investigator (Dr. Monika Arora), who is an adolescent health expert. These included: 1) quantitative study tools (Survey for Peer Educators, Survey for Adolescents, Out of Pocket Expenditure Survey for Parents of Adolescents); 2) qualitative tools (Indepth interview guide for: ASHA, ASHA facilitator, Peer Educators, Parent of Peer Educators, Parents of Adolescents, School teachers, AFHC Counsellors, Medical Officer, NGO representative, NGO mentor, Faculty Training and Focus Group Discussion guide for Adolescents and structured observation checklists: Peer Educator Trainings, Peer Educator sessions, Adolescent Friendly Club meetings, Adolescent Friendly Health Clinics, Adolescent Health and Wellness days). The team members from India and UK extensively contributed to the development of these study tools and protocols: Dr. Stefanie Dringus (Global Health Consultant), Ms. Shalini Bassi (Nutritionist and public health researcher), Dr. Deepika Bahl (Nutritionist and public health researcher), Ms. Heeya Maity (young public health researcher), Dr. Smritima Lama (health researcher) contributed for the development of qualitative guides and structured observation checklists. Dr. Ambarish Dutta (Epidemiologist), Dr. Amanda J. Mason-Jones (public health specialist and epidemiologist), Dr. Deepika Bahl, Ms. Shalini Bassi, Ms. Heeya Maity contributed for the development of household level surveys for Peer Educators and Adolescents. Dr Sarit Kumar Rout (Health Economist) led the development of Out of Pocket Expenditure Survey for administration with parents of Adolescents. He was facilitated by Ms. Priya Amrit, who is a young researcher. The State level dissemination and validation workshop report developed and submitted to the MoHFW-GOI, State Family Welfare Bureau (SHFW) and IPSC is also an output of joint collaboration. The collaboration has resulted in a list of manuscripts that have either been published or are planned for publication in peer-reviewed journals, aiming to widely disseminate the findings of the study. Published Manuscripts 1. Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis was jointly developed by Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators and published in PLoS One (https://pubmed.ncbi.nlm.nih.gov/36129932/). 2. Amanda Mason-Jones, Marlon Freeman, Tina Rawal, Shalini Bassi, Theo Lorenc, Monika Arora. Peer-based interventions to improve adolescent health: an overview of systematic reviews. PROSPERO 2017 CRD42017076290 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017076290. 3. Bahl D, Bassi S, Arora M. The Impact of COVID-19 on children and adolescents: Early evidence in India. ORF Issue Brief No. 448, March 2021, Observer Research Foundation. Available at: https://www.orfonline.org/research/the-impact-of-covid-19-on-children-and-adolescents-early-evidence-in-india. 4. Bahl D, Bassi S, Manna S, Arora M. Adolescent Friendly Health Clinics (AFHCS) In India and its Compliance with Benchmarks: A Scoping review. (Accepted for publication in F1000 Research) Manuscripts under review 5. Amanda J. Mason-Jones, Marlon Freeman, Theo Lorenc, Tina Rawal, Shalini Bassi, Monika Arora. Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews (Under Review, Journal of Adolescent Health). 6. Gayatri Nayak, Deepika Bahl, Shalini Bassi, Heeya Meity, Amanda Mason-Jones, Stefanie Dringus, Monika Arora, Ambarish Dutta. Knowledge, Attitudes and Practices of the adolescents and PEs to various components of RKSK: Findings from a cross-sectional survey. Submitted to International Journal of Adolescent Medicine and Health. (Submitted in BMC Public Health). Manuscripts in the offing 7. Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews. 8. Do adolescents spend anything from their pocket to access health care services? Evidence from India. 9. Compliance of Adolescent Friendly Health Clinics (AFHCs) with National and International Standards 10. Role of peer educators from India's National Adolescent Health Programme for the COVID-19 pandemic response 11. Cost of providing RKSK services and its variations across districts of India 12. The dose-response relationship between peer-educator engagement and knowledge and practices of the adolescents of India, a report from two states 13. Delivery of PE programme during COVID-19 pandemic in Government and NGO led implementation model: Successes and Challenges 14. Impact of PE programme in improving Adolescent health and well-being 15. Identifying challenges in implementing PE programme in Adolescent Health and solutions for scale-up |
| Start Year | 2020 |
| Description | Collaborations and partnerships were established for implementing this study in two Indian states (Maharashtra and Madhya Pradesh) with Public Health Foundation of India (PHFI), Indian Institute of Public Health- Bhubaneswar, Ministry of Health and Family Welfare-Government of India (MoHFW-GoI), National Health Mission, Directorate of Health Services, Madhya Pradesh, State Family Welfare Bureau Pune, Government of Maharashtra and University of York, UK |
| Organisation | University of York |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The study involves a multi-disciplinary team of established public health researchers and epidemiologists from India and UK, who are research active, with expertise in epidemiology, implementation science, Adolescent health, health economics and social sciences. Dr Amanda J. Mason-Jones, co-investigator from the University of York on this study and a member of the Independent Project Steering Committee (IPSC). She is guiding the Overview of Systematic Review component of the study, including: Training study team on data extraction, quality assessment, inputs on SR protocol and supervising the MPH student from the University of York and the team member from PHFI (Ms. Tina Rawal, voluntary contribution) for conducting the overview of a systematic review and writing overview manuscripts. She led the development of a manuscript from the Overview of Systematic Review component entitled "Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews" which was submitted to the Journal of Adolescent Health and is currently under review. The development of the second manuscript from this review entitled "Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews" is in progress. Dr. Stefanie Dringus is guiding the qualitative component of the study and also contributing to manuscript writing from the qualitative study component. Dr. Ambarish Dutta, Additional Professor - Epidemiology at the Indian Institute of Public Health, Bhubaneswar is leading the quantitative component of the study and Dr Sarit Kumar Rout, Additional Professor at Indian Institute of Public Health, Bhubaneswar is leading the cost component of the study. Dr. Dutta and Dr. Rout are also contributing to the manuscript writing from the study components they are leading. Dr. Monika Arora as PI has been guiding overall research conduction, ethics approvals and coordinating with lead of all research questions as advised by the IPSC. She has led development of research protocols, analysis plan and finalized manuscripts being written by research teams currently. The study also helped to build the capacity of young researchers (Ms. Heeya Maity, Ms. Gayatri Naik, Ms. Priya Amrit). Under the guidance of PI (Dr. Monika Arora) and other senior team members and investigators on this study( Ms. Shalini Bassi, Senior Research Scientist at PHFI and Project Manager on this grant and Dr. Deepika Bahl, Senior Research Associate at PHFI and Qualitative Researcher on this study), they have been involved in the development of study tools, undertaking review of literature, conducting structured observations, quantitative surveys with adolescents, Peer Educators and parents, conducting indepth interviews with RKSK stakeholders. They were also trained to collect data virtually during the pandemic period and are also contributing to data analysis and manuscript writing. Ms. Tina Rawal was trained in Systematic Review as part of this study. Other partnership activities Dr. Monika Arora, Ms. Shalini Bassi and Dr. Deepika Bahl are the Resource Faculty for training the State Master Trainers on Rashtriya Kishor Swasthya Karyakram (RKSK), being organized by the Ministry of Health and Family Welfare-Government of India. These training sessions were held for the Master Trainers i.e Medical Officers and Counsellors from the RKSK programme to improve availability of Adolescent Friendly Services (AFHCs) across the country. During these training sessions, Dr. Monika Arora and Dr. Deepika Bahl led the sessions on Substance Misuse, Non-Communicable Diseases and Ms. Shalini Bassi on Prevention and Management of Non-Communicable Diseases risk factors, the key thematic areas of RKSK. Ms. Shalini Bassi is also a Master Trainer for National and State Resource Group (SRG and NRG) on School Health Program under Ayushman Bharat organized by Ministry of Health and Family Welfare and the Ministry of HRD, Government of India. She led the session on Prevention and Management of Substance Misuse. Ms. Shalini Bassi and Dr. Deepika Bahl (member of study team) under the guidance of Dr. Monika Arora, contributed for a Review. The objective of this study was to review the overall planning, implementation and monitoring of adolescent and school health programmes currently implemented in India and determine if they are in alignment with the indicators for achieving universal health coverage for adolescents in India. This was published in BMJ Open (Jain N, Bahl D, Mehta R, et al. Progress and challenges in implementing adolescent and school health programmes in India: a rapid review BMJ Open 2022; 12: e047435. doi: 10.1136/bmjopen-2020-047435). Dr. Monika Arora, Dr. Deepika Bahl and Ms. Shalini Bassi also undertook a Scoping Review on Adolescent Friendly Health Clinics (AFHCs) to understand the status of the AFHCs in India and compliance of these AFHCs with the benchmark proposed by the Ministry of Health and Family Welfare-Government of India (MoHFW-GoI) under India's National Adolescent Health Programme (i.e Rashtriya Kishor Swasthya Karyakram). This review has been accepted for publication in F1000 Research. Dr. Monika Arora shared the learnings from this study during the 1st Asian Congress on Adolescent Health ADOLESCON 2022 held in November 2022 with the larger Pediatric community and adolescent health practitioners from all over India and Asia. Based on the study findings, she presented the recommendations to develop evidence-based policy positions for health promotion among adolescents, in order to prioritise Adolescent Health at all levels, for the Pediatricians and Associations. During the Implementation Science and Research Methodology workshop organized for mid-career medical researchers from academic institutions, Dr. Monika Arora shared the research design and process evaluation framework of this ongoing research with the workshop participants during her session entitled "Stakeholder engagement and community-based participatory approaches". The workshop was organized collaboratively by Indian Society for Clinical Research (ISCR), Christian Medical College (Ludhiana), PHFI and St. John's Medical College and Research Institute (Bengaluru). The Government of India has developed (piloting phase) a mobile based App for peer educators to maintain the programme records (number of sessions conducted with adolescents by peer educators, themes on which session was undertaken, number of adolescents attended the session, number of adolescents referred to health facility like AFHCs and health and Wellness Centre). In this regard, a workshop was organized by Ministry of Health and Family Welfare-Government of India to roll out this App in selected states and districts of India. Ms. Shalini Bassi and Dr. Deepika Bahl also participated in this workshop and shared the evidence from the field for this new intervention being developed and also offered PHFI's support to evaluate the feasibility and acceptability of this app under the current award in the study states and districts. |
| Collaborator Contribution | A key element of this study is that the PHFI collaborated with MoHFW-GoI (as an implementation partner) right from the inception of this research study. The focus on studying Rashtriya Kishor Swasthya Karyakram's (RKSK's, India's National Adolescent Health Programme) Peer Educator (PE) program is at their expressed request. MoHFW-GOI and the State Health Departments (Madhya Pradesh and Maharashtra) are providing continuous leadership and guidance to this study, further reiterating the government's commitment at all levels to this evaluation. There has been continuous communication between PHFI, MoHFW (at Centre), State health departments for the implementation of the study activities as well as dissemination of the study findings. Representation from State Health Department and District RKSK officials during the training workshops organized for training the data collection teams to collect the qualitative and quantitative study data. The state health department and District RKSK officials and NGO implementing the PE Programme (in case of Madhya Pradesh) facilitated the qualitative, quantitative and routine RKSK programme data collection in four study districts. The list of villages, Peer Educators and Adolescents were sampled in their consultation. The District RKSK teams also shared the implementation plan for conducting the structured observations by the PHFI study team. The visits for conducting the structured observations of Peer Educator trainings, Peer Educator sessions, Adolescent Health, Wellness Day and Adolescent Friendly Club meetings and Adolescent Friendly Health Clinics were made in consultation with state and district RKSK teams. A meeting was also held with the Deputy Commissioner-Ministry of Health and Family Welfare-Government of India and Adolescent Health team to discuss the study findings, successes, identified gaps as well as provided recommendations for strengthening the implementation and scale-up of PE programme. As part of the dissemination component of the study, a one-day State Level Dissemination and Validation Workshop was held in Pune (Maharashtra) on 10th January 2023. This multi-stakeholder event engaged the participation of 60 stakeholders, including senior officials from the Ministry of Health and Family Welfare-Government of India, State Family Welfare Bureau, Pune and RKSK stakeholders from district, block and village levels. The discussions during the workshop provided an opportunity to present the study findings by the PHFI study team and deliberated with the Peer Educators, Frontline Health workers and other programme implementers on challenges and opportunities as identified through the i-Saathiya study. - The workshop provided an opportunity to communicate the findings of this research award to the highest level of the decision making at the centre (i.e Ministry of Health and Family Welfare-Government of India) and State (State Family Welfare Bureau, Pune) for relevant changes for strengthening the programme implementation. - All the high-level dignitaries in the government agreed with the study recommendations. - The workshop also provided an opportunity for the Peer Educators and adolescents to share their experiences, learnings and challenges with the PE programme and highlighted their contributions in COVID-19 pandemic response activities. - The discussions also explained reasons for successes, identified activities, and approaches for scale-up of PE programme in other non-RKSK districts in the state of Maharashtra and for consideration as best practice at the National level. The state-level workshop for Madhya Pradesh is yet to be scheduled in March 2023, in consultation with the National Health Mission-Madhya Pradesh. The National Level workshop will be organized in consultation with the Ministry of Health and Family Welfare-Government of India that will encompass recommendations from state-level dissemination and validation workshops. The national-level workshop will provide evidence for strengthening the Peer Education program at the state level for program implementation in other districts and learning from the states that can be taken at the national level to scale up the program. The Independent Project Steering Committee (IPSC) formulated as part of this study is providing continuous guidance to the research activities. This Committee includes independent academic members, representatives from senior officials from the Adolescent Health Division-MoHFW, GoI, adolescent health experts and key investigators from the study team. Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The manuscript titled "Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis" published in PLOS One was jointly developed by the Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators. |
| Impact | These outputs are the result of multi-disciplinary collaboration. o Since the inception of this study, Independent Project Steering Committee (IPSC) has convened seven times (2020-2022) to guide revisions of Research Aims and study protocol according to the COVID-19 context in India, discussed the study updates and provided guidance on future funding opportunities to follow up the current cohort of peer educators and adolescents to understand the impact of PE intervention. The IPSC Committee is a multi-disciplinary expert team, having membership from independent academic members (Prof. Robert Blum, Prof. David Ross and Dr. Harish K Pemde), representatives from senior official from the Adolescent Health Division-MoHFW, GoI (Dr. Zoya Rizvi), adolescent health experts (Prof. Vikram Patel) and key investigators from the study team (Dr. Monika Arora, Dr. Amanda J. Mason-Jones). o The multi-disciplinary study team from India and UK contributed for the development of study tools under the guidance of Principal Investigator (Dr. Monika Arora), who is an adolescent health expert. These included: 1) quantitative study tools (Survey for Peer Educators, Survey for Adolescents, Out of Pocket Expenditure Survey for Parents of Adolescents); 2) qualitative tools (Indepth interview guide for: ASHA, ASHA facilitator, Peer Educators, Parent of Peer Educators, Parents of Adolescents, School teachers, AFHC Counsellors, Medical Officer, NGO representative, NGO mentor, Faculty Training and Focus Group Discussion guide for Adolescents and structured observation checklists: Peer Educator Trainings, Peer Educator sessions, Adolescent Friendly Club meetings, Adolescent Friendly Health Clinics, Adolescent Health and Wellness days). The team members from India and UK extensively contributed to the development of these study tools and protocols: Dr. Stefanie Dringus (Global Health Consultant), Ms. Shalini Bassi (Nutritionist and public health researcher), Dr. Deepika Bahl (Nutritionist and public health researcher), Ms. Heeya Maity (young public health researcher), Dr. Smritima Lama (health researcher) contributed for the development of qualitative guides and structured observation checklists. Dr. Ambarish Dutta (Epidemiologist), Dr. Amanda J. Mason-Jones (public health specialist and epidemiologist), Dr. Deepika Bahl, Ms. Shalini Bassi, Ms. Heeya Maity contributed for the development of household level surveys for Peer Educators and Adolescents. Dr Sarit Kumar Rout (Health Economist) led the development of Out of Pocket Expenditure Survey for administration with parents of Adolescents. He was facilitated by Ms. Priya Amrit, who is a young researcher. The State level dissemination and validation workshop report developed and submitted to the MoHFW-GOI, State Family Welfare Bureau (SHFW) and IPSC is also an output of joint collaboration. The collaboration has resulted in a list of manuscripts that have either been published or are planned for publication in peer-reviewed journals, aiming to widely disseminate the findings of the study. Published Manuscripts 1. Engagement of health workers and peer educators from India's National Adolescent Health Programme during the COVID-19 pandemic: Findings from a situational analysis was jointly developed by Indian study team and RKSK officials from the Ministry of Health and Family Welfare and UK investigators and published in PLoS One (https://pubmed.ncbi.nlm.nih.gov/36129932/). 2. Amanda Mason-Jones, Marlon Freeman, Tina Rawal, Shalini Bassi, Theo Lorenc, Monika Arora. Peer-based interventions to improve adolescent health: an overview of systematic reviews. PROSPERO 2017 CRD42017076290 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017076290. 3. Bahl D, Bassi S, Arora M. The Impact of COVID-19 on children and adolescents: Early evidence in India. ORF Issue Brief No. 448, March 2021, Observer Research Foundation. Available at: https://www.orfonline.org/research/the-impact-of-covid-19-on-children-and-adolescents-early-evidence-in-india. 4. Bahl D, Bassi S, Manna S, Arora M. Adolescent Friendly Health Clinics (AFHCS) In India and its Compliance with Benchmarks: A Scoping review. (Accepted for publication in F1000 Research) Manuscripts under review 5. Amanda J. Mason-Jones, Marlon Freeman, Theo Lorenc, Tina Rawal, Shalini Bassi, Monika Arora. Can peer-based interventions improve adolescent sexual and reproductive health? An overview of systematic reviews (Under Review, Journal of Adolescent Health). 6. Gayatri Nayak, Deepika Bahl, Shalini Bassi, Heeya Meity, Amanda Mason-Jones, Stefanie Dringus, Monika Arora, Ambarish Dutta. Knowledge, Attitudes and Practices of the adolescents and PEs to various components of RKSK: Findings from a cross-sectional survey. Submitted to International Journal of Adolescent Medicine and Health. (Submitted in BMC Public Health). Manuscripts in the offing 7. Peer-based interventions to improve adolescent health (substance abuse, violence, mental health): An overview of systematic reviews. 8. Do adolescents spend anything from their pocket to access health care services? Evidence from India. 9. Compliance of Adolescent Friendly Health Clinics (AFHCs) with National and International Standards 10. Role of peer educators from India's National Adolescent Health Programme for the COVID-19 pandemic response 11. Cost of providing RKSK services and its variations across districts of India 12. The dose-response relationship between peer-educator engagement and knowledge and practices of the adolescents of India, a report from two states 13. Delivery of PE programme during COVID-19 pandemic in Government and NGO led implementation model: Successes and Challenges 14. Impact of PE programme in improving Adolescent health and well-being 15. Identifying challenges in implementing PE programme in Adolescent Health and solutions for scale-up |
| Start Year | 2020 |
| Description | National level workshop on "School Health & Wellness Programme-Roadmap for 2022 onwards" |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Other audiences |
| Results and Impact | During this National Consultation, interactions of Dr. Monika Arora were held with the stakeholders from the study states (Madhya Pradesh and Maharashtra) and they expressed that the study cohort should be followed longitudinally to understand the PE programme roll out and impact. The discussions were also held to get their insights on how horizontal and vertical scale up workshops, proposed under this study can be organized. |
| Year(s) Of Engagement Activity | 2021 |
| Description | State-Level Dissemination and Validation Workshop |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Study participants or study members |
| Results and Impact | The State Level Dissemination and validation workshop was attended by 60 stakeholders and held in Pune (Maharashtra). The workshop provided an opportunity to present the study findings by the PHFI study team to the highest level of decision-making and deliberate with the Peer Educators, Frontline Health workers and other programme implementers on challenges and opportunities as identified through the i-Saathiya study. The discussions also explained reasons for successes, identified activities, and approaches for scale-up of PE programme in other non-RKSK districts in the state of Maharashtra and for consideration as best practice at the National level. |
| Year(s) Of Engagement Activity | 2023 |
| URL | http://N.A |
| Description | The Impact of COVID-19 on children and adolescents: Early evidence in India |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | A brief on the Impact of COVID-19 on children and adolescents published. This brief collected and analysed current evidence in India regarding the impact of COVID-19 on the health and well-being of children (5-9 years) and adolescents (10-19). |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://www.orfonline.org/research/the-impact-of-covid-19-on-children-and-adolescents-early-evidence... |