CM10.8-10 | CM10.8-10 | Adolescent Health, Gender Issues and RMCH Services — Summary & Reflection

KEY TAKEAWAYS

Adolescence (WHO: 10-19 years) carries India's highest anaemia prevalence: 59.1% of girls (NFHS-5). Child marriage affects 23.3% of women aged 20-24 (NFHS-5). Tanner staging describes puberty in 5 stages; girls: thelarche (Stage 2, ~9-11 yrs) → menarche (Stage 3-4); boys: testicular enlargement → spermarche. Nutritional needs: iron 12 mg/day, calcium 1,300 mg/day, protein 52 g/day (boys)/46 g/day (girls). WIFS: weekly IFA (60 mg iron + 500 mcg folic acid) for grades 6-12; take after food for GI tolerance. RKSK (2014): 6 domains — nutrition, sexual/reproductive health, NCDs, mental health, injuries/violence, substance use; peer educator model. ARSH clinics: adolescent-friendly (confidential, non-judgemental), CHC/DHH level. Sex ratio at birth NFHS-5: 929 girls/1,000 boys; biological baseline ~952; deficit reflects son preference + sex-selective abortion. PCPNDT Act 1994: prohibits prenatal sex determination for non-medical purposes; PHC MO must report violations to District Appropriate Authority. POCSO Act 2012: mandatory reporting of child sexual abuse (under 18) to police/CWC within 24 hours, regardless of victim's consent. Gender-responsive RMCH services include ARSH, female health workers, women's panchayat participation, and BBBP for sex ratio correction.

REFLECT

You have just completed your first month as PHC Medical Officer. The ASHA submits her monthly report showing 0 ARSH clinic visits by adolescents, 0 WIFS tablets distributed (the supply has not arrived), and no peer educators trained. Meanwhile, the school in your catchment has a child marriage happening next week — a 15-year-old girl is being married off. List the steps you would take in the next 48 hours: which programme system failures need immediate administrative action, which legal obligations are triggered by the child marriage, and what communication would you send to the district CMO?