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Training adolescent girls to mobilise the community to use health services, Tamil Nadu
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Subject Area="Behavioural Change Communication." Objective="Community health workers."
Details for Reform Option "Training adolescent girls to mobilise the community to use health services, Tamil Nadu"

Background: The success and sustainability of community health programmes primarily depend on the participation of the community. It was decided to make use of adolescent girls in the rural areas to create a greater demand for health services, particularly reproductive health services. Action: The programme selects non-school going adolescent girls (aged 15 to 18) from the villages and trains them at block headquarters for 5 days – three days at first, then a refresher day after 6 months and another refresher day after another three months. The training includes information on personal hygiene, menstrual hygiene and other problems for adolescents as well as about conception, antenatal (AN) care, danger signs during pregnancy and the importance of institutional deliveries and postnatal (PN) care. The girls are also taught about maternal and child health issues, empowering them to take care of/support pregnant women, following the advice of the Village Health Nurses (VHNs – Tamil Nadu equivalent of Auxiliary Nurse Midwives). They are also told who to contact if they fear a villager is contemplating killing a female child. Each girl is then expected to take care of 5 to 6 pregnant women and 5 postnatal women in their village, providing advice on diet, regular consumption of Iron and Folic Acid (IFA) tablets and the benefits of breastfeeding, as well as persuading them to use institutional services. Results: Has yet to be evaluated but will be monitored with a monthly review on the number of visits made by the adolescent girls to pregnant women; the number of women taking IFA; number of cases referred to VHNs/other hospitals; number of women having AN/PN care; number of newborns referred and number of infants fully immunised.

Cost Workshop (5 days for 20 people) to finalise curriculum and methodology of training: INR 79,000. Cost of training 63 trainers for two days each: INR 55,020. Cost of training 10,500 girls (in batches of 50): INR 69,51,000. Background materials: INR 220,000 (€3,940) TOTAL: INR 73,05,020 (€130,836)
Place Madurai and Theni districts, Tamil Nadu, from November 2002.
Time Frame Two months to complete curriculum, methodology of training, select trainers and girls and get the approval of central and state government. Five days training workshop. Two days to train each trainer.

Motivation: Younger girls are more open to new ideas and are keen to learn about their own bodies. Cost effective: For relatively little cost, healthcare provision is extended further out into the community. The girls can be involved in other health programmes at a later date. Empowering: The scheme makes the girls feel they are an important part of their community. It is hoped it may encourage some to go back to school.


Written curriculum: Relies on a high level of literacy as the curriculum is written.


Curriculum. District microplan (to help recruit the girls). Trainers.

Who needs to be consulted

State Government. Central Government (Ministry of Health and Family Welfare) Medical Officers at Primary Health Centres. Village Heath Nurses.



Sustainable if the funding is in place.

Chances of Replication

Tamil Nadu Public Health department plan to extend the scheme to all districts under RCH2. The programme was approved by the GOI Ministry of Health and Family Welfare.




Submitted By

Clare Kitchen, Research Consultant, ECTA, New Delhi. September 2004.

Status Active
Reference Files
g.o_6 training adolescent girls.doc Government Order: GO (2D) No 6 (21 January 2003) – Capacity building of adolescent girls to act as link persons between the community and the health service providers in Madurai and Theni Districts.
CAPACITY BUILDING OF ADOLESCENT GIRLS -2.doc Report: Capacity Building of Adolescent Girls to Empower them as Link Persons in the Community for Health Programmes (Tamil Nadu State Government).
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