title: A primary care approach for adolescent care and counseling services.
abstract: OBJECTIVE
  Adolescents can have mental, emotional, and behavior problems that are a source of stress for the child as well as the family, school and community. These may disrupt the adolescent's ability to function normally. Adolescents also have reproductive concerns especially at menarche. Considering the extent of problems of adolescents and the lack of adolescent care and counseling services, it was felt that community adolescent care counseling services should be made available. This article describes the steps involved in the setting up of Taluk model of adolescent care and counseling services.
  
  
  METHODS
  Following steps were involved in setting up a Taluk model of adolescent care counseling service delivery system. Step I: Focus Group Discussions (FGDs) among Stakeholders. Step II: Conceptualization and Strategy planning for service delivery. III: Finalization of service delivery model Step IV: Workshops for finalization of TSQ-T 2008 version the tool to be used for assessing the adolescents in the ARSH clinics. Step V: Training Programme for Medical/Paramedical health staff. Step VI: Awareness programs for mothers of adolescents. Step VII: Setting up of ACS/ARSH clinics at Taluk hospitals. Step VIII: Evaluation of the utilization of services at Taluk hospitals. The clinic has been well utilized with 1,588 adolescents being seen in 2 years.
  
  
  RESULTS
  Medical and Reproductive problems among adolescent girls were anemia, underweight, dysmenorrhoea, menstrual irregularities and symptoms of Polycystic Ovarian Syndrome, whereas among boys problems were mostly related to concerns about masturbation and its perceived ill effects. The psychosocial problems ranged from minor anxieties, sadness and adjustment problems to psychiatric disorders. Scholastic problems included poor concentration, poor study habits and low intelligence quotient.
  
  
  CONCLUSIONS
  The success of the clinics in these five hospitals can be replicated in other parts of the state as well as the country. These will go a long way to ameliorate the morbidity of adolescents.
authors: Child Development Centre, Medical College, Thiruvananthapuram 695011 Kerala, India. cdcmkc@gmail.com
authors: M K C
authors: MK
authors: Nair
authors: D S
authors: DS
authors: Chacko
authors: M S
authors: MS
authors: Indira
authors: K E
authors: KE
authors: Siju
authors: Babu
authors: B
authors: George
authors: P S
authors: PS
authors: Russell
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