Table 1.

Priority actions for adolescent and school health in India

	Indicators for priority action	Description	Rashtriya Kishor Swasthya Karyakram	School health programme (Ayushman Bharat)	Programmes with other ministries (WCD, MoYAS)
I.	Strengthen service delivery across the sectors and platforms
A	Prioritise adolescents in UHC benefit packages	Develop comprehensive, evidence-based adolescent health programmes and services responding to disease burden and needs, tackling a full spectrum of adolescent health issues including and beyond sexual and reproductive health.	√	√	√
B	Invest in education of health workers	Invest in the education of health workers, the public health workforce and other professionals, including leadership models, to improve the quality of and demand for adolescent services.	√	√	√
C	Implement legal frameworks	Implement legal frameworks that adopt a human rights approach and guarantee access to services in the best interest of adolescents, including those most marginalised and vulnerable	√	√	√
D	Develop and implement national quality standards	Develop and implement national quality standards for adolescent responsive healthcare services that are both technically sound and attractive to adolescents themselves.	√	–	–
E	Improve efficiency by codelivering or bundling health services	Improve efficiency by codelivering or bundling health services and information for adolescents and deploying interventions across multiple platforms such as health facilities, schools, e-health and community-based initiatives	√	√	√
F	Engage and act beyond the health sector	Engage and act beyond the health sector, addressing the broader structural, environmental and social determinants of adolescent health as a path for prevention.	√	√	√
II.	Improve governance—enhance financing
G	Acknowledge the economic benefit of investment in adolescent health	Acknowledge the economic benefit of investment in adolescent health so that it is included in health spending considerations.	√	√	–
H	Assess the impact of out-of-pocket payments	Assess the impact of out-of-pocket payments on adolescents and remove user fees or reduce costs accordingly	X	X	X
I	Cover all adolescents with mandatory, prepaid, pooled funding	Cover all adolescents with mandatory, prepaid, pooled funding for the health services that comprehensively address adolescent health needs	X	X	X
J	Increase spending of allocated budget for adolescent health	Increase spending on adolescent health by improving capacity in the states and districts, while strengthening the costing and budgeting of programmes	X	X	X
K	Include adolescent specific focus in UHC investment plans	Include adolescent-specific focus in UHC investment plans so that investments reach beyond domain-specific service delivery and include comprehensive provisions for adolescent health	√	√
L	Ensure that financing and service delivery are designed so to ‘leave no one behind’	Ensure that financing and service delivery are designed so that ‘leave no one behind’ by focusing on the needs of the most vulnerable and marginalised adolescents, reducing disparities driven by gender, sexual orientation, age, socioeconomic status, migrant status or disability	√	√
III.	Through accountability, research, monitoring and evaluation
M	Engage adolescents in national and subnational policy, legislation and programme processes	Engage adolescents in national and subnational policy, legislation and programme processes through formal and informal mechanisms. Deploy technology and increase capacities of adolescents for a shared role in design, implementation, monitoring and evaluation	√	√	–
N	Monitor adolescent health	Monitor adolescent health and service coverage, quality and spending of budget through existing national data systems and surveys (eg, national HMIS, Global Youth Tobacco Survey and STEPS on non-communicable diseases risk factors) across different ministries.	√	X	–
O	Report regularly on adolescent health indicators	Report regularly on adolescent health indicators, with disaggregation by sex and age (10–14/15–19/20–24 years) and use the information to take public health actions.	√	√	–
P	Drive evidence-based programming, policy and resource allocation	Drive evidence-based programming, policy and resource allocation by identifying priority health needs of different adolescent groups and using the monitoring reports	√	√	X
Q	Strengthen research and policy capacity	Strengthen research and policy capacity to increase understanding of health determinants, disease burden and evidence-based action specific to adolescent health	X	X	X

√: Indicator covered/included in the health programme.

X: Indicator is not planned or covered in the health programme.

-: Indicator not relevant for the health programme.

HMIS, Health Management Information System; MoYAS, Ministry of Youth Affairs and Sports; UHC, Universal Health Coverage; WCD, Women and Child Development.