Implementation of RKSK Adolescent Substance Use Counselling Services in Three High-Burden Districts of Madhya Pradesh: A Cross-Sectional Study

Apoorva Dubey

doi:10.69968/ijisem.2026v5i41-6

Authors

Apoorva Dubey Master of Public Health, SAM Global University, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.69968/ijisem.2026v5i41-6

Keywords:

adolescents, substance use, RKSK, counselling, Adolescent Friendly Health Clinic, Madhya Pradesh, implementation evaluation

Abstract

Background: Adolescent substance use is an important public health concern, particularly in socially and economically vulnerable settings. The Rashtriya Kishor Swasthya Karyakram (RKSK) includes adolescent-friendly counselling and preventive services intended to address substance misuse.

Objective: To evaluate the implementation of RKSK adolescent substance use counselling services in Shahdol, Rewa, and Sidhi districts of Madhya Pradesh, with particular emphasis on awareness, Adolescent Friendly Health Clinic (AFHC) utilization, counsellor availability, privacy, perceived usefulness, and implementation barriers.

Methods: A descriptive cross-sectional quantitative study was conducted among 100 adolescents aged 10–19 years in selected areas of Shahdol, Rewa, and Sidhi. The districts were purposively selected and respondents were recruited using purposive/convenience sampling. Data were collected using a structured questionnaire covering awareness and utilization, service quality, and implementation barriers. Descriptive statistics, including frequencies and percentages, were used.

Results: Forty-two percent of respondents were partially aware of RKSK counselling services, while 28% were fully aware. Although 44% had visited an AFHC at least once, 38% knew about AFHCs but had never visited. Counsellors were reported to be always available by 24% and available only sometimes by 41%. Privacy was reported as always maintained by 35% and sometimes maintained by 39%. Peer educators were the most commonly reported source of information (34%). Counselling was considered very useful by 31% and moderately useful by 40%. The largest reported implementation barrier was lack of awareness (37%), followed by shortage of counsellors (24%) and social stigma (19%).

Conclusion: RKSK provides an important institutional framework for adolescent substance-use prevention and counselling, but implementation remains constrained by incomplete awareness, low service utilization, inconsistent counsellor availability, gaps in privacy, inadequate IEC materials, and stigma. Strengthening peer-led and school-based awareness, counsellor capacity and availability, confidential AFHC infrastructure, and programme monitoring may improve service uptake and quality.

References

[1] Barua A, Watson K, Plesons M, Chandra-Mouli V, Sharma K. Adolescent health programming in India: a rapid review. Reprod Health. 2020;17(1):87.

[2] Jain N, Bhatnagar T, Sahoo KC, et al. Progress and challenges in implementing adolescent and school health programmes currently implemented in India. BMJ Open. 2022;12(5):e047435.

[3] Shah T, Mavalankar D, Singh A. Situational analysis of Rashtriya Kishor Swasthya Karyakram implementation in Gujarat. J Family Med Prim Care. 2022;11(2):450-458.

[4] Ministry of Health and Family Welfare, Government of India. Rashtriya Kishor Swasthya Karyakram (RKSK) Strategy Handbook. New Delhi: MoHFW; 2014.

[5] Ministry of Health and Family Welfare, Government of India. RKSK Implementation Guide on Adolescent Friendly Health Clinics. New Delhi: MoHFW; 2015.

[6] Ministry of Health and Family Welfare, Government of India. National Adolescent Health Programme: Rashtriya Kishor Swasthya Karyakram. New Delhi: MoHFW; 2014.

[7] Chandra-Mouli V, Lane C, Wong S. What does not work in adolescent sexual and reproductive health: a review of evidence on interventions commonly accepted as best practices. Glob Health Sci Pract. 2015;3(3):333-340.

[8] Patton GC, Sawyer SM, Santelli JS, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423-2478.

[9] World Health Organization. Global status report on alcohol and health 2018. Geneva: WHO; 2018.

[10] World Health Organization. Adolescent mental health and substance use prevention framework. Geneva: WHO; 2021.

[11] National Institute of Mental Health and Neuro Sciences. Magnitude of Substance Use in India. Bengaluru: NIMHANS; 2019.

[12] United Nations Office on Drugs and Crime. World Drug Report 2022. Vienna: United Nations; 2022.

[13] UNICEF India. Adolescent Development and Participation in India: Situation Analysis Report. New Delhi: UNICEF; 2021.

[14] United Nations Population Fund. Counselling for Adolescents: Learning Manual for RKSK Counsellors. New Delhi: UNFPA India; 2020.

[15] National Health Systems Resource Centre. Adolescent Health Care Training Manual for Community Health Officers. New Delhi: NHSRC; 2021.

[16] Viner RM, Ozer EM, Denny S, et al. Adolescence and the social determinants of health. Lancet. 2012;379(9826):1641-1652.

[17] Picoito J, Santos C, Loureiro I, Aguiar P, Nunes C. Gender-specific substance use patterns and associations with family, school and peer factors in adolescents. Child Adolesc Psychiatry Ment Health. 2019;13:4.

[18] Richter M, Kunst AE, Kannas L, et al. Socioeconomic inequalities in adolescent smoking across countries. Eur J Public Health. 2015;25(3):457-463.

[19] Godley SH, Smith JE, Meyers RJ, Godley MD. The adolescent community reinforcement approach for adolescent cannabis users. Rockville, MD: SAMHSA; 2001.

[20] Campos-Melady M, Smith JE, Meyers RJ, Godley SH, Godley MD. Effect of therapist adherence and competence in adolescent substance use counselling outcomes. Psychol Addict Behav. 2017;31(1):112-123.

[21] Webb CA, DeRubeis RJ, Barber JP. Therapist adherence and competence in relation to treatment outcomes: a meta-analytic review. J Consult Clin Psychol. 2010;78(2):200-211.

[22] Sahadevan S, et al. Effect of adolescent health policies on health outcomes in developing countries. Youth. 2023;3(4):43-58.

[23] Ministry of Health and Family Welfare, Government of India. Peer Education Programme under Rashtriya Kishor Swasthya Karyakram: Operational Guidelines. New Delhi: MoHFW; 2020.

[24] Daniel S. Peer Education Programme under Rashtriya Kishor Swasthya Karyakram: Implementation Experiences and Lessons. New Delhi: National Centre for Good Governance; 2021.

[25] Patton G, Coffey C, Cappa C, et al. Health of the world's adolescents: a synthesis of internationally comparable data. Lancet. 2012;379(9826):1665-1675.