The WHO Global Accelerated Action on Adolescent Health stated that "health professionals should lead the international and national movements in adolescent health care by collaborating with other stakeholders" [6]. Worldwide, pediatricians are the strongest advocates for adolescent health. In 1999, the Indian Academy of Pediatrics (IAP) adopted the age on policy of pediatric care. This policy stated that pediatricians should look after healthcare needs of young people upto and including 18 years of age [7]. This led to the formation of IAP Committee on Adolescent Health and the establishment of Adolescent Health Academy (AHA) in 2000, as a multidisciplinary, speciality chapter of IAP, dedicated to adolescent healthcare.

Adolescence is a transitional phase of life between childhood and adulthood. It is one of the most rapid periods of growth and development. Adolescence is characterized by autonomy bids, greater need for privacy, identity crisis, peer affiliation, experimentation, mood swings, impulsivity, and sometimes conflicts with family. It is an age of opportunity as well as vulnerability. Highly reactive limbic and reward systems with a relatively immature ‘control center’ – the prefrontal cortex – makes adolescents prone to high-risk behaviors such as drug use, self-harm, unsafe driving, unhealthy media usage and unsafe sexual practices. The lifestyle adopted in this period invariably tracks into adulthood.

Adolescents are known to have poor health-seeking behavior as they may find the current healthcare facilities irrelevant to their needs. Adolescents feel that they are often judged and criticized by adults, and hence, hesitate to approach them for help. Adolescent healthcare providers should be familiar with neurodevelopment and psychosocial changes occurring in this age group. They should have a respectful, empathetic and non-judgmental attitude towards teens.

The existing health services do not cater to the specific problems of adolescents. Moreover, it is a challenge for the health sector to respond to their needs adequately by offering services in a friendly manner in a non-threatening environment. Global research has identified two key common characteristics of adolescent friendly health services (AFHS) as perceived by adolescents. These are protection of confidentiality, and to be treated with respect by the healthcare provider. The key ‘friendly’ component of AFHS mandates facility-based clinical and counseling services for adolescents, which are:

According to WHO standards, infrastructure should be clean, bright and colourful; it should be easily accessible by the adolescents (distance and convenient working hours); proper awareness should be created about the clinic and range of service it provides; the healthcare workers at clinic should be non-judgmental and competent health service providers; they should maintain privacy and confidentiality; adequate community awareness should be created about the services provided; and there should be provision for referral from the periphery/community and further referral linkages with the higher facilities and specialty clinics [8].

In clinical practice, pediatricians should incorporate the following changes into their practice:

Recognizing the need for a comprehensive program for adolescents, in 2014, the Government of India launched Rashtriya Kishor Swasthya Karyakram (RKSK), a national adolescent health strategy encompassing community-based health promotion alongside strengthening and scale up of adolescent friendly health clinics offering preventative, diagnostic and curative services in six key areas: nutrition, sexual and reproductive health, non-communicable diseases, substance misuse, injury and violence prevention, and mental health [2]. Subsequent reports evaluating the implementation of RKSK have since identified several barriers to implementation.

Since the year 2000, IAP in association with AHA has conducted many skill- and capacity-building professional training programs and community-oriented activities to promote adolescent health in all parts of the country. Mission Kishore Uday 2013 focussed on comprehensive adolescent health care and Mission Kishore Uday 2018-19 to prevent adolescent suicides are examples of such programs [9]. In 2019, to ensure standardized quality healthcare for adolescents, IAP decided to formulate guidelines on AFHS and management of suicidal behavior in clinical practice. To promote research and disseminate scientific information, Indian Journal of Adolescent Medicine was launched by AHA IAP in 2019.

Active involvement and contribution of IAP members to adolescent healthcare and RKSK would help to ensure universal health coverage for all adolescents. Healthy adolescents would thereby achieve their optimum potential as adults, and contribute to building a strong and prosperous nation.

1. United Nations Department of Economic and Social Affairs Population Division. World Population Prospects: 2015 Revision, Key Findings and Advance Tables. New York: United Nations; 2015.

2. Adolescent Health Division, Ministry of Health and Family Welfare, Government of India. Strategy Handbook. Rashtriya Kishor Swasthya Karyakram; 2014.

3. Azzopardi PS,　Hearps SJC,　Francis KL,　Kennedy EC, Mokdad AH, Kassebaum NJ, et al. Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories, 1990-2016. Lancet. 2019;393:1101-18.

4. Patton GC,　Sawyer SM,　Santelli JS,　Ross DA, Afifi R, Allen NB, et al. Our future: a　Lancet　commission on adolescent health and wellbeing. Lancet. 2016;387: 2423-78.

5. Patton GC,　Olsson CA,　Skirbekk V,　Saffery R, Wlodek ME, Azzopardi PS, et al. Adolescence and the next generation. Nature. 2018;554:458-66.

6. World Health Organization. Global Accelerated Action for the Health of Adolescents (AA-HA): Guidance to Support Country Implementation. Geneva: WHO; 2017.

7. John JT. IAP policy on age of children for pediatric care. Indian Pediatr. 1999;36:461-3.

8. World Health Organization. Making Health Services Adolescent Friendly: Developing National Quality Standards for Adolescent Health Services. Geneva: WHO; 2012.