Published: 2021-08-27

Contribution of community health volunteers in facilitating mobilization for nutritional screening among adolescents (10-19 years) residing in urban Puducherry, India – an operational research study

Sathish Rajaa, Swaroop K. Sahu, Mahalakshmy Thulasingam


Background: Many countries have experimented with community health volunteers (CHVs) to expand their health systems. Adolescents represent 20% of India's population and serve as a vital resource in transforming its social and economic fortunes. Thus, we aimed at evaluating the contribution of CHVs in mobilizing adolescents for the adolescent health clinics (focusing on adolescent nutrition and anaemia) in a selected primary health centre (PHC) of Puducherry.

Methods: A community-based operational research study was conducted in the urban field practice area of JIPMER, Puducherry. Around 5-6 volunteers were selected from each of the 13 anganwadis functioning under the PHC. The volunteers were interviewed before enrolment for willingness. About four batches of sensitization and training sessions were conducted to provide necessary training regarding the prioritized topic. CHVs were then given three months to mobilize the adolescents. This model was evaluated using the theoretical underpinning technique.

Results: Of the total 85 CHVs suggested, around 65 (76.5%) showed willingness in rendering services. About 32 (49.2%) discontinued during the initial weeks of the intervention due to various reasons. The remaining CHVs reached 61 (17.2%) new adolescents and motivated around 48 (78.6%) individuals to visit the health center. All 48 were screened for malnutrition and anemia. About 25 (52%), 5 (10.2%) and 31 (64%) adolescents were diagnosed to have undernourishment (BMI<18.5), obesity (BMI>25) and anaemia (Hb<12) respectively.

Conclusions: About half of the CHVs who volunteered remained till the end. The involved volunteers improved the adolescent coverage by tripling the number of adolescent beneficiaries.


Community health volunteers, Adolescent, Operational research, Health promotion, Nutrition, Anemia

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Four Major Pillars of Primary Health Care System (PHC). Nursing Exercise. 2017. Available at: Accessed on 22 July 2019.

Bridges J, Lucas G, Wiseman T, Griffiths P. Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review. BMJ Open. 2017;7(7):016127.

Vareilles G, Pommier J, Kane S, Pictet G, Marchal B. Understanding the motivation and performance of community health volunteers involved in delivering health programmes in Kampala, Uganda: a realist evaluation protocol. BMJ Open. 2015;5(1):e006752.

United Nations Children's Fund. What Works for Children in South Asia Community Health Workers. UNICEF. Available at: rosa/community.pdf. Accessed on 22 July 2019.

Kironde S, Kahirimbanyi M. Community participation in primary health care (PHC) programmes: Lessons from tuberculosis treatment delivery in South Africa. Afr Health Sci. 2002;2(1):16-23.

Dongre AR. A Community Based Approach to Improve Health Care Seeking for Newborn Danger Signs in Rural Wardha, India. Indian J Pediatr. 2009;76(1):45-50.

Jacobs C, Michelo C, Chola M, Oliphant N, Halwiindi H, Maswenyeho S, et al. Evaluation of a community-based intervention to improve maternal and neonatal health service coverage in the most rural and remote districts of Zambia. PLOS One. 2018;13(1):e0190145.

Iron-Segev S, Lusweti JN, Kamau-Mbuthia E, Stark AH. Impact of Community-Based Nutrition Education on Geophagic Behavior and Dietary Knowledge and Practices among Rural Women in Nakuru Town, Kenya: A Pilot Study. J Nutr Educ. 2018;50(4):408-14.

World Health Organization. Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals. WHO. Available at: alliance/knowledge/publications/alliance/Global_CHW_web.pdf. Accessed on 22 July 2019.

Lomazzi M, Borisch B, Laaser U. The Millennium Development Goals: experiences, Achievements and what's next. Glob Health Action. 2014;7(1):23695.

Adolescent Health (RKSK): National Health Mission. Available at: php?lang=1&level=2&sublinkid=818&lid=221. Accessed on 22 July 2019.

Nagata JM, Ferguson BJ, Ross DA. Research Priorities for Eight Areas of Adolescent Health in Low- and Middle-Income Countries. J Adolesc Health. 2016;59(1):50-60.

Woldie M, Feyissa GT, Admasu B, Hassen K, Mitchell K, Mayhew S, et al. Community health volunteers could help improve access to and use of essential health services by communities in LMICs: an umbrella review. Health Policy and Plan. 2018;33(10):1128-43.

Koon AD, Goudge J, Norris SA. A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa. Human Res Health. 2013;11(1):54.

Scott VK, Gottschalk LB, Wright KQ, Twose C, Bohren MA, Schmitt ME, et al. Community Health Workers' Provision of Family Planning Services in Low‐and Middle‐Income Countries: A Systematic Review of Effectiveness. Stud Family Plann. 2015;46(3):241-61.

Tripathi A, Kabra SK, Sachdev HP, Lodha R. Home visits by community health workers to improve identification of serious illness and care seeking in newborns and young infants from low-and middle-income countries. J Perinatol. 2016;36(1):74.

Department of Health & Family Welfare Services - Government Of Puducherry - India. Primary Health Centres. Available at: in/primary_health_centres.htm. Accessed on 22 July 2019.

Chandrakumari A, Sinha P, Singaravelu S, Jaikumar S. Prevalence of anemia among adolescent girls in a rural area of Tamil Nadu, India. J Fam Med Prim Care. 2019;8(4):1414.

Kishori Shakti Yojana | Ministry of Women & Child Development | GoI. Available at: Accessed on 23 July 2019.

Nutrition programme for adolescent girls | National Portal of India. Available at: https://www.india. Accessed on 22 July 2019.

Rajiv Gandhi Scheme for Empowerment of Adolescent Girls: Sabla | National Portal of India. Available at: Accessed on 22 July 2019.

Haldane V, Chuah FL, Srivastava A, Singh SR, Koh GC, Seng CK, et al. Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PloS one. 2019;14(5):e0216112.

Kew KM, Carr R, Crossingham I. Lay‐led and peer support interventions for adolescents with asthma. Cochrane Database Syst Rev. 2017(4).

Mahalakshmy T, Premarajan KC, Soundappan K, Rajarethinam K, Krishnamoorthy Y, Rajalatchumi A, et al. A Mixed Methods Evaluation of Adolescent Friendly Health Clinic Under National Adolescent Health Program, Puducherry, India. Indian J Pediatr. 2019;86(2):132-9.