Consider multiple focal points of catchment. Beyond health centers, coverage for adolescents should extend to various locations:

• Health Centers: Establish Adolescent Health Corners for health services.
• Schools: Utilize guidance counseling services and infirmaries.
• Barangay Centers: Utilize facilities such as Community Police Units (CPU), Violence Against Women and Children (VAWC) desks, and Sangguniang Kabataan (SK) corners.

At the other end of the network, ensure that the network includes end-referral points for essential adolescent services, including:

• General Health Services
• Teenage Pregnancy Support
• Mental Health Services
• Shelter and Protection from Abuse or Violence
• Educational Support
• Employment Assistance

By considering these focal points and end-referral points, the network can ensure comprehensive coverage and accessibility for adolescents across various domains of health and well-being.

• Identify the range of services offered within the network. Define the scope of services encompassing both health and non-health sectors to address the comprehensive needs of adolescents. This entails establishing service packages covering Adolescent Health alongside other essential components for Adolescent Development, such as Education, Social Welfare, and Protection.

Table 1: Summary of minimum service package for Health & Non-health Adolescent Services summarized from the KADA Playbook and ISDN4AHD Guidebook.

• Establish criteria for safe spaces for adolescents.
  • Develop a set of criteria encompassing facility standards, equipment availability, staffing requirements, and service provision guidelines to ensure the creation of safe spaces for adolescents. Health centers designated as AFHFs must adhere to a standardized checklist tailored to meet the specific needs of adolescents. This checklist outlines the essential requirements for different levels of accreditation, ensuring that facilities meet the necessary standards for adolescent-friendly care (refer to Figure 2).

Figure 2: Adolescent-friendly Health Facility Levels of Accreditation. (Source: DOH Adolescent Health and Development Program Manual of Operations, p 95).

• • Schools should adhere to guidelines established by the Department of Education (DepED) or the Local Government Unit’s (LGU) respective Schools Division Office (SDO). A sample guideline for setting up teen centers, derived from the Policy Guidelines on the Implementation of Comprehensive Sexuality Education (DepEd Order 2018-031), can serve as a reference.
  • Barangays are required to establish a separate child protection corner or Violence Against Women and Children (VAWC) desk in accordance with the standards outlined in the Joint Memorandum Circular 2020-001, issued by the Department of the Interior and Local Government (DILG) and the Council for the Welfare of Children (CWC).
  • Other non-health community centers can follow the standards provided by the Council for the Protection of Children (CPD) for establishing Teen Centers.

The KADA/ISDN Team has the flexibility to incorporate additional standards tailored to the specific needs identified and resources available within the LGU.

Figure 3: Physical Standards for KADA Centers. (Source: DOH KADA Network Service Delivery Network Training Workshop Module 0- Introduction to the KADA Network Playbook).

• Generate a  directory of facilities, including their location, office head, designated point of contact, contact details, offered services, and available referral points. For frontline facilities such as health centers, schools, barangays, and teen centers, the inventory should specify which services are directly provided on-site and which require referral, along with the corresponding referral destinations. Additionally, for endline services, identify the existing channels for back-referral.

Conduct needs analysis of health workers and volunteers in terms of adolescent health and development. While each office has a specialized role in the network, it is important to emphasize the importance of those service providers at the frontline of the network and their relation with the end referral facilities and adjacent referral streams.

• Conduct a needs analysis.
  • Evaluate the proficiency of health workers and volunteers in adolescent health and development. Acknowledge the specialized roles of each office within the network while emphasizing the significance of frontline service providers and their connection with end referral facilities and adjacent referral streams.
• Training Requirements for Frontline Service Providers. Ensure that frontline service providers undergo training in conducting HEEADSSS screening, a systematic approach to assessing risks in adolescents. This training includes:
  • Foundational Course on Adolescent Health Care for Primary Service Providers
  • Adolescent Job Aid (AJA) or AJA 2.0 Skills Enhancement Training (ASET) – comprehensive course that can be provided to service providers, in order to capacitate them in conducting HEEADSSS screening.
  • Adolescent Health Education and Practical Training (ADEPT) – improve the CHV’s ability to communicate with adolescents, improve the capacity to conduct HEEADSSS screening.
  • Sexually Healthy and Personally Empowered-Adolescent (SHAPE-A) – improve CHV’s ability to communicate with adolescents and practice non-judgmental conversation. SHAPE-A can also be taught to peer educators.
• Capacitate All Staff.
  • Train all staff, including security guards, clerks, and community health volunteers, in non-biased, non-judgmental communication to create an inclusive environment for adolescents. Conduct a Whole-site Orientation within the facility to educate all staff on proper communication with adolescents using the SHAPE-A and KADA Communications Plan.

    Tip: Collaborate with the Gender and Development Office to expand mandatory Gender Sensitivity and Gender Audit training for all LGU staff, enhancing their communication skills.

• Orient End-Referral Service Providers.
  • Orient service providers working at end-referral points and the network’s central command (if applicable) on receiving and providing referral protocols. Standardize referral forms and protocols, and establish a system for referral and back-referral by convening the ISDN TWG/City Leadership Team.

• Regular Staff Meetings:  The service providers, once capacitated with the required training, need to be coached and supervised to reinforce their confidence in delivering service. Hold regular staff meetings with Adolescent Health and Development  providers to provide ongoing support and boost their confidence. These meetings serve as a platform to address challenges, share best practices, and disseminate experiences.
• Refresher Training: Conduct refresher training sessions regularly for service providers across all offices to ensure they remain updated with the latest knowledge and skills required for effective service delivery.
• Mutual Support Groups: Recognize the mental and emotional burden associated with handling adolescent cases. Establish mutual support groups among service providers to create a supportive environment where they can share their burdens and receive affirmation from their peers.

Engage Youth Champions and Peer Navigators:

• Involve youth champions and peer navigators in the planning, development, implementation, and monitoring of programs. Orient them on conveying key messages effectively. Peer navigators, known for their approachability, can assist adolescents in accessing SRH services, particularly in schools or community centers. Peer educators, commonly found in mental health or drug-related programs, can also provide valuable support.

 Capacity Building for Volunteers:

• Strengthen volunteers’ capacity through peer navigators’ training and similar activities.
  • Offer SHAPE-A Training to enhance skills for empathic listening and communication with adolescents.
  • Provide Peer Navigators Training, developed by organizations like USAID ReachHealth, to equip peer educators with basic information on nearby Service Delivery Points.
  • Utilize resources like the Healthy Young Ones User Guide for Primary Healthcare Providers.

Tip: In some regions, youth leaders may serve as peer educators or navigators. However, note that peer educators are limited to providing information and health promotion only.

Disseminate Information:

• Utilize a network of peer navigators and CHVs, and other service providers to disseminate information about the network and its range of services effectively.

After establishing and strengthening the initial frontline sites, it’s essential to consolidate the service network into a clear directory and referral algorithm. The system must be able to:

• Standardize referral protocols in the initial catchment areas;
• Categorize and send the appropriate referral request to the concerned agency/ies; and,
• Monitor if service was provided and give regular feedback.

1. Convene a workshop involving all relevant stakeholders to collaboratively develop the referral algorithm. During this session, each agency should:
   • Identify Liaison Points: Determine specific individuals or units within each agency responsible for receiving and processing referrals.
   • Outline Internal Services: Document the range of services offered by each office or agency involved in the network.
   • Define Lead Time and Protocols: Establish lead times and internal protocols for handling referrals within each agency, ensuring efficient and timely service delivery.
2. Designate a central command or secretariat to oversee the network’s operations. Engage entities like the Sangguniang Kabataan (SK) Federation and the City Youth Development Office (LYDO) to serve as the central coordinating body or secretariat for the Technical Working Group.
3. Develop a referral algorithm that outlines all potential referral pathways within the network.

Figure 4: Sample AHD Referral System. (Source: CPD Information and Service Delivery Network for Adolescent Health and Development Guidebook p.52).

1. Create a manual of procedures that details standard referral protocols and specific protocols for each service provided by the participating offices or agencies. This document will serve as a reference guide for implementing the referral process effectively and consistently across the network.

• Implement a client satisfaction survey system to gather feedback from adolescents accessing services. These surveys should be easily accessible, straightforward, and allow for anonymity to encourage honest responses.

  Tip: Consider digitizing this system, like in the City of Manila, by creating a QR code linked to a Google form. This makes it easily accessible for respondents and simplifies data collection for the Health Department.

• Hold regular meetings with the Technical Working Group (TWG) to review and discuss updates and potential changes to the Information and Service Delivery Network (ISDN).
• Document the provision of adolescent sexual and reproductive health services thoroughly. Utilize a Quality Implementation Checklist for AFHS  as a monitoring tool to ensure adherence to standards.
  • Use feedback gathered from client satisfaction surveys to inform service enhancement initiatives and improve the overall quality of care provided to adolescents.