TCIHC Urban Tales: Firozabad Midwife Is a Beacon of Hope for Adolescent Health

The following story is part of a series from The Challenge Initiative for Healthy Cities (TCIHC) called “Urban Tales,” occasional real-life stories of women and girls in India benefiting from TCIHC’s work supporting local governments to implement high-impact family planning and adolescent and youth sexual and reproductive health (AYSRH) interventions.

Nirmesh Kashyap is an Auxiliary Nurse Midwife who works with adolescents in Firozabad’s slums.

Nirmesh Kashyap is an Auxiliary Nurse Midwife (ANM) from Firozabad who works with adolescents in the city’s slum areas. Here, she recalls one of her most memorable experiences helping a young adolescent patient:

For the last two years, I am conducting community adolescent health day in slum areas where I meet adolescents, 15 to 19 years old, and use interactive games provided by TCIHC to trigger discussion on SRH (sexual and reproductive health) issues.

Community adolescent days are generally reverberant with the chatter of adolescents who turn up for the event. However, on 4 March 2021, I came across a 17-year-old named Suman who was unusually quiet. After the event, along with other adolescents, she was referred to visit the nearest urban primary health center (UPHC) for a facility adolescent health day (F-AHD) to avail adolescent health services.

When she visited on F-AHD, I counseled her on a nutritious diet, mental health issues and menstrual hygiene to help her express herself. She underwent hemoglobin testing, body mass index screening, and accepted sanitary napkins and iron-folic acid supplements. Yet she remained silent. For the next few months, she consecutively visited the UPHC on F-AHD to collect sanitary napkins. During each of her visit, I made efforts to talk to her personally. One day, I inquired if she had some problem or wanted to discuss anything that she had tears in her eyes. During counseling, she shared that a lump in her breast was the cause of her worry and the reason behind her aloofness. Additionally, no one in her family was aware of this issue.

I discussed her case with the medical officer-in-charge and visited her house. Suman lives with her grandparents. I discussed her health condition with them and advised them to visit the district hospital to seek Rashtriya Kishor Swasthya Karyakram (RKSK – India’s National Adolescent Health Program) counselor and doctor’s advice. Fortunately, they understood the gravity of the situation and visited the district hospital with Suman.

After a few months, Suman met me at the UPHC but this time, with a wide smile, she shared, ‘Didi, doctor operated on me and it was just on time! and it is all because of your timely advice that I am fit and relieved. Thank you didi for helping me.’

I patted her shoulder and assured her that this is what we are here for.”

Firozabad is one of the AYSRH cities of TCIHC where ANMs like Nirmesh are coached and sensitized by TCIHC’s AYSRH counselors on providing SRH information and services to adolescents in a friendly manner. For the last two years, these coached ANMs are promoting adolescent-friendly health services through community adolescent health day and facility adolescent health day in Firozabad.