Evaluating the Accessibility, Availability, and Utilization of Services in Adolescent Friendly Health Clinics: Insights from a Rural, Backward Caste-Dominated District in Eastern India

Objective: In India, despite the presence of Adolescent Friendly Health Clinics (Anwesha Clinics), barriers to accessing these services remain prevalent. This study explores the accessibility, availability, and utilization of services at Anwesha Clinics in Bankura Health District, a rural, backward caste-dominated district in eastern India. Material and Methods: This study employed an analytical design with an explanatory sequential mixed-methods approach, combining quantitative and qualitative data. The research was conducted across three randomly selected Anwesha Clinics in Bankura, covering a total sample size of 212 adolescents. Data collection spanned 18 months (April 2021–September 2022) and included a pre-designed semi-structured questionnaire for quantitative data, focus group discussions (FGDs) with adolescents who never visited the clinic, and in-depth interviews with counselors for qualitative insights. Clinic infrastructure and IEC materials were assessed using a UNFPA (United Nations Population Fund) reportbased checklist. Quantitative data were analyzed using SPSS for descriptive statistics, chi-square tests, and logistic regression to identify predictors of service utilization. Qualitative data were thematically analyzed, with coding to identify themes related to service access and barriers. Results: The study found 66.51% service utilization, predominantly for counseling, menstrual issues, and anemia. Barriers included lack of awareness, distance, privacy concerns, and inadequate clinic infrastructure. Logistic regression identified significant predictors of service utilization, with females, adolescents from lower socio-economic classes, and those within 3 km of a clinic being more likely to utilize services. Conclusion: Enhancing clinic infrastructure, increasing awareness, and ensuring privacy are crucial for improving adolescent engagement with Adolescent Friendly Health Clinics.