The Tarunya Project's efforts to improve the quality of adolescent reproductive and sexual health services in Jharkhand state, India: a post-hoc evaluation.

Following the International Conference on Population and Development Adolescent Reproductive and Sexual Health (ARSH) was recognized as a top development priority in India's National Population Policy 2000. In 2006 a separate ARSH strategy was articulated within the National Rural Health Mission. In Jharkhand, one of the poorest and least developed states in India, in 2008 the state government launched a Tarunya Project in collaboration with EngenderHealth. The project provided cascading ARSH training to government staff at secondary care facilities and strengthened outreach activities to enhance community engagement. After 5 years of implementation, the project was evaluated by a team from the World Health Organization. The evaluation found that the project provided training and ongoing backstopping support to strengthen the ARSH readiness of health facilities. The project's intervention efforts contributed to improvement in quality and initial use of ARSH services. The performance of health facilities was appreciated by clients. But there was little correspondence between the project's monitoring and the period of exposure of the facilities to the project's interventions and service quality. The evaluation also showed that handholding and backstopping by the project were still very much needed.