Across India, millions of young people step into adulthood without access to reliable sexual and reproductive health (SRH) information or mental health support. In Bihar, where the youth population is largest in proportion (25.2 million, 58% of Bihar’s population) and deeply underserved, this gap is especially stark. More than 40% of young women aged 20–24 were married before 18, menstrual hygiene practices remain worryingly low, and adolescent fertility is among the highest in the country. Layered onto this is the silent crisis of mental health—where mental health needs remain largely unmet, creating systemic barriers to well-being.
Alternative Approach: Youth Health Spaces Inside Colleges
Introduced in Bihar, with technical support from the Population Foundation of India (PFI) , Sehat Kendras are youth-friendly health spaces set up inside_ colleges. These spaces provide judgment-free access to SRH and mental health information through trained counselors and peer educators. They also link young people to government health services.
The model began as a pilot in 31 colleges and has now expanded into 60 institutions across 31 districts, reaching over 80,000 young people across the state, through public systems.
Key Design Features
Sehat Kendras transform institutions young people already trust, their campuses, into safe entry points for health support.
The model is innovative has four key features:
1. Full integration with public systems
The initiative is embedded within the government’s education and health departments. Colleges host the spaces, state systems deploy facilitators, and convergence across departments ensures young people receive comprehensive support rather than fragmented services.
2. Youth-centred, not clinic-centred
Young people learn and ask questions in a comfortable, stigma-free environment.
3. SRH + mental health + gender + menstrual hygiene under one roof
The integrated curriculum mirrors reality, enabling deeper understanding and behavioural change.
4. Peer leadership as a mechanism for norm change
Each Sehat Kendra trains peer educators who spark conversations and lead group sessions, fostering community ownership.
What the Evidence Indicates
An impact study of Sehat Kendra suggests improvements in awareness on SRH and health outcomes in Bihar. The findings indicate
- An increase in mental health awareness, with 96% of respondents acknowledging familiarity with the topic.
- 95% of respondents reported increased awareness of SRH, with over 55% considering Sehat Kendra as their primary source of information.
- Menstrual hygiene practices have also improved, with 84% of respondents using sanitary napkins, compared to the state average of 58.8% reported by NFHS-5.
- Awareness of HIV/AIDS has increased significantly, with 85% of respondents demonstrating comprehensive knowledge.
- Over 85% actively applied the knowledge gained from Sehat Kendra in their communities and 97% recommended it to their peers.
Considerations for Scalability and Sustainability
Many promising youth initiatives struggle to scale because they rely on expensive infrastructure, external staffing, or donor-driven mechanisms. Sehat Kendras were intentionally designed to avoid these pitfalls.
- Government ownership from the beginning ensures sustainability
- Using college campuses and trained faculty/peer educators keeps costs low and scalable
MIS systems built for low-resource settings ensure easy monitoring. The experience to date raises questions about how such models could be extended to reach a wider youth population across Bihar.
Some possible directions for Sehat Kendras would include:
- Adapting to schools, training Institutes and community learning spaces
- Building digital learning modules and tele-counselling support
- Strengthening research and evidence for national replication
- Supporting inter-state learning and policy adoption
Sehat Kendras creates a systemic solution illustrate how integrated campus based approaches may contribute to :
- Elevating youth voices
- Normalising help-seeking
- Strengthening public systems
- Reducing early marriage and adolescent pregnancy
- Improving mental well-being and social confidence
- Building healthier, more gender-equitable communities
The experience offers lessons for states exploring institutional approaches to youth and health and wellbeing.
