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Policy brief on the case for investing in research to increase access to and use of contraception among adolescents.
Seattle, Washington, PATH, 2015 Mar. 4 p.This document outlines why governments and donors should invest now in research to help determine and implement the most effective and efficient ways to enable adolescents to access and use contraception. It summarizes the findings of a longer technical report.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (FS-15-136; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This executive summary introduces the full report (See POPLINE record 337627) examining the 50-year period starting in the mid-1960s that witnessed a dramatic decline in fertility and steady increase in contraceptive use in the Latin America and Caribbean (LAC) region.
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr.  p. (TR-15-101; USAID Cooperative Agreement No. AID-OAA-L-14-00004)This report examines the 50-year period starting in the mid-1960s that witnessed a dramatic decline in fertility and steady increase in contraceptive use in the Latin America and Caribbean (LAC) region. The current contraceptive prevalence rate (all methods) of 74 percent is among the highest of any region in the developing world. Many factors have contributed to the dramatic decline in fertility in the LAC region over the past 50 years: increased educational levels, improved economic conditions, decreased infant and child mortality, rapid urbanization, political stability, and changing cultural norms, among others. While recognizing the influence of these factors on fertility, what role did use of family planning play in fertility decline in the region? What lessons can be drawn for other developing countries committed to a development path that strengthens family planning services and improves health and living standards for their people? This report examines the specific role of family planning in accelerating fertility decline in the LAC region.
The World Health Organization Multicountry Survey on Maternal and Newborn Health project at a glance: the power of collaboration.
BJOG: An International Journal of Obstetrics and Gynaecology. 2014 Mar; 121 Suppl 1:v-viii.Add to my documents.
Adolescent fertility since the International Conference on Population and Development (ICPD) in Cairo.
New York, New York, United Nations, 2013.  p. (ST/ESA/SER.A/337)This report presents new estimates of the levels and trends in adolescent fertility worldwide from 1990-1995 to 2005-2010. It highlights key social and demographic factors underlying adolescent fertility, including early marriage, first sex, contraceptive use and education. This period coincides with assessments of progress in implementing the Programme of Action of the ICPD and the Millennium Development Goals, which include a focus on reducing early childbearing, expanding access to reproductive health and investing in the human capital of youth, especially girls.
New York, New York, United Nations Population Fund [UNFPA], 2013.  p.This report presents an update on pregnancies among adolescents. The report covers trends during the last 10 years and variations across geographic, cultural and economic settings, as well as interventions available to minimize pregnancy among adolescents. The report lists evidence for these programmatic approaches, and challenges that nations will have to deal with in the next 20 years given current population momentum.
WHO Guidelines on preventing early pregancy and poor reproductive outcomes among adolescents in developing countries.
Journal of Adolescent Health. 2013 May; 52(5):517-522.Adolescent pregnancy and its consequences represent a major public health concern in many low- to middle-income countries of the world. The World Health Organization has recently developed evidence-based guidelines addressing six areas: preventing early marriage; preventing early pregnancy through sexuality education; increasing education opportunities and economic and social support programs; increasing the use of contraception; reducing coerced sex; preventing unsafe abortion; and increasing the use of prenatal care childbirth and postpartum care. In each of these areas, the World Health Organization recommends directions for future research. The summary concludes with a brief look at global and regional initiatives that provide a window of opportunity for stepping up action in this important area.
New York, New York, UNICEF, 2012 Apr.  p.Adolescents experience intense physical, psychological, emotional and economic changes as they make the transition from childhood to adulthood. This edition of Progress for Children sets out who adolescents are, where they live, what they do, what their problems are and how their needs are -- or are not -- being met. Understanding adolescents in all their diversity is fundamental to improving their lives.
Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. WHO guidelines.
Geneva, Switzerland, WHO, Department of Maternal, Newborn, Child and Adolescent Health, 2011. 195 p.The purpose of these guidelines is to improve adolescent morbidity and mortality by reducing the changes of early pregnancy and its resulting poor health outcomes. The publication's two main objectives are to: 1) identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and acces to maternal health services by adolescents; and 2) provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions that are most appropriate for the needs of their countries and contexts. The document provides a summary of the recommendations for each of the six major outcomes presented in this guideline. Both action and research recommendations are listed.
[Ethic evaluation of sexual health programs on adolescence]. Valoracion Etica de los Programas de Salud Sexual en la Adolescencia.
Cuadernos De Bioetica. 2011 Jan-Apr; 22(74):77-91.In public health services, the interest in sexuality seems to turning from traditional topics such as potential treatments for male erectile dysfunction, psychosomatic disorders, the control of premature ejaculation and contraception. Instead, an increasingly prominent role is being given to prevention strategies carried out by means of campaigns or through sexual health programme sin schools. The different teaching strategies that underlie these programmes, which in many cases lack social consensus but are often promoted by international organizations such as WHO or UNESCO, reveal not only divergent ethical conceptions and worldviews on the meaning of sexuality, but also conflicting starting points, means and goals, focusing either on barrier-contraceptive methods or on sexual abstinence and personal responsibility. There is therefore a pressing need to understand the scientific evidence underlying each educational approach and the ethical postulates of each pedagogical proposal. This paper presents an outline of a six-point adolescent sexuality education program, which is respectful of individuals' ethical convictions. Given that few works on preventive medicine issues include an ethical evaluation of the steps followed in their development, this article also proposes a systematic evaluation of strategies for sexual health in the community that is developed through four steps verifying the following aspects: 1) the accuracy of information, 2) the level of evidence, 3) efficiency and 4) non-maleficence about the target population of each health program. The methodology used in these sexual health programs is another aspect that will verify their ethical consistence or, conversely, their absence of ethical values. We emphasize the duty of designers of programme for children not to carry then out against the will of their parents or tutors, and not conceal sensitive and relevant information.
Geneva, Switzerland, WHO, .  p.The Preventing early pregnancy: What the evidence says? in Developing Countries presents the evidence to design national policies and strategies. It contains recommendations on action and research for preventing: (1) early pregnancy: by preventing marriage before 18 years of age; by increasing knowledge and understanding of the importance of pregnancy prevention; by increasing the use of contraception; and by preventing coerced sex; (2) poor reproductive outcomes: by reducing unsafe abortions; and by increasing the use of skilled antenatal, childbirth and postnatal care. These guidelines are primarily intended for policy-makers, planners and programme managers from governments, nongovernmental organizations and development agencies. They are also likely to be of interest to public health researchers and practitioners, professional associations and civil society groups. They have been developed through a systematic review of existing research and input from experts from countries around the world, in partnership with many key international organizations working to improve adolescents’ health. Similar partnerships have been forged to distribute them widely and to support their use. (Excerpt)
London, United Kingdom, IPPF, 2011 Jan.  p.Girls Decide: Choices on Sex and Pregnancy explores innovative projects for girls and young women that offer great potential for making a difference on a large scale. These projects empower girls and young women, and affect all areas of their development, by implementing a positive approach towards their sexual and reproductive health and rights. When girls and young women understand that their sexual identities, feelings, emotions, sexual behaviour and aspirations are legitimate and respected, they are empowered. When they have access to the knowledge and the opportunities to make choices about relationships, sexuality and pregnancy, and when communities and societies give girls and young women the space and support they need to become confident, decision-making individuals, everyone benefits. It is time for policy- and decision-makers, educators, service providers and community leaders to re-think strategies for girls and young women: invest in, protect and promote policies, programmes, services and research that incorporate a positive approach to their choices around all aspects of sex, sexuality and pregnancy.
Improving maternal health to achieve the Millennium Development Goals in the Eastern Mediterranean Region: a youth lens.
Eastern Mediterranean Health Journal. 2008; 14 Suppl:S97-106.The fifth Millennium Development Goal (MDG) aims to improve maternal health. The 2 targets set for this goal are to "reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio" and "achieve, by 2015, universal access to reproductive health". Six indicators have been selected to help track progress towards these targets: maternal mortality ratio; proportion of births attended by skilled health personnel; contraceptive prevalence rate; adolescent birth rate; antenatal care coverage (at least 1 visit and at least 4 visits); and unmet need for family planning. This paper briefly outlines the general situation in relation to maternal health in the Eastern Mediterranean Region of the World Health Organization (WHO) and goes on to focus on the perspective of adolescent pregnancy and reproductive health.
European Journal of Contraception and Reproductive Health Care. 2008 Mar; 13(1):58-70.Acceptance of sexual and reproductive health as fundamental to the sustainable development of societies has allowed for creation of new reproductive health programmes and policies. WHO sexual and reproductive health (SRH) strategies were developed in the WHO Regional Office for Europe (2001), as well as globally (2004). Adolescent SRH is important in both strategies. Despite these commitments, adolescents remain vulnerable to poor reproductive health. The goal of this paper is to analyse the current status of SRH of adolescents in Europe. Key reproductive health indicators were chosen. Information was obtained from published studies, databases and questionnaires sent to WHO reproductive health counterparts within the health ministries in the Member States of the WHO European Region. Pregnancy rate, age at first sexual intercourse, contraceptive use at first and last intercourse, contraceptive prevalence, HIV knowledge, and STI rates vary widely according to the population considered. Gender difference and lack of information pertaining to SRH of all adolescent populations are other key findings. While the SRH of most European adolescents is good, they remain a vulnerable population. Lack of standardized reproductive indicators and age specific aggregate data make it difficult to accurately assess the situation in individual countries or perform cross country comparison. (author's)
Geneva, Switzerland, World Health Organization [WHO], 2007.  p. (WHO Discussion Papers on Adolescence; Issues in Adolescent Health and Development)The World Health Organization (WHO) has been contributing to meeting the Millennium Development Goals (MDGs) by according priority attention to issues pertaining to the management of adolescent pregnancy. Three of the aims of the MDGs - empowerment of women, promotion of maternal health, and reduction of child mortality - embody WHO's key priorities and its policy framework for poverty reduction. The UN Special Session on Children has focused on some of the key issues affecting adolescents' rights, including early marriage, access to sexual and reproductive health services, and care for pregnant adolescents. This review of the literature was conducted to identify (1) the major factors affecting the pregnancy outcome among adolescents, related to their physical immaturity and inappropriate or inadequate healthcare-seeking behaviour, and (2) the socioeconomic and political barriers that influence their access to health-care services and information. The review also presents programmatic evidence of feasible measures that can be taken at the household, community and national levels to improve pregnancy outcomes among adolescents. (excerpt)
Geneva, Switzerland, WHO, 2006. 35 p.Marriage is widely regarded as a place of safety to shelter from the risks of adolescence. In many parts of the developing world, parents and policy makers see marriage as a walled garden where cultural and family values protect young girls from defilement and stigma. Particularly in poorer and rural areas, there is pressure on parents to marry off their daughters while they are very young before they become an economic liability. Millions of girls reluctantly enter into marriage while they are still children, just sexually mature but unready in every other way for this profound change in their lives. Typically, an adolescent bride knows little of her new husband or new life, has little control over her destiny and is unaware of the health risks that she faces. When an adolescent girl starts a sexual relationship with a man 10 years older than she is, he may be sexually experienced. If he is infected with a sexually transmitted infection (STI) or with HIV, a marriage certificate offers no protection. In the context of the AIDS pandemic, it is a chilling fact that the majority of unprotected sex between an un-infected adolescent girl and an infected older man takes place within marriage with the blessing of parents and community. Neither AIDS nor STIs respect marriage as a place of safety. (excerpt)
[Activities of the Oficina Provincial de la Mujer for the prevention of adolescent pregnancies continue] Siguen actividades de la Mujer en prevencion de embarazos en adolescentes.
Logros. 1999 Nov-Dec; 4(1):9.The Provincial Office for Women, in coordination with the United Nations Children's Fund (UNICEF), has given several workshops for mayors, health workers, political leaders, agronomists, and others. (excerpt)
Should adolescents be specifically targeted for nutrition in developing countries? To address which problems, and how?
Geneva, Switzerland, World Health Organization [WHO], . 38 p.Concern for nutrition in adolescence has been rather limited, except in relation to pregnancy. This paper reviews adolescent-specific nutritional problems, and discusses priority issues for the health sector, particularly in developing countries. Chronic malnutrition in earlier years is responsible for widespread stunting and adverse consequences at adolescence in many areas, but it is best prevented in childhood. Iron deficiency and anaemia are the main problem of adolescents world-wide; other micronutrient deficiencies may also affect adolescent girls. Improving their nutrition before they enter pregnancy (and delaying it), could help to reduce maternal and infant mortality, and contribute to break the vicious cycle of intergenerational malnutrition, poverty, and even chronic disease. Food-based and health approaches will oftentimes need to be complemented by micronutrient supplementation using various channels. Promoting healthy eating and lifestyles among adolescents, particularly through the urban school system, is critical to halt the rapid progression of obesity and other nutrition related chronic disease risks. There are pressing research needs, notably to develop adolescent-specific anthropometric reference data, to better document adolescents' nutritional and micronutrient status, and to assess the cost-effectiveness of multinutrient dietary improvement (or supplements) in adolescent girls. Our view is that specific policies are needed at country level for adolescent nutrition, but not specific programmes. (author's)
In: Towards adulthood: exploring the sexual and reproductive health of adolescents in South Asia, edited by Sarah Bott, Shireen Jejeebhoy, Iqbal Shah, Chander Puri. Geneva, Switzerland, World Health Organization [WHO], Department of Reproductive Health and Research, 2003. 31-42.The World Health Organization defines “adolescence” as 10–19 years old, “youth” as 15– 24 years old, and “young people” as 10–24 years old. Nevertheless, adolescence should be considered a phase rather than a fixed age group, with physical, psychological, social and cultural dimensions, perceived differently by different cultures. As a group, adolescents include nearly 1.2 billion people, about 85% of whom live in developing countries. Behaviours formed in adolescence have lasting implications for individual and public health and, in many ways, a nation’s fate lies in the strength and aspirations of its youth—important reasons to invest in adolescent health and development. This presentation describes the general situation of adolescent health (exploring adolescent sexual and reproductive health in particular) and highlights some key elements of successful programmes. (excerpt)
[Unpublished] 2002. Presented at the 2002 International Union for the Scientific Study of Population [IUSSP] Conference on Southeast Asia's Population in a Changing Asian Context, Bangkok, Thailand, June 10-13, 2002.  p.The Islamic Republic of Iran is committed to improving the quality of life of its people one of the ways being through reducing the fertility that would lead to the improved health status and welfare of the people. UNFPA assistance complements the government’s plans and programmes to achieve these goals. During the Third UNFPA Country Programme.The activities are focused in the remote provinces of Sistan/Baluchistan, Bushehr, Kordestan, Golestan and Islamshahr located in South of Tehran. In order to assess the impact of UNFPA activities at the end of its Third Country Programme, a series of baseline surveys have been conducted by the Statistical Centre of Iran with collaboration of the UNFPA-Iran in the selected pilot areas. The paper presents the results of the baseline survey conducted to assess the knowledge and awareness about reproductive health matters among the students of the Junior and High Schools. This information will facilitate the monitoring and evaluation of the current programme of the Ministry of Education and help formulate the future plan of action. A random sample of schools was drawn from the list of 70 pilot schools. The targeted sample was 3,000 students and ultimately 2,951 students participated in the Survey. 1375 were boys and 1576 were girls, 440 were 8th Grade Junior high school students and 2511 were high school students from grades 9-11. The objective of the project is to impart information to the students on appropriate reproductive health matters in a culture friendly manner with sharper focus on adolescents growing up and puberty. The results of the survey reveal the need for reproductive health (RH) education in schools. The girls were more aware and informed about RH issues than the boys. These issues included even important topics like consequences of early marriage, the need for family planning prevention and treatment of HIV/AIDS. Within the sample as would be expected the students at the high school level had more knowledge on the subject of reproductive health than the students of the Junior high school level. There was generally a favorable attitude towards gender equity and equality. The project can be strengthened based on the Baseline Survey results which identify the critical areas where the level of knowledge is low. In order for the programme to succeed however training of teachers should be of high quality so that they are able to effectively discuss these sensitive topics in the classroom. (author's)
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (DMA-02)Teenage pregnancies have been a major health concern in Dominica. Although fertility rates were declining overall, 26% of all live births in 1984 were to teenagers 19 years old and under, the majority of whom were unmarried. Family planning (FP) services were available on request to teens at most clinics but the Ministry of Health (MOH) initiated plans to make contraception more accessible to this age group by establishing youth clinics in collaboration with the UNFPA and the International Planned Parenthood Federation. Tulane University was asked to design and implement an operations research study to test the feasibility of operating these clinics with the objective of reducing teenage pregnancy by providing sex education and making contraceptives readily available. The project was designed at a cost of US $17,326 to test 2 alternative strategies in 6 communities. One rural and one urban community were assigned to each of 2 treatment groups, and another urban community and rural community formed the control group. Treatment group 1 had a separate youth clinic facility established, open 2 days a week to teen clients. Services provided included family life education, FP counseling, distribution of contraceptive methods, and general health care. Group 2 had youth clinics which operated from the existing health centers, with different hours for the teen clients. In the control group, there were no special services provided for the younger age group, although FP services were provided at the local health center or clinic. Although the 4 clinics were established, there was official reluctance to publicize the fact that contraceptives were among the services available. As a result, the project was terminated early. Using a quasi-experimental design, the study was to be based on pre/post-intervention surveys and the collection of service statistics. The baseline survey indicated that knowledge about the reproductive process was higher among older teens, but 90% of all respondents did not know the most fertile time for a woman. Knowledge of FP methods increased with age among both males and females. Over 90% of all teens knew at least one contraceptive method. 78% of males claimed to have had sex as did 46% of females. The reported use of contraceptives during first sexual encounter was significantly higher for females than males. Over 50% of the males who claimed to have had sex said they disapproved of premarital sex, as did nearly 66% of the females. More than 75% of respondents wanted more information on sexually transmitted diseases and contraceptive methods and thought sex education should be taught in schools.
Laren, Netherlands, World Population Foundation, 1992. 20 p.The World Population Fund is a non-profit organization created in 1987 to increase awareness of the nature, size, and complexity of rapid population growth and to support population projects in developing countries. The foundation hopes that its efforts will improve global standards of living. Projects emphasize the collection, analysis, and dissemination of population information; the formulation and implementation of population policies; maternal and child health care and family planning (FP); and improving the position of women. Collaborating regularly with the Dutch government, the UN, and other international organizations, the World Population Fund is the only organization in the netherlands which concerns itself specifically with problems of world population growth. This report outlines the consequences of world population growth; fund activities in 1991 in information, education, and training; project fundraising; family planning efforts in Burkina Faso, India, and Tanzania; and collaboration with the Consultancy Group for maternal health and FP. Fund accounts are presented. Teenage pregnancy, population pressures and environmental degradation, urbanization, and economic development are discussed. If present population growth trends continue, world population will triple within the next century to 18 billion with 90% of the growth in developing countries. Widespread poverty, malnutrition, disease, and early mortality will be the consequences of such growth. While experience shows that FP programs can help lower population growth rates, demand for FP is greater than supply in most developing countries. In fact, 300 million couples, the majority of whom live in developing countries, are being denied the universal right to freely decide the number and spacing of their children. The persistence of social and political controversy over funding family planning in developing countries, funding shortages, and inadequate policies and programs continue to result in teenage and child pregnancies, abortions, unwanted births, malnourished mothers and children, and maternal mortality. Balanced population policies and programs integrated within development plans are called for. To that end, the World Population Fund in 1992 will emphasize interactions between population growth and environment while also focusing upon the needs of and services for youth.
Report of the Regional Awareness Conference on Population and Development, Castries, Saint Lucia, 30 April - 1 May 1984.
[Unpublished] 1984. , 53,  p.The Population and Development Project of the Caribbean region aims to increase the awareness of regional leaders on population issues, explain the consequences of continued demographic trends upon socioeconomic development, present up-to-date medical protocols for family planning services to medical practitioners, and improve family planning service delivery in selected countries. Proceedings from a Regional Awareness Conference on Population and Development and presented. Opening remarks of the conference were made by the Minister of Health of Saint Lucia, the Secretary-General of the Caribbean Community, and representatives from the UNFPA and CARICOM. Chairmen for conference sessions were elected, an agenda adopted, and procedural matters settled. An abstract of the regional population policy paper is discussed, followed by consideration of the benefits of population programs for family planning and health, and presentation of the medical steering committee's work. National population task force reports are included for Antigua and Barbuda, Barbados, Dominica, Grenada, Monsterrat, St. Christopher-Nevis, St. Lucia, St. Vincent and the Grenadines, Anguilla, Bermuda, the British Virgin Islands, Guyana, Trinidad and Tobago, Turks and Caicos, and the Bahamas. Jamaica's experience in formulating and implementing its population policy follows, preceding presentations on migration and adolescent fertility. Concluding sections cover resources for the awareness of population impacts on development, a suggested draft model of national population policy, information on the development law and policy program, a panel discussion of population policy implications, and proposals and recommendations for a plan of action to implement population policy. A list of participants is included among the annexes.
St. John's, Antigua, CFPA, 1987. 39 p.In the 1920s 1/3 of the children in the Caribbean area died before age 5, and life expectancy was 35 years; today life expectancy is 70 years. In the early 1960s only 50,000 women used birth control; in the mid-1980s 500,000 do, but this is still only 1/2 of all reproductive age women. During 1987 the governments of St. Lucia, Dominica and Grenada adopted formal population policies; and the Caribbean Family Planning Affiliation (CFPA) called for the introduction of sex education in all Caribbean schools for the specific purpose of reducing the high teenage pregnancy rate of 120/1000. CFPA received funds from the US Agency for International Development and the United Nations Fund for Population Activities to assist in its annual multimedia IEC campaigns directed particularly at teenagers and young adults. CFPA worked with other nongovernmental organizations to conduct seminars on population and development and family life education in schools. In 1986-87 CFPA held a short story contest to heighten teenage awareness of family planning. The CFPA and its member countries observed the 3rd Annual Family Planning Day on November 21, 1987; and Stichting Lobi, the Family Planning Association of Suriname celebrated its 20th anniversary on February 29, 1988. CFPA affiliate countries made strides in 1987 in areas of sex education, including AIDS education, teenage pregnancy prevention, and outreach programs. The CFPA Annual Report concludes with financial statements, a list of member associations, and the names of CFPA officers.
Plan of action for the eradication of harmful traditional practices affecting the health of women and children in Africa.
[Unpublished] 1987. 14 p.The traditional and harmful practices such as early marriage and pregnancy, female circumcision, nutritional taboos, inadequate child spacing, and unprotected delivery continue to be the reality for women in many African nations. These harmful traditional practices frequently result in permanent physical, psychological, and emotional changes for women, at times even death, yet little progress has been realized in abolishing these practices. At the Regional Seminar of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children in Africa, held in Ethiopia during April 1987, guidelines were drawn by which national governments and local bodies along with international and regional organizations might take action to protect women from these unnecessary hazardous traditional practices. These guidelines constitute this "Plan of Action for the Eradication of Harmful Traditional Practices Affecting the Health of Women and Children in Africa." The plan should be implemented within a decade. These guidelines include both shortterm and longterm strategies. Actions to be taken in terms of the organizational machinery are outlined, covering both the national and regional levels and including special support and the use of the mass media. Guidelines are included for action to be taken in regard to childhood marriage and early pregnancy. These cover the areas of education -- both formal and nonformal -- measures to improve socioeconomic status and health, and enacting laws against childhood marriage and rape. In the area of female circumcision, the short term goal is to create awareness of the adverse medical, psychological, social and economic implications of female circumcision. The time frame for this goal is 24 months. The longterm goal is to eradicate female circumcision by 2000 and to restore dignity and respect to women and to raise their status in society. Also outlined are actions to be taken in terms of food prohibitions which affect mostly women and children, child spacing and delivery practices, and legislative and administrative measures. Women in the African region have a critical role to play both in the development of their countries and in the solution of problems arising from the practice of harmful traditions.