Motherhood in ChildhoodFacing the Challenge of Adolescent Pregnancy

30 October 2013India

Theme for the State of World Population Report 2013

Up Ahead UNFPA, Rights and Adolescent Pregnancy Global Statistics The Challenges Worldwide The Underlying Causes Pressures from Many Directions & Levels Ecological Model India: Factsheet Foundations for Progress Eight Ways to Get There The Benefits Research Needs Voices

“From a human rights perspective, a girl who becomes pregnant- regardless of the circumstances or reasons - is one whose rights are undermined.”

—Dr. Babatunde Osotimehin Executive Director, United Nations Population Fund Under-Secretary-General of the United Nations.

UNFPA is guided by the Programme of Action of the International Conference on Population and Development (ICPD), respecting protecting and fulfilling adolescents human rights including their right to sexual and reproductive health and reproductive health.

UNFPA, Rights and Adolescent Pregnancy

Countries with 20% or more of women ages 20-24 reporting a birth before age 18

Per cent of adolescent girls in marriages and adolescent birth rates

Developing Regions Girls , ages 15-19Currently Married (%) Adolescent Birth Rate

Arab States 12 50

Asia and Pacific 15 80

East Asia and Pacific 5 50

South Asia 25 88

Eastern Europe and Central Asia 9 31

Latin America and Caribbean 12 84

Sub-Saharan Africa 24 120

East and Southern Africa 19 112

West and Central Africa 28 129

Developing Countries 16 85

Lifetime cost of adolescent pregnancy of the current cohort of girls 15 to 19 years old, as share of annual GDP

Pregnancy Desires and Contraceptive UseThe proportion of married adolescents who are or wish to become pregnant varies widely by region

Want to avoid pregnancy, using no methodWant to avoid pregnancy, using a traditional methodWant to avoid pregnancy, using a modern methodWant pregnancy or are intentionally pregnant

Sub-Saharan Africa

South Central & Southeast Asia

Latin America & Caribbean

20,000 girls giving birth every day Missed educational and other opportunities 70,000 adolescent deaths annually from complications from pregnancy,

childbirth 3.2 million unsafe abortions among adolescents each year Perpetuation of poverty and exclusion Basic human rights denied Girls’ potential unfulfilled

The Challenges Worldwide

Child Marriage Gender inequality Obstacles to human rights Poverty Sexual violence and coercion National policies restricting access to

contraception, age- appropriate sexuality education

Lack of access to education and reproductive health services

Underinvestment in adolescent girls’ human capital

The Underlying Causes

An ‘ecological’ approach to adolescent pregnancy is one that takes account the full range of complex drivers (individual, family, school/peers, community, national) of adolescent pregnancy and the interplay of these forces

Pressures from Many Directions & Levels

For more details on the ‘ecological’ approach please refer to Page 33, State of World Population Report 2013

Ecological Model

India: Factsheet

Indicators Value

Percentage of women aged 20-24 married before age 18 (NFHS-3) 47.4

Percentage of women aged 20-24 married before age 15 (NFHS-3) 18.2

Percentage of women aged 20-24 who had already given birth by 18 years of age (NFHS-3)

21.7

Percentage of women aged 20-24 who had already given birth by 15 years of age (NFHS-3)

3.4

India: Percentage of women age 20-24 married before age 18

Source: DLHS- 3

Median age at first marriage and first birth among women aged 25-29 by educational attainment

No education <5 years complete 5-7 years complete 8-9 years complete 10-11 years complete0

5

10

15

20

25

15.516.4

17.1

18.519.6

18.4 18.819.6

20.821.7

Median age at first marriage Median age at first birth Source: NFHS -3

Refer to notes below

India: Factsheet (Cont.)Indicators Value

Percentage of married adolescent girls 15-19 years who are currently using a modern method of contraception (NFHS-3)

6.9

Percentage of married adolescent girls 15-19 years who have an unmet need for family planning (NFHS-3)

27.1

Percentage of ever married women aged 15-19 who have ever experienced spousal physical violence (NFHS-3)

25.3

Percntage of ever married women aged 15-19 who have ever experienced spousal sexual violence (NFHS-3)

13.1

Refer to notes below

Empower Girls: Building girls’ agency, enabling them to make decisions

Rectify gender inequality: Put girls and boys on equal footing

Respect human rights for all: Upholding rights can eliminate conditions that contribute to adolescent pregnancy

Reduce poverty: In developing and developed countries, poverty drives adolescent pregnancy

Foundations for Progress

“What is needed is a new way of thinking about the challenge of adolescent pregnancy. Instead of viewing the girl as the problem and changing her behaviour as the solution, governments, communities, families and schools should see poverty, gender inequality, discrimination, lack of access to services, and negative views about girls and women as the real challenges, and the pursuit of social justice, equitable development and the empowerment of girls as the true pathway to fewer adolescent pregnancies.”

—Dr. Babatunde Osotimehin Executive Director, United Nations Population Fund Under-Secretary-General of the United Nations.

The Way Ahead...

Refer to notes below

1. Girls 10 to 14: Preventive interventions for young adolescents2. Child marriage: Stop marriage under 18, prevent sexual violence and

coercion3. Multilevel approaches: Build girls’ assets across the board; keep girls on

healthy, safe life trajectories4. Human rights: Protect rights to health, education, security and freedom

from poverty5. Education: Get girls in school and enable them to stay enrolled longer6. Engage men and boys: Help them be part of the solution7. Sexuality education and access to services: Expand age-appropriate

information, provide health services used by adolescents8. Equitable development: Build a post-MDG framework based on human

rights, equality, sustainability

Eight Ways to Get There

... And The Benefits Better Maternal and Child Health: Later pregnancies reduce health

risks to girls and to their children More Girls Completing their Education: This reduces the likelihood of

child marriage and delays child bearing leading eventually to healthier birth outcomes. Also builds skills, raises girls’ status

Equal Rights and Opportunity: Preventing pregnancy helps ensure girls enjoy all basic human rights

Increased Economic Productivity and Employment: Investments that empower girls improve income-earning prospects

Adolescent Girls’ Potential Fully Realized: Prospects are brighter for a girl who is healthy, educated and able to enjoy rights

Research Needs

Data on needs and experiences of young adolescents 10-14 years Data about pregnancies or births outside of marriage Data and insights about the men and boys who father the children of

adolescent girls More in-depth data and contextual information on patterns, trends,

and the circumstances of pregnancy among girls under 18 Need for periodic survey on extent and types of violence experienced

by adolescents

Voices from across the world

“I knew about condoms, but could not ask my husband to use one. I was only 16 when I got married and felt he would get angry, as I was

less educated than him.”

Pinki, 19, India

“I am always imagining what my life would be like if I had met someone before I was pregnant, someone who taught me to be

assertive, someone who talked to me about relationships, the advantages and

disadvantages of engaging in sex so young. Maybe I would not be in this situation”

Swinton, 20, pregnant at 15, Zimbabwe

“I was given to my husband when I was little and I don’t even remember when I was given because I was so little. It’s my husband who

brought me up”

Kanas, 18, Ethiopia

“Pregnancy is not like going to a party and then it is over. Before you even think about

having sexual relationships, you should always think about the consequences.”

Valeria, 15, Nicaragua

“I was going out with my boyfriend for a year and he used to give me money and clothes. I

got pregnant when I was 13… He promised he would take care of me. After that, he left. ”

Ilda, 15, Mozambique

“As I look back... I remember many goals I wanted for myself but could not achieve”

Jessica, 39, pregnant at 18, USA

“I was 16 and never missed a day of school. Then one day I was told that I had to leave it all, as my parents bartered me for a girl my

elder brother was to marry. I pleaded with my mother, but my father had made up his mind ”

Komal, 18, India

“When we devote attention and resources to the education, health and well being of adolescent girls, they will become an even greater force for positive change in society that will have an impact for generations to come.”

- United Nations Secretary- General Ban Ki-moon

Refer to notes below

Delivering a world where every pregnancy is wanted, every childbirth is safe and every young person’s potential is fulfilled

http://india.unfpa.org/