Abstract:

Adolescence is an important time for promoting health and preventing disease. The World Health Organization (WHO) defines an adolescent as an individual in the 10-19 years age group and usually uses the term young person to denote those between 10 and 24 years. Adolescent health encompasses changing transitions within multiple domains, including the physical, social, emotional, cognitive, and intellectual. These changes have important implications for health. During this period of increasing independence, adolescents face critical choices about health-related behaviors in areas such as sexuality, physical activity, diet, and use of health care services. These behaviors affect health during adolescence and young adulthood and, in the long-term, are related to many of the leading causes of adult morbidity and mortality. Therefore, the protection and promotion of health during this life stage is of great importance and has been shown to yield benefits not only for adolescents now, but also for their future adult lives and for their future children. This paper explore two key issues underpinning adolescent health, teen pregnancy, and child marriage. Trends in early marriage and early childbearing help determine national poverty levels and economic productivity. Decisions about whether to remain in school, whether to marry, or whether to engage in sexual activity have implications for education and health. The paper argues that failure to understand the interrelationship between adolescent pregnancy and child marriage may jeopardize earlier investments in maternal and child health, erodes future quality and length of life, and escalates suffering, inequality, and social instability.

References:

[1] WHO. Adolescent pregnancy: WHO factsheet. 2022 https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy (accessed March 15,2023).

[2] WHO.The Global Health Observatory available online https://www.who.int/data/gho/indicator-metadata-registry/imr-details/4669 (accessed March 15, 2023).

[3] Siniša F (2018) Adolescent Pregnancy is a Serious Social Problem. J Gynecol Res Obstet.

[4] Sedgh G et al. (2015). Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015 Feb;56(2):223-30.

[5] Huda MM et al. (2020) Time trends and sociodemographic inequalities in the prevalence of adolescent motherhood in 74 low-income and middle-income countries: a population-based study. Lancet Child & Adolescent Health. 2020.

[6] United Nations, Department of Economic and Social Affairs (UNDESA), Population Division. World population prospects 2019. Online edition, revision 1, 2019. https://population.un.org/wpp/.

[7] UNFPA (2013a). Adolescent pregnancy: A review of the evidence. New York: UNFPA; 2013.

[8] UNFPA (2013b). Motherhood in Childhood: Facing the challenge of adolescent pregnancy. New York: UNFPA; 2013.

[9] UNICEF. Child marriage, Adolescent pregnancy, and Family formation in West and Central Africa: Patterns, trends, and drivers of change. New York: UNICEF; 2015.

[10] Petroni S et al. (2017) New findings on child marriage in sub-Saharan Africa. Annals of global health. 2017.

[11] WHO (FACTSHEET,2023) Adolescent Pregnancy https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy (accessed March 10,2023).

[12] UNFPA (2017) Adolescent pregnancy: A matter of human rights https://www.unfpa.org/adolescent-pregnancy#readmore-expand (accessed March 15, 2023).

[13] Patton GC, Coffey C, Sawyer SM, et al. Global patterns of mortality in young people: a systematic analysis of population health data. The Lancet. 2009.

[14] Maheshwari MV, Khalid N, Patel PD, Alghareeb R, Hussain A. Maternal and Neonatal Outcomes of Adolescent Pregnancy: A Narrative Review. Cureus. 2022 Jun.

[15] National Research Council (US) Panel on Adolescent Pregnancy and Childbearing; Hofferth SL, Hayes CD, editors. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing, Volume II: Working Papers and Statistical Appendices. Washington (DC): National Academies Press (US); 1987. Chapter 8, The Children of Teen Childbearers. Available from: https://www.ncbi.nlm.nih.gov/books/NBK219236/.

[16] Ahman E, Shah IH (2011). New estimates and trends regarding unsafe abortion mortality. Journal of Gynecology and Obstetrics. 2011 Nov.

[17] United Nations Children’s Fund (UNICEF). Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women. UNICEF Child Nutrition Report Series, 2022. UNICEF, New York, 2023.

[18] UNICEF. Progress for Children. A Report Card on Adolescents. New York, NY, USA: UNICEF; 2012.

[19] United Nations Children’s Fund. Covid-19: A threat to progress against child marriage. UNICEF, New York, 2021.

[20] UNICEF (2014) Ending child marriage: progress and prospects. New York: UNICEF, 2014. https://gdc.unicef.org/resource/ending-child-marriage-progress-and-prospects. (Accessed March 16, 2023.

[21] Centre for Reproductive Rights. Adolescent sexual and reproductive health and rights. Centre for Reproductive Rights. https://reproductiverights.org/our-issues/adolescent-sexual-and-reproductive-health-and-rights/. (Accessed March 16, 2023).

[22] Nour NM. Health consequences of child marriage in Africa. Emerg Infect Dis.

[23] Presler-Marshall, E.; Jones, N. (2012). Charting the future: Empowering girls to prevent early pregnancy. London: Overseas Development Institute (ODI) and Save the Children.

[24] Hindin, M. J. & Fatusi, A. O. (2009). Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions. Int Perspect Sex Reprod Health, 35(2), 58-62.

[25] Erulkar, A. (2013). Adolescence lost: the realities of child marriage. J Adolesc Health, 52(5), 513-514.

[26] Jensen, R.; Thornton, R. (2003). Early Female Marriage in the Developing World. Gender and Development, 11(2), 11.

[27] UNFPA and Save the Children. Adolescent Sexual and Reproductive Health: Toolkit for Humanitarian Settings. A Companion to the Inter-Agency Field Manual on Reproductive Health in Humanitarian Settings. UNFPA and Save the Children, September 2009.

[28] Amin, S. (2011). Programs to address child marriage: Framing the problem. Transitions to Adulthood (Brief no. 14). New York, USA: Population Council.

[29] Nguyen, M. C.; Wodon, Q. (2012). Global Trends in Child Marriage. Washington, DC, USA: World Bank

[30] Mensch, B. S.; Grant, M.J.; Blanc, A.K. (2006). The Changing Contect of Sexual Initiation in Sub-Saharan Africa. Population and Development Review.

[31] Population Council (2014). BALIKA (Bangladeshi Association for Life Skills, Income, and Knowledge for Adolescents) Retrieved March 31, 2014.

[32] Mekonnen, T., Dune, T. & Perz, J. Maternal health service utilisation of adolescent women in sub-Saharan Africa: A Systematic scoping review. BMC Pregnancy Childbirth 19, 366 (2019).

[33] Chandra-Mouli, V., McCarraher, D.R., Phillips, S.J. et al. Contraception for adolescents in low- and middle-income countries: needs, barriers, and access. Reprod Health 11, 1 (2014).

[34] Ninsiima, L.R., Chiumia, I.K. & Ndejjo, R. Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: A Systematic Review. Reprod Health 18, 135 (2021).

[35] Geary RS, Gómez-Olivé FX, Kahn K, Tollman S, Norris SA. Barriers to and facilitators of the provision of a youth-friendly health services programme in rural South Africa. BMC Health Serv Res. 2014;14(1):1–8.

[36] Mazur A, Brindis CD, Decker MJ. Assessing youth-friendly sexual and reproductive health services: A Systematic Review. BMC Health Serv Res. 2018;18(1):1–12.

[37] Onukwugha FI, Hayter M, Magadi MA. Views of service providers and adolescents on use of sexual and reproductive health services by adolescents: a systematic review. Afr J Reprod Health. 2019.

[38] Efevbera Y, Bhabha J, Farmer P, Fink G. Girl child marriage, socioeconomic status, and undernutrition: evidence from 35 countries in Sub-Saharan Africa. BMC Med. 2019 Mar 8;17(1):55.

[39] Loaiza SE, Wong S. Marrying too young: end of child marriage. New York: United Nations Population Fund; 2012.

[40] Lloyd, C. B., & Mensch, B. S. (2008). Marriage and childbirth as factors in dropping out from school: an analysis of DHS data from sub-Saharan Africa.

[41] Psaki et al. (2021) What Are the Drivers of Child Marriage? A Conceptual Framework to Guide Policies and Programs. J Adolescent Health. 2021.

[42] Munthali AC, Zulu EM. The timing and role of initiation rites in preparing young people for adolescence and responsible sexual and reproductive behaviour in Malawi. Afr J Reprod Health. 2007 Dec;11(3):150-67.

[43] Crooks, R., Bedwell, C. & Lavender, T. Adolescent experiences of pregnancy in low-and middle-income countries: a meta-synthesis of qualitative studies. BMC Pregnancy Childbirth 22, 702 (2022).

[44] Jaruseviciene L et al (2014) Perceptions of quality in primary health care: perspectives of patients and professionals based on focus group discussions. BMC Fam Pract. 2014 Jun 28; 15:128.

[45] Khan, S.; Mishra, V. (2008). Youth Reproductive and Sexual Health DHS Comparative Reports. Calverton, MD, USA: Macro International Inc.

[46] Girls as Brides (2015) Setting the age of marriage at 18 can have a huge impact on child marriage https://www.girlsnotbrides.es/articulos/three-laws-that-countries-can-adopt-to-address-child-marriage/ (accessed March 17, 2023).