Co-authored by Joy Cunningham and Kate Plourde
This year's International Conference on Family Planning (ICFP) saw the largest youth delegation in its history. Approximately 300 young people between the ages of 18 and 25 attended, doubling the number who participated in 2011. These young family planning activists moderated panels, delivered plenary presentations and assisted in launching ground-breaking publications, such as the United Nations Population Fund's State of World Population 2013 report on adolescent pregnancy and the International HIV/AIDS Alliance's paper on young people living with and affected by HIV. Young people's needs were a major focus of conference presentations, events and press coverage. Government officials publically recognized the importance of young people and encouraged their active participation as emerging leaders in the field of family planning and reproductive health.
The attention to the unique needs of this population could not be more timely. Every day, 20,000 girls under the age of 18 in developing countries give birth. That is roughly 833 girls every hour, or 14 girls each minute. Of the 7.3 million girls who give birth each year, two million are under the age of 15 (UNFPA). Adolescent mothers face devastating social, educational, economic and health outcomes. Girls who become pregnant confront discrimination within their communities and are often forced to drop out of school or get married. Pregnancy during adolescence increases the risk of anemia, postpartum hemorrhage, prolonged obstructed labor, obstetric fistula, malnutrition and mental health disorders. Complications from pregnancy and childbirth are the leading cause of death for 15- to 19-year-old girls (UNFPA). Furthermore, adolescent mothers are more likely to have a lower income and have more children at shorter intervals throughout their lifetime.
Unfortunately, many young women around the world are unable to access life-changing and lifesaving contraceptive technology. In some regions of the world, the unmet need for contraception is as high as 68 percent among young women (Guttmacher, IPPF). Adolescent girls may be unable to access contraceptives because they lack transportation and money. Cultural and gender norms about sexuality make many young people, especially girls, unwilling or unable to admit to premarital sex, which affects their willingness to discuss contraceptive options with health care providers or their partners. A cultural expectation to demonstrate fertility and unequal power dynamics within relationships also hinders young women's ability to use contraception. Finally, health care providers who hold preconceived notions about what contraceptive methods should be available to youth might limit their options.
The good news is that unintended adolescent pregnancy is preventable. In fact, in 2010, modern contraceptives were estimated to prevent 3.1 million unintended adolescent pregnancies annually (Guttmacher, IPPF). In Addis Ababa, Ethiopia, where the conference was held, we heard many presentations about how intrauterine devices and implants can be safe and effective for youth desiring more long-acting methods of contraception.
At the conference, youth participants developed a call for action on young people and family planning, highlighting the importance of comprehensive sexuality education, improving accessibility and reducing barriers, increasing meaningful engagement and youth participation, and ensuring the provision of youth-friendly services (IPPF). This landmark document not only highlights the importance of renewed energy and commitment to reducing adolescent pregnancy, but also demonstrates the importance of involving young people as catalysts for change.
When girls are able to make their own decisions about whether and when to have children, they are more likely to stay in school, participate in the work force and have healthier, better-educated children. All girls deserve a happy, healthy and safe adolescence, and the attention being devoted to young people's sexual and reproductive health needs at this year's ICFP is a step toward helping them reach their full potential. Now that the conference has drawn to a close, let's work to ensure that the international attention on youth remains strong and results in real action to improve the lives of young people.
Ward Cates, M.D., M.P.H., is President Emeritus with FHI 360
Joy Cunningham is a technical advisor in the Global Health, Population and Nutrition group at FHI 360. In her role, Joy manages a portfolio of activities that address youth sexual and reproductive health and gender.
Kate Plourde is a technical officer for the Global Health, Population and Nutrition group at FHI 360. A member of the Research Utilization team, her portfolio of work focuses on youth sexual and reproductive health and gender.