Adolescent health

By Jainarine Deonauth

On October 11, the world marked the first ever International Day of the Girl Child under the theme, “Ending Child Marriages”. While child marriages are not a major problem in Guyana, it is still very necessary that mechanisms be put in place whereby persons can access accurate and up-to-date information about sexual and reproductive health in general. This is important as it would empower persons, especially young people, to make informed choices about their own well-being.
The World Health Organisation (WHO) has been at the forefront in terms of conducting research and making public its findings on major health issues affecting the world’s population. These statistics have proven to be interesting and are, indeed, very helpful to stakeholders as they provide guidance in policymaking and implementation at local, national, and international levels.
Official statistics released recently by WHO on adolescent health, in particular the prevalence and related consequences of early pregnancy, shed some light on the kind of choices our young people are making. For example, it was found that the number one cause of death among girls aged 15-19 is death during pregnancy and childbirth.
About 16 million girls aged 15 to 19 and two million girls under the age of 15 give birth every year. Worldwide, one in five girls has given birth by the age of 18. In the poorest regions of the world, this figure rises to over one in three girls and almost all adolescent births–about 95 per cent–occur in low- and middle-income countries. It is also no surprise that adolescent births are more likely to occur among poor, less educated and rural populations.
According to WHO, several factors contribute to adolescent births. In many societies, girls may be under pressure to marry and bear children early, or they may have limited educational and employment prospects. It was also found that some adolescents do not know how to avoid becoming pregnant, or are unable to obtain contraceptives. And even where contraceptives are widely available, sexually active adolescents are less likely to use contraceptives than adults.
A further breakdown shows that in Latin America, Europe, and Asia, only 42-68 per cent of adolescents who are married or in partnerships use contraceptives. In Africa, the rate ranges from 3-49 per cent.
It is, therefore, well accepted that education is a major preventive factor for early pregnancy, meaning the more years of schooling, the fewer early pregnancies. There is a lack of sex education in many countries and, certainly, this needs to be addressed. A global survey related to sex education estimates that only 36 per cent of young men and 24 per cent of young women aged 15-24 in low-and middle income countries have comprehensive and correct knowledge of how to prevent HIV. Of note too is that early marriage increases exposure to violence and abuse, and increases the risk of HIV infection. It was found that more than one third of girls in some countries reported that their first sexual encounter was coerced.
So what are the consequences? Many of our young girls choose to have an abortion, which contributes substantially to lasting health problems and maternal deaths. An estimated three million unsafe abortions occur globally every year among girls aged 15-19 years. Having babies during adolescence has serious consequences for the health of the girl and her infant, especially in areas with weak health systems.
In essence, adolescent pregnancy is a major contributor to maternal and child mortality, and to the vicious cycle of ill-health and poverty. The Global Strategy for Women’s and Children’s Health , launched by the United Nations secretary general in 2010, stresses the importance of addressing the health and welfare of adolescent girls in order to achieve the fifth Millennium Development Goal: maternal mortality reduction.
In May 2011, the World Health Assembly adopted a resolution urging member states to accelerate actions to improve the health of young people. It included these specific measures: reviewing and revising policies to protect young people from early child-bearing; providing access to contraception and reproductive health-care services; and promoting access to accurate information on sexual and reproductive health. While Guyana has already started working aggressively in these areas, there is still a far way to go.