Preventing Early Pregnancy

7/31/2019 Preventing Early Pregnancy

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16 million adolescent girlsbetween 15 and 19 becomemothers every year

Adolescent pregnancies are mostcommon among poor and lesseducated girls and those living inrural areas

Despite progress, adolescentpregnancy continues to increasein some regions of the developingworld

At a glance

OMS


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Adolescent pregnancy and childbirth isassociated with greater health risks forthe mother: Complications of pregnancyand childbirth are the leading cause ofdeath in adolescent girls aged 15-19 years

in developing countries.

Adolescent pregnancy is harmful to thehealthof infants: Babies of adolescent mothersare more likely to die, to have low birth

weight, and to have long time ill effects.

Adolescent pregnancy reinforces thevicious cycle of poverty and ill health:Adolescent mothers in many places leave orare made to leave school, and are lesslikely than their peers to develop vocational

Consequences

OMS


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Based on

Thorough review of the evidence

Practical experience of policy makers,programme managers, and front-line workers fromcountries around the world

Developed in a systematic andtransparent manner

In partnership with

Guttmacher Institute

International Center for Research on Women

FHI360 Population Council

Centro Rosarino de Estudios Perinatales(Argentina)

Supported financially by

United Nations Population Fund United States Agency for International

WHO Guidelines on preventing early pregnancyand poor reproductive outcomes in adolescentsin developing countries

UN


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Early pregnancy and poorreproductive outcomes amongadolescents are determined by aweb of micro- and macro-levelfactors:

Individuals make choices to engage inspecific behaviours

Family and community norms,traditions, and economic circumstancesinfluence these choices

Policy and regulatory frameworks

facilitate or hinder choices

Actions are needed at each ofthese levels by differentsectors.

Adolescents too have key roles

to play.ONU

Levels of Early PregnancyDeterminants

JOEY

OLOUGHLIN


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OUTCOME 1

INDIVIDUAL, FAMILY & COMMUNITY-LEVEL ACTIONS

Inform and empower girls

Keep girls in school

Influence cultural norms that support

early marriage

POLICY-LEVEL ACTIONS

Prohibit early marriage

UNF

PA

Reduce marriage beforeage 18


7/18

OUTCOME 1

EVIDENCE

21 ungraded reports or studies, and the

expert panels recommendations Evidence from Afghanistan,Bangladesh, Egypt, Ethiopia, India, Kenya,Nepal, Senegal & Yemen

Interventions included communicatingtargeting adolescents, community

members, and other political decisionsUNF

PA

Reduce marriage beforeage 18


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Create understanding and supportto reduce pregnancy before the

age of 20 years

OUTCOME 2

INDIVIDUAL, FAMILY & COMMUNITY-LEVELACTIONS

Educate girls and boys about sexuality

Build community support for preventing earlypregnancy


Support pregnancy prevention programmesamong adolescents

JOEYOLOUGHLIN


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OUTCOME 2

EVIDENCE

2 graded systematic reviews, 3 ungraded studies, and theexpert panel's recommendations

Evidence from Mexico, Nigeria, and poor socioeconomicsegments of developed countries

Interventions included sexuality education, cash transferschemes, early childhood education & youth development and

life skills buildingJOEYOLOUGHLIN

Create understanding and supportto reduce pregnancy before the

age of 20 years


10/18

Increase use of contraception


Legislate access to contraceptive informationand services

Reduce the cost of contraceptives to

adolescents (conditional recommendation)INDIVIDUAL, FAMILY & COMMUNITY-LEVELACTIONS

Educate adolescents about contraceptive use

Build community support for contraceptiveprovision to adolescents

Enable adolescents to obtain contraceptiveservices

WHO

OUTCOME 3


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Increase use of contraception

EVIDENCE

7 graded studies or systematic reviews, 26ungraded studies, and the expert panels

recommendations Evidence from Bahamas, Belize, Brazil, Cameroon,Chile, China, India, Kenya, Madagascar, Mali, Mexico,Nepal, Nicaragua, Rwanda, Sierra Leone, SouthAfrica, United Republic of Tanzania & Thailand

Interventions included health system

improvements, and community and stakeholderengagement.

OUTCOME 3

WHO


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Reduce coerced sex

INDIVIDUAL, FAMILY & COMMUNITY-LEVELACTIONS

Empower girls to resist coerced sex

Influence social norms that condone coercedsex

Engage men and boys to critically assessgender norms


Prohibit coerced sex

OUTCOME 4

UN


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Reduce coerced sex

EVIDENCE

2 graded studies, 6 ungraded studies orreports & expert panels recommendations

Evidence from Botswana, India, Kenya, SouthAfrica, Tanzania, & Zimbabwe

Interventions included communication directedat girls, boys and men & the communitymembers to influence knowledge, understanding& attitudes on coerced sex

UN

OUTCOME 4


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Enable access to safe abortion and post-abortion services for adolescents

Reduce unsafe abortion

INDIVIDUAL, FAMILY, & COMMUNITY-LEVELACTIONS

Inform adolescents about dangers of unsafe

abortion Inform adolescents about where they canobtain safe abortion services, where legal

Increase community awareness of thedangers of unsafe abortionHEALTH SYSTEM-LEVEL ACTIONS

Identify and remove barriers to safe abortion

servicesUN

OUTCOME 5


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Reduce unsafe abortion

EVIDENCE

No available studies

Expert panel relied on its experienceand judgment to inform therecommendations

UN

OUTCOME 5


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Increase use of skilled

antenatal,childbirth, and postpartumcare

INDIVIDUAL, FAMILY, & COMMUNITY-LEVELACTIONS

Inform adolescents and community

members about the importance of skilledantenatal and childbirth careHEALTH SYSTEM-LEVEL ACTIONS

Ensure that adolescents, families, andcommunities are well prepared for birth andbirth-related emergencies

Be sensitive and responsive to the needs of

young mothers and mothers-to-be WHO

OUTCOME 6


Expand access to skilled antenatal,childbirth, and postnatal care

Expand access to Basic and ComprehensiveEmergency Obstetric Care


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EVIDENCE

1 graded study, 1 ungraded study,

existing WHO guidelines & expert panelsrecommendations

Studies from Chile and India

Interventions included home visits toadolescent mothers and a cash transferscheme contingent upon health facilitybirths

WH

O

OUTCOME 6

Increase use of skilled

antenatal,childbirth, and postpartumcare


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Educated and empowered women and girls can

make informed decisions about their own

health.

DR. MARGARET CHAN, DIRECTOR-GENERAL, WHO

When girls are educated, healthy and can avoid

child marriage, unintended pregnancy and HIV,

they can contribute fully to their societies battles

against poverty.

DR. BABATUNDE OSOTIMEHIN, EXECUTIVE DIRECTOR, UNFPA

Documents

Preventing Early Pregnancy