1. Reproductive Health of Adolescent Girls: Perspectives from WDR07 Emmanuel Jimenez December 1, 2009 www.worldbank.org/wdr2007

2. Motivation  Investing in in the human capital of young people (12-24 years) is key to development:  A higher base on which to build human capital to grow and reduce poverty

3. 3 But new challenges for youth HIV prevalence rate (%) in young (15-24) pregnant women Source: UNAIDS

4. Motivation  Investing in in the human capital of young people (12-24 years) is key to development:  A higher base on which to build human capital to grow and reduce poverty  A large youth cohort is a potential demographic dividend

5. Structure of the WDR  5 Transitions  3 Policy Lenses

6. Human capital during 5 youth transitions key for poverty reduction and growth 12 100 % of Cohort Age 24 Learning in school after primary-age Working Forming families Participating in civic life Taking health risks

7. 3 types of questions asked of each transition: a ‘youth lens’ on policy Policies affecting human capital formation during Youth transitions: Economy wide policies and institutions: macro stability, investment climate, governance, labor market regulations Education and Training Health services Welfare & family services Infrastructure Youth ‘Lenses’ “ Youth friendly” policies

8. 3 types of questions asked of each transition: a ‘youth lens’ on policy Opportuni ties Capability Second- chances Policies affecting human capital formation during Youth transitions: -- Economy wide policies and insts: macro stability, invest. climate, governance, labor market regulations -- Education -- Training -- Health services -- Welfare & family services -- Infrastructure Youth ‘Lenses’ “Youth friendly” policies

9. 9 Opportunities: a good education Percent of young women, 15-24, who can read a simple sentence or know condoms can prevent HIV/AIDS after six years of primary school  Inadequate preparation for adolescence improve quality of basic education  Relevance of education for jobs curriculum reform, flexibility in school systems

10. 10 Opportunities: health services  alternatives to early marriage and childbearing: schooling and work  proper nutrition  access to health services:  reproductive health technology and services  antenatal and obstetric care  child health services  involving young men in SRH

11. Applying the framework: Opportunity  Opportunity: Countries HAVE invested in access to human capital; lens focus on education quality and relevance to labor market  Capability  Second-chances

12. 3 types of questions asked of each transition: a ‘youth lens’ on policy Opportunities Capability Second- chances Policies affecting human capital formation during Youth transitions: -- Economy wide policies and insts: macro stability, invest. climate, governance, labor market regulations -- Education -- Training -- Health services -- Welfare & family services -- Infrastructure Youth ‘Lenses’ “Youth friendly” policies

13. Capable decision-making: % of youth who think they have the most influence on human capital decisions

14. Capabilities: information  Half of 2,000 Kenyan adolescents chosen from KLPS randomly selected for VET voucher  Half of these receive information intervention targeted to females:  -- avg returns from KLPS  -- encouraged to attend male- dominated trades Initial results:  Large effect on demand for male trades  Will probably affect earnings since avg earnings on tailoring and computers which some girls enter are high. 14 Source: DHS

15. Relieving the information constraint

16. …Incentives also matter. Positive ones, like  conditional cash transfers:  Mexico’s Oportunidades:.2 more years of schooling at 13-15 reduced child morbidity and mortality  Bangladesh’s Female Secondary Stipend Program  Cambodia’s secondary scholarship program for girls  involve youth in program design esp those to change attitudes

17. …Or negative ones like taxes

18. Outline  Motivation  Structure/Framework of the Report  Applying Framework: Examples  Opportunity:  Capability: Policy targets Govts and now Parents; lens improve the capacity of youth to decide among opportunities  Second-chances:

19. 3 types of questions asked of each transition: a ‘youth lens’ on policy OpportunitiesCapability Second- Chances Policies affecting human capital formation during Youth transitions: -- Economy wide policies and insts: macro stability, invest. climate, governance, labor market regulations -- Education -- Training -- Health services -- Welfare & family services -- Infrastructure Youth ‘Lenses’ “Youth friendly” policies

20. Second-chances: Recovering from poor outcomes High costs of not giving young people another chance to recover:  Effects are long-lasting  Later recovery as adults is more costly  May inhibit investment by others (e.g., high HIV/AIDS prevalence leads to lower investment) Examples:

21. Examples of second-chance programs for RHA  Training for dropouts to re-enter mainstream educ  Child-care services in schools for students  Family planning and maternal services for youth

22. Policy Framework  Opportunity  Capability  Second-chances: Prevention; lens Help young people recover from poor outcomes

23. Moving forward in Countries  Coordination: youth outcomes require improved multi-sector efforts  Voice: the constituency of youth is weak (which is why for this Report, we had extensive consultation)  Evaluation: many youth- specific initiatives are still new; impact must be studied Providing school uniforms not only increased enrollment in Kenya – it lowered teenage pregnancy