1. Adolescents: Strengthening Evidence to Address their SRHR Needs
AFP Partners Meeting, Kenya
Adolescents: Strengthening Evidence to Address their SRHR Needs
Michelle J Hindin, MHS PhD
Scientist

2. Adolescents Definitions: How many?
Adolescents year olds
Youth year olds
Young people year olds
How many?
There are approximately 1.2 billion adolescents
They make up 18% of the world’s population
88% of adolescents live in low- and middle-income countries
One in every six people in low-income countries is an adolescent
In 2050, sub-Saharan Africa is projected to have more adolescents than any other region.
Adolescents are not a homogenous group and have diverse Sexual and Reproductive Health (SRH) needs

3. What do we know? Pregnancy
In developing countries, year olds will have about 21 million pregnancies
About half end in abortion, often unsafe
Unsafe sex and lack of contraceptive use are leading risk factors of morbidity for young people (ages 15-24).
Pregnancy during adolescence can have long-ranging adverse social, educational and economic consequences. These consequence vary by social context, marital status, age, wealth and education.
Darroch JE et al., Adding It Up: Costs and Benefits of Meeting the Contraceptive Needs of Adolescents, New York: Guttmacher Institute, adding-it-meeting-contraceptive-needs-of-adolescents.

4. What do we know: Contraception
Approximately 38 million year olds women in developing countries are sexually active and do not want a child in the next two years.
40% are using a modern contraceptive method
60% are not using a modern or any method at all
In Africa, unmet need need for modern contraception is higher among married adolescents.
In Asia, unmet need for modern contraception is higher among unmarried sexually active adolescents
In Latin America and the Caribbean, unmet need is similar between married and unmarried.
Woog V et al., Adolescent Women’s Need for and Use of Sexual and Reproductive Health Services in Developing Countries, New York: Guttmacher Institute, 2015,
Years.
Married women
Unmet need among married women aged 15–19 was lowest in
Rwanda (6%) and highest in Ghana (62%).
• Asia 7% in Indonesia to 42% in Nepal.
• Latin America and the Caribbean ranged from 13% in Cuba to
57% in Haiti.
Unmarried sexually active women
• • Unmet need among this group was especially acute in
Africa: In 20 countries, more than 50% of unmarried,
sexually active 15–19-year-olds had an unmet need for
contraception.
• Asia 25% in Kazakhstan to 94% in Laos.
• LAC 14% Cuba 55% range.
Darroch JE et al., Adding It Up: Costs and Benefits of Meeting the Contraceptive Needs of Adolescents, New York: Guttmacher Institute, adding-it-meeting-contraceptive-needs-of-adolescents.

5. Which Interventions work?
Reviewed published and gray literature review of interventions for young people on pregnancy prevention
>30,000 screened
21 articles of high quality (interventions, evaluations)
What works to prevent pregnancy?
Method provision (Kenya)
Economic Incentives/School Uniforms (Kenya, Malawi)
But also didn’t work in Kenya, Malawi, Zambia
Education program/teacher training (Kenya)
What works to increase contraceptive use?
Provision of methods (Keya)
Life skills training/Peer education (Ethiopia, Uganda, Senegal, India, Cameroon)
Mass media (India)
Hindin MJ et al (In Press) “Interventions to prevent unintended and repeat pregnancy among young people in low- and middle-income countries: A systematic review of the grey and published literature. Journal of Adolescent Health

6. Current Research for ASRH in WHO/HRP
Better use of existing data
Systematic reviews (Global)
pharmacy provision of RH commodities
provider bias in service provision
DHS secondary analyses of Adolescents (40+ countries)
early and first births (by age and socio-demographic characteristics)
contraceptive use patterns (never, ever, current use)
pharmacy as source of contraceptive method
Improve access to and quality of SRH services
AHEAD (facility-based intervention to prevent rapid repeat pregnancy)
ARMADILLO (digital health intervention to improve contraceptive knowledge and use)
Address contextual, social and policy barriers
GEAS (gender norms and social context)
Policy analyses and documenting best practices
Adolescent briefers (disaggregated by marital status)

7. For additional information
Michelle J Hindin
WHO/RHRhttp://
HRP
Filename