1. Why Prioritize Ethiopian 10-14 Year Olds? Jennifer Catino EngenderHealth October 9, 2007

2. Overview Stages of adolescence Stages of adolescence Significance of puberty transition: Increased exposure to risks and vulnerabilities Significance of puberty transition: Increased exposure to risks and vulnerabilities Largely neglected age group Largely neglected age group Importance of earlier investment Importance of earlier investment Opportunities of earlier investment Opportunities of earlier investment

3. Age1419212022232415171618111213109 Girls Boys Preadolescence Early Adolescence Middle Adolescence Late Adolescence Youth Young Adulthood Youth Young Adulthood Preadolescence Early Adolescence Middle Adolescence Late Adol Stages of adolescence Chong, Erica, Hallman, Kelly, and Martha Brady. Investing When it Counts: Generating the evidence base for polices and programmes for very young adolescents. New York: UNFPA and Population Council, 2006.

4. DevelopmentaldomainsPreadolescence 9-12 years (girls) 10-13 years (boys) Early Adolescence 12-14 years (girls) 13-15 years (boys) Body Growth spurt Secondary sex characteristics Sensation seeking Menstruation in girls Ejaculation in boys Brain More logical thinking Craving for new information Abstract thinking Sexual Exploration of sex roles Increased sexual arousal and experimentation Sexual preferences explored Gender norms consolidated Emotional Increased self-consciousness Need for greater privacy, autonomy High level self-consciousness Increased stress Separation from parents – dependency on friends Social Academic, social demands increase Gradual separation from parents Increased peer pressure More time spent alone and in peer groups Interest in opposite sex “friends” New social privileges expected Susceptibility to peer pressure at peak Developmental stages of young adolescents Chong, Erica, Hallman, Kelly, and Martha Brady. Investing When it Counts: Generating the evidence base for polices and programmes for very young adolescents. New York: UNFPA and Population Council, 2006.

5. Social significance of puberty transition 10-14 year olds often experience rapid transitions to new social roles 10-14 year olds often experience rapid transitions to new social roles - Caregiver - Bread winner - Spouse - Parent - Spouse - Parent

6. Increased exposure to risks and vulnerabilities Premature school-leaving Premature school-leaving Increased need for contribution to family economy Increased need for contribution to family economy –Unpaid domestic labor –Paid labor –Migration to seek economic opportunity Social isolation Social isolation FGM FGM Early marriage Early marriage

7. Emergent issues for girls by age 12: Sexual maturation Sexual maturation Consolidation of gender norms Consolidation of gender norms Disproportionate care and domestic work burden Disproportionate care and domestic work burden Withdrawal from and/or lack of safety in public space Withdrawal from and/or lack of safety in public space School leaving and school safety School leaving and school safety Loss of peers Loss of peers Migration for work Migration for work Pressure for marriage Pressure for marriage

8. SRH risks faced during early adolescence Early sexual debut Early sexual debut Sexual coercion/violence Sexual coercion/violence Early, unwanted pregnancy Early, unwanted pregnancy Unsafe abortion Unsafe abortion Maternal mortality Maternal mortality Maternal morbidity Maternal morbidity –Obsetric fistula HIV/STIs HIV/STIs

9. Largely neglected age group Despite significant vulnerabilities and needs, 10-14 year olds are NOT often: Despite significant vulnerabilities and needs, 10-14 year olds are NOT often: –Included in research –Included in policies –Targeted by existing youth programs and services

10. Importance of early investment Most youth programs start too late Most youth programs start too late If we really want to impact SRH, we need to prevent unwanted outcomes before they occur If we really want to impact SRH, we need to prevent unwanted outcomes before they occur Prevention of early and high fertility will also stem population growth, which will contribute not only to personal wellbeing, but also to national social and economic development Prevention of early and high fertility will also stem population growth, which will contribute not only to personal wellbeing, but also to national social and economic development

11. Opportunities for early investment May be easier to reach 10-14 year olds May be easier to reach 10-14 year olds 10-14 year olds may be more open, flexible and creative 10-14 year olds may be more open, flexible and creative May be easier to promote the development of positive behaviors rather than change negative ones May be easier to promote the development of positive behaviors rather than change negative ones

12. What do 10-14 year olds need? Participation in finding solutions Participation in finding solutions Continued education Continued education Social and peer support and protection Social and peer support and protection Safe places to meet, learn and recreate Safe places to meet, learn and recreate Personal assets/life skills Personal assets/life skills Positive health habits/information/services Positive health habits/information/services Opportunities for personal and professional development close to home Opportunities for personal and professional development close to home

13. Conclusions Adolescence consists of a series of stages Adolescence consists of a series of stages 10-14 year olds experience rapid physical, emotional, social and cognitive changes 10-14 year olds experience rapid physical, emotional, social and cognitive changes Transitions to new social roles often confer specific risks and vulnerabilities Transitions to new social roles often confer specific risks and vulnerabilities Addressing these needs requires context- specific policies and programs Addressing these needs requires context- specific policies and programs

14. Timing is everything! Early intervention = Effective prevention Thank you!