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Issues at a Glance
Youth's Reproductive Health: Key to Achieving the Millennium Development Goals at the Country Level
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Five years ago, the leaders of 189 countries came together at the Millennium Summit and pledged to: eliminate poverty; create a climate for sustainable development; and ensure human rights, peace, and security for the entire world's people. Eight overarching Millennium Development Goals (MDGs) measure progress towards this vision. None of the MDGs explicitly references youth's reproductive health, even though its relationship to alleviating poverty cannot be overlooked.
Youth's Reproductive Health
People under the age of 25 represent nearly half of the world's population,[1] giving them a powerful role in the world's health and future. Despite youth's diversity in culture, background, language, and socioeconomic status, their lives reflect similar, intersecting issues and events. For youth ages 15 through 24, life sometimes seems to be overshadowed by reproductive health issues, including unintended pregnancy as well as HIV and other sexually transmitted infections (STIs).
- Worldwide, about 6,000 youth ages 15 to 24 are infected with HIV each day.[2]
- Young people experience over 100 million new cases of STIs each year.[2]
- Young women experience high rates of unintended pregnancy. Each year, about 15 million teenage women give birth.[3] In Latin America and the Caribbean, about 40 percent of teenage pregnancies are unintended while in sub-Saharan Africa the percent varies widely from 11 to 77 percent.[4]
Since youth's decisions about their sexual and reproductive health affect not only their lives, but also the health of the global community, there is an urgent need for programs and policies to address the complex reproductive health needs of earth's one billion youth ages 15 to 24.[5]
Youth's Reproductive Health and the Millennium Development Goals
At the 1994 International Conference on Population and Development (ICPD), the international public health community for the first time acknowledged the reproductive health challenges facing young people. At ICPD, nations agreed to make adolescent sexual and reproductive health a priority. The Programme of Action called for unfettered universal access to a variety of family planning methods as well as to services to prevent and treat STIs, including HIV.[6] The emergence of the MDGs in 2000 made it critical to continue to support integrated, comprehensive programs that holistically address adolescents' reproductive health. The MDGs include no explicit goals on youth's reproductive health, yet a country's ability to meet the MDGs regarding poverty, HIV and AIDS, and maternal and child mortality rates is integrally linked to the reproductive health and well-being of its youth.[7]
Creating Benchmarks for Youth's Reproductive Health
To achieve four of the eight MDGs, governments must include in their Poverty Reduction Strategy Papers and Country Assistance Strategies ways to improve youth's reproductive health. Below are summaries and recommendations regarding youth's reproductive health and four MDGs.
Millennium Development Goal 3: Promoting Gender Equality and Empowering Women
By signing on to the MDGs, all 189 United Nations Member States have pledged to "eliminate gender disparity in primary and secondary education preferably by 2005, and at all levels of education by 2015."
Facts—
- Early marriage is a major factor in gender inequity in secondary education. About half of women are married during adolescence in much of sub-Saharan Africa; 50 to 75 percent in India and Bangladesh; less than 30 percent in the Middle East and North Africa; and 20 to 40 percent in Latin America and the Caribbean.[4] Seldom do these young women have a voice in regard to their marriage.[8]
- Research shows that early marriage sharply reduces girls' access to education while their families' plans for early marriage often preclude educating their daughters.[8]
- Research shows that young women's enrollment in secondary school is inversely related to being married before age 18.[8]
Recommendation—Governments should implement strategies to increase the age of young women's marriage to at least post secondary school and create a benchmark to measure progress towards accomplishing this.
Millennium Development Goal 4: Reducing Child Mortality
United Nations Member States have pledged to "reduce by two-thirds the mortality rate among children under five by 2015."
Facts—
- Infant mortality is highest in countries with the largest proportions of births to adolescents.[9]
- Children born to mothers under the age of 20 are significantly more likely to die than those born to mothers ages 20 to 29.[9]
- Young adolescents are more likely to experience premature labor, spontaneous abortion, and stillbirths than are older women.[4,8]
Recommendations—Governments should implement strategies to reduce early childbearing, such as increasing the minimum legal age of marriage, promoting youth's access to sex education and family planning services, and improving access to pre- and postnatal care for pregnant and parenting young women.
Millennium Development Goal 5: Improving Maternal Health
United Nations Member States have pledged to "reduce by three-quarters the maternal mortality ratio by 2015."
Fact—
- Maternal mortality is twice as high for women ages 15 to 19 as for women ages 20 to 34.[8]
Recommendations—To reduce maternal mortality, governments should address the negative consequences of pregnancy on the health of young women and implement strategies to provide comprehensive sex education, family planning services, and pre-natal care for young people. Increasing the minimum age of legal marriage will also assist in accomplishing this goal.
Millennium Development Goal 6: Combating HIV/AIDS, Malaria and Other Diseases
UN Member States have pledged to "halt and begin to reverse the spread of HIV/AIDS by 2015."
Facts—
- Throughout the world, almost 6,000 youth ages 15 to 24 are infected with HIV each day; this is half of all new HIV infections.[1]
- Half of 15-year-old youth in the worst affected countries may eventually die of AIDS.[9]
- Adolescent women in the countries most severely affected by HIV and AIDS are two to six times more likely to become infected with HIV than are their male peers.[9] Many of these young women were infected by the older men they were forced to marry.[8]
Recommendations—Governments should implement science-based strategies to address the HIV and AIDS epidemic. Early marriage, lack of knowledge about HIV prevention, adults' discomfort in discussing reproductive health, stigma related to HIV, and lack of access to youth-friendly reproductive health care (including access to condoms and to HIV testing and counseling) all contribute to high rates of HIV among youth. Governments must include specific benchmarks regarding youth and HIV education, delaying sexual debut, increasing condom availability, improving youth's access to health services, and reducing stigma related to HIV.
Youth's Involvement in the MDGs
Young people are the key to accomplishing and sustaining the goals of the Millennium Summit. By including benchmarks related to youth's reproductive health in Poverty Reduction Strategy Papers and Country Assistance Strategies, governments will move successfully towards creating a healthy and economically secure populace. Further, young people have much to say about what will assist them best to meet such benchmarks. As such, youth must become key participants in country level processes. Governments should include young people in developing and implementing their strategies as well as in country delegations to General Assembly meetings regarding the MDGs. The future reproductive choices of the world's two billion young people will largely determine the quality of life on this planet for decades to come.
References
- UNAIDS. 2004 Report on the Global AIDS Epidemic. [4th Global Report] Geneva, Switzerland: Author, 2004.
- UNAIDS. Young People and HIV/AIDS: Opportunity in Crisis. Geneva, Switzerland: Author, 2002.
- Boyd A et al. The World's Youth 2000. Washington, DC: Population Reference Bureau, 2000.
- Mahler K, Rosoff JL. Into a New World: Young Women's Sexual and Reproductive Lives. New York: Alan Guttmacher Institute, 1998.
- United Nations. World Population Prospects, The 2002 Revision. [Vol II, Sex and Age] New York: Author, 2001.
- United Nations Population Fund. The State of World Population, 1997. New York: Author, 1997.
- World Bank. World Development Indicators 2002. Washington, DC: Author, 2002.
- Mathur S et al. Too Young to Wed. Washington, DC: International Center for Research on Women, 2003.
- Zwicker C et al. Commitments: Youth Reproductive Health, the World Bank, and the Millennium Development Goals. Washington, DC: Global Health Council, 2004.
Special thanks to the Global Health Council for its informative publication, Commitments: Youth Reproductive Health, the World Bank, and the Millennium Development Goals.
May 2005 © Advocates for Youth
RELATED RESOURCE >> Youth's Reproductive Health Targets Must Be Included in the Millennium Declaration
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