preventing early pregnancy
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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
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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
POLICY-LEVEL ACTIONS
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
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Increase use of contraception
POLICY-LEVEL ACTIONS
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
POLICY-LEVEL ACTIONS
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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POLICY-LEVEL ACTIONS
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
POLICY-LEVEL ACTIONS
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
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