This a translation of an article published in the blog Gente Saludable of the IDB.
By Patricia Jara.
When a woman becomes pregnant her life changes radically. If she is an adolescent, the consequences are even greater. Education is put to the test, possibilities of work are dwindled and social and family relations move to another dimension. Additionally, if this pregnancy takes place in a developing country, it is more likely for young women to be more exposed to poverty.
95% of pregnancies in adolescent mothers occur in these countries, which is equivalent to 20,000 daily births among minors under age 18. According to the United Nations Population Fund (UNFPA), out of the 7.3 million deliveries among minors under age 18, 2 million correspond to girls under age 15.
This reality is extremely important to us: Latin America and the Caribbean is the second region in the world with the highest teen pregnancy rates.
To put a halt to this reality, multiple initiatives have been put into action starting with the idea that programs that contribute the most in improving adolescent sexual and reproductive health combine
- Dissemination of useful and precise information
- Development of socio-emotional skills in adolescents
- Access to care methods, both in schools and health clinics
Initiatives which are effective in practice
This task is a challenge for all countries, not only low-income ones. Costa Rica, for example, in spite of enjoying a high level of human development, displays a fertility rate of 56 children for every 1000 women ages 15 to 19. This data is way above the OECD indices, which encompass the most developed economies in the world and to which Costa Rica is similar in several dimensions.
That is why, since 2014, the Salud Mesoamérica Initiative, financed by the Inter-American Development Bank and with the support of other institutions, works on the prevention of adolescent pregnancy in this and other Central American countries.
The new care protocols that are being implemented distance themselves from prohibition or intimidation. They seek, however, to work with adolescents and service providers to achieve a better acceptance and an appropriate use of long-lasting modern contraceptive methods. The secret to reach the 43,000 adolescents that have been cared for with this new modality has been the closeness of the professionals to share information with them, differentiating between risky and safe practices and, above all, underscoring the importance of health and self-care.
The challenge: promote safe sexual and reproductive behaviors among adolescents
Promotion and prevention actions at the population level face enormous challenges, specially in the field of communications. Messages with the highest preventive potential are those that make sense and influence decision making. This challenge is even greater in adolescent sexual and reproductive health. The idea is, neither more nor less, to achieve in them the conviction that they must:
- Systematically use safe contraceptive methods in an appropriate manner.
- Refrain from consuming alcohol or do it in a moderate way so as to not expose themselves to relations without protection nor consent.
- Seek qualified advice when dealing with their sexual and reproductive health.
Sexual awakening is a crucial component of adolescence, both the biological manifestations and the hormonal changes experimented by young people, as well as the desire of asserting their identity and their place in the social environment. That is why it is essential that young people safely experiment affectively and sexually, overcoming the reckless attitude that leads them to excessively rely on their invulnerability or to not think about the possible consequences of their actions.
Jess P. Shatkin, psychiatrist from the New York University School of Medicine and father to two adolescents, argues that at that age decisions follow an impulsive behavior more tan reason, due to unbalances in neurological development. Therefore, preventing risk by instilling fear or by punishing is useless. The key lies in support and empathy.
Adolescent attitudes, preferences and practices are key to avoid undesired outcomes such as pregnancies or sexually transmitted diseases. However, this does not depend solely on personal decisions. Young people, specially girls and adolescent women, are very vulnerable to sexual and gender violence. Abuses, exploitation and cultural environments that tolerate early sexual initiation or early marriage, increase risks. Likewise, the absence of sexual education in schools or the lack of access to contraceptive methods condition the freedom of choice of adolescents, in particular of women.
Faced with an often complex situation, what can we do specifically? We can start by raising young people that, instead of boasting that “it is not going to happen to me”, adopt the more reflexive attitude of “it could also happen to me”.
What other strategies do you know to face adolescent pregnancy? What is the situation in your country? Tell us in the comments section or by mentioning
Patricia Jarais a sociologist in the Inter-American Bank’s Division of Social and Health Protection at the Chile office.