Are adolescent girls' sexual and reproductive health and rights being left behind?
This week we mark World Population Day, and one year on from the 2017 London Family Planning Summit, where financial commitments reached £1.9 billion by 2020 to accelerate progress on rights-based family planning programmes.
Although there have been significant gains for girls and women in recent years, progress has been slow, fragile and fragmented due to lack of political commitment, inadequate resources and persistent discrimination against women and girls. Currently:
- 4.3 billion people of reproductive age worldwide will have inadequate sexual and reproductive health services over their lifetimes
- 23 million adolescent girls in developing countries have experienced an unmet need for modern contraceptives
- Complications from pregnancy and childbirth is the second leading cause of death for adolescent girls globally, exceeded only by suicide
- 2 million births a year occur among girls under the age of 15 in developing countries
Are adolescent girls being left behind?
Progress is particularly slow for adolescent girls who face barriers due to their age as well as their gender. Discriminatory social norms and attitudes towards girls and young women often lead to them being denied a voice, agency and autonomy in decisions about their sexual and reproductive health rights (SRHR).
The recent landmark report from the Guttmacher-Lancet Commission on SRHR for All highlights the significant obstacles facing adolescents, particularly those aged 10-14 years.
A lack of information and access to services can leave girls and young women vulnerable and unable to protect themselves from unwanted pregnancy and sexually transmitted infections – including HIV, as well as from pregnancy and childbirth related complications.
Girls and young women who live in poverty, in crisis or emergency settings or who belong to vulnerable and excluded groups face even greater barriers to having the right to decide and control what happens to their bodies, including the timing and spacing of any children.
Our recent research on adolescent girls in crises, in Bangladesh and South Sudan, shows that girls and women experience a loss of support and protection mechanisms, financial pressures and a lack of reliable healthcare. During conflict, girls and women can also become systematic targets for various forms of abuse and violence.
– Girl, 15-19, South Sudan
This is often underreported due the trauma as well as the fear of stigma and discrimination. These environments frequently lead to restrictions on movement and a lack of access to adolescent and youth-friendly health services that have an adverse impact on girls’ and young women’s abilities to realise their sexual and reproductive rights.
What needs to happen now?
To support accelerated progress on SRHR for adolescent girls – especially those living in humanitarian settings that means information and services are accessible and affordable regardless of age, gender, marital status, or socioeconomic status – the Guttmacher-Lancet Commission recommends:
- Better evidence and data including data disaggregation by age and sex.
- Ensuring adolescents have access to gender-responsive, youth-friendly sexual and reproductive health information and services without discrimination, including through comprehensive sexuality education.
- Addressing sexual and gender-based violence through policies, services and prevention programmes.
- Providing additional support to groups often marginalised, disadvantaged and subject to discrimination – particularly adolescent girls.
The necessary investments in SRHR are modest and affordable for the majority of countries, but require actions beyond the health sector to change harmful social norms, laws and policies to uphold human rights and achieve gender equality.
It is still early to see the impact of the commitments made at the Family Planning Summit last year. Yet to truly accelerate progress on the SRHR agenda, it is critical that the needs of adolescent girls are continued to be prioritised by governments, agencies and institutions.
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