Break the vicious cycle

Investing in adolescent girls and community mobilisation are keys to prevent early marriages, pregnancies and maternal mortality

July 12, 2013 02:05 pm | Updated 02:05 pm IST

Too young for it: In India, 47 per cent girls get married before they are 18 years. Photo: V. Ganesan.

Too young for it: In India, 47 per cent girls get married before they are 18 years. Photo: V. Ganesan.

In India, four million adolescent girls aged 15-19 years give birth every year. They account for 16 per cent of all births, and nine per cent of all maternal deaths. Every hour, three out of seven deaths due to complications from pregnancy, child bearing and unsafe abortions are among girls and women aged 15-24.

Global estimates suggest 16 million teenage girls who give birth every year never had the opportunity to plan their pregnancy.

Calling for greater attention to adolescent pregnancy, the World Population Day this year (celebrated on July 11) focused on complications from pregnancy and child birth which are the leading cause of death among girls in this age group in developing countries.

Adolescent pregnancy is not just a health issue, it is a development issue. It is rooted in poverty, gender inequality, child marriage and lack of education, and often means an abrupt end to childhood, curtailed education and lost opportunities.

According to the United Nations, there are over 600 million girls in the world today, more than 500 million of them in developing countries. With the right skills and opportunities during adolescence, girls can invest in themselves, their families and communities.

“The greatest returns on investment come from investing in adolescent girls. Educated and healthy girls have the opportunity to reach their full potential and claim their human rights. They are also more likely to marry later, delay childbearing, have healthier children, and earn higher incomes. They can help lift themselves and their present and future families out of poverty. They will be a force for change in their communities and generations to come”, said Frederika Meijer, UNFPA Representative India and Bhutan.

Breaking the cycle of adolescent pregnancy requires commitment from nations, communities and individuals in both developed and developing countries to invest in adolescent girls. Governments should accelerate efforts to prevent child marriage and its consequences, and promote policies that support girls’ rights, she said.

Adolescents and youth must be provided with age-appropriate comprehensive sexuality education to develop the knowledge and skills they need to protect their health throughout their lives. However, education and information are not enough. Good quality reproductive health services must also be readily available for adolescents to make informed choices and be healthy.

On its part, India has adopted RMNCH+A strategy which marks a paradigm shift in integrating the health needs of country’s large young population in efforts to improve reproductive, maternal and child health. The reproductive, maternal, neonatal, child health and adolescent health cover the entire continuum of care for adolescent girls to their children.

The strategy seeks to deliver health services in homes, and communities, along with public health facilities. The focus is on 184 high priority districts.

In India, 47 per cent girls get married before they are 18 years, according to the National Family and Health Survey-3 data. Early marriage leads to early child bearing as social pressures often force girls and young women to prove their fertility soon after marriage. As a result, they bear children early even before they are physically and emotionally ready to be mothers. The low status of girls, combines with lack of appropriate information and family planning and access to services prevents girls from negotiating the use of family planning methods, and plan when and how many children to have.

The contraceptive use in this age group is also very low with only seven per cent using contraceptive and the unmet need for family planning is higher among 15-19 years at 27 per cent as compared to 13 per cent across all age groups.

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