Reproductive Health Response in Conflict (RHRC) Reproductive Health Response in Conflict (RHRC)

Adolescent Reproductive Health

Adolescents have a right to accurate information and appropriate services

 

Key Messages

Overview


Facts & Statistics


Stories from the Field

 

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Colombian teenager

Colombian teenager
Photo by: Estudio 3 for RAISE, 2008

Facts

Global Statistics
    • In over 20 countries around the world, children and youth are direct participants in war. An estimated 200,000 to 300,000 children are serving as soldiers for both rebel groups and government forces in current armed conflicts.1
    • As of 2005, nearly half of the world’s population (almost 3 billion) is under the age of 25, making it the largest youth generation in history.2
    • According to a study by Laski and Wong (2010), young adults with greater social assets (stable homes, schooling) receive the majority of adolescent RH services, which tend to reach urban, in-school, older, unmarried boys, and in many cases boys aged 24 years and older. Those with fewest social assets (migrants, less stable families, individuals with limited or no schooling who experience the most frequent, unprotected sexual relations) receive a negligible share of youth-serving resources.3

Adolescent Pregnancy and Maternal Newborn Health

    • Adolescent girls are at the highest risk for maternal mortality.  Each additional pregnancy increases a girl’s risk of maternal death.4 Maternal mortality was found to be twice as high for women aged 15–19 years and five times higher for girls aged 10–14 years compared to women aged 20–29 years.5
    • Eighty-two million girls in developing countries, ages 10 to 17, marry before their 18th birthday. Every day over 70,000 adolescent girls are married and nearly 40,000 give birth.6
    • Adolescent 10 to 19 years of age represent 11 percent of all births worldwide. Adolescents account for 23 percent of the overall burden of disease due to pregnancy and childbirth.7
    • The birth rate (number of births per 1000 women) for girls aged 15-19 in least developed countries is 116, versus 53 for the world, and 37 for developed countries.8
    • Every year, 14 million adolescent girls aged 15 to 19 give birth without the assistance of a skilled birth attendant.9
    • Complications from pregnancy and childbirth are the two leading causes of death for 15 to 19 year old girls worldwide.10
    • Girls aged 15 to 19 years are twice as likely to die from pregnancy and childbirth complications then older women.11
    • Over 16 million girls age 15-19 give birth each year,12 and 9 out of 10 of these births take place in developing countries.13
    • A 2010 study of 14 sub-Saharan countries found that teenager mothers were more likely to lack maternal health care then women aged 20 to 39 years14.
    • More than one million infants and approximately 70,000 of their adolescent mothers die each year in developing countries.15
    • One third of women worldwide give birth before the age of 20,16 with deliveries by women under 20 totaling 15 million annually.17
    • Girls under the age of 16 are at increased risk for prolonged obstructed labor which often leads to fistula because the pelvis of a young girl is not yet fully developed for childbirth.18

Family Planning and Unsafe Abortion Among Adolescents

    • Between 2.2 to 4 million adolescent girls obtain abortions each year.19
    • As of 2004, 59 percent of all unsafe abortions in Africa were among young women aged 15 to 24.20
    • The unmet need for contraceptives among adolescents is more than twice that of married women.21
    • In 2004, 13 percent of sexually active sub-Saharan African women age 15 to 19 used contraception.22
    • Female education is one of the most effective ways to prevent high-risk pregnancy and newborn deaths. Educated girls are more likely to grow up to be healthy mothers who are better positioned to care for their children. The longer girls stay in school, the later they marry and begin childbearing.23
    • An infant’s risk of dying in his or her first year of life is 60 per cent higher when the mother is under age 18 than when the mother is 18 or older.24
    • A study of 18 Demographic and Health Surveys conducted in Africa between 1993 and 2001 found that two out of five unmarried females aged 15–24 were sexually active.25
    • According to a study of six developing countries, women younger than 25 were more likely than others to stop using their contraceptive method after 24 months.26

HIV/AIDS and STIs Among Children and Adolescents

    • Every day, about 500,000 young people, mostly women, are infected with an STI.27
    • As of 2005, young people aged 15–24 account for an estimated 45 percent of new HIV infections worldwide.28
    • According to a 2008 UNAIDS report, 3.3 million youth in sub-Saharan Africa are living with AIDS and 76 percent of youth living with HIV/AIDS are female.29
    • As of 2005, one-third of all women living with HIV are between the ages of 15 and 24.30
    • Married adolescent girls are at higher risk for HIV than unmarried girls their own age or older married women because these girls have little bargaining power to insist on condom use if they suspect their husbands are unfaithful.31
    • In Africa, where the majority of new HIV infections are among the young, the risk for girls (aged 15 to 24) compared with boys is two to one. In sub-Saharan Africa, infected young women outnumber infected young men 3.6 to one.32
    • In Uganda, the risk of HIV infection doubles for girls 15 to 19 who have male partners ten or more years older.33
    • Studies from Uganda demonstrate that a child who drops out of school is three times more likely to contract HIV in her/his twenties than a child who completes basic education.34
    • In 2003, the prevalence of HIV among South African women visiting antenatal clinics was estimated to be 15 percent among women aged 15 to 19 years and 30 percent among women aged 20 to 24 years.35
    • The Declaration of Commitment on HIV/AIDS aimed for 90 percent of young people to be knowledgeable about HIV by 2005; however, studies demonstrate that less than 50 percent of young people achieved comprehensive knowledge.36
    • Almost nine out of ten children with HIV live in sub-Saharan Africa, where more than 12 million children were been orphaned by AIDS in 2005.37
    • It is estimated that in 2008, more than 90 percent of children living with HIV acquired the virus during pregnancy, birth or breastfeeding—forms of HIV transmission that can be prevented, but often go unnoticed in conflict settings.38
    • Around 9 percent of children (under 15) in sub-Saharan Africa have lost at least one parent to AIDS, and one in six households with children are caring for at least one orphan.39
    • Caring for those with HIV-related illnesses or young children orphaned by AIDS is often expected of many young girls who must often sacrifice their own education to do so.40
    • Studies from Uganda demonstrate that a child who drops out of school is three times more likely to contract HIV in her/his twenties than a child who completes basic education.41

Female Genital Cutting/Mutilation (FGC/FGM)

    • In Africa, about 3 million girls are at risk for FGC/FGM annually.42
    • An estimated 100 to 140 million girls and women worldwide are currently living with the consequences of FGC/FGM.43
    • Women and girls who have undergone FGC/FGM are significantly more likely to have adverse obstetric outcomes than those without that have not. In addition, the health risks appeared to increase with the severity of the FGC/FGM.44

Refugee/Internally Displaced/Conflict-affected Statistics 

    • Youth from communities with greater exposure to sexual violence were significantly less likely to use condoms at their last sexual encounter and were more likely to be HIV positive or to have experienced and adolescent pregnancy than were youths from communities with lower violence.45
    • In response to queries regarding allegations of sexual exploitation or sexual abuse by UN Peacekeeping Operations, the UN Secretariat received 105 reports of allegations. Forty-five per cent of those allegations involve sex with minors and 15 percent involved rape or sexual assault.46

Africa

    • A psychiatric epidemiological survey of young survivors (8-19) of the 1994 Rwandan Genocide measuring traumatic exposures using an inventory of possible war time experiences and post-traumatic stress reactions reported that among respondents, 30 percent witnessed rape or sexual mutilation.47
    • In the Democratic Republic of Congo, UNFPA reported 15,996 new cases of sexual violence registered in 2008. In North Kivu alone, of the 4,820 cases of sexual violence 65 percent were committed against children.48
    • A study of adolescent pregnancies in Congolese refugee camps in Tanzania found that almost 30 percent of all births were by girls between the ages of 14 and 18, putting them at high risk for death and disability.49
    • Since June 2002, the Lord’s Resistance Army (LRA), a rebel group in northern Uganda, has abducted 8,400 children, the highest rate of child abduction since the beginning of the 17-year war.50
    • UNICEF estimates that 80 percent of the LRA are abducted adolescents, many of whom were forced to attack their own families, neighbors, and villages.51
    • A Belgian study of abducted child soldiers in Uganda found that 35 percent of girls had been “given as a wife” to rebel fighters.52
    • From the beginning of the conflict in Uganda, an estimated 25,000 children have been abducted in the northern region. Of those abducted 30 percent were girls, of whom 1,000 conceived during captivity.53
    • Twenty percent of urban refugee girls in South Africa faced sexual violence and exploitation and 60 percent of urban refugee children had limited information on the transmission and prevention of HIV/AIDS.54
    • Girls comprised 25 per cent of soldiers in Sierra Leone. The majority was recruited as soldiers, cooks, cleaners and forced sexual partners, otherwise known as “bush wives”.55
    • In a program for girls associated with armed groups in Sierra Leone, 32 percent reported having been raped and 66 percent were single mothers.56
    • Only 26 percent of adolescent girls in Somalia have heard of HIV/AIDS, and only one percent know how to protect themselves against contracting HIV.57
    • Girls as young as eight years old in the Central African Republic (CAR) were raped. Sources in CAR report that some child combatants, who were among the suspected perpetrators of rape and other abuses, appeared to be under 10 years old.58

Asia

    • In Afghanistan, 40 percent of girls are married before they reach the age of 18.59
    • A survey of adolescent Bhutanese refugees in Nepal revealed that 22 percent of boys and 46 percent of girls “did not know anything” about sexual contact, while only 41 percent of all respondents knew that condom usage prevented STIs.60
    • According to a study conducted by Benner et al. on reproductive health and quality of life of young Burmese refugees in Thailand, young Burmese refugees in Thailand had limited knowledge of reproductive health issues and showed clear interest in wanting RH education and services from health workers rather than parents or teachers. Marital status also played a role in knowledge of sexual health, as married youth were 6 times more likely to know more about reproductive health than unmarried youth.61

South America

    • A survey by Colombian NGO Profamilia found that displaced girls and young women aged 13 to 19 had the highest rate of pregnancy and child bearing in the country for their age group (30 percent versus 19 percent for their non-displaced counterparts).62
    • In Colombia, women are victims of 95 percent of all cases of spousal violence. Half of the women who suffer from aggression fall into the age range of 15 to 24 years.63

     

     

Updated December 2010. Please note: while this site is periodically updated, it is up to the user’s discretion to verify that the facts provided are the most current.

 

References
Note: Links provided only if resource is available to public.

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Key Displacement Facts		 General Reproductive Health Adolescents
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