Why teenagers need to get contraceptives

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Lucy Lamble,
Liz Ford and
Kary Stewart

For 1.8 billion young people, family planning will be vital in shaping lives and livelihoods. As leaders prepare for the London Family Planning Summit, Lucy Lamble looks at the challenges ahead

There are currently an estimated 1.8 billion young people in the world; the biggest cohort of young people ever, with nearly nine out of 10 of them living in developing countries. In 2012, London hosted a summit that set the agenda for family planning up to 2020. For a long time adolescents have not featured prominently on the development agenda, but increasingly there’s a realisation that their futures depend on being able to plan their families.

So if we are not giving information to young boys and girls, then they don’t get the knowledge and empowerment they need to make great decisions. And of course, it affects the livelihood of the girl and the babies that they’re giving birth to. In 2016 alone, 82m unintended pregnancies, 25m unsafe abortions and 124,000 maternal deaths were averted due to the use of modern effective methods of family planning. But despite this many people in the world still can’t count on access to contraception, and now many countries are about to face additional problems as the US cuts funding.

This month the Global development podcast ahead of the second London Family Planning Summit, which started yesterday, looked at how these challenges will affect the growing population of young people in the developing world and consequently the economy of their countries.

At the 2012 London summit, some of the world’s richer countries pledged $2.6bn over the next eight years and FP2020 was set up to monitor that promise. Beth Schlachter is their executive director.

BS:  In 2012, building on the excitement from the London summit, the global community set the goal of expanding access to contraception so that 120 million additional women and girls in the world’s 69 lowest income countries would be able to use contraception. And by that we mean that they would have access to a range of high quality products, that they would have healthcare services that consider their needs and are based on high quality information, on counselling sessions that really work with women to determine what their needs are and what would best suit their purposes.
Julia Bunting (JB) is from the Population Council.

JB: When you give a woman or a young person the right to determine freely and for themselves whether, when and how many children to have, then their life chances are transformed. They don’t have unintended pregnancies, they’re not at much risk of unsafe abortions and maternal mortality. We see that they choose to have fewer children and to invest more in those children. So those children have greater life chances; they’re likely to be more healthy, they have more years of education and they’re more likely to be productive in the labour force.

And when we see this happen at an aggregate level – the choices of many individuals happening – then we see real benefits for countries in terms of their economic growth and development as well as things like security and stability.

LL: What’s known as the demographic dividend. How does that work?

JB: The demographic dividend is a phenomenon that occurs when there is increased access to contraception that leads to reductions in fertility and that creates a change in the population age structure. So what we see is that there are fewer young people and more people of working age. And when we get that dependency ratio the number of young people to working age people when that reduces what we see is a real opportunity for economic growth because there are more people working.

Now for that to come to be, it’s not just that you need to increase access to contraception, you also need to increase human capital, improve people’s health and education, and you need to implement policies around labour and employment and trade.

And the demographic dividend is a very real phenomenon. We’ve seen it happening in countries around the world. So if you just take some of the examples, for example, the Asian tigers – the east Asian tigers countries like South Korea and Taiwan and Singapore – they experienced the demographic dividend between the late 1960s and the 1990s, and the economic miracle that we saw in those countries was in part a result of these investments. And they estimate that about a third of that economic growth was a result of harnessing the demographic dividend.

LL: FP2020 publishes a report every year looking at the progress across the 69 countries they target.

BS: Where we’ve seen considerable progress is in a lot of the difficult work that has to take place for governments to provide programmes to meet the needs of their citizens. So a lot of the work that we do as well is around social norms and around expanding the understanding within communities for why women should have access to products that give them control over the most intimate part of their lives. So we do a lot of work to help women understand what contraception is; to help communities support women having access to that, with the understanding that women have more autonomy as they have healthier lives, as they have healthier children at birth and that they’re able to support them through early childhood, that we then have healthier families, stronger economics in local communities and potential for growth overall economically in countries.

So family planning is one of those interesting areas of work where both human rights and economics come together in a really interesting and challenging way. So we have to look at both sides of it, both the technical, the bureaucratic, the delivery side as well as the human side of healthcare and need for individual people.

LL: Global development deputy editor Liz Ford (LF) travelled to Uganda where sex education is under great pressure.

My name is Ali Kaviri (AK): I’m a youth rights and women’s campaigner in Uganda. A Women Deliver young leader and I’m also the World Contraception Day ambassador for Uganda.

LF: What about sex education in Uganda, is it taught in schools?

AK: I will give you my experience. Like I only gotten about sex education maybe just a few phrases during biology lessons, where we draw the female reproductive organ. Where we would draw a female reproductive system, a male reproductive system and then have discussions and all that. But in terms of sexuality education, or comprehensive sexuality education, right now they don’t even have this conversation, it’s banned. That means organisations cannot even take this message to young people. Young people now are just wondering on their own.

LL: In Uganda, many believe that young people should not be educated about sex but instead be taught to abstain. Yet, adolescents are having sex. According to the country’s 2016 Demographic and Health survey, a quarter of girls aged 15 to 19 have had a baby or are pregnant. Annet Kyarimpa Mukabe (AKM) is coordinator of safe motherhood with Reproductive Health Uganda.

AKM: Uganda has one of the highest teenage pregnancies in the world, estimated at 25%. And one of the contributing factors is lack of access to family planning, cultural and traditional barriers that inhibit young girls from talking about sexuality issues. But also the environment in which young people access sexual and reproductive health services is not very conducive.

LL:  Annet Nabizzizzi (AN) is a volunteer for Reproductive Health Uganda in Mbale.
AN: I dropped from school because of unwanted pregnancy. I am a mother through very painful condition. I was 16 years, I gave birth at 17 years. I feel so bad for the young ones, the young girls. At least I counsel … I try to counsel them not to be like me.

LF: So, Annet, if your 15-year-old daughter came up to you and wanted to talk to you or ask about taking contraception what would you say, or what would you do?

AN: I first counsel her. But if she do insist I give the [contraceptives].

LF: How would you feel about giving her something like that?

AN: I feel very bad. I feel bad. I feel bad because early sex is not good.

LF: But what would compel you to give her what she wanted?

AN: Because she might get pregnant when she’s still in school.

AK: What now this means for us as young people, and especially with saying a lot in terms of increasing access to information so you can make informed choices in life, we’re going to see many young girls you know deferred. We’re going to have so many, let’s say, girls drop out of school due to pregnancy-related cases, due to child marriages, due to quite a number of things. And that means it has a bearing of course to the economy. That means you’re having child families that cannot be able to support and our people shall continue to live in poverty for many years to come.

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