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Basic facts
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There are more than 1.5 billion young people between the ages of 10 and 24; 85% of
them live in developing countries.
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About one in ten of all births worldwide are to adolescent women
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Below 18, a pregnant adolescent is two to five times more likely to die than a woman
18-25
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The majority of first births in sub-Saharan Africa are to adolescent women
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Low birth weight is more common in babies born to adolescents than in adult women
Source: World Health Organization
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www.unfpa.org
The site of the UN Population
Fund includes news, features and The State of World Population 1999. Six billion:
a time for choices. |
For Dr Pramilla Senanayake, assistant
director-general of the International Planned Parenthood Federation*, young people
hold the keys to improving the record on reproductive health
*IPPF
(www.ippf.org) links family
planning associations in 150 countries. It is the largest voluntary organization
in the world concerned with family planning and sexual and reproductive health.
Pregnancy related problems are a leading cause of death among adolescents. Are most
of these unwanted pregnancies?
You have to distinguish between pregnancies within and outside marriage. In countries
like Bangladesh, Nepal and some parts of Africa, the number of girls married by 15
or 16 is exceedingly high—up to 70 or, 80 per cent. In those situations, pregnancy
within marriage may be wanted but we know that it is hazardous, in terms of its consequences
on health, education and economic opportunity. Outside of marriage, the vast majority
of pregnancies are unwanted. The “sugar-daddy” phenomenon is common, while a more
recent trend is the false belief by some men that by sleeping with a virgin, they
will not get AIDS.
Does pregnancy generally mean an end to education ?
Yes, or else girls often end up having botched-up backstreet abortions because
they are afraid of being expelled. You could argue that schools should be encouraged
to keep pregnant students but in reality, this doesn’t really work. These women have
special needs. In countries as far afield as Jamaica and Tanzania, we have set up
special schools for pregnant mothers allowing them to complete their education. Once
the child is born, they often continue into vocational education as long as childcare
facilities exist.
What impact did the 1994 International Conference on Population and Development
have?
The United Nations Population Fund took a leadership role by spearheading the need
to look at adolescents as a group whose sexuality had to be recognised and whose
needs had to be met in terms of education, information and services. This has to
be done in a holistic way. The conference made the world aware that this was not
a problem that you could just sweep under the carpet. But at a country level, progress
in taking care of teenagers’ needs has been slow. NGOs are setting the example in
most cases, notably with peer education projects that are giving promising results.
To what extent has sex education improved, particularly in developing countries?
In some countries including my own (Sri Lanka) sex education exists, but in reality
teachers are not trained to handle these issues. Sex education is not just about
having sex, it’s about relationships and making choices. Girls need empowerment to
say “no” to a relationship and this is difficult for them. This kind of sex education
is still rare in schools and often starts too late. Primary school is the important
starting point. But you also have to look at what is happening outside the school,
because very often girls drop out at the secondary level, and there are some 125
million children who never go to school at all. The potential of distance learning,
media and other communication forms has to be more broadly harnessed.
What do we know about the impact of sex education programmes?
Study after study has pointed out that sex education delays childbearing and
does not lead to promiscuity or to early sexual experimention. It is usually the
reverse: if you are forearmed with that knowledge, you are more cautious. In every
walk of life, we train young people to cope, we give them skills and knowledge, but
when it comes to sex education, there seems to be a myth that the less you tell them
the better off they are. It makes no sense. It is control of power by an older generation.
How can access to contraception be improved, notably in Africa?
There is a crying need for information on contraception. Information has to be
made available through a variety of sources: in clinics, in pharmacies, through peer
groups, the media, etc. Services have to be made more youth-friendly and accessible
to all young people regardless of their marital status. Young people themselves should
play an active role in defining how health services should be run. The press can
play a pivotal role: we are running a particularly successful operation with the
BBC World Service known as Sexwise. It is a 12-part series on sex education, family
life education, contraception and parenting. In South Asia, where it was first launched
in eight languages, we received some 75,000 queries from listeners. After being extended
in 1999 to Europe and Eurasia, the series will go global in July 2000 and is expected
to reach over 60 million listeners in Africa, the Arab world, Latin America, South
East Asia and China by the end of the year.
In 1999, the U.S. introduced a rule that aims to defund organizations outside
the U.S. which provide any abortion-related information and assistance to women in
need. Are you concerned about this?
This rule is hurting women. It is depriving funds for NGOs like ours. This means
we are unable to provide reproductive health services, including contraception and
family planning to women who are in need. This results in more unwanted pregnancies
because services are not available and women who could have gone to have services
ended up having botched-up abortions. It is very shortsighted.
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