Adolescent Sexual and Reproductive Health Challenges and Universal Health Coverage: Report Series

October 1, 2014: A new World Bank Group global analysis examining socioeconomic status in relation to adolescent sexual and reproductive health (ASRH) outcomes in Bangladesh, Burkina Faso, Ethiopia, Nepal, Niger, and Nigeria finds that:

  • At least one-quarter of adolescent females 15-19 years of age are married in the countries studied; the highest prevalence is found in in Bangladesh (65%) and Niger (63%)
  • 50% of adolescents 15-19 years of age have given birth in the countries studied
  • Less than 50% of married adolescent females 15-19 years of age use modern contraception in the countries studied
  • Almost 40% of married adolescent females have had sexual intercourse before age 15 in Nigeria, Bangladesh, and Niger. Less than 30% have had sex before age 15 in Ethiopia, Burkina Faso, and Nepal

A second case study, conducted in Bangladesh, presents results on the multi-sectoral nature of the adolescent, sexual and reproductive health burden revealing that: 

  • Adolescent girls (15-19 years) in the slums of Dhaka are married on average at 15 years of age (ranging from 12 to 17 years) and 70% already had their first child by 19 years of age
  • Most females deliver at home. The primary barriers to facility-based deliveries include: tradition; societal shame and embarrassment; and perception that facility-based delivers are associated with health emergencies and complications   

Adolescents (10-19 years of age) around the world face tremendous challenges in meeting their sexual and reproductive health needs. Inadequate access to health information and services, as well as inequitable gender norms, can have serious implications on their health and welfare, as well as economic development and poverty reduction – key priorities for the World Bank Group.  

Indeed, ensuring access to quality ASRH and family planning services is fundamental to human development, as outlined in the World Bank’s Reproductive Health Action Plan (2010-2015). As a result, the Bank Group is working in high ASRH burden countries to improve services so that women and children survive and can live healthy, productive lives.

ASRH is inseparable from all aspects of adolescent health, providing an opportunity for health gain or loss. During adolescence, the risk of injury and mental disorders is greatest, while behaviors associated with later-life non-communicable diseases, such as tobacco use, obesity and physical inactivity, are established. This affects the future health, social adjustment, and economic prospects of today’s adolescents, as well as their capacity as parents and the health of their children.

Within this context, ASRH investments should be adapted to a country’s unique needs, including: 

  • Investing in universal access to integrated ASRH
  • Investing in poor and vulnerable young populations
  • Investing in high-impact adolescent interventions in other sectors, ensuring sustainability
  • Strengthening health systems to scale up access to quality adolescent user friendly health services
  • Gaining policy and political will at the country level
  • Harmonizing technical and investment efforts among partners at the country level
  • Establishing country data systems to drive adolescent health policy and programming
  • Fully involving adolescents in the development of adolescent health programs

Investment in the health, education, and rights of young people, and the alignment of related policies, is critical as it enables productivity and economic growth. Meanwhile, empowering young people in their healthy development, including ASRH practices and rights, provides the right conditions so that they can become productive adults, as well as protect their health and their family’s well-being.