UNFPAState of World Population 2003
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HOME: STATE OF WORLD POPULATION 2003: Overview of Adolescent Life
State of World Population
Overview of Adolescent Life
Gender Inequality and Reproductive Health
HIV/AIDS and Adolescents
Promoting Healthier Behavior
Meeting Reproductive Health Services Needs
Comprehensive Programmes for Adolescents
Giving Priority to Adolescents
Sources for Boxes
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Overview of Adolescent Life

Why is Reproductive Health Important?
Adolescent Reproductive Health and Poverty
A Changing World
Education and Employment
Ensuring a Better Future: Investment in Youth

Why is Reproductive Health Important?

Sexual and reproductive health has been defined by the international community as a state of complete physical, mental, and social well being, and not just merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.(3) It is an essential component of young people’s ability to become well-adjusted, responsible and productive members of society.(4)

Subsequent chapters of this report detail the major issues involved in ensuring adolescents’ rights and meeting their needs in relation to sexual and reproductive health.

Chapter 2 examines gender inequality in relation to early marriage, premarital sexual activity and violence against women and girls. Chapter 3 looks at HIV/AIDS and its impact on the young. Chapter 4 highlights efforts to influence adolescents’ behaviour by giving them information about sexual and reproductive health. Chapter 5 discusses the provision of “youth-friendly” reproductive health services. Chapter 6 gives examples of comprehensive programmes addressing adolescents’ needs for information, services and skills training. Finally, Chapter 7 outlines necessary policy changes and benefits of investing in adolescents, including their sexual and reproductive health.

Reproductive health is a lifelong concern. A mother’s reproductive health status has an impact on her children and their health.

As boys and girls grow up, adults treat them differently and establish different expectations for their behaviour. The differences often determine life outcomes, and many are related to or have an impact on sexuality. In a wide variety of social settings, overtly or by insinuation, girls are conditioned from childhood to expect the role of wife and mother, and boys to expect the role of breadwinner and head of household. Demands on children exist inside the home and out of it; whether children can expect education and in what form; the teenager’s introduction to sexuality, courtship and marriage practices; and information and services regarding reproductive health before and during marriage, reflect these differential gender expectations.

Adverse reproductive health outcomes in later adolescence, including unwanted pregnancy, unsafe abortion and sexually transmitted infections (STIs), can be ascribed to conditions such as lack of education and opportunity, but occur in all social groups. Often, differential gender expectations and treatment in childhood and the early teenage years are important contributors.

Expectations that young women should be responsible for contraception, pressure on young men to prove their masculinity, the aggressive/submissive behaviour exhibited by many young people, for example, are the outcomes of behaviour patterns established early in life.

These matters are often difficult to discuss and hard for young people themselves to raise. Part of the reason, or at least the rationale, for public reticence is that young people themselves do not put sexual and reproductive health high on their list of active concerns. But reproductive health is connected to many of their top-line issues, such as completing education, finding employment, securing their economic position, making secure relationships and, eventually, founding a family of their own.

Teachers, spiritual leaders, employers, governments and communities must help young people, and their parents, as they prepare to exercise the rights and responsibilities of adulthood. Political systems must find ways to involve young people in making and executing the policies that shape their lives. The remainder of this chapter provides a glimpse into the range of situations that must be addressed.


In 1994, the International Conference on Population and Development (ICPD) stressed the importance of adolescence to sexual and reproductive health throughout the life cycle. It also—for the first time in an international agreement—recognized that adolescents have particular health needs that differ in important ways from those of adults, and stressed that gender equity is an essential component of efforts to meet those needs.

The ICPD Programme of Action urges governments and health systems to establish, expand or adjust programmes to meet adolescents’ reproductive and sexual health needs, to respect rights to privacy and confidentiality, and to ensure that attitudes of health care providers do not restrict adolescents’ access to information and services. It further urges governments to remove any barriers (laws, regulations or social customs) between adolescents and reproductive health information, education, and services.

The 1999 Special Session of the General Assembly, ICPD+5, recognized the right of adolescents to the highest attainable standards of health, and provision of appropriate, specific, user-friendly and accessible services to address effectively their reproductive and sexual health needs including reproductive health education, information, counselling and health promotion strategies [paragraph 73].

Article 24 of the Convention on the Rights of the Child affirms that children have the right to attain the highest standards of health and to health care, including family planning education and services (a right also recognized in earlier conventions and conferences).

In June 2003, the UN committee that monitors the implementation of the Convention elaborated: “States Parties should provide adolescents with access to sexual and reproductive information, including on family planning and contraceptives, the dangers of early pregnancy, the prevention of HIV/AIDS and prevention and treatment of STIs. In addition, States Parties should ensure access to appropriate information regardless of marital status, and prior consent from parents or guardians.”

The Convention on the Elimination of All Forms of Discrimination against Women (1979) supports women’s rights to reproductive health information and services and to equity in reproductive decisionmaking and matters of sexual health. In 1999, the committee that oversees the implementation of this treaty urged state signatories to accept that whenever the Convention uses the term “women” it applies to girls and female adolescents as well. See Sources

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