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HOME: STATE OF WORLD POPULATION 2003: Overview of Adolescent Life
State of World Population
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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
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Overview of Adolescent Life

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

Ensuring a Better Future: Investment in Youth

The involvement of adolescents in social development is a task most countries have yet to address. Broad social changes are increasing the time between physical maturity and acceptance into adult social roles. Social institutions must adjust to offer adolescents full participation because in many settings, they have proven to be dynamic agents of change.

Adolescence can be neither denied nor seen as “a time between”. The choices young people make, the goals they set and the opportunities they are offered are not just preparatory: they are a meaningful and important part of their lives. Young people’s choices can set them on courses that can benefit or harm them, their families, friends and communities. Yet adolescents are offered inadequate information, opportunities, resources and support necessary to guide their choices.

6 RECOGNIZING ADOLESCENTS’ ‘EVOLVING CAPACITIES’

The Convention on the Rights of the Child details governments’ responsibility to guarantee the rights of all children up to age 18, including the right to privacy (Article 16), and to information “regardless of frontiers” (Article 13). All but three countries (the United States, Timor-Leste and Somalia) have adopted the Convention.

The Convention also acknowledges that children’s ability to make important decisions, including decisions about their health, increases with age and experience. Article 5 calls on governments to respect the rights and duties of parents, legal guardians and extended families or communities (if empowered by local custom) to guide and direct children in the exercise of their rights “in a manner consistent with the evolving capacities of the child”.

The ICPD similarly noted the need to balance the responsibilities and rights of parents or guardians with the “evolving capacities” of “adolescents” (a term not in the Convention but used throughout the ICPD Programme of Action).

“Children incapable of judgement [Note: this is a legal term for incapacity or lack of maturity] are entitled to the protection and guidance that parents or guardians can provide,” say legal scholars Rebecca Cook and Bernard Dickens. But the concept of “evolving capacities” also implies increasing autonomy. Policies “that treat competent adults as if they are children,” they argue, “can become demeaning and insulting.” Laws ostensibly designed to protect adolescents, for example by denying them access to contraception without parental consent, can jeopardize their health and may also violate the Convention and other human rights treaties. See Source

In many cases, legal frameworks and administrative arrangements exist to provide young people with essential services such as employment guidance, education and health care, including reproductive health information and services. The problem is more often one of the implementation of policy than of making it.

Investments in adolescents must be strategic. The returns will be generous (see Chapter 7). Inadequate investment stifles opportunity and exposes young people to unnecessary risks. Different sorts of deprivation reinforce each other.

However, investing in young people’s health, education and employment; promoting their social and political inclusion; and reducing the risks to which they are exposed also has a reinforcing effect and promotes a wide spectrum of human rights and development goals. This is certainly true of investments to prevent early marriage and to help adolescents avoid early and unwanted pregnancy, coerced sex, unsafe motherhood and sexually transmitted infections including HIV/AIDS.

This report provides examples of strategies that work, a starting point for reflection, adaptation and improvement.

Table 3: Consequences of Under-investment in Adolescents

Consequences of Limited Investments in Adolescent Reproductive Health
& Reproductive and Development Rights
Reproductive
Health
Consequence

Contributing Factors Consequences for Self Consequences for
Families, Society and
National Development
Early
pregnancy &
childbearing
  • Early marriage
  • Poverty (motivates early pregnancy/early marriage for economic and personal security)
  • Gender discrimination/low value of girls/sense of identity and control/status based on roles as wives, mothers; low self-esteem
  • Lack of information, education, counselling and services for prevention; lack of information about pregnancy risks at too young an age
  • Inability to negotiate contraceptive use, fertility decisions, or postponement of pregnancy due to gender and age, sociocultural expectations
  • Lack of reproductive rights
  • Risks of complications from pregnancy (obstructed labour, obstetric fistulas, anaemia/haemorrhage, death)
  • School drop out
  • Diminished employment and income-earning options
  • Poverty
  • Responsibilities, pressures of childrearing too much, too soon before socio-economic and psychological development
  • Potential for self-development curtailed
  • Higher infant and maternal morbidity and mortality
  • Higher health care costs
  • Higher social welfare costs, especially in the case of single and unmarried mothers
  • Abandonment of newborns
  • Reduced prospects of eradicating poverty (as educational level of mother is key factor in breaking intergenerational transmission of poverty)
  • Reduced skilled human capital for socio-economic development; less skilled workforce; reduced earnings
  • Increased dependency of young mothers on male providers (even if abusive), related to persistent gender inequality and lack of women’s empowerment
  • Increased population momentum; reduced demographic bonus

 

Unwanted
pregnancy
  • Lack of reproductive rights
  • Low access to contraceptive information, education, counselling and services.
  • Myths and misconceptions about pregnancy and contraceptive safety
  • Gender relations—‘pregnancy is woman’s responsibility’; attitudes of lack of male responsibility for pregnancy prevention or consequences; gender stereotypes—girls not equipped with negotiating and assertiveness skills; submissiveness and ignorance expected of girls
  • Sexual violence
  • Forced sex and forced pregnancy as weapons of war
  • Poverty (less years of school, or more years out-of-school; less access to information or services, or to sexuality education; girls less informed about their bodies)

 

  • Recourse to abortion, including unsafe abortion (with high risks of maternal morbidity or death)
  • Single and early motherhood
  • Larger family size than the partners desire
  • Reduced chances for selfdevelopment and skills-building to break out of poverty
  • Reduced investments in children’s needs and development
  • Reinforcement of gender inequality—loss of socio-economic opportunities and women’s full development potential
  • Increased population momentum
Sexual
Abuse,
Violence &
Exploitation
  • Children and adolescents, especially girls, subject to sexual abuse and incest – silence kept from fear, lack of education, marginalization, lack of protection, and social norms and taboos
  • Poverty (false promises of increased income for self and family)
  • Sexual trafficking and slavery profitable; limited enforcement, corruption, etc.; lack of protections for at-risk or already enslaved girls
  • Conflict and post-conflict situations (increased sexual abuse and rape because of fragmented social and family fabric)
  • Low status of girls and young women; low self-esteem; male power and sociocultural legitimacy of sexual violence
  • Psychological, physical and emotional trauma
  • Unwanted pregnancy, unsafe abortion, STIs/HIV/AIDS
  • Impaired ability to establish trusting relations, intimacy, sexual relations; increased prospects of repetitively abusive relationships
  • Reduced freedom, life in fear and violence, including freedom of movement
  • Persistence of gender violence and sexual abuse of children and adolescents (violating universal values and human rights related to respect for human dignity, personal and bodily integrity, freedom and self-determination, and fundamental reproductive rights)
  • Reinforcement of acceptability of violence
  • Diminished educational attainment; increased absenteeism from work and reduced productivity and loss of income to employers
  • Increased crime, reduced law and order, increased corruption (from sexual trafficking)
  • Depression
  • Slowed progress against HIV/AIDS

 

STIs/
HIV/AIDS
  • Lack of information on safer sex
  • Gender discrimination/lack of decision-making power
  • Lack of access to methods of protection
  • Sexual abuse, violence and exploitation
  • Poverty (leads to transactional or intergenerational sex)
  • Multiple sexual partners
  • Premature death or potential selfdevelopment curtailed
  • Discrimination and stigma
  • Increased poverty
  • Infertility
  • Cervical cancer and other sequelae of some non-fatal infections
  • Orphanhood
  • Lost productivity and investments
  • Hopelessness and anomie
  • Agricultural, health, education and other systems fail
  • Disruption of social and economic systems
  • Overburden of health care system
  • Destruction of family networks

 

Under-
employment
  • Weak job creation
  • Low entrepreneurial skills
  • Socio-economic exclusion
  • Gender discrimination in employment and remuneration and unrecognized labour
  • Lack of skills
  • Unsafe exploitation
  • Child labour, and sexual exploitation, Transactional sex
  • Poverty
  • National stability and security harmed
  • Economic growth and social development reduced
  • Increased marginalization
  • Low social mobility
  • Poor health, nutrition and education

 

Low civil
and social
participation
  • Lack of settings/institutions for including young people
  • Restrictions on girls’ mobility and gender segregation
  • Social and political exclusion
  • Lack of opportunities to participate and voice concerns
  • Inability to use democratic institutions
  • Disenfranchised youth as a source of civil unrest
  • Lack of inputs from young people in the development of policies and programmes
  • Lack of social and political tolerance

 

Note: Points presented in bold type reflect issues addressed in the Millennium Development Goals

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