UNFPAState of World Population 2004
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HOME: STATE OF WORLD POPULATION 2004: Adolescents and Young People
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Adolescents and Young People

Implementing the ICPD Consensus
Second Generation of Programmes
UNFPA Global Survey Findings
Role of NGOs
Key Health and Development Concerns
Meeting Young People’s Needs
Promoting Healthier Behaviour
Youth-friendly Services
Legal Progress
Key Challenges

Key Health and Development Concerns

Eighty-seven per cent of young people 15-24 live in the developing world.(10) People under age 15 constitute 31 per cent of the population in developing countries and 43 per cent in the least developed.(11) In 2000, adolescents and young people between 10 and 24 were 29 per cent of the population in developing countries and 32 per cent in the least developed, compared to 20 per cent in developed countries.(12)

POVERTY AND GENDER: CYCLES AND IMPACTS. Young people make up one fourth of the 1 billion people who live below the extreme poverty line of $1 a day.(13) Some 106 million youth live in extreme poverty in South Asia, 60 million in sub-Saharan Africa, 51 million in East Asia and the Pacific, and 15 million in Latin America and the Caribbean. Extreme poverty often prevents adolescents from attending school, perpetuating the cycle of poverty and making this group even more difficult for health, education or youth development programmes to reach.

Youth populations continue to grow in poor countries. The poorer the country, the greater the share young people have in that country’s population. Contraceptive use and access to health services increase with education and economic status, as do the age at marriage and first birth.

Illiteracy among those aged 15-24 declined in all regions between 1990 and 2000, but is still substantially higher among females than males, and there has been little progress in reducing that gap since 1990.(14) Girls continue to be faced with limited access to education opportunities, often constrained by traditional gender roles that give priority to educating boys.

EARLY SEXUAL ACTIVITY. In most of the world, young people are reaching puberty at earlier ages and marrying later than in the past, and premarital sexual relations appear to be increasing.

Data for the late 1990s show that, among young women who were sexually active by age 20, 51 per cent in Africa and 45 per cent in Latin America and the Caribbean initiated sexual activity prior to marriage. By contrast, the corresponding proportion for males was 90 per cent in Africa and 95 per cent in Latin America and the Caribbean.(15) In many developed countries, the onset of sexual activity takes place predominantly prior to marriage for both men and women.

ADOLESCENT PREGNANCY. The ICPD Programme of Action called on countries to “protect and promote the rights of adolescents to reproductive health education, information and care and greatly reduce the number of adolescent pregnancies”. (16) While adolescent pregnancy is declining in many countries, it is still a large concern—especially due to the health risks early pregnancy poses for both the mother and child, and its impact on girls’ education and life prospects. Women and girls under 20 still account for 17 per cent of all births in the least-developed countries (17) and for 14 million births worldwide each year.

One woman in three in developing countries gives birth before age 20, ranging regionally from 8 per cent in East Asia to 55 per cent in West Africa.(18)

Pregnancy is a leading cause of death for those aged 15 to 19, with complications of childbirth and unsafe abortion being the major factors. Women aged 15-19 account for at least one fourth of the estimated 20 million unsafe abortions and nearly 70,000 abortion-related deaths each year.

For both physiological and social reasons, mothers aged 15 to 19 are twice as likely to die in childbirth as those in their 20s, and girls under age 15 are five times as likely to die as women in their 20s. Obstructed labour is especially common among young, physically immature women giving birth for the first time. Those who don’t die from unrelieved obstructed labour may lose their babies and suffer from fistula, a hole in the birth canal that leaves them incontinent and often social outcasts.

RISK OF STIS AND HIV/AIDS. Every 14 seconds, a young person is infected with HIV/AIDS. In many settings, the number of new infections among young women is several times that for young men.(19) Two thirds of newly infected young people in sub-Saharan Africa are female. Only a small percentage of young people living with HIV/AIDS know their status. In both developed and less-developed countries, most people who become sexually active at a young age do not know how to protect themselves.

Young women are often unable to negotiate condom use with male partners and may fear violence if they try to do so.

One third of new cases of curable STIs each year— more than 100 million—are among women and men younger than 25.(20) Having another untreated STI significantly increases the risk of HIV infection.

HEIGHTENED RISKS FOR MARRIED ADOLESCENTS. Despite a global trend towards later marriage (the average age of first marriage among women rose from 21.4 in 1970 to 25.5 in 2000(21) ), 82 million girls in developing countries who are now between ages 10 and 17 will be married before their 18th birthday.(22)

Married adolescents often face greater reproductive health risks than those not married. They often face familial and social expectations to begin childbearing right after marriage. Their access to contraceptives is often limited. And many face the risk of STIs or HIV infection from older husbands who may have multiple sexual partners, but negotiating condom use is not an option.

A study in the late 1990s found that contraceptive prevalence among sexually active, unmarried adolescents was more than 30 per cent in seven sub-Saharan African countries (Benin, Cameroon, Cape Verde, Kenya, Nigeria, South Africa and Zambia) and more than 60 per cent in six countries in Latin America and the Caribbean (Bolivia, Brazil, Colombia, Costa Rica, the Dominican Republic and Peru), in both cases much higher than among their married counterparts. (23) Condom use in particular was considerably higher among unmarried adolescents in these countries than among those who were married.(24)

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