Adolescents and Young People
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)