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Adolescent, Sexual and Reproductive Health and Rights
Approximately 21 million young women aged 15–19 give birth each year—accounting for 11% of all births worldwide—and over 75% of births among women in this age-group occur in developing countries[i]. Furthermore an estimated 26 million women and adolescent girls in their childbearing years need humanitarian assistance around the world2. Pregnancy during adolescence is associated with an increased risk for adverse birth outcomes as well as complications during labour and delivery. Compared to women aged 20-24, mothers under the age of 20 face higher maternal health risks and are more likely to miscarry, have a stillbirth or to lose their newborn baby. Conditions related to pregnancy and childbirth were the leading cause of death among 15-19 year old females in 2015.
Access to high-quality sexual and reproductive health information and services is a fundamental right. However, in many parts of the world, adolescents lack access to comprehensive information and services. This can be a result of a range of factors. Policy and legal barriers, such as restrictions on provision of comprehensive sexuality education or requirements for parental consent for access to contraception, can prevent provision of comprehensive information and services. At the same time, stigma and discrimination related to age, sexual orientation and gender identity, HIV-status, disability or marital status can prevent adolescents from accessing the information and services they need. These factors are often exacerbated in humanitarian and conflict settings which increase adolescents’ vulnerability to violence, poverty, separation from families, sexual abuse, and exploitation. During crisis adolescents experience loss of support systems and social structures which may engage them in risky sexual behaviour, increasing the risk of STIs including HIV and unplanned pregnancies.
Gender inequality and harmful social norms and practices (such as child marriage) further constrain girls’ and boys’ autonomy, freedom and opportunities. Furthermore, the threat and reality of sexual and gender-based violence hinders adolescents’ ability to make decisions about their sexual and reproductive health and are a direct violation of their SRH rights.
Save the Children’s Adolescent Sexual and Reproductive Health and Rights (ASRHR) programs work with adolescents, families, schools, communities, and health systems to increase the availability, accessibility and quality of sexual and reproductive health information and services across the adolescent life span. Together with ministries of Education, Health and Social Affairs, Save the Children strengthens the capacity of schools, health service providers and community organizations to provide comprehensive sexuality education to adolescents and link them to youth friendly SRH services. This enables adolescents to be better informed about their sexual and reproductive health and rights and thus able to make and act upon informed decisions about their reproduction and sexual activity free from discrimination, coercion, violence, and infection. Save the Children and its partners simultaneously work with communities to become supportive of ASRHR. The organization also implements ASRHR programs in humanitarian settings including acute, protracted crisis as well as natural disasters. As a member of the Inter-Agency Working Group (IAWG) on Reproductive Health in Crises we work with various International NGOs to provide global technical assistance and advocate for ASRHR services in humanitarian situations. In these crisis situation Save the Children often provides direct SRH services and works with health providers and youth to increase access and reduce related mortality and morbidity for this vulnerable group.
Save the Children also works across thematic areas to implement programmes to end harmful practices such as child marriage, preventing sexual and gender based violence, and promoting gender equality. These issues and themes are, amongst other topics, also part of comprehensive sexuality education.
[1] Darroch J, Woog V, Bankole A, Ashford LS. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. New York: Guttmacher Institute; 2016
2 UNFPA, 2015
Photo: Jonathan Hyams/Save the Children
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Very Young Adolescent Sexual & Reproductive Health and Gender Program Design Guide
The Very Young Adolescent Sexual & Reproductive Health and Gender Program Design Guide provides simple and actionable guidance for programs with very young adolescents (VYA) across different contexts. A resource for nongovernmental organizations, governme
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A Sensemaker Approach: Addressing key contextual and gender-related barriers to adolescent sexual and reproductive health rights and services in Northern Nigeria
This briefing was developed as part of a series on child marriage and accountability showcasing lessons-learned from Save the Children programming around the world. It details work with an interactive story collection app to provide insights into the dist
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The Power of Movements
This handout was developed to be shared with participants at Women Deliver 2019, the world's largest conference on gender equality and the health, rights, and wellbeing of girls and women. The leaflet aims to highlight some of the ways in which our progra
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Scaling-up Normative Change Interventions for Adolescent and Youth Reproductive Health: An Examination of the Evidence
A review article published in the Journal of Adolescent Health that examines the scale-up processes and documentation of 13 successful Adolescent and Youth Reproductive Health (AYRH) interventions with significant normative change components that have bee
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Growing Up GREAT! Brief
This brief informs program implementers and provides an overview of the Growing Up GREAT program. Growing Up GREAT! adapts elements of two tested models—Gender Roles, Equality, and Transformations (GREAT) from northern Uganda and GrowUp Smart from Rwanda—
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Growing up GREAT! Gameboard & Question Cards
This gameboard and question cards are designed to be used by Very Young Adolescents (VYA) and adults to discuss gender norms, gender-based violence (GBV), and sexual and reproductive health (SRH) in a fun and engaging way. The Growing Up GREAT! toolkit ad
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Keep It Real Primary School Peer-Led Sexuality Education Manual
This manual is intended to be delivered by students for students through peer education, and it should be used to complement Comprehensive Sexuality Education by teachers. The manual covers various themes: Growing Up, Being a Girl or a Boy, Safety and Sex
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Growing Up GREAT Health Provider Lesson Guide
This lesson guide is designed for healthcare providers to help them teach adolescents on being healthy, and it is a part of the Growing Up GREAT! toolkit, which adapts elements of two tested models—Gender Roles, Equality, and Transformations (GREAT) from
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Growing up GREAT! Girls' and Boys' Flipbooks
These flipbooks provide Very Young Adolescent (VYA) boys and girls (10-14 years) with information about puberty, gender equality, healthy relationships, violence, and other related themes during weekly club sessions. It is part of the Growing Up Great! to
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Growing Up GREAT Links to the National Family Life Curriculum
This document provides information on how to integrate the Growing Up GREAT! materials to deliver lessons from the National Family Life Education program. Growing Up GREAT! is a health education program for adolescents between the ages of 10 and 14, which
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Growing up GREAT! Girls' and Boys' Puberty Books
These puberty books can be used by very young adolescent (VYA) boys and girls, and it equips them with knowledge and information on their changing bodies. It is part of the Growing Up GREAT! program toolkit, which uses a socio-ecological approach with an
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Growing Up GREAT! Health Center Visit Guide
This guide is designed to help health providers introduce teenagers to a "health culture" through a facility visit. It is part of a larger toolkit within the Growing Up GREAT! program, and can be helpful for program implementers. Growing Up GREAT! adapts