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