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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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Growing Up GREAT! Implementation Guide
Growing Up Great! is a scalable, multi-level intervention designed to improve sexual and reproductive health (SRH) and gender equity among very young adolescents (VYA) and the important adults in their lives. It supports VYAs and their communities to ques
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Finding A Voice: Shifts in Reproductive Health Understanding, Attitudes, and Practices in Nepali Youth
In Nepal, the average age for marriage is 17.9 for women and 21.7 for men. Nationally, modern contraceptive use among married adolescents (15–19) is only 15%. Karnali Pradesh Province has the second highest total fertility rate and second highest adolesce
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"Am I Doing The Wrong Thing?" How Social Norms Influence Provider Provision of Contraceptive Services to Adolescents
This brief shares insights and findings from qualitative research conducted in Nairobi, Kenya using the Social Norms Exploration Tool (developed by the Passages Project) to explore root causes of provider bias in contraceptive services to adolescents by e
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Very Young Adolescent Sexual and Reproductive Health Landscape: Where are we now? Where do we go from here?
Very young adolescents (VYAs; ages 10-14) experience rapid physiological changes while also learning to navigate shifting gendered expectations about their behavior and roles. Intervening with this age group provides an unparalleled opportunity to improve
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Ensuring the Continuity of Voluntary Family Planning and Reproductive Health Care and Interventions for Youth During the COVID-19 Pandemic
This document provides brief summary responses to key questions for health program managers and public health practitioners on adaptations required to ensure continuity of voluntary family planning and reproductive health (FP/RH) care and interventions fo
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Connect: Increasing Use of Pospartum Family Planning by First-Time Parents
This project overview describes the Connect project and its approaches and strategies for increasing access to postpartum family planning for first-time parents in Bangladesh and Tanzania. Adolescent Sexual and Reproductive Health
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Adolescent Sexual and Reproductive Health and Rights (ASRHR) Project Brochure
Read this brochure to learn more about the Adolescent Sexual and Reproductive Health and Rights Project that was implemented in 8 countries and at the regional level, from 2016 to 2019.
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ASRHR Project: Stories of Change
This booklet (June 2019) presents some stories of change from young people and adults from the 8 countries in East and Southern Africa (Kenya, Uganda, Tanzania, Malawi, South Africa, Swaziland, Zambia and Zimbabwe) where the Adolescent Sexual and Reproduc
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Children and Adolescent Sexual and Reproductive Health and Rights: Setting the foundation for an empowered youth
Comprehensive sexuality education (CSE) is a rights based and gender transformative approach to enhance adolescent knowledge and skills around sexuality, with the goal of enabling young people to make informed desicions and choices. It is largely focused
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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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The FLASH Toolkit: The Financial Literacy and Sexual Health Toolkit: Very Young Adolescents 10-14
This curriculum is for very young adolescents aged 10-14 years and combines financial literacy, livelihoods readiness, sexual and reproductive health, and gender-equitable content delivered in a fun and interactive way. It can be used in small groups to s
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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