The Interagency Youth Working Group (IYWG) provided technical leadership to advance the reproductive health and HIV/AIDS outcomes of young people in developing countries. The project has ended and while the website is no longer being updated, it still contains useful information, such as the text here, and long lists of very useful resources on humanitarian settings, young people and adolescent pregnancy.
Humanitarian settings and young people
Nearly 85 percent of the world’s young people live in developing countries, where most humanitarian crises occur. However, the sexual and reproductive health (SRH) needs of these young people are widely unmet. Natural and man-made emergencies can disrupt the family, social, and economic structures that young people depend on, placing them at risk of poverty, violence, and sexual exploitation and abuse. In situations where education and health services are lacking or have been suspended, young people are left without access to SRH information and services and at the same time face higher SRH risks, such as substance abuse, sexually transmitted infections, HIV infection, unwanted pregnancy, and unsafe abortion.
SRH services for young people during emergency situations must be innovative, accessible, and culturally appropriate. Young people should be involved in the development, implementation, and monitoring of program activities to ensure that they are responsive to the specific needs of young people. Including both boys and girls in educational activities that promote gender equity can reduce gender-based violence and high-risk sexual behavior. Family and community involvement in SRH programming for young people in humanitarian settings is also crucial to ensure their safety and security and to reduce their vulnerability to sexual exploitation, recruitment, or abduction by harmful individuals or groups.
Approximately 14 million girls between the ages of 15 and 19 give birth each year, and the actual rate of pregnancy among this age group is likely to be even higher. An estimated 40% of young unmarried women have experienced an unwanted or unintended pregnancy. Many pregnancies among adolescents are uncounted because pregnancies among this age group are often not carried to term. In developing countries, approximately one-third of adolescent girls give birth before they are 20 years old and between 2.2 and 4 million adolescent girls undergo unsafe abortions each year.
Many factors place adolescent girls at a high risk of early or unintended pregnancy, including poverty, gender inequality, lack of education, and early marriage. The same factors that increase the likelihood of early or unintended pregnancy among adolescents are further exacerbated by the occurrence of early or unintended pregnancy. For example, girls who become pregnant are more likely to leave school early, have a lower income, and have more children at shorter intervals throughout their lifetime. In contrast, young women who avoid unintended pregnancy are more likely to stay in school, participate in the work force, and have healthier, more educated children.
Not only does pregnancy during adolescence have negative social impacts, it poses significant risks to the health and lives of young women. Pregnancy is especially dangerous for very young adolescents who are not fully physically developed. Childbirth-related complications are the number one cause of death among girls ages 15–19. The main causes of adolescent maternal mortality are high blood pressure, uterine infection, unsafe abortion, and malaria.
Pregnancy during adolescence also increases the risk of anemia, post-partum haemorrhage, prolonged obstructed labour, obstetric fistula, malnutrition, and mental health disorders, including depression. In general, adolescents face more birth complications than do older women.
Poor understanding of reproductive health knowledge, limited access to health care and family planning, inability to make health decisions, and incomplete physical development all fuel the disparate rates of negative, pregnancy-related health outcomes among adolescents. Compared to older women, adolescent girls also are more likely to give birth without a skilled birth attendant.
Strategic investment must be made to curb the multiple vulnerabilities that place girls at risk of unintended pregnancies, pregnancy-related complications, unsafe abortion, and death.