Accelerating the Reduction of Adolescent Pregnancy in Latin America and the Caribbean: What Do We Need to Move Forward?

Photo: ©UNICEF/ECU/2017/Vallejo. Ecuador. 

[This article has been published in Spanish in Planeta Futuro-El País]

Rodolfo Gómez Ponce de León is Regional Assessor for Sexual and Reproductive Health at CLAP SPMR, PAHO/WHO (Montevideo, Uruguay). He participated in the first regional edition for Latin America of the leadership workshop "Safe Mothers and Newborns" organized by ISGlobal, centre supported by ”la Caixa”, in collaboration with AECID and OPS.

Over the last thirty years, the total fertility rate (number of children born per woman) in Latin America and the Caribbean has decreased considerably—from 3.95 in the period 1980-1985 to 2.15 in the period 2010-2015. This decline has been associated with changes in macroeconomic conditions and an upturn in the economic growth of the region. However, while the reduction has been very significant in adult women (> 18 years), the fertility rate among adolescents (10-19 years) in the region has declined more slowly than in any other region in the world. In fact, the adolescent fertility rate in Latin America and the Caribbean is currently the second highest in the world after sub-Saharan Africa and the region has been cited as the only place experiencing an upward trend in the number of pregnancies in girls aged under 15 years.

The adolescent fertility rate in Latin America and the Caribbean is currently the second highest in the world after sub-Saharan Africa and the region has been cited as the only place experiencing an upward trend in the number of pregnancies in girls aged under 15 years

In view of the slow progress on remedying this problem and its negative impact in several spheres—public health, development, human rights and equality—the Pan American Health Organisation/World Health Organisation (PAHO/WHO), the United Nations Population Fund (UNPF) and the United Nations Children’s Fund (UNICEF) published a consensus document on strategic approaches and priority actions to help reduce adolescent pregnancy.

This document establishes seven priority actions to accelerate the reduction of adolescent pregnancy in Latin American and the Caribbean:

1. Make adolescent pregnancy, its drivers and impact, and the most affected groups more visible with disaggregated data, qualitative reports, and stories.

2. Design interventions targeting the most vulnerable groups, ensuring the approaches are adapted to their realities and address their specific challenges.

3. Engage and empower youth to contribute to the design, implementation and monitoring of strategic interventions.

4. Abandon ineffective interventions and invest resources in applying proven interventions.

5. Strengthen inter-sectoral collaboration to effectively address the drivers of adolescent pregnancy in Latin America and the Caribbean.

6. Move from boutique projects to large-scale and sustainable programmes.  

7. Create an enabling environment for gender equality and adolescent sexual and reproductive rights.

Satisfying the unmet need for modern contraception among women aged between 15 and 19 years would avert 2.1 million unplanned births, 3.2 million abortions and 5,600 maternal deaths every year. It is therefore essential to prioritise funding of reproductive health services for this population group, upgrading facilities that offer contraception and improving supply systems. The average cost of preventing an adolescent pregnancy is US$21 per user per year. These measures must be complemented by information and communication activities targeting adolescents of both sexes to ensure that they have real access to modern contraceptive methods.

Satisfying the unmet need for modern contraception among women aged between 15 and 19 years would avert 2.1 million unplanned births, 3.2 million abortions and 5,600 maternal deaths every year

A complex interplay of factors is involved in the phenomenon of adolescent pregnancy. This means that we will only achieve progress when we address the problem simultaneously on all levels of the social-ecological framework with interventions adapting the best practices to national and local contexts.

The measures implemented should be designed to meet the contraceptive needs of all adolescents and also to reach out to teenage mothers and pregnant adolescents to help them avoid future unplanned pregnancies. All interventions should be based on approaches that respect the adolescents’ right to health and prioritise gender equality and the elimination of gender stereotypes. In addition, more needs to be done to promote the engagement of civil society, the key to building support for adolescent health, in general, and for the sexual and reproductive health rights of young people in particular.

All members of the community—including parents, teachers, and religious leaders—must be engaged and play important roles in keeping adolescents safe and creating opportunities for their future. These groups are, however, characterised in many cases by a lack of awareness of the issues and a poor understanding of adolescent sexuality. A robust civil society movement is essential if we are to overcome political resistance and inertia on this issue and create accountability mechanisms capable of combatting injustice and inequities.

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