There are now more than 1 billion 10- to 19-year-olds worldwide--the largest generation of young people ever to move into adulthood. In the developing world, more than one-third of the population is under the age of 15; in Sub-Saharan Africa and some other regions, that number has risen to one-half.
Adolescents' special needs and constraints pose unique challenges with regard to the delivery of reproductive health (RH) services. For RH services aimed at adolescents to be effective, young people's perspective must be elicited and incorporated into their design, implementation, and evaluation.
High-Risk Population
The definition of adolescence varies to some degree both between and within societies. Everywhere, though, the period is marked by some common characteristics.
In all societies, adolescents undergo physical and emotional changes they may not understand. They are especially susceptible to peer pressure and the need for approval. In addition, adolescents may feel invincible or may fail to understand the possible consequences of their actions, making them
especially apt to engage in risk-taking behavior.
For these reasons, adolescents are particularly at risk for such RH problems as sexually transmitted infections (STIs), unintended pregnancy, poor maternal and child health, and unsafe abortion. For example, about one in 20 teenagers worldwide contracts an STI each year. Maternal mortality for women ages 15 to 19 is twice as high as for those in their 20s, and complications of pregnancy, childbirth, and unsafe abortion are the major causes of death for women in this age group.
In addition, unmarried adolescents facing issues of sexuality, pregnancy, or STIs are often more alone in their predicament than their families and communities may realize. As a result, their need for information and counseling is especially critical.
Programmatic Considerations
Successful programs for adolescents have shown that certain strategies are helpful in reaching and serving this population.
In addition to input from young people themselves, involving parents, teachers, and sports and community leaders in youth services is often a good way to encourage their use. This may also help lend community support for the program.
Making services free or low-cost can increase adolescents' use of and access to them. Adolescents are also more likely to use services if they are offered at sites where young people are likely to be--such as schools, sports centers, and youth clubs--or at sites or during special hours reserved only for youth.
Staff attitudes and behavior can have a great impact on adolescents' use of RH services. Adolescents may avoid services if they believe their behavior will be judged or received negatively by providers and counselors or if they feel their discussions are not kept private and confidential. They are more likely to be helped by counselors and peer educators who are fully familiar with the issues and pressures young people face.
Projects Aimed at Youth
AVSC is involved in a variety of projects that address the RH needs of adolescents.
In Nepal, AVSC and the International Center for Research on Women are embarking on a joint project that will enable adolescents and community groups to assist in planning, implementing, and evaluating community-based activities and services for adolescents.
In Ukraine, AVSC has been working with the Ministry of Health and local health authorities to improve RH services for adolescents. A project with a health center in Mikolayev aims to make services more youth-friendly and client-oriented by incorporating the findings from a community needs assessment focusing on young people.
Ukraine's second National Family Planning Week, which was held in May, focused on adolescents. The event included roundtable discussions, visits to family planning clinics, and radio and TV spots.
Earlier this year, AVSC worked with a teen center in Russia to develop a comic book on STIs and safer sex aimed at adolescents. The booklet has been
distributed throughout Eastern Europe.
In addition to these activities, AVSC's counseling curriculum contains information and suggestions on counseling adolescents.
The consequences of adolescents' behavior can affect their entire lives. Through careful attention to adolescents' needs, programs can set these clients on the path to healthy adulthood.
Victor Chen is a freelance editor and writer for AVSC.
