Focus on Adolescent Pregnancy

Prof E. Bijoykumar Singh *

Observance of World Population Day at MFDC: Theme 'Focus is on Adolescent Pregnancy' :: Pix - Deepak

July 11 is World Population Day. It is observed all over the world for the promotion of crucial population related issues such as the importance of family planning, including gender equality, poverty, maternal health and human rights. The day has been celebrated every year since 1989. World population Day was instituted by the Governing Council of the United Nations Development Program in 1989, inspired by the date on which the world's population reached five billion i.e. July 11, 1987.

I was born in a world with 2.754 billion and today we have crossed the 7 billion mark. Since 1989, with the United Nations Population Fund's (UNFPA) encouragement, governments, non-governmental organizations, institutions and individuals organize various educational activities to celebrate the annual event. Different events like seminar discussions, educational awareness sessions etc are conducted to mark the day's celebration.

Every year the celebrations of World Population Day are based on the particular theme, decided by the United Nations. This year's World Population Day is focusing on adolescent pregnancy. In Manipur University also, the Department of Adult and continuing education observed World population day with lectures on the theme. In his message on the occasion of World Population Day2013, Ban Ki-moon, Secretary General of the United Nations wrote"..... We must also provide all adolescents with age-appropriate, comprehensive education on sexuality.

This is especially important to empowering young women to decide when and if they wish to become mothers. In addition, we must provide comprehensive sexual and reproductive health services that cover family planning and the prevention and treatment of sexually transmitted infections, including HIV. And we must guarantee the maternal health services that women need. When we devote attention and resources to the education, health and wellbeing of adolescent girls, they will become an even greater force for positive change in society that will have an impact for generations to come.

Adolescence is a transitional stage of physical and psychological human development occurring during the period from puberty to legal adulthood (age of majority). The period of adolescence is most closely associated with the teenage years. Adolescence is viewed as a transitional period between childhood and adulthood, whose cultural purpose is the preparation of children for adult roles.

It is a period of multiple transitions involving education, training, employment and unemployment, as well as transitions from one living circumstance to another. There can be different ages at which an individual is considered to be mature enough to be entrusted by society with certain privileges and responsibilities such as driving a vehicle, having legal sexual relations, drinking alcohol , voting, entering into contracts, finishing certain levels of education, contesting an election and marriage.

Adolescent pregnancy is no longer a simple health issue, it is a development issue. It reflects deeper social malaises such as poverty, gender inequality, violence, child and forced marriage, power imbalances between adolescent girls and their male partners, lack of education, and the failure of systems and institutions to protect their rights. There are over 600 million girls in the world today, more than 500 million of them in developing countries. How they pass into adulthood is going to have profound impact on our present and future.

The opportunities and choices girls have during adolescence will enable them to begin adulthood as empowered, active citizens. With the right skills and opportunities, they can invest in themselves, in their families and their communities. Pregnancy robs the adolescent girl, the right to freely decide how many children she wants to have and when. Pregnancy jeopardizes the rights, health, education and potential of far too many adolescent girls, depriving them of a better future and also the society of potential output. The point is adolescence is a time when we have to invest in our future career, not in having children. Of course the stark reality of backwardness may give it as the only option to numerous adolescent girls. That is why we consider it as a development issue. This is also a face of inclusive development.

Adolescence is a very critical phase in everyone's life, more so in a woman's life. What happens during her adolescence shapes the direction of her life and that of her family. Adolescent girls become vulnerable to leaving school, child marriage, early pregnancy, HIV, sexual exploitation, coercion and violence. Adolescent girls are less likely than older women to access sexual and reproductive health care including modern contraception and skilled assistance during pregnancy and childbirth and most of them are poor.

They have little control over household income, have limited knowledge about sexual reproductive health issues and lack the ability to make independent decisions about their health. They often do not have access to health care that meets their specific needs. This inefficiency fuels intergenerational cycle of poverty. The poverty of women breeds further poverty. It is like saying I am poor because I am poor.

The fact sheet of adolescent pregnancy provided by UNFPA is as follows. Complication in pregnancy and child birth are the leading causes of death among adolescent girls age 15-19 years in low and middle income countries resulting in thousands of deaths every year. Adolescent pregnancy brings detrimental social and economic consequences for a girl, her family, her community and her nation. The younger the girl is when she becomes pregnant whether she is married or not the greater the risk for her health.

Whether married or unmarried, young women are less likely than their older counterparts to use modern contraceptives. Approximately one in three adolescent girls is married before age 18 in the developing world 9 excluding China). About 16 million girls aged 15 t0 19 years, ninety percent of whom are married give birth every year accounting for about 11% of all births worldwide. Adolescent pregnancies put newborns at risk. Fifteen percent of all unsafe abortions in low and middle income countries are among adolescent girls age 15-19 years. Young people age 15 to 24 accounts for 41% of new HIV infections worldwide.

Breaking the cycle of adolescent pregnancy requires commitment from every stakeholder in development in both developed and developing countries to invest in adolescent girls. Adolescents and youth must be provided with age-appropriate comprehensive sexuality education to develop the knowledge and skills they need to protect their health throughout their lives. It is more challenging in Manipur where the youth are vulnerable to so many things.

Their disorientation due to the fast changes in the society is immense. However, education and information are not enough. Good quality reproductive health services must also be readily available in order for adolescents to make informed choices and be healthy. At the local level, communities should provide the infrastructure to deliver reproductive health care in a youth-friendly and sensitive way. It is easier said than done. Youth friendly reproductive health care system is not as simple as it sounds. Such sensitivity can get easily drowned in the surge of crash commercialisation.

The multiple benefits of investment in this direction are – girls stay healthy, avoid unintended pregnancy, finish an education, engage in productive work, choose to have fewer and healthier babies when they are ready. It benefits the family, the society, the economy and the environment and ultimately all of us. Governments should enact and enforce national laws that raise the age of marriage to 18 and should promote community-based efforts that support girls' rights and prevent child marriage and its consequences.

Though we have set 18 years as the legal age of marriage for girls our performance has not been encouraging .Every second child in India is married underage. India has the largest number of child brides in the world with 47% girls married under the legal age of 18. In 2007-8 it was found that 24.7% of married women in age group 20-24 in Manipur had married before 18, the legal age of marriage. It is as high as 68% in Bihar. Enacting the law and implementing it are equally important.