The guideline recommends holistic efforts to provide viable alternatives to early marriage by strengthening girls’ education, savings, and employment prospects. If all girls finished their secondary schooling, it has been estimated that child marriages could be reduced by as much as two thirds.
In a bid to tackle the leading cause of death globally among
15–19-year-old girls, the World Health Organisation (WHO) has released a new
guideline aimed at preventing adolescent pregnancy and its significant related
health complications.
Among other strategies, the guideline urges rapid action to
end child marriage, extend girls’ schooling, and improve access to sexual and
reproductive health services and information – all critical factors for
reducing early pregnancies among teenagers around the world.
“Early pregnancies can have serious physical and
psychological consequences for girls and young women and often reflect
fundamental inequalities that affect their ability to shape their relationships
and their lives,” said Dr Pascale Allotey, Director of Sexual and Reproductive
Health and Research at WHO and the United Nations’ Special Programme in Human
Reproduction (HRP).
Allotey said that tackling this issue means creating conditions
where girls and young women can thrive by ensuring they can stay in school, be
protected from violence and coercion, access sexual and reproductive health
services that uphold their rights and have real choices about their futures.
More than 21 million adolescent girls become pregnant each
year in low and middle-income countries, around half of which are unintended.
With impacts on girls’ education, social connection and future employment
prospects, early pregnancy can create cycles of intergenerational poverty that
become difficult to break.
It also brings serious health risks, including
relatively higher rates of infections and preterm births, as well as
complications from unsafe abortions, linked to particular challenges in
accessing safe and respectful care.
Reasons for early pregnancy are varied and interrelated,
including gender inequities, poverty, lack of opportunity, and inability to
access sexual and reproductive health services. There is a strong correlation
with child marriage: in low- and middle-income countries, 9 in 10 adolescent
births take place among girls who were married before the age of 18.
The guideline recommends holistic efforts to provide viable
alternatives to early marriage by strengthening girls’ education, savings, and
employment prospects.
If all girls finished their secondary schooling, it has been
estimated that child marriages could be reduced by as much as two-thirds. For
girls at highest risk, the guideline recommends considering incentives to
support secondary school completion, such as targeted financial stipends or
scholarship programmes. The guideline also recommends laws to prohibit marriage
below the age of 18, consistent with human rights standards, and community
engagement to prevent the practice.
"Early marriage denies girls their childhood and has severe
consequences for their health,” said Dr Sheri Bastien, Scientist for Adolescent
Sexual and Reproductive Health at WHO. “Education is critical to change the
future for young girls, while empowering adolescents to understand consent,
take charge of their health, and challenge the major gender inequalities that
continue to drive high rates of child marriage and early pregnancy in many
parts of the world.”
The recommendations highlight the need to ensure adolescents
can access high-quality, adolescent-responsive sexual and reproductive health
services, including contraceptive options.
In some countries, the
World Health Organisation notes that consent from an adult is required to access
services, which is a significant barrier to their use.
This guideline updates an earlier edition of the guideline
on adolescent pregnancy prevention from 2011 and focuses particularly on
preventing child marriage and improving adolescents’ access to and use of
contraception.
Meanwhile, globally, there has been progress in reducing
adolescent pregnancies and births. In 2021, an estimated 1 in 25 girls gave
birth before the age of 20, compared to 1 in 15 two decades prior. However, in
some countries, close to 1 in 10 adolescent girls aged 15 to 19 years give
birth each year.
