Young People's Reproductive Health Needs Neglected

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Country Statistics at a Glance Fact Sheet: Why Good Reproductive Health is Critical to the Well-Being of Youth Download a print version of the FactSheet (pdf - 145 kb) Download a print version of this News Release (pdf - 73 kb) Media Contacts For more information, or to arrange an interview, contact: Kimberley Cline (202-557-3423 or kcline@popact.org) Sally Ethelston (202-557-3418 or sae@popact.org)

New PAI Report Finds Many Nations Still Reluctant to Tackle Major Health Issue

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April 29 - Iran is providing more consistent sexual and reproductive health education for young people than the United States, according to a new report profiling seven countries by Population Action International (PAI).

While the U.S. administration is increasingly focusing its policy and funding on 'abstinence-only' education, Iran's programs are employing more comprehensive, age-appropriate educational materials, explicit pre-marital counseling and male education.

The PAI report, In This Generation: Sexual and Reproductive Health Policies for a Youthful World, examines how seven countries - the United States, Iran, the Netherlands, Mexico, India, Ghana, and Mali - have responded to the reproductive health needs of their young people. The report concludes that, with the notable exception of the Netherlands, most countries are not doing enough.

The need for sound youth reproductive health policies and programs has never been greater. Half of the world's population is under the age of 25 and within 15 years - less than one generation - all 3 billion will have reached reproductive age.

The report documents a widespread reluctance among adults, whether parents, teachers, or policymakers, to openly discuss issues of sexuality with young people. This lack of openness - and leadership - is undermining young people's reproductive and sexual health and, in too many cases, threatening their very lives. Young people between the ages of 15 and 24 have the highest rates of sexually transmitted infections (STIs) worldwide, representing over two-thirds of all cases in the developing world. Today, half of all new HIV infections occur among people under the age of 25.

"It's time to stop looking at reproductive health as a sex issue and start looking at it as a health issue," says Margaret E. Greene, PhD, a senior researcher at PAI and primary author of In This Generation.

• Almost uniformly, the study exposes marked contradictions and obstacles to change within each country's approach to reproductive health policies.
• In the United States, almost all states require or encourage some form of sex education in the public school curriculum. Yet, there is enormous state-by-state variation. Even the medical accuracy of some sex education materials can be called into question.
• In Iran, pragmatic interpretations of Shari'a (Islamic law), and government support for youth programs and age-appropriate reproductive health information have created a favorable climate for youth reproductive health policy. However, there is still considerable support for early marriage and high fertility within some Iranian communities.
• In Mali, despite increasing numbers of youth-focused reproductive health programs, 70 percent of 19 year-olds are either pregnant or have a child. One in five women are married by age 15.
• In India, reproductive health services have traditionally focused on contraceptive access for married women. While services are expanding, some aspects of reproductive healthcare - such as sexuality education, treatment and diagnosis of STIs, and services for young, unmarried men - are still largely neglected.
• In Mexico, 57 percent of the population is under age 25. While the government has committed to a program of sex education and family planning, teachers receive no training on the subject and often skip sex education completely or limit discussion.
• In Ghana, despite a national reproductive health policy with specific provisions for adolescents, actual access to information and services is severely limited by adults' judgmental views of sexually active youth.
• Of the seven countries profiled, the Netherlands has most effectively addressed issues of youth sexuality. With one of the youngest populations in Western Europe and similar proportions of sexually active adolescents, the Netherlands has some of the lowest rates of adolescent pregnancy and abortion on the continent.

A discussion of the reproductive health and educational needs of half of the world's population is not likely to occur at the upcoming United Nations Special Session on Children, where reproductive rights and sexuality remain the most contentious issues on the agenda.

Country Statistics at a Glance In This Generation: Sexual and Reproductive Health Policies for a Youthful World. © Population Action International, 2002
	United States	Netherlands	Mexico	Mali	Iran	India	Ghana
Total population, year 2000 (in thousands)	285,556	15,987	98,872	11,351	70,330	1,008,937	19,306
Population ages 0-24 (% of total population)	35%	30%	53%	66%	59%	52%	62%
Population ages 10-24 (% of total population)	21%	18%	31%	32%	36%	30%	34%
Annual population growth rate	1.05%	0.52%	1.63%	2.68%	1.69%	1.69%	2.2%
GNP per capita (PPP US$, 1999)*	$33,833	$23,052	$7,719	$693	$5,163	$2,149	$1,793
Average births per woman 15-49 (TFR)	2.1	1.5	2.8	7	2.6	2.9	4.55
Births to women ages 15-19 (as percent of all births)	12.4%	1%	15%	21%	9%	9%	15%
Births to women ages 20-24 (as percent of all births)	25%	9%	32%	28%	27%	40%	27%
Percent of 15-19 year-olds ever married (male/female)	1% / 4%	0.2% / 2%	6% / 16%	5% / 50%	5% / 26%	10% / 36%	NA
Percent of 20-24 year-olds ever married (male/female)	19% / 33%	7% / 26%	39% / 55%	29% / 88%	34% / 69%	40% / 83%	NA
Young women (15-19) using any method of contraception	29.8%	NA	30%	5%	34%	8%	NA
HIV prevalence in females 15-24	0.2 - 0.3%	0.1 - 0.1%	0.1 - 0.1%	1.7 - 2.4%	No Data	0.4 - 0.8%	2.4 - 4.4%
HIV prevalence in males 15-24	0.3 - 0.8%	0.1 - 0.3%	0.3 - 0.5%	1.0 - 1.6%	No Data	0.1 - 0.6%	0.8 - 2.0%
Years of schooling required	10	11	6	9	5	NA	9
Literacy among youth ages 15-24 (male/female)	NA	NA	97% / 96%	71% / 58%	96% / 92%	79% / 59%	93% / 86%
Primary Gross Enrollment Ratio (male/female)**	102 / 101	109 / 107	116 / 113	58 / 40	102 / 95	109 / 90	84 / 74
Secondary Gross Enrollment Ratio (male/female**	98 / 97	134 / 129	64 / 64	17 / 8	81 / 73	59 / 39	44 / 28

Notes:
* A measure of per capita income that takes into account relative purchasing power across countries.
** Total number of children enrolled for every 100 school age children.

Principal sources:
UNAIDS. 2000. Report on the Global HIV/AIDS Epidemic: June 2000. Geneva: UNAIDS.
UNESCO. 1995. Statistical Yearbook. Paris: UNESCO.
UNESCO. 1999. Statistical Yearbook. Paris: UNESCO.
United Nations Population Division. 2000. World Marriage Patterns 2000 [Wall chart]. New York: United Nations.
United Nations Population Division. 2001. World Population Prospects: The 2000 Revision. New York: United Nations.
United Nations. 1997. Report on the World Social Situation. New York: United Nations.
World Bank. World Development Report 2000/2001: Attacking Poverty. Washington, DC: World Bank.