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This post, written by Amy Babchek from the Nike Foundation, originally appeared on the Girl Effect website and is available here.
Girls are finally on the agenda for family planning pledges, but misinformation about their needs and behavior stops girls getting access to the advice and resources they need for family planning. Amy Babcheck from the Nike Foundation is myth-busting.
At this year’s London Summit on Family Planning, global leaders pledged funds and resources for an additional 120 million women and girls by 2020. That’s right—girls. Adolescent girls and young women represent 26 million, or 20 percent, of that total, and that’s a major breakthrough.
Adolescent girls and young women in developing countries haven’t always been included when it comes to meeting family planning needs. Why? Because they become entangled in religious, political and cultural arguments, many of which are myths, yet still widely believed. Here are some of the worst…
MYTH: The world knows a lot about the situation of adolescent girls under the age of 15 when it comes to early sexual activity and early childbearing.
TRUTH: Publicly available information on the situation of very young adolescent girls ages 10-14 years is limited. Yet we know from secondary analysis that in 14 sub-Saharan African countries, 15 percent or more of girls reported having sex before their 15th birthday. And that’s just those who reported—the number is likely to be higher. A substantial proportion of sexual encounters involving very young adolescents are forced or coerced.
Want more details? Investing when it counts
MYTH: Adolescent girls understand their body, menstrual cycle, conception and contraception.
TRUTH: Cultural barriers make correct information about puberty and reproductive health and contraceptives inaccessible. Girls often feel shame and humiliation about their menstrual cycle, so even when they do know where or whom to ask questions, they don’t. This also affects their contraceptive use and ability to plan pregnancy. Because adolescent girls don’t understand their body well, they also don’t understand how they become pregnant or how to prevent pregnancy.
MYTH: Adolescent girls who have correct information about and access to family planning (contraception) begin having sex earlier, and have more partners.
TRUTH: Girls who have access to information and contraception have a later age at sexual debut, are less likely to experience coerced sex (if they have built social assets), and are more likely to use contraception when they do have sex.
Want more details? Start with a girl: a new agenda for global health
MYTH (that we often hear from girls): Contraception makes girls infertile, gain weight, grow facial hair and/or get cancer.
TRUTH: Most contraception has no effect on girls’ fertility; some medically intensive methods (such as IUD, implants, etc.) need to be properly administered by a trained medical provider to be safe for girls and women.
Want more details? World Contraception Day: myths, rumours and rubbish
MYTH: All modern contraceptive methods work for adolescent girls.
TRUTH: Permanent sterilization is not an option. And girls want contraceptive methods that they can control, that they can keep very private and that are longer acting —but not permanent. Sex for girls is often out of their control, and when they can’t negotiate condom use to protect them from disease, they at least want to be protected from unwanted pregnancy. Girls don’t want to be seen acquiring or using contraceptives because, whether married or not, using contraceptives goes against cultural norms (girls shouldn’t have sex out of wedlock and should want babies once they are married). Girls often don’t have the means to regularly acquire contraceptives.
Want more details? Start with a girl: a new agenda for global health
MYTH: Girls who do access contraceptives are adequately informed about how to use them.
TRUTH: Girls often have misinformation or misunderstanding about how to properly use contraceptive methods, with the pill being among the most misunderstood.
Commit your resources to girls and young women, the untapped accelerators of economic development, and by 2020 you will have unleashed the girl effect through access to contraceptives and family planning.
Call to Action: The Sino-implant (II) Initiative was recently selected as a finalist for the Katerva Award in the Human Development Category. Click here to vote for the project for the People’s Choice Award. Deadline is January 29, 2013.
Markus Steiner is a senior epidemiologist at FHI 360 and project director for the Sino-implant (II) initiative. Heather Vahdat is an associate scientist at FHI 360, where she serves as project manager for the Sino-implant (II) initiative. Kate Rademacher is a senior technical officer at FHI 360 and serves as the strategic partnership manager for the Sino-implant (II) initiative.
All women benefit from access to longer-acting contraceptive methods. From a mother living in a rural village with limited access to health care services to a young woman living in an urban center who is focused on completing her education and starting a career. The peace of mind, independence, and continuous contraceptive protection that comes with a long-acting method is priceless.
Contraceptive implants are a vital commodity in the spectrum of contraceptive choice. They provide discrete, long-term pregnancy prevention without the need for a pelvic exam, which has been shown to be a barrier to uptake of intrauterine devices (IUDs) for many women. Contraceptive implants are a popular method in developing countries; however, until recently, the high cost of implants has been a barrier to access.
The Sino-implant (II) initiative has been at the forefront of helping to reduce the cost of implants in resource-constrained settings. Manufactured by Shanghai Dahua Pharmaceutical Co., Ltd., Sino-implant (II) is a low-cost, highly effective contraceptive implant currently labeled for four years of use that is available for approximately US $8 per unit. Through the initiative, which is led by FHI 360 with funding from the Bill & Melinda Gates Foundation, Sino-implant (II) has been registered in 22 countries in Sub-Saharan Africa, Asia, and Latin America since 2008.
Sino-implant (II) entered the international contraceptive market as a game-changing product. Through a network of dedicated distribution partners, Sino-implant (II) has been introduced through in-country programs and provided an opportunity to diversify the contraceptive commodity stock. The lower price of Sino-implant (II) has meant that cost savings could be used to support larger procurements of contraceptive implants, other health commodities, training, or other program needs.
So what is the “So What?” of the cost savings offered by Sino-implant (II)?
- More than 870,000 units of Sino-implant (II) have been distributed
- US $10.4 million in cost savings have been generated when compared to buying similar, more expensive implants
- According to the Marie Stopes International Impact Calculator, the procurement of 870,00 units of Sino-implant (II) can prevent:
- 1.2 million unintended pregnancies
- 150,000 abortions
- 3,500 maternal deaths
Recently, Sino-implant (II) (marketed in parts of Africa, Asia, and Latin America under trade names including Zarin, Femplant, Trust, and Simplant) was selected as a finalist for the Katerva Award in the Human Development Category. Click here to vote for the project for the People’s Choice Award. Voting began on January 14and runs through January 29, 2013. For more information on the Katerva award or Sino-implant (II) initiative, visit: http://katerva.org/2012-nominees/sino-implant-ii/
A Note from the IYWG: Among adolescents who have access to contraception, poor compliance, inconsistent use, and discontinuation are common and often result in unintended pregnancy. Longer-acting family planning methods—including contraceptive implants—provide more effective coverage than shorter-acting methods such as Depo-Provera and oral contraceptives (OCs). According to the World Health Organization, implants are safe and appropriate for adolescents. Implants are discreet, easy to use, and effective for 3-5 years without any need for resupply or regular action by the user. In addition, implants remove the challenge of user compliance and therefore have a very low failure rate. Researchers estimate that if 20 percent of the 17.6 million women using OCs and Depo in sub-Saharan Africa who wanted long-term protection switched to implants, more than 1.8 million unintended pregnancies could be averted over a five-year period.
Every fourth Thursday in November, Americans celebrate Thanksgiving—a holiday dedicated to giving thanks for whatever and whomever we are grateful to have in our lives. In honor of this U.S. tradition, we are asking people around the world why they are thankful for contraception.
There are many reasons to be thankful for contraception. Contraception provides young people the choice to determine their own future. Modern contraceptive use prevents 3.1 million unintended adolescent pregnancies each year. When adolescents are able to avoid unintended pregnancy they are more likely to stay in school and to earn a greater income throughout their lifetime. This is true for both adolescent mothers and fathers; boys who become fathers are also less likely to complete secondary school than their non-parenting peers. Preventing unintended pregnancies among adolescents also reduces the number of maternal deaths worldwide—adolescent pregnancy and pregnancy-related complications are the number one cause of death among female adolescents. Finally, condoms play a dual role: they help prevent against pregnancy and HIV infection. By preventing early or unintended pregnancy and HIV infection, contraception saves lives and improves educational and employment opportunities for young people.
We are thankful for the millions of lives contraception saves and for the opportunities it provides not only young people, but all women and men worldwide. That is why this Thanksgiving we want to know why YOU are thankful for contraception. Log on to our Facebook page and tell us about the positive effects that access to contraceptives has had on your life, or why you are grateful for the promise contraception holds for all people worldwide.
I was overjoyed to give birth to my first baby—a girl—earlier this year. Before becoming a mother at age 32, I graduated from high school, college, and graduate school. I served as a Peace Corps volunteer in Morocco and married a fellow volunteer. I traveled the world, living and working on three continents. I changed careers. I volunteered as a prison tutor, an advocate for people living with AIDS, a financial literacy mentor for low-income women, an editor of a quarterly literary publication, and an auxiliary board member of Heshima Kenya.
Though U.S. teen pregnancy rates have dropped in recent years, access to quality reproductive health and family planning information and services for young women is still a pressing issue in America and around the world. The World Health Organization (WHO) estimates that 16 million girls, ages 15-19 give birth every year; 95 percent of these births occur in developing countries. Interestingly, WHO reports that seven countries account for half of all adolescent births: Bangladesh, Brazil, the Democratic Republic of Congo, Ethiopia, India, Nigeria, and the United States.
Unlike my high school friends, who generally received prenatal services and gave birth in hospitals under the care of obstetricians, many adolescent mothers in developing countries receive little or no prenatal care and give birth without the presence of a skilled birth attendant. As a result, many of these young women face debilitating but preventable conditions such as obstetric fistula, uterine rupture, or even death. Like my high school friends, they are less likely to finish school and to have economic opportunities than their peers who have not given birth during adolescence.
World Contraception Day, which falls each year on September 26, is a global campaign with a vision for a world where every pregnancy is wanted. Its mission is to raise awareness of contraception so that young people can make informed sexual and reproductive health decisions.
Contraception saves lives. It also changes lives. When girls and women are able to choose with their partners when and how often they have children, their educational path lengthens, their economic opportunities strengthen, and their capacity to become active, dedicated citizens of their communities, and the world, soars. The benefits of a woman’s access to family planning reach far beyond her and her family; there is no limit to the good a woman can do in the world when her potential is unleashed. For proof, visit Women Deliver’s list of the 100 most inspiring people delivering for girls and women.
To learn more about contraceptive options, please visit the K4Health Toolkits.
This video and the post below were developed by Pathfinder International and originally appeared on their blog on July 23, 2012.
Can you imagine walking 18 miles to get contraceptives? Or being told your clinic is out of stock? It seems absurd right? But in many countries, this happens every day. Doctors are overworked, under supported, and stressed out. Women struggle to care for their large families and access the services they need, sometimes waiting hours, even overnight to visit a clinic.
We try to make it funny in this video but the reality is no joke. Choice matters about if, when, and how often to have children; choice matters about getting tested for and STI or HIV; choice about sexual and reproductive health matters for all women, everywhere.
If you agree, share this video today! The more people who understand the issues, the more voices we have calling for change.
Even here in the United States, we see barriers to reproductive choice. However, oftentimes those barriers are even more challenging in developing countries. Shannon Wu, one of our donors said, “Most women in America have access to knowledge and health care when it comes to their sexual and reproductive life. But in other parts of the world, women’s health is almost always the last thing to be discussed or taken care of, if at all.”
Right now more than 222 million women want, but lack access to contraceptives. One woman dies every 90 seconds during pregnancy or childbirth because she lacks access to maternal care. And HIV is the number one cause of death for women of reproductive age in the developing world.
If you want to change these numbers, and improve the lives of women, take a simple action now: share the video. Help start an important conversation with your friends, family, girlfriends, boyfriends, husbands, wives, colleagues that reproductive health care is no joke. Choice matters.
We’d love to know what you think of the video. Did it remind you of the reproductive health care issue that drives you to make a difference? Use the comments below and thank you for sharing!
A note from the IYWG
Young people face multiple negative sexual and reproductive outcomes including unintended pregnancy, HIV and other sexually transmitted infections, and maternal mortality and morbidity. Each year, lack of access to family planning services leads to approximately 7.4 million unintended pregnancies among adolescents, and each year nearly 70,000 women between the ages of 15 and 19 die in childbirth. Preventing unintended pregnancies among adolescents would reduce the number of maternal deaths as well as improve educational and employment opportunities for young women. To learn more about young people and contraceptive,s view our blog archive for contraceptives posts or our topic page on Contraceptive Options for Young People.
“The Stories Behind the Statistics” is a series we developed for the Gates Foundation blog, “Impatient Optimists.” The following post is the first in our three-part series on contraception. The original post, located on “Impatient Optimists,” is available here.
Over the past couple of months, in our Stories Behind the Statistics series, we shared with readers the overwhelming rate of adolescent pregnancy and its devastating effect on the lives of girls. One of the commitments made on July 11, 2012 at the Family Planning Summit was to increase access to contraceptives for young women and girls. These global commitments could not be timelier in a world where approximately 16 million girls between the ages of 15 and 19 give birth each year; one million die or suffer serious injury or disease as a result of pregnancy; and millions more face discrimination in their communities, are forced to drop-out of school, and face social isolation as a result of unplanned or unintended pregnancy.
It is estimated that as many as half of all pregnancies worldwide are unintended and a disproportionate amount of unintended pregnancies occur among young, unmarried girls who often lack access to contraception. Approximately 85-95 percent of sexually active young women who do not use contraceptives become pregnant within one year of initiating intercourse.
In some regions of the world, such as sub-Saharan Africa, South-central Asia, and Southeast Asia the unmet need for contraception among adolescents is as high as 68 percent. Young people face multiple barriers to accessing contraceptives including lack of information, social stigma, provider bias, lack of confidentiality, and policy restrictions.
Lack of information about contraceptives, and myths related to side effects, are commonly reported by young people as reasons for not using contraceptives. Young people need information, skills, and products to make informed decisions about how they can protect themselves from pregnancy in a way that is consistent with their own values. Young people also face multiple medical and institutional barriers to receiving contraceptive services, including provider bias, parental consent restrictions, notification laws, and unnecessary medical tests such as pelvic exams.
In many societies, young women have limited control over their contraceptive choice. Often they do not have the power to negotiate contraceptive use with their partners; their family planning decisions might be made for them by parents, partners, spouses, or in-laws. Married adolescents face particular barriers to contraceptive access including increased societal pressure to have children, fear of their spouse, or lack of transportation to health services.
Fulfilling the unmet need for family planning among adolescents could prevent an estimated 7.4 million unintended pregnancies. Preventing unintended pregnancies among adolescents would reduce the number of maternal deaths as well as improve educational and employment opportunities for young women. Expanding young people’s access to contraceptives means giving girls and young women the choice to determine their own future.
In the next two posts of this series we will hear from two young people–one from Zimbabwe and one from the United States– about why contraceptive access is important to them.
“The Stories Behind the Statistics” is a series we developed for the Gates Foundation blog, “Impatient Optimists.” The following post is the third in our three-part series on adolescent pregnancy. The original post, located on “Impatient Optimists,” is available here.
Gaj Bahadur Gurung works as the program coordinator for the National Federation of Women Living with HIV and AIDS in Nepal.
For a young girl in Nepal or South Asia, pregnancy can be disastrous. If it occurs outside the context of marriage, it will bring her disgrace and might lead to expulsion from her family and school. The young woman may be perceived as deviant in the community and will be considered a curse for her family.
Young women have little choice or control over contraceptives. For unmarried young girls in South Asia, male condoms are their only contraceptive option. Yet, patriarchal gender roles and norms make it difficult or impossible for girls to negotiate condom use with a male partner and often inhibit girls from even buying condoms or other types of contraception.
A lack of appropriate information also contributes to adolescent pregnancy. Parents rarely discuss sexual and reproductive health with their children, and the school curriculum has outdated and inadequate information. In spite of the attempts by nongovernmental organizations to disseminate information, some people are difficult to reach, especially low-income girls in mobile populations.
Early marriage is another major contributor to pregnancy among adolescents. Early marriage is quite normal in this culture, and once married, a young woman is expected to give birth to prove her family’s honor. Once a young married woman becomes pregnant, she receives tons of affection, but often she drops out of school, becomes more economically dependent on her family, and has less social interaction.
Policies and programs must both help prevent early and unintended pregnancy (for married and unmarried women) and mitigate the negative consequences for girls who do become pregnant. Programs should provide young women access to, control over, and informed choice about sexual and maternal health services. Youth-friendly maternity services with easy access for young girls would minimize health risks to mother and baby during pregnancy, delivery, and the post-delivery period.
At yesterday’s landmark Family Planning Summit, hosted by the UK Government and the Bill & Melinda Gates Foundation and UNFPA, global leaders from national governments, donor organizations, civil society, the private sector, and the research and development community committed to increasing contraceptive access for 120 million women and girls by 2020. The commitments made at this unprecedented event also included sustaining access for the approximately 260 million women who currently use contraceptives and aim to deliver contraceptives, information, and services to a total of 380 million women and girls by 2020. The government of Malawi committed to increasing the rate of contraceptive use by 60% by 2020, with specific focus on young women ages 15-24. Malawi also committed to raising the legal age of marriage to 18 and improving youth sexual reproductive health programs.
These global commitments are crucial to addressing the critical need for contraception among adolescents globally. In developing countries, approximately one-third of adolescent girls give birth before they turn 20. It is estimated that as many as 50 percent of pregnancies worldwide are unintended and a disproportionate amount of unintended pregnancies occur among young, unmarried girls who often lack access to contraception. Approximately 85 to 95 percent of sexually active young women who do not use contraceptives become pregnant within one year of initiating intercourse. The unmet need for contraception among adolescents is as high as 68% in some regions, such as sub-Saharan Africa, South-central Asia, and Southeast Asia.
Fulfilling the unmet need for family planning among adolescents could prevent an estimated 7.4 million unintended pregnancies. Preventing unintended pregnancies among adolescents would reduce the number of maternal deaths as well as improve educational and employment opportunities for young women. Thus, the commitments made yesterday have the promise to vastly improve the health and lives of millions of young people globally.
To learn more about the family planning commitments made at yesterday’s summit, read the DFID and Bill & Melinda Gates Foundation press release.