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Su Balasubramanian manages the Because I am a Girl initiative at Plan International USA. She previously received a BSE in computer engineering from Case Western Reserve University, served as a Peace Corps volunteer in Samoa, earned an MBA focused in social entrepreneurship and marketing from Duke University and worked in brand management at Procter and Gamble.

Imagine being a child in the developing world. It’s hard enough to be faced daily with the cruel injustices of poverty, HIV/AIDS, lack of clean water, scarcity of education, and an abundance of trafficking and child labor. Now imagine being a girl—when it means that you watch your brothers go to school while you stay home to walk miles to fetch water from the well or that you eat only after the rest of your family has finished. Or that you are helpless to the threat of sexual violence. Or that you will be married and pregnant by the time you are 12.

Millions of girls around the world suffer this fate each day. We often feel so far-removed from these issues, and sometimes we imagine that they just can’t be true, because they are so extreme and overwhelming. What’s the solution?

The solution is multi-faceted and holistic. It’s educating girls while protecting them from trafficking and violence. It’s ensuring that they receive the healthcare they need. It’s making sure they are not only getting enough to eat but that their nutrition is sound. But for these needs to be met, people have to believe that girls are worth investing in. Often, the allocation of resources and support is determined by others, usually men who hold powerful positions in the family and in the community. So, helping girls means reaching out to men and boys. Everyone benefits when girls are valued and there is equity in the ways girls and boys are treated.

This year’s Because I am a Girl report asks an important question, “So what about men and boys?” I’d like to share a personal story that is one answer to this question.

Many years ago, my father, the eldest son from a rural farming village inSouth India, was destined to take over the farm. However, he decided that waking at 4 am to milk cows or working in a sugar cane field through the heat of each day wasn’t the life he desired for his family. He sought every possible opportunity to achieve a better life, the classic American dream. My father immigrated to the States and arrived with one suitcase, $5 in his pocket and a determination that seemingly no challenge or hardship could diminish. Despite the strong cultural norms in which he had been immersed throughout his upbringing, he instilled in all of us, my brother and sister alike, the importance of our education. He loved us and valued us all. He taught us that our fate should be determined by how hard we work, not by our sex. Because of my parents’ efforts and the opportunities that I was afforded as a result, I am able to appreciate the fruits of their labor today. And I am able to dedicate my career to affording girls in developing countries some of the same opportunities.

I am sure that this is only one of the many stories of how the men in our lives have been integral in instilling in girls a sense of value, of purpose and ultimately, the opportunity to thrive. Men and boys have an important role to play in the success of girls, and when we invest in girls, we see meaningful impact on the lives of their families and in their communities.

Read the full Because I am a Girl Report: “So, What About Boys?”

Learn more about programming for adolescent boys on our topic area page.


October 16 was World Food Day. Worldwide, 925 million people do not have enough to eat, and 98% of those who are affected by food insecurity live in developing countries. The UN’s Food and Agriculture Organization estimates that in 2009, approximately 1 billion people worldwide were undernourished. While nutrition and food insecurity are not often discussed in the context of youth sexual and reproductive health, food insecurity has devastating effects on the lives of adolescents and can exacerbate many negative and sexual reproductive health outcomes among this age group.

Globally, adolescent females are at a greater risk of poor nutrition than adolescent males. According to this year’s State of the World’s Children Report, Adolescence in an Age of Opportunity, there is “a considerably higher incidence of anemia among female adolescents aged 15–19 as compared to their male counterparts.”  In some countries, as many as half of the girls between the ages of 15 and 19 are anemic, and many more are underweight. The highest prevalence of underweight adolescent girls is inIndia, where 47% of girls are underweight. The implications of hunger for adolescent girls are serious, beyond the obvious health-related repercussions. For example, in developing countries, where many girls face high rates of early marriage and unintended pregnancy, poor nutrition increases the risk of maternal death or morbidity.

Food insecurity also has important implications for HIV prevention. According to OVC, lack of food security may lead to:

  • Increased sexual risk-taking behavior, including transactional sex or intergenerational sex
  • Increased school dropout
  • Increased stress on  traditional support networks

The effects of hunger on adolescents can be far-reaching, and the prevalence of poor nutrition among this age group puts young people at a greater risk of negative sexual and reproductive health outcomes. In honor of this year’s World Food Day, spread the word about the link between hunger and adolescent sexual and reproductive health and consider making a donation to your local food bank.

To learn more about World Food Day, visit the Food and Agriculture Organization of the United Nation’s World Food Day web page.

In November “more than a 1,000 family planning experts will gather in Senegal to examine cutting edge research and family planning programs” at the second International Conference on Family Planning (ICFP). This year’s conference has dedicated one of its tracks to the family planning needs of youth. The international attention to the unique needs of this population could not be more timely. In developing countries, as many as one-third of adolescent girls give birth before their 20th birthday. Furthermore, lack of access to family planning services leads to approximately 7.4 million unintended adolescent pregnancies every year. 

To help ensure that the attention on the family planning needs of young people is translated into action  in the field, the IYWG is hosting our annual meeting as a conference auxiliary event. This year’s meeting, What’s Next? Maintaining the Focus on Youth After Dakar will focus on applying conference lessons to the field of youth sexual and reproductive health. If you are attending the ICFP in Dakar, please join us as leading experts on youth sexual and reproductive health, programmers, researchers and young people share their insights and experience in an informal setting. To learn more about our annual meeting and about the other exciting events the IYWG is sponsoring at the ICFP, please visit our website. We look forward to seeing you in Dakar.

On Monday the New York Times published an article titled, “Contraceptive Used in Africa May Double Risk of H.I.V,” which suggests that injectable contraception use may increase the risk of HIV transmission. The article, which sites a recent study published by The Lancet Infectious Diseases, is causing worldwide concern about the safety of hormonal contraception, but what do the study findings really mean? And what are the implications for the field?

Globally 5 million young people are living with HIV, and approximately 3,500 young people are infected with HIV every day.  Young women are especially vulnerable to HIV; females make up 57% of all young people living with HIV. Injectable contraception is particularly popular among young women aged 16-25 years, the same population that is at highest risk for contracting HIV. Many young people prefer injectables because they are private and do not require a daily regimen. Contraceptives, including injectable contraception, play a very important role in reducing unintended pregnancies, abortions and associated negative maternal health outcomes. The risks associated with early and unintended pregnancy are severe for adolescent girls. Each year, approximately 16 million girls between the ages of 15-19 give birth and pregnancy is the number one cause of death among females age 15-19.  

Given this new information, how can we, as public health professionals ensure that young women are both protected from HIV, and are also provided with the most appropriate contraceptive options? 

The World Health Organization (WHO) has indicated that it will make no immediate change in contraceptive guidelines.  Scientists acknowledge that while the study cited in the New York Times article does have strengths, the findings were derived from observational data and thus may not be conclusive.  Given the life saving benefits of contraceptives, these services must remain accessible to youth. It is important to ensure that all providers evaluate any possible HIV risk associated with injectable contraception in the context of the proven benefits of effective contraception. More emphasis must be placed on dual protection. In general, women at risk for HIV are never encouraged to use a hormonal method alone without using a condom for disease prevention.   These findings emphasize the importance of counseling young people about the consistent use of condoms with all hormonal and non- hormonal contraceptives for the prevention of HIV and STIs.

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This blog is brought to you by the Interagency Youth Working Group (IYWG) with financial assistance from the U.S. Agency for International Development and the U.S. President's Emergency Plan for AIDS Relief. The content is managed by FHI, which functions as the secretariat for the IYWG.
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