Improving the Well-Being of Adolescent Girls in Developing Countries

Abstract

This paper conducts a large, narrative review of interventions that might plausibly (a) increase educational attainment, (b) delay childbearing, and/or (c) delay marriage for adolescent girls in low- and middle-income countries (LMICs). Using 108 interventions from 78 studies, predominantly in LMICs, the paper summarizes the performance of 15 categories of interventions in improving these outcomes. Transfer programs emerge as broadly effective in increasing educational attainment but their effects on delaying fertility and marriage remain mixed and dependent on context. Construction of schools in underserved areas and the provision of information on returns to schooling and academic performance also increase schooling. No category of interventions is found to be categorically effective in delaying pregnancies and reducing child marriages among adolescent girls. While targeted provision of sexual and reproductive health services, including vouchers and subsidies for family planning, and increasing job opportunities for women seem promising, more research is needed to evaluate the longer-term effects of such interventions. We propose that future studies should aim to measure short-term outcomes that can form good surrogates for long-term welfare gains and should collect detailed cost information.

Effects of Performance‐Based Financing on Availability, Quality, and Use of Family Planning Services in the Democratic Republic of Congo: An Impact Evaluation

“…The program was not designed in any way to specifically target adolescent FP use, but it managed to positively impact some factors related to barriers to adolescents' use of FP services. Research from other settings suggests that adolescents' use of FP services is more likely to be price-sensitive (Athey et al 2021;Bergstrom and Özler 2023) and the program reduced fees. Health provider attitudes toward adolescents' access to FP services remain a key barrier (Mbadu .…”

“…Research from other settings suggests that adolescents’ use of FP services is more likely to be price‐sensitive (Athey et al. 2021; Bergstrom and Özler 2023) and the program reduced fees. Health provider attitudes toward adolescents’ access to FP services remain a key barrier (Mbadu Muanda et al.…”

“…An iterative process of adaptation and learning is required to design adolescent‐sensitive services to increase FP uptake by this critical population. While many of the barriers that prevent adolescents’ use of FP are known, there are either knowledge gaps or mixed results related to interventions addressing them (Bergstrom and Özler 2023; Xu et al. 2020).…”

“…As a result, many women and couples are unable to realize their personal reproductive preferences, resulting in higher exposure to pregnancy-related risks in settings with high maternal mortality. The consequences of unintended pregnancies are particularly large for adolescents (Fatusi et al 2021) due to the higher maternal mortality risk (Nove et al 2014) and long-term welfare consequences that they face from school dropout, early age of marriage, and marginalization (Bergstrom and Özler 2023;Hall et al 2018).…”

“…2021) due to the higher maternal mortality risk (Nove et al. 2014) and long‐term welfare consequences that they face from school dropout, early age of marriage, and marginalization (Bergstrom and Özler 2023; Hall et al. 2018).…”