Trends in adolescent first births in five countries in Latin America and the Caribbean: disaggregated data from demographic and health surveys

Abstract

BackgroundAdolescents in the Latin American and Caribbean region continue to experience poor reproductive health outcomes, including high rates of first birth before the age of 20 years. Aggregate national level data fails to identify groups where progress is particularly poor. This paper explores how trends in adolescent births have changed over time in five countries (Bolivia, Colombia, Dominican Republic, Haiti, and Peru) using data disaggregated by adolescent age group, wealth and urban / rural residence.MethodsThe study draws on Demographic and Health Survey data from five countries where three surveys are available since 1990, with the most recent after 2006. It examines trends in adolescent births by wealth status and urban/rural residence.ResultsThere has been little progress in reducing adolescent first births over the last two decades in these countries. Adolescent first births continue to be more common among the poorest and rural residents, and births among the youngest age-group (< 16 years) are particularly concentrated among these populations.ConclusionAdolescent first births continue to be a major issue in these five countries, including amongst the youngest group (< 16 years), although the contexts in which it is occurring are changing over time. Efforts are needed to expand sexual education and services for adolescents and young people, as well as introduce and enforce legislation to provide effective protection from abuse or exploitation. Greater disaggregation of adolescent fertility data is needed if we are to measure progress towards the attainment of the Sustainable Development Goals to “leave no-one behind”.

The State of Adolescent Sexual and Reproductive Health

“…In Latin America and the Caribbean, despite descending trends in total fertility, the proportion of births to adolescent mothers still accounts for 20%, the highest regional proportion in the world [42,43]. The adolescent birth rate differs greatly by household wealth (Figure 8): the rate in the lowest wealth quintile is, on average, 4.5 times larger than that in the highest wealth quintile [32].…”

The Political, Research, Programmatic, and Social Responses to Adolescent Sexual and Reproductive Health and Rights in the 25 Years Since the International Conference on Population and Development

“…First, there is stronger evidence on the nature and scale of problems (e.g., HIV-related mortality in adolescents) [220]. Second, there is a better understanding of the causes of these problems and how they differ depending on the context (e.g., the differing causes of adolescent pregnancy among different groups of girls even in the same geographic area) [221]. Third, there has been impressive progress in defining the consequences of the problem to individuals, families, and communities in some areas (e.g., the World Bank-ICRW study on the economic costs of child marriage) [222].…”

Age disparities in unmet need for contraception among all sexually active women in Colombia: an analysis of the 2015 Demographic Health Survey

“…found that teenage pregnancy (before aged 20) is related to the household wealth level (21). The social vulnerability of younger women affects not only their ability to exercise their rights in the present but also their futures and those of their families since inequities are cumulative throughout life and generations (12).…”

“…On reproductive health outcomes, these differences mainly affect fertility rates in younger women (20). Age barriers related to the provision of reproductive health services leave behind the poorest, least formally educated, and most vulnerable women, which is disturbing due to the social and economic costs of phenomena such as teenage pregnancy (7,(21)(22)(23).…”

“…Although policy advancements are crucial, the implementation reveals that the youngest women have relatively worse outcomes in sexual and reproductive health. Teenage pregnancy has increased over time, particularly among under 16 years old, and it is related to the socio-economic conditions (21) and social and cultural barriers such as the urban and rural areas of residence, traditional gender stereotypes, and ethnicity (21,28,29). In Colombia, the fertility rate decreased slowly among 15-19 years-old but increased among 10-14 years-old girls (26).…”