Youth in Sub-Saharan Africa : a chartbook on sexual experience and reproductive health

Topics covered include education and exposure to information; sexual experience and marriage; HIV/AIDS; childbearing; contraception; and maternal health. Key findings include the following: (1) Although education levels have risen dramatically in most survey countries, less than half of those aged 16-20 attend school. Also, gender gaps between boys and girls persist in school enrollment and in access to the mass media. (2) In nine countries, at least one-third of young women married before age 18 and at least half had sex before age 18. The premarital period is lengthening: young women spend a longer time single than their mothers did. (3) In countries with data available, 13% to 38% of single teenage women and 8% to 39% of single teenage men either received or gave gifts or money in exchange for sex during a recent period. In such situations, adolescents may be unable to negotiate condom use or the fidelity of their partners, leaving them at greater risk of sexually transmitted infections and unintended pregnancy. (4) In most of the countries, over 50% of adolescents believe that they have little or no risk of getting AIDS, even though HIV prevalence among young people is high in many of these countries. (5) Young men are more likely to report condom use than young women. In a number of settings, however, teenage women are more vulnerable to AIDS: HIV infection levels are often higher among teenage women than among teenage men, in part because their partners are likely to be older, more sexually experienced men rather than men their own age. (6) In eight countries, teenage birth rates show some sign of decline, but levels of unintended pregnancies among teenagers are high. More than one-fifth of recent births were reported by young women as unintended. (7) Modern contraceptive use among adolescents is low. In seven countries, less than 5% of married adolescent women report use of a modern method. Single, sexually active adolescents are often more likely to rely on contraception than are their married counterparts. Modern contraceptive use among single, sexually active women ranges from 5% in Mozambique to 23% in Ghana. (8) In eight countries, at least 10% of 16-year olds have started childbearing. This is of concern, since very young mothers tend to be at a much higher risk of pregnancy-related complications and infant death than women in their twenties or thirties. (9) Although many adolescent mothers received prenatal care for recent births, access to professional delivery care remains limited. In 10 countries, less than 55% of young women reported receiving such care. Includes policy recommendations.