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The highest rates of early childbearing are found in sub-Saharan African countries

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Adolescence is a vulnerable phase in human development as it represents a transition from childhood to physical and psychological maturity. During this period, adolescents learn and develop knowledge and skills to deal with critical aspects of their health and development while their bodies mature. Adolescent girls, especially younger girls, are particularly vulnerable because they face the risks of premature pregnancy and childbirth. Indeed, in the least developed countries, over one in 4 women (27 per cent) aged 20–24 years have had a live birth before age 18. Similar proportions are observed in sub-Saharan Africa. This represents about 12 million women in least developed countries who delivered during their adolescent age. The highest proportions of early childbearing are found in sub-Saharan Africa, where birth rates among adolescents reach over 200 births per 1000 girls age 15–19, compared to lower rates in other regions (figure 1). Countries such as Central African Republic, Niger, Chad, Angola and Mali top the list of countries with highest adolescent birth rate (above 178). In the 2010–2015 period, over 45 per cent of women 20–24 reported having given birth for the first time by age 18.

ADOLESCENT PREGNANCY ACROSS GENERATIONS

While very early childbearing (birth before age 15) appears to decline steadily in all regions, childbearing among older adolescents (births before age 18) has remained stagnant across age groups of women. The overall median proportion of childbearing before age 15 span from 3 per cent among women aged 40-49 to 1 per cent among adolescents age 15-19. However, the median rate of childbearing before age 18 remained at around 21per cent among older age groups before declining to 17 per cent among women age 20-24 (figure 2 A-B). The trend pattern varies however across regions. West and Central Africa is the region with the highest rate of adolescent childbearing but with a steady decline across age groups of women. Lowest rate are found in CEE/CIS region with levels below 4 percent across all age groups.

While childbearing among younger adolescent girls has declined, it has remained stagnant among older girls
Percentage of adolescent girls with a live birth before age 15 (A) and before age 18 (B) by UNICEF regions

Source: UNICEF analysis based on 96 countries with DHS/MICS data from 2006-2015.

ANTENATAL, DELIVERY AND POSTNATAL CARE AMONG ADOLESCENTS

Because most adolescents who are pregnant are at their first pregnancy, the need for careful monitoring and quality care is more acute. Paradoxically, coverage of maternal health indicators, including contact with health system and quality of care appear consistently lower among adolescents than older women, particularly in sub-Saharan African and South Asia (figure 3).  Even more alarming is the lower coverage among younger adolescents, those aged 15-17 years compared to older adolescents (18-19 years old). In sub-Saharan Africa, the difference in coverage between young mothers aged 15-17 and older mothers aged 20-34 for obtaining at least four antenatal care visits is 10 percentage points.   For the receipt of critical interventions during antenatal care visits, such as blood and urine tests, in addition to the measurement of blood pressure, the difference between young mothers and older mothers is 9 percentage points. Fewer adolescent mothers received skilled delivery or postnatal care for themselves or their newborns compared to older mothers.

Adolescents lag behind in coverage of antenatal, delivery and postnatal care in sub-Saharan Africa and South Asia (excluding India)
Coverage (in percentage) of maternal health indicators among women aged 15-17, 18-19, and 20-34 years old

Notes: For sub-Saharan Africa weighted averages based on 27-34 countries covering 75-85% of births. For South Asia (excluding India), weighted averages based on 2-5 countries covering 57 to 97% of births.

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