Reproductive Health of Adolescent Girls: Perspectives from WDR07

Emmanuel Jimenez

December 1, 2009

www.worldbank.org/wdr2007

Motivation

Investing in in the human capital of young people (12-24 years) is key to development: A higher base on which to build human

capital to grow and reduce poverty

3

But new challenges for youth

HIV prevalence rate (%) in young (15-24) pregnant women

0

10

20

30

40

50

Source: UNAIDS

Motivation

Investing in in the human capital of young people (12-24 years) is key to development: A higher base on which to build human

capital to grow and reduce poverty A large youth cohort is a potential

demographic dividend

Structure of the WDR

5 Transitions 3 Policy Lenses

Human capital during 5 youth transitions key for poverty reduction and growth

12

100 % of Cohort

Age24

Learning in school after primary-age Working

Forming families

Participating in civic lifeTaking health risks

3 types of questions asked of each transition: a ‘youth lens’ on policy

Policies affecting human capital formation during Youth transitions:

• Economy wide policies and institutions:

• macro stability,• investment climate, • governance,• labor market regulations

• Education and Training• Health services • Welfare & family services • Infrastructure

Youth ‘Lenses’

“Youth friendly”policies

3 types of questions asked of each transition: a ‘youth lens’ on policy

Opportunities

Capability Second-chances

Policies affecting human capital formation during Youth transitions:

-- Economy widepolicies and insts: macro stability,invest. climate, governance, labor market regulations-- Education-- Training-- Health services -- Welfare & familyservices -- Infrastructure

Youth ‘Lenses’

“Youth friendly”policies

9

Opportunities: a good education

Percent of young women, 15-24, who can read a simple sentence or know condoms can prevent HIV/AIDS after six years of primary school

Inadequate preparation for adolescence improve quality of basic education

Relevance of education for jobs curriculum reform, flexibility in school systems

0

10

20

30

40

50

60

70

80

90

100

Ghana Zambia Ghana Zambia

Literacy Condom Knowledge

10

Opportunities: health services

alternatives to early marriage and childbearing: schooling and work

proper nutrition access to health services:

reproductive health technology and servicesantenatal and obstetric care child health services

involving young men in SRH

Applying the framework: Opportunity Opportunity: Countries HAVE invested

in access to human capital; lens focus on education quality and relevance to labor market

Capability Second-chances

3 types of questions asked of each transition: a ‘youth lens’ on policy

Opportunities Capability Second-chances

Policies affecting human capital formation during Youth transitions:

-- Economy widepolicies and insts: macro stability,invest. climate, governance, labor market regulations-- Education-- Training-- Health services -- Welfare & familyservices -- Infrastructure

Youth ‘Lenses’

“Youth friendly”policies

Capable decision-making: % of youth who think they have the most influence on human capital decisions

Capabilities: information

Half of 2,000 Kenyan adolescents chosen from KLPS randomly selected for VET voucher

Half of these receive information intervention targeted to females: -- avg returns from

KLPS -- encouraged to attend

male-dominated trades

Initial results: Large effect on

demand for male trades

Will probably affect earnings since avg earnings on tailoring and computers which some girls enter are high.

14

Source: DHS

Source: DHS

Relieving the information constraint

…Incentives also matter. Positive ones, like

conditional cash transfers: Mexico’s Oportunidades:

• .2 more years of schooling at 13-15• reduced child morbidity and mortality

Bangladesh’s Female Secondary Stipend Program

Cambodia’s secondary scholarship program for girls

involve youth in program design esp those to change attitudes

…Or negative ones like taxes

Impact of a one percent price increase

-2

-1.5

-1

-0.5

0

Perc

en

t ch

an

ge

smoking smoking alcohol binge marijuana use drinking use

China U.S. High school students

Outline Motivation Structure/Framework of the Report Applying Framework: Examples

Opportunity: Capability: Policy targets Govts and now

Parents; lens improve the capacity of youth to decide among opportunities

Second-chances:

3 types of questions asked of each transition: a ‘youth lens’ on policy

Opportunities CapabilitySecond-Chances

Policies affecting human capital formation during Youth transitions:

-- Economy widepolicies and insts: macro stability,invest. climate, governance, labor market regulations-- Education-- Training-- Health services -- Welfare & familyservices -- Infrastructure

Youth ‘Lenses’

“Youth friendly”policies

Second-chances: Recovering from poor outcomes

High costs of not giving young people another chance to recover:

Effects are long-lasting Later recovery as adults is more costly May inhibit investment by others (e.g., high

HIV/AIDS prevalence leads to lower investment)

Examples:

Examples of second-chance programs for RHA

Training for dropouts to re-enter mainstream educ

Child-care services in schools for students Family planning and maternal services for

youth

Policy Framework

Opportunity Capability Second-chances: Prevention; lens

Help young people recover from poor outcomes

Moving forward in Countries

Coordination: youth outcomes require improved multi-sector efforts

Voice: the constituency of youth is weak (which is why for this Report, we had extensive consultation)

Evaluation: many youth-specific initiatives are still new; impact must be studied

Providing school uniforms not only increased enrollment in Kenya – it lowered teenage pregnancy