Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?
Adolescent sexual and reproductive health (ASRH) continues to be a major public health challenge in sub-Saharan Africa where child marriage, adolescent childbearing, HIV transmission and low coverage of modern contraceptives are common in many countries. The evidence is still limited on inequalities...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-01-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/1/e002231.full |
| _version_ | 1826937657964363776 |
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| author | Sarah Neal Ties Boerma Dessalegn Y Melesse Martin K Mutua Allysha Choudhury Yohannes D Wado Cheikh M Faye |
| author_facet | Sarah Neal Ties Boerma Dessalegn Y Melesse Martin K Mutua Allysha Choudhury Yohannes D Wado Cheikh M Faye |
| author_sort | Sarah Neal |
| collection | DOAJ |
| description | Adolescent sexual and reproductive health (ASRH) continues to be a major public health challenge in sub-Saharan Africa where child marriage, adolescent childbearing, HIV transmission and low coverage of modern contraceptives are common in many countries. The evidence is still limited on inequalities in ASRH by gender, education, urban–rural residence and household wealth for many critical areas of sexual initiation, fertility, marriage, HIV, condom use and use of modern contraceptives for family planning. We conducted a review of published literature, a synthesis of national representative Demographic and Health Surveys data for 33 countries in sub-Saharan Africa, and analyses of recent trends of 10 countries with surveys in around 2004, 2010 and 2015. Our analysis demonstrates major inequalities and uneven progress in many key ASRH indicators within sub-Saharan Africa. Gender gaps are large with little evidence of change in gaps in age at sexual debut and first marriage, resulting in adolescent girls remaining particularly vulnerable to poor sexual health outcomes. There are also major and persistent inequalities in ASRH indicators by education, urban–rural residence and economic status of the household which need to be addressed to make progress towards the goal of equity as part of the sustainable development goals and universal health coverage. These persistent inequalities suggest the need for multisectoral approaches, which address the structural issues underlying poor ASRH, such as education, poverty, gender-based violence and lack of economic opportunity. |
| first_indexed | 2024-04-24T23:20:37Z |
| format | Article |
| id | doaj.art-7bbfe1acd1ab4b6db2a74e0e69be51cf |
| institution | Directory Open Access Journal |
| issn | 2059-7908 |
| language | English |
| last_indexed | 2025-02-17T18:44:00Z |
| publishDate | 2020-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj.art-7bbfe1acd1ab4b6db2a74e0e69be51cf2024-12-11T13:50:09ZengBMJ Publishing GroupBMJ Global Health2059-79082020-01-015110.1136/bmjgh-2019-002231Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?Sarah Neal0Ties Boerma1Dessalegn Y Melesse2Martin K Mutua3Allysha Choudhury4Yohannes D Wado5Cheikh M Faye6Social Statistics and Demography Department, University of Southampton, Southampton, UKCountdown to 2030 for Women`s, Children`s and Adolescents` Health, Institute for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, CanadaCountdown to 2030 for Women`s, Children`s and Adolescents` Health, Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, CanadaWest Africa Regional Office, African Population and Health Research Center, Dakar, SenegalData and Analytics Section, UNICEF, New York City, New York, USAAfrican Population and Health Research Center, Nairobi, KenyaWest Africa Regional Office, African Population and Health Research Center, Dakar, SenegalAdolescent sexual and reproductive health (ASRH) continues to be a major public health challenge in sub-Saharan Africa where child marriage, adolescent childbearing, HIV transmission and low coverage of modern contraceptives are common in many countries. The evidence is still limited on inequalities in ASRH by gender, education, urban–rural residence and household wealth for many critical areas of sexual initiation, fertility, marriage, HIV, condom use and use of modern contraceptives for family planning. We conducted a review of published literature, a synthesis of national representative Demographic and Health Surveys data for 33 countries in sub-Saharan Africa, and analyses of recent trends of 10 countries with surveys in around 2004, 2010 and 2015. Our analysis demonstrates major inequalities and uneven progress in many key ASRH indicators within sub-Saharan Africa. Gender gaps are large with little evidence of change in gaps in age at sexual debut and first marriage, resulting in adolescent girls remaining particularly vulnerable to poor sexual health outcomes. There are also major and persistent inequalities in ASRH indicators by education, urban–rural residence and economic status of the household which need to be addressed to make progress towards the goal of equity as part of the sustainable development goals and universal health coverage. These persistent inequalities suggest the need for multisectoral approaches, which address the structural issues underlying poor ASRH, such as education, poverty, gender-based violence and lack of economic opportunity.https://gh.bmj.com/content/5/1/e002231.full |
| spellingShingle | Sarah Neal Ties Boerma Dessalegn Y Melesse Martin K Mutua Allysha Choudhury Yohannes D Wado Cheikh M Faye Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? BMJ Global Health |
| title | Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? |
| title_full | Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? |
| title_fullStr | Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? |
| title_full_unstemmed | Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? |
| title_short | Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? |
| title_sort | adolescent sexual and reproductive health in sub saharan africa who is left behind |
| url | https://gh.bmj.com/content/5/1/e002231.full |
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