Reproductive Health Among Adolescents and Youth in Pakistan: The Evidence and the Challenges Dr' Zeb

1
Reproductive Health Among Adolescents and
Youth in PakistanThe Evidence and the
ChallengesDr. Zeba A. Sathar
(Tamgha-i-Imtiaz)Country Director Population
Council, Islamabad
2
Why are Adolescents so important?

• The largest proportion of Pakistanis are
  adolescents and youth
• They represent the future both in terms of
  demography but also development
• They tend to get neglected in policies and
  programs which focus on married women or young
  children

3
Population Projections with Slow and Rapid
Decline in Fertility
Slow
Rapid
Continued..
4
(No Transcript)
5
National survey

• Theme
• Transitions to adulthood social context,
  education, work, and marriage among 15 to 24 year
  olds
• Objective
• To establish a base of knowledge to facilitate
  national debate, action, and research on
  adolescents and youth

6
Sampling sites(October 2001March 2002)
Rural
Urban
7
Framework for studying adolescents
Opportunities Schools/colleges Jobs Training
centers Health facilities Leisure
opportunities Information Constraints Community
attitudes Poverty Social sanctions
Antecedents Gender Household economic
status Region Parents characteristics
Outcomes Education Work Marriage Childbearing
8
Schooling of young people(15-24 years old)
9
Work status
10
Prior knowledge of puberty(15-24 years old)
11
Demand for information on Puberty (15-24 years
old)
12
Source of information about puberty (15-24 years
old pubescent)
13
Source of discussion on sensitive health
problems (15-24 years old)
Ever Married
14
Source of discussion on sensitive health
problems (15-24 years old)
Never Married
15
Sources of information/ discussion
YOUNG MALES
YOUNG FEMALES

• Most would talk to their FATHERS for education,
  work, and marriage
• For sensitive health issues majority would
  consult a DOCTOR/HAKEEMS
• FRIENDS are main and favorite source for Puberty
  information

• MOTHERS are the center point of all discussions
  on work, education, marriage
• Information about sensitive health (RH) is
  received from MOTHERS
• Married girls rely on their SPOUSES for almost
  all kinds of information

16
Proportions married(20-24 men and women)
Source Durrant 2000
17
Transition to puberty, marriage and childbearing
18
Married and pregnant before 20(Women aged 20-24)
19
Antenatal care received by females for first birth
20
Desired number of children, boys, and girls, by
sex and marital status, among 20-24 year olds
21
Contraceptive useamong married women aged 20-24
22
Conclusions

• Puberty
• Majority of young girls informed by mothers about
  puberty
• Friends first source of information on puberty
  for boys
• Schooling and socio-economic class not
  co-related with prior information on puberty
• General and Reproductive Health
• Most married girls consult husbands for health
  problems
• Boys consult doctors
• Unmarried girls most neglected group

23
Recommendations

• Youth programs and plans in RH must tackle
  diversity
• Prioritize young women and poor youth
• Target parents and schools and teachers to
  improve heath communication
• Peer group networks best way to reach boys
• Young husbands and wives need counseling on
  delaying first birth

24
Remember the big picture!

• Investments in youth and adolescents have
  tremendous pay offs in terms of development,
  fertility transition, HIV AIDs etc.
• These investments have to be multiplied to
  several fold their current levels, given the
  numbers
• Ensure integration of programs for youth
• If this opportunity is overlooked-dire
  consequences to follow