As we write this, the world is on the cusp of something unprecedented: the largest generation of young people in human history is approaching reproductive age.
Not only is this generation the biggest, it is likely to be the healthiest and most educated the world has ever seen. More have gone to school than any previous generation. Most of them are vaccinated against the diseases that devastated populations that came before them. As they have grown, more have benefited from the nutrients their bodies and minds need to develop to their fullest potential. No previous generation has ever been so well-equipped to expand the limits of human possibility.
But for all the investments society has made in this generation, there is one crucial area in which we are falling short: ensuring their access to contraceptives. In sub-Saharan Africa, almost half of unmarried, sexually active adolescents who want to avoid pregnancy are not using contraceptives. Similarly, one in four married adolescents who want to prevent a pregnancy are not using a contraceptive method. The risks they face are enormous and threaten progress for everyone.
That is why family planning is an issue we should all care about. When a young woman gets pregnant before she turns 20, it can rob her of the chance to live her healthiest and most productive life. A teenager who becomes pregnant faces higher risk of eclampsia and infection. In low- and middle-income countries, complications in pregnancy and childbirth are a leading cause of death for adolescent girls. Thousands more young women survive childbirth but suffer from pregnancy-related health issues for the rest of their lives.
Unplanned pregnancy interrupts young women’s plans in other ways, too. An adolescent who becomes pregnant often drops out of school, lowering her lifelong earning potential and trapping her family in an intergenerational cycle of poverty. Babies born to teenagers are more likely to be born early, be undernourished and suffer poor health.
We are sensitive to the fact that the topic of contraceptives remains controversial, especially as it relates to young people. But many countries have successfully tackled the sensitivities and our responsibility to this generation and to our shared future demands we act.
In 2012, 36 countries came together to form a global partnership to support the right of women and girls to decide for themselves whether and when to get pregnant. This effort aims to provide an additional 120 million women and girls with access to contraceptives by 2020. We have made progress, reaching 24.4 million more women by 2015.
But far less progress has been made to reach adolescent girls who continue to have a high unmet need for contraception. It is now clear that any successful effort to expand contraceptives to adolescents must address the specific challenges facing young people.
For example, we’ve learned that, too often, the adults to whom young people turn for guidance are uncomfortable discussing topics like sex and family planning—or they fear that by having conversations about sex, they will appear to condone it. The result is that young people’s views of contraceptives are often shaped by rumors and misinformation. Girls worry that using contraceptives or carrying condoms would make people think they were promiscuous—or even prostitutes. Married adolescents are often pressured to have a child right after marriage making it challenging to access contraceptive services if they want to wait before becoming pregnant. And, in many places, young women – both married and unmarried – don’t have a place to seek high-quality counseling and care from an unbiased healthcare provider.
To combat the challenges connecting young people with contraceptives, our two organizations are coming together to invest $30 million in improving adolescents’ ability to control their future. In partnership with Population Services International and others, the goal is to expand access to contraceptive tools and services for more young women and their partners in Ethiopia, Tanzania and Nigeria.
This grant, Adolescents 360, will fund programs developed by young people, for young people that respond to adolescents’ specific and varied needs in obtaining contraceptives. We will look to adolescents themselves to identify solutions to help combat the stigma and misinformation that often stand between their peers and contraceptives. Our hope is that this initiative will be a step toward better understanding this diverse and complex generation, and that our work in this area will inspire other donors and governments to put adolescents at the center of their efforts to expand contraceptive access.
Today, there are hundreds of thousands of young women each year whose dreams—and even lives—are cut short by unwanted pregnancies. But imagine what is possible if we could give every one of those young women the tools to determine her own future.
We know from the data that when girls are able to go to school, their own children are more likely to survive childhood. Young women who have completed some education have better prospects in the workplace and a greater chance of living a fuller, more fulfilling life. What’s more, the evidence is clear that there is a direct relationship between the number of girls who go to school and a country’s economic progress. When countries invest in young women, they’re investing in their own economic future and setting the stage for rapid growth.
Michael Anderson is the CEO of the Children’s Investment Fund Foundation.
Chris Elias is the president of the Global Development Program at the Bill & Melinda Gates Foundation.
