World Health Organization (WHO) has released a new guidelines to curb adolescent pregnancy and associated health complications to prevent death among 15-19-year-old girls.

Among other strategies, the guideline urges rapid action to end child marriage, improve education and school retention, besides access to sexual and reproductive health services and information

 According WHO data, more than 21 million adolescent girls become pregnant each year in low- and middle-income countries, half of which are unintended.

Director of Sexual and Reproductive Health and Research at WHO and the United Nations’ Special Programme in Human Reproduction (HRP) Pascale Allotey says tackling early pregnancies means creating conditions where girls and young women can thrive by ensuring they can stay in school, be protected from violence and coercion, access sexual and reproductive health services that uphold their rights and have real choices about their futures.

“All these critical factors for early pregnancies among teenagers around the world have serious physical and psychological consequences for girls and young women, and often reflect fundamental inequalities that affect their ability to shape their relationships and their lives,” said Dr Allotey

Reasons for early pregnancy vary, but are interrelated including gender inequities, poverty, lack of opportunity and inability to access sexual and reproductive health services, with also a strong correlation with child marriage; and in low- and middle-income countries.

Nine out of 10 adolescent births take place among girls who marry before the age of 18, according to WHO.

Dr Sheri Bastien, Scientist for Adolescent Sexual and Reproductive Health at WHO, said that early marriage denies girls their childhood and has severe consequences for their health.

“Education is critical to change the future for young girls, while empowering adolescents, both boys and girls, to understand consent, take charge of their health, and challenge the major gender inequalities that continue to drive high rates of child marriage and early pregnancy in many parts of the world,” said Dr Bastein.

The guideline recommends holistic efforts to provide viable alternatives to early marriage by strengthening girls’ education, savings, and employment prospects. Consequently, if all girls finished their secondary schooling, it has been estimated that child marriages could be reduced by as much as two thirds.

For girls at highest risk, the guideline further recommends considering incentives to support secondary school completion, such as targeted financial stipends or scholarship programmes. The guideline also recommends laws to prohibit marriage below the age of 18, consistent with human rights and community engagement to prevent the practice.

The guidelines, which are an update of an earlier edition on adolescent pregnancy prevention from 2011, focuses particularly on preventing child marriage and improving adolescents’ access to and use of contraception

The recommendations highlight the need to ensure adolescents can access high-quality, adolescent-responsive sexual and reproductive health services, including contraceptive options.

According to the guidelines, in some countries, consent from an adult is required to access services, which is a significant barrier to their use with young girls who get pregnant, also needing to be able to access high-quality and respectful healthcare during and after pregnancy and birth, free from stigma and discrimination, as well as safe abortion care.

WHO says that comprehensive sexuality education is essential for both boys and girls to ensure they know where to access such services and how to use different types of contraception.

This has been shown to reduce early pregnancies, delay the onset of sexual activity, and improve adolescents’ knowledge about their bodies and reproductive health.

Globally, there has been progress in reducing adolescent pregnancies and births. In 2021, an estimated 1 in 25 girls gave birth before the age of 20, compared to 1 in 15 two decades prior. There remain significant disparities. In some countries, close to 1 in 10 adolescent girls (15-19 years) give birth each year.

In Kenya, the government and stakeholders have developed guidelines and policies to address teenage pregnancies, focusing on prevention, support and reintegration into education.

These include the National Plan of Action on Adolescents and Teenage Pregnancy, the National School Re-Entry Guidelines and other initiatives that promote adolescent health.

The guidelines are intended to ensure that teenage girls who become pregnant or have children can continue their education and receive the necessary support.

• A Tell Media / KNA report / By Wangari Ndirangu