ASRH Facts & Stats

Global Statistics:

  • It is estimated that some 250,000 children and adolescents under the age of 18 are involved in more than 30 conflicts worldwide. Thousands of children have been recruited into armed groups in the Central African region (Chad, Central African Republic and Sudan).
    • Reference: Fact sheet: Children Associated with armed groups and forced central Africa, UNICEF, 2011
  • Today, as a result of lower fertility rates and longer life expectancy, about 35% of the global population is under age 20, 58% is between ages 20 and 64, and 7% 65 or older. Asia, Latin America, and Oceania all have population age structures similar to the global averages.
  • According to a study by Laski and Wong (2010), young adults with greater social assets (stable homes, schooling) receive the majority of adolescent RH services, which tend to reach urban, in-school, older, unmarried boys, and in many cases boys aged 24 years and older. Those with fewest social assets (migrants, less stable families, individuals with limited or no schooling who experience the most frequent, unprotected sexual relations) receive a negligible share of youth-serving resources.
    • Reference: Laski, L. & Wong, S. (2010). “Addressing diversity in adolescent sexual and reproductive health services.” International Journal of Gynecology and Obstetrics. 110, 510-512.
  • Far too many women, children, and adolescents worldwide still have little or no access to essential, good-quality health services and education, clean air and water, adequate sanitation, and good nutrition. They face violence and discrimination, are unable to participate fully in society, and encounter other barriers to realizing their human rights. As a result, as the MDG era draws to a close, the annual death toll remains unacceptably high: 289,000 maternal deaths, 2.6 million stillbirths, 5.9 million deaths in children under the age of five— including 2.7 million newborn deaths—and 1.3 million adolescent deaths.

Adolescent Pregnancy and Maternal Newborn Health

  • The risk of maternal mortality is highest for adolescent girls under 15 years old and complications in pregnancy and childbirth is a leading cause of death among adolescent girls in developing countries.
  • Among adolescents girls aged 15-19 the two leading causes of death are suicide and complications during pregnancy and childbirth. 2.5 million under 16 year olds give birth and 15 million under 18 year olds are married.
  • Between 2011 and 2020, more than 140 million girls will become child brides, according to the UNFPA. If current levels of child marriages hold, 14.2 million girls annually or 39,000 daily will marry young. Of the 140 million girls who will marry before the age of 18, 50 million will be under the age of 15.
  • The 10 countries with the highest rates of child marriage are: Niger (75%), Chad and Central African Republic (68%), Bangladesh (66%), Guinea (63%), Mozambique (56%), Mali (55%), Burkina Faso and South Sudan (52%), and Malawi (50%).
  • The five countries with the greatest absolute increases in the number of adolescent girls are all sub-Saharan African nations: Nigeria (9.2 million), United Republic of Tanzania (3.7 million), Democratic Republic of the Congo (3.3 million), Uganda (2.5 million), and Kenya (2.3 million).
  • The most recent estimates indicate that almost one in five women aged 20 to 24 (19%) had a live birth by their 18th birthday.
  • There has been a marked, although uneven, decrease in the birth rates among adolescent girls since 1990, but some 11% of all births worldwide are still to girls aged 15 to 19 years old. The vast majority of these births (95%) occur in low- and middle-income countries.
  • The proportion of all births among those under 18 varies by region; 28% in West and Central Africa and 25% in Eastern and Southern Africa, compared to just 4% in Eastern Europe and Central Asia. By contrast, Latin America and the Caribbean’s proportion is closer to the global average of 18%.
  • The 2014 World Health Statistics indicate that the average global birth rate among 15 to 19 year olds is 49 per 1,000 girls. Country rates range from 1 to 299 births per 1,000 girls, with the highest rates in sub-Saharan Africa.
  • Complications during pregnancy and childbirth are the second leading cause of death for 15-19 year-old girls globally. However, there has been a significant drop in the number of deaths in all regions since 2000, most notably in South-East Asia where mortality rates fell from 21 to 9 per 100,000 girls.
  • In Latin America, the risk of maternal death is four times higher among adolescents younger than 16 years than among women in their twenties.
  • The proportion of births that take place during adolescence is about 2% in China, 18% in Latin America and the Caribbean, and more than 50% in sub-Saharan Africa. Half of all adolescent births occur in just seven countries: Bangladesh, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Nigeria, and the United States.
  • Early childbearing increases risks for both mothers and their newborns. In low- and middle-income countries, babies born to mothers under 20 years of age face a 50% higher risk of being still born or dying in the first few weeks versus those born to mothers aged 20-29. The younger the mother, the greater the risk to the baby. Newborns born to adolescent mothers are also more likely to have low birth weight, with the risk of long-term effects.
  • About 16 million girls aged 15 to 19 and some 1 million girls under 15 give birth every year, most in low- and middle-income countries.
  • Up to 65% of women with obstetric fistula develop this as adolescents, with dire consequences for their physical and social lives.
  • At a level 20 of state fragility, a measure used to determine how vulnerable an area is to crisis based on violence, justice and law, national institutions, economic stability, and resilience in the country, UNFPA found birth rates ranged from approximately zero to 25 births per 1,000 women. This is compared to a level of 120 where rates ranged from about 50 to 225 per 1,000 women.
  • During the 2012 food crisis in Niger, 39 percent of adolescent girls were mothers.
  • Thirty percent of births in Tanzania in Congolese refugee camps in 2003 were among adolescent girls aged 14 to 18.
    • Reference: Takei, Y., Mtalai, M., & Lugoi, J. (2003). Conference 2003: Reproductive health from disaster to development: The cases of adolescent pregnancy and its impact in the Congolese refugee camps in Kigoma region, Tanzania. Reproductive Health Response in Conflict Consortium. Retrieved July 12, 2016 from http://www.alnap.org/pool/files/confprocdingsnew.pdf; WRC, Save the Children, UNHCR, & UNFPA (2012). Adolescent sexual and reproductive health programs in humanitarian settings: An in-depth look at family planning services. Retrieved July 5, 2016 from https://www.unfpa.org/sites/default/files/resource-pdf/AAASRH_good_practice_documentation_English_FINAL.pdf
  • In Afghanistan, 25 percent of women aged 20 to 24 gave birth for the first time before turning 18.
  • After the Nepal earthquake, 10 percent of girls under 20 were having children.
  • An estimated 25 percent of Yemeni woman aged 20-24 had a child before turning 18.
    • Reference: Badahdah, A.M. (2016). Attitudes toward restricting the sexual and reproductive rights of women living with HIV infection in Yemen. The Journal of the Association of Nurses in AIDS Care, 27(2), 180-187. doi: 10.1016/j.jana.2015.10.006
  • Mortality is five times more likely to occur during childbirth among adolescent girls younger than 15 than women older than 20 when exposed to violence.
    • Reference: Violence against Women and Girls in Humanitarian Emergencies. (2013, October). Department for International Development. Retrieved June 22, 2016, from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/271932/VAWG-humanitarian-emergencies.pdf.

 

Family Planning and Unsafe Abortion Among Adolescents

  • Among countries with complete abortion records, the highest adolescent abortion rate was in England and Wales (20 per 1,000 women) and Sweden (20), with the lowest in Switzerland (5). In half of these countries the proportion of pregnancies that ended in abortion ranged from 35-55%. In Mexico and the countries in sub-Saharan Africa, where abortion is legally restricted, the adolescent abortion rate ranged from 11 in Ethiopia to 44 in Mexico, and rates tended to higher than in countries with liberal abortion laws. The proportion of teen pregnancies ending in abortion ranged from 9% in Ethiopia to 24% in Mexico.
  • Fourteen percent of all unsafe abortions in low- and middle-income countries are among women aged 15–19 years. About 2.5 million adolescents have unsafe abortions every year, and adolescents are more seriously affected by complications than are older women.
  • Unmet need for family planning is higher, on average, among young unmarried women than among young married women.*
  • Unmet need among young unmarried women is highest, around 40%, in the two African regions (41.7% in West and Central Africa; 39.8% in East and Southern Africa)*
  • Among individual countries, it is highest in Senegal (69.5%) and lowest in Ukraine (7.3%).*
  • Total demand for contraception among unmarried women age 15 to 24 is consistently high—about 90% in all the regions. By and large, young sexually active unmarried women typically do not want to become pregnant.*
    • Resource: Unmet need for family planning among women: levels and trends, DHS report*
  • Among married adolescents who do not want a pregnancy, 54% in Latin America and the Caribbean are using a modern contraceptive method, compared with 32% in South Central and Southeast Asia and 21% in Sub-Saharan Africa. Among unmarried, sexually active adolescent women who want to avoid pregnancy, 41% in Sub-Saharan Africa and 50% in Latin America and the Caribbean are using a modern method. The remainder are using either traditional methods (17% and 8%, respectively) or no method (42% and 43%).
  • WHO published guidelines in 2011 with the UNFPA on preventing early pregnancies and reducing poor reproductive outcomes. They also made recommendations for action that countries could take, with 6 main objectives:
  1. reducing marriage before the age of 18;
  2. creating understanding and support to reduce pregnancy before the age of 20;
  3. increasing the use of contraception by adolescents at risk of unintended pregnancy;
  4. reducing coerced sex among adolescents;
  5. reducing unsafe abortion among adolescents;
  6. increasing use of skilled antenatal, childbirth and postnatal care among adolescents. Reference: WHO, Adolescent pregnancy, 2014
  • Stillbirths and death in the first week of life are 50% higher among babies born to mothers younger than 20 years than among babies born to mothers 20–29 years old. Deaths during the first month of life are 50–100% more frequent if the mother is an adolescent versus older, and the younger the mother, the higher the risk. The rates of preterm birth, low birth weight and asphyxia are higher among the children of adolescents, all of which increase the chance of death and of future health problems for the baby.
  • A study of 18 Demographic and Health Surveys conducted in Africa between 1993 and 2001, found that two out of five unmarried girls and young women aged 15–24 were sexually active.
    • Reference: Cleland J and Ali M, Sexual abstinence, contraception and condom use by young African women: a secondary analysis of survey data, Lancet, 2006, 368(18):1788–1793.
  • Discontinuation of contraception is a particularly important issue for adolescents and young women because they tend to have more limited access than older individuals to contraceptive services, as well as more unpredictable and irregular sexual activity, and are probably less knowledgeable about how to use contraceptive methods effectively. According to a study in six developing countries, women younger than 25 were more likely than others to stop using their contraceptive method after 24 months.
  • In 2010 in Columbia, 54.8 percent of adolescents aged 15 to 19 and in a relationship used contraception. During the same year, among adolescents sexually active and not in a relationship: 37 percent of 15 to 19-year-olds and 20 percent of 13 to 14-year-olds used a contraceptive injection, and 23 percent of 15 to 19-year-olds and zero percent of 13 to 14-year olds used an IUD.
  • A study, conducted from 2004 to 2005 in a refugee camp in Uganda, found that 91 percent of female Acholi adolescents had trouble accessing condoms.
    • References: Plan International. (2013). Because I am a girl: The state of the world’s girls 2013: In double jeopardy: Adolescent girls and disasters. Plan International. Retrieved June 27, 2016, from http://resourcecentre.savethechildren.se/sites/default/files/documents/biaag_2013_report_in_double_jeopardy_eng.pdf; Patel, S.H., Muyinda, H., Sewankambo, N.K., Oyat, G., Atim, S., & Spittal P.M. (2012).
    • In the face of war: Examining sexual vulnerabilities of Acholi adolescent girls living in displacement camps in conflict- affected Northern Uganda. BMC International Health and Human Rights, 12(38). doi: 10.1186/1472-698X-12-38

HIV/AIDS and STIs Among Children and Adolescents

  • Every hour, 26 adolescents (15-19) were newly infected with HIV in 2014 (220,000 total). Adolescent girls and young women are disproportionately affected by HIV in Sub-Saharan Africa, particularly in countries with high HIV prevalence. In Sub-Saharan Africa, 7 in 10 new infections in 15-19 year olds are among girls.
    • Reference: Unicef, Adolescents are the outliers in the AIDS response, 2016
  • Adolescents account for about 5% of all people living with HIV and about 12% of new adult HIV infections.
    • Reference: Unicef, Adolescents are the outliers in the AIDS response, 2016
  • Regions with the highest numbers of HIV-positive adolescents are Sub-Saharan Africa and South Asia. Of the 2.0 million adolescents living with HIV, about 1.6 million (82%) live in Sub-Saharan Africa.
    • Reference: Unicef, Adolescents are the outliers in the AIDS response, 2016
  • Eighty-two percent of the estimated 2.1 million adolescents aged 10–19 years living with HIV in 2012 were in Sub-Saharan Africa, and the majority of these (58%) were women and girls.
    • Reference: Idele, P., Gillespie, A., Porth, T., Suzuki, C., Mahy, M., Kasedde, S., & Luo, C. (2014). Epidemiology of HIV and AIDS Among Adolescents. Journal of Acquired Immune Deficiency Syndromes, 66. doi:10.1097/qai.0000000000000176
  • Child brides are subject to heightened HIV-related vulnerabilities. For adolescent girls, marriage often signifies the start of frequent and unprotected sexual activity, and in many countries signifies increased risk of HIV infection.
  • In Eastern and Southern Africa, 15- to 24-year-old adolescent girls and young women are infected at rates two to five times higher than boys their age.
  • The HIV epidemic in Uganda continues to disproportionately affect young women. In 2013, HIV prevalence among young people aged 15-24 in Uganda was estimated at 4.2% for women and 2.4% for men. The majority of new HIV infections occur among young women and adolescent girls.
  • A survey conducted in South Africa in 2012, found that HIV prevalence among women was nearly twice as high as men. Rates of new infections among young women aged 15-24 were more than four times greater than that of men in the same age range, and this age group accounted for 25% of new infections in South Africa.
  • There were 3.2 million children living with HIV around the world at the end of 2013 , 91% of these reside in sub-Saharan Africa. Worldwide, it is estimated that 17.8 million children under 18 have been orphaned by AIDS, and that this will rise to 25 million by 2015. Around 15.1 million, or 85% of these children live in Sub-Saharan Africa.
    • Reference: UNAIDS, The Gap Report, 2014 and WHO, World AIDS Day: Business Unusual: Time to end the AIDS epidemic, 2014.
  • Children continue to become infected perinatally, during labour, or while breastfeeding. However, the rate of mother-to-child transmission fell in 2013, 16% of children born to women living with HIV became infected compared to 25.8% in 2009.
  • Compared with girls who have at least six years of schooling, girls with no education are twice as likely to acquire HIV and do not seek help in cases of intimate partner violence, which can increase the risk of HIV infection by 50%, according to a South African study.
    • Reference: UNAIDS & The African Union, Empower Young Women and Adolescent Girls: Fast-Tracking the End of the AIDS Epidemic in Africa, 2015.
  • Among refugees in Nepal and from Bhutan in 2003, only 41 percent of adolescents knew getting a STI could be prevented by using a condom, and 22 percent of adolescent boys and 46 percent of adolescent girls did not know about sexual contact.
  • In 2011 and 2012, only 26 percent of female adolescents and 34 percent of adolescent boys had a full understanding of HIV/AIDS.
    • Reference: Ministry of Health and Population, New ERA, & ICF International (2012). Nepal demographic and health survey 2011. Retrieved on July 14, 2016 from http://dhsprogram.com/pubs/pdf/FR257/FR257%5B13April2012%5D.pdf; UNFPA (2015). Upgrading adolescent sexual and reproductive health services in Nepal. Retrieved July 14, 2016 from http://nepal.unfpa.org/news/upgrading-adolescent-sexual-and-reproductive-health-services-nepal

Female Genital Cutting/Mutilation (FGC/FGM)

  • In Africa, about 3 million girls are at risk for FGC/FGM annually.
  • It is estimated that more than 200 million girls and women alive today have undergone FGC/FGM in the countries where the practice is concentrated. Furthermore, there are an estimated 3 million girls at risk of undergoing FGC/FGM every year. The majority of girls are cut before they turn 5 years old.
    • Reference: Female genital mutilation (FGM), WHO, 2016
  • The evidence base on the physical health complications of FGC/FGM, which covers over half a century of research from more than 20 countries in Africa and beyond, shows that FGC/FGM is associated with an increased risk of urinary tract infections, bacterial vaginosis, painful sexual intercourse, and obstetric difficulties.
    • Reference: Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis, Rigmor C Berg et al. 2014

Child Marriage

Transactional Sex Work

  • In 1999, during the Sierra Leone Civil War, adolescents under 15 compromised 37 percent of cases of transactional sex and sex work.
    • Reference: Bradshaw, S., & Fordham, M. (2013, August). Women, girls and disasters: A review for DFID. Middlesex University and Northumbria University and Gender and Disaster Network. Retrieved June 21, 2016, from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/236656/women-girls-disasters.pdf; DFID. Violence against Women and Girls in Humanitarian Emergencies. (2013, October). Department for International Development. Retrieved June 22, 2016, from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/271932/VAWG-humanitarian-emergencies.pdf.
  • In Burkina Faso in 2012, 25 percent of adolescent girls interviewed in a study had noted that they had participated in transactional sex, 46 percent of which had been during the food crisis.
  • Female Sex workers (FSW) who had experienced any violence (physical or sexual) were significantly more likely to be vulnerable to both reproductive health and HIV risks. For example as compared to FSWs who did not experience violence, FSWs who experience any violence had a higher number of pregnancies, had experienced pregnancy loss, had experienced forced termination of pregnancy, and had multiple forced termination of pregnancies, which are factors indicative of vulnerability to reproductive health risks. Similarly women reporting the experience of violence were significantly more likely than those who did not experience violence to report inconsistent condom use in the past two years, current inconsistent condom use, symptoms of STI in the last six months, and a high perception of HIV risk, which are factors indicative of HIV risk.

 

Violence Against Women

  • In South Kivu, Democratic Republic of the Congo, in 2009, children, 15 years and younger, were 1.5 percent of rape survivors, while those 20 years and younger were 13 percent of survivors. This indicates that adolescents, 16 to 20 years old, made up 11.5 percent of rape survivors.
  • In Cote d’Ivoire, adolescents between 10 and 18 made up 60 percent of reported rape survivors in 2013.
    • Reference: (2015). Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action Camp Coordination and Camp Management Food Security and Agriculture Reducing risk, promoting resilience and aiding recovery. Retrieved June 22, 2016, from http://gbvguidelines.org/
  • In Somalia, girls under 18 made up 35 percent of reported rape survivors in 2013.
    • Reference: (2015). Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action Camp Coordination and Camp Management Food Security and Agriculture Reducing risk, promoting resilience and aiding recovery. Retrieved June 22, 2016, from http://gbvguidelines.org/
  • A survey conducted in Rwanda looking at the effect of the genocide in 1994 determined that about 30 percent of youth, eight to 19-years-old, witnessed rape or sexual mutilation.
    • Reference: Neugebauer, R., Fisher, P.W., Turner, J.B., Yamabe, S., Sarsfield, J.A., & Stehling-Ariza, T. (2009). Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide. International Journal of Epidemiology, 38(4), 1033-1045. doi: 10.1093/ije/dyn375
  • In response to queries regarding allegations of sexual exploitation or sexual abuse by UN Peacekeeping Operations, the UN Secretariat received 105 reports of allegations. Forty-five percent of those allegations involve sex with minors and 15% involved rape or sexual assault.
    • Reference: United Nations General Assembly, Report of the Secretary General, Special Measures for protection from sexual exploitation and sexual abuse, 2005, p. 4.

Refugee/Internally Displaced/Conflict-affected Statistics

  • During the Ebola crisis, 9.8 million, out of the total 18.7 million individuals impacted by Ebola, were children and adolescents
    • Reference: UNICEF (2015). Humanitarian action for children 2015: Overview. UNICEF. Retrieved July 12, 2016 from http://www.unicef.org/appeals/files/HAC_Overview_2015_WEB_27_01_15.pdf; Bhabha, J., Garfield, R., Johnson, K., Luchsinger, G., Oddy, L., Adhiambo Onyango, M., . . . Searle, L. (2015). The State of World Population 2015. The United Nations Population Fund. Retrieved June 21, 2016, from http://www.unfpa.org/sites/default/files/sowp/downloads/State_of_World_Population_2015_EN.pdf
  • Fifty-two percent of refugees in the Syria crisis are youth.
    • Reference: UNHCR (2013). The future of Syria: Refugee children in crisis. Retrieved July 14, 2016 
  • Fifty percent of individuals living in crisis are under 20.
    • Reference: Bhabha, J., Garfield, R., Johnson, K., Luchsinger, G., Oddy, L., Adhiambo Onyango, M., . . . Searle, L. (2015). The State of World Population 2015. The United Nations Population Fund. Retrieved June 21, 2016, from http://www.unfpa.org/sites/default/files/sowp/downloads/State_of_World_Population_2015_EN.pdf; OCED (2015). States of fragility 2015: Meeting post-2015 ambitions. OECD Publishing. http://dx.doi.org/10.1787/9789264227699-en
  • Interviews with humanitarian workers showed that only 42.1 percent planned to provide menstrual hygiene products to adolescent girls, suggesting that this is still yet to be seen as a priority need by many organizations.

Africa

  • A psychiatric epidemiological survey of young survivors (8-19) of the 1994 Rwandan Genocide, measuring traumatic exposures using an inventory of possible war time experiences and post-traumatic stress reactions, reported that among respondents, 30% witnessed rape or sexual mutilation.
    • Reference: Neugebauer R et al, Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide, International Journal of Epistemology, February 8, 2009.
  • From January to September 2014, UNFPA recorded 11,769 cases of sexual and gender-based violence in the DRC provinces of North Kivu, South Kivu, Orientale, Katanga and Maniema; 39 per cent of these cases were considered to be directly related to the dynamics of conflict, perpetrated by armed individuals. As in 2013, North Kivu and Orientale remain the provinces most affected by conflict-related sexual violence, with 42 per cent of all incidents taking place in Orientale.
    • Reference: Sexual Violence in Conflict, Democratic Republic of the Congo, 2015.
  • UNICEF estimates that 80% of the LRA are abducted adolescents, many of whom were forced to attack their own families, neighbors, and villages.
    • Reference: Mazurana, S. McKay, Girls in Fighting Forces in Northern Uganda, Sierra Leone and Mozambique: Policy and program recommendations, CIDA, June 2003.
  • Comprehensive knowledge of HIV/AIDS is a combination of 5 indicators: knowledge of 2 modes of transmission and 3 misconceptions. The regional average of such knowledge now stands at 41% for men and 33% for women. Across the countries, enormous variations occur, ranging from 4% of young women with comprehensive knowledge of HIV prevention in Somalia to 65% in Namibia.
    • Reference: Preventing HIV infection among adolescents and young people, Eastern and Southern Africa, UNICEF, 2013
  • A 2013 study conducted in Ethiopia, South Sudan, and Zimbabwe suggest that adolescents view girls as more vulnerable to the effects of disasters than boys. In particular, about 50 percent of adolescents in Ethiopia, 85 percent in South Sudan, and 60 percent in Zimbabwe viewed sisters as more affected than brothers.
  • An IAWG global evaluation study from 2010 to 2012 of three humanitarian settings: Burkina Faso, Democratic Republic of Congo, and South Sudan, found most health facilities lacked even one provider who was trained in adolescent reproductive and sexual health.
    • Reference: Casey, S. E., Chynoweth, S. K., Cornier, N., Gallagher, M. C., & Wheeler, E. E. (2015). Progress and gaps in reproductive health services in three humanitarian settings: Mixed-methods case studies. Conflict and Health, 9(Suppl 1), s3. doi:10.1186/1752-1505-9-s1-s3

 

Asia

  • Afghanistan’s minimum age of marriage for girls is 15 or 16, below the internationally recommended standard of 18. These unions mainly happen in rural areas, especially along the borders with Pakistan. In Afghanistan, however, coerced child marriage persists. Although getting reliable data is difficult, the most recent surveys estimate some 46% of Afghani women are married by age 18, 15% of them before age 15. According to the Afghanistan Independent Human Rights Commission, between 60% and 80% of all marriages in Afghanistan are forced.
  • One in four Afghani women age 20-24 had their first child before age 18.
  • According to a study conducted by Benner et al. on reproductive health and quality of life of young Burmese refugees in Thailand, young Burmese refugees in Thailand had limited knowledge of reproductive health issues and showed clear interest in wanting RH education and services from health workers rather than parents or teachers. Marital status also played a role in knowledge of sexual health, as married youth were 6 times more likely to know more about reproductive health than unmarried youth.
    • Reference: Benner et al (2010) ‘Reproductive health and quality of life of young Burmese refugees in Thailand’, Conflict and Health, 4:5.

South America