What is ASRH?
Adolescents—defined by the United Nations (UN) as those between the ages of 10 and 19 years old—are protected under the Convention on the Rights of the Child. Yet, their vulnerabilities and needs often remain unaddressed, including their sexual and reproductive needs.
Adolescent sexual and reproductive health (ASRH) includes the sexuality and reproductive health processes, functions, and systems of adolescents. The World Health Organization (WHO) defines reproductive health as:
“a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.
Reproductive health implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. WHO defines sexuality health as:
“a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity”
Global Statistics in ASRH
- There are approximately 1.2 billion adolescents globally―making up 16% of the world’s population and 23% of the population in the least developed countries.1
- Nearly 1.2 million adolescents die each year, mainly to preventable causes, such as road injuries, complications of pregnancy/giving birth, or due to HIV/AIDS. Two-thirds of these deaths occurred in the least developed countries in Africa and Southeast Asia.2
- Despite an overall decline in mortality, the estimated number of global AIDS-related deaths among adolescents aged 10-19 years old has nearly tripled from 21,000 deaths in 2000 to 60,000 deaths in 2014.3
- More than 1 in 4 women (or 27%) of women in the least developed countries gave birth before they were 18. This represents an estimated 12 million women in the least developed countries that delivered babies during their adolescent years.4
- Complications during pregnancy and childbirth is the leading cause of death for 15-19 years old girls globally.5
- Adolescent mothers (ages 10 to 19 years) face higher risks of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years. Additionally, babies born to mothers under 20 years of age face higher risks of low birthweight, preterm delivery, and severe neonatal conditions.6
- Every year approximately 3.9 million girls aged 15-19 years undergo unsafe abortions.7
- Globally, about 1 in 6 adolescent girls (15-19 years old) are currently married or in a union. In the least developed countries, around 40% of women were married before 18, with 12% of women married before 15 years old.8
ASRH in Humanitarian Settings
- In 2016, more than 600 million young people were living in fragile and conflict-affected contexts.9
- Children under 18 years old accounted for 52% of the refugee population in 2017, up from 41% in 2009.10
- Estimates of direct conflict deaths suggest that more than 90% of all casualties occur among young adult males.11
- Among the list of 30 countries with the highest prevalence of child marriage in 2012, more than half were fragile or conflict-affected countries.12
- In humanitarian settings, adolescents face:
- Loss of family, social, education, and religious structures;
- High risk of child-marriage;
- High risk for sexual violence;
- Increased consensual or coerced sexual activity;
- High risk for forced recruitment to armed groups;
- Limited access to health services.
- Adolescent girls are an overlooked group within crisis-affected affected populations. Existing power differences in relations between men and women can be heightened during an emergency—placing adolescents girls at an increased risk of abuse, exploitation, pregnancy and sexually transmitted infections, and violence.
- Adolescent girls are also vulnerable to early and forced marriage. During conflict, families may turn to child marriage to cope with economic hardship and to protect girls from increased violence.
- Adolescent boys also face particular vulnerabilities during crises, including recruitment into armed forces and uptake of aggressive and risky behaviors, including alcohol and drug use.
- Unaccompanied boys are also affected by gender-based violence. Transactional or survival sex involving boys and young men is often minimized or unreported, increasing difficulties for boys and young men to access services.