Reproductive Health of Adolescent Girls: Perspectives from WDR07
Emmanuel Jimenez
December 1, 2009
www.worldbank.org/wdr2007
Motivation
Investing in in the human capital of young people (12-24 years) is key to development: A higher base on which to build human
capital to grow and reduce poverty
3
But new challenges for youth
HIV prevalence rate (%) in young (15-24) pregnant women
0
10
20
30
40
50
Source: UNAIDS
Motivation
Investing in in the human capital of young people (12-24 years) is key to development: A higher base on which to build human
capital to grow and reduce poverty A large youth cohort is a potential
demographic dividend
Structure of the WDR
5 Transitions 3 Policy Lenses
Human capital during 5 youth transitions key for poverty reduction and growth
12
100 % of Cohort
Age24
Learning in school after primary-age Working
Forming families
Participating in civic lifeTaking health risks
3 types of questions asked of each transition: a ‘youth lens’ on policy
Policies affecting human capital formation during Youth transitions:
• Economy wide policies and institutions:
• macro stability,• investment climate, • governance,• labor market regulations
• Education and Training• Health services • Welfare & family services • Infrastructure
Youth ‘Lenses’
“Youth friendly”policies
3 types of questions asked of each transition: a ‘youth lens’ on policy
Opportunities
Capability Second-chances
Policies affecting human capital formation during Youth transitions:
-- Economy widepolicies and insts: macro stability,invest. climate, governance, labor market regulations-- Education-- Training-- Health services -- Welfare & familyservices -- Infrastructure
Youth ‘Lenses’
“Youth friendly”policies
9
Opportunities: a good education
Percent of young women, 15-24, who can read a simple sentence or know condoms can prevent HIV/AIDS after six years of primary school
Inadequate preparation for adolescence improve quality of basic education
Relevance of education for jobs curriculum reform, flexibility in school systems
0
10
20
30
40
50
60
70
80
90
100
Ghana Zambia Ghana Zambia
Literacy Condom Knowledge
10
Opportunities: health services
alternatives to early marriage and childbearing: schooling and work
proper nutrition access to health services:
reproductive health technology and servicesantenatal and obstetric care child health services
involving young men in SRH
Applying the framework: Opportunity Opportunity: Countries HAVE invested
in access to human capital; lens focus on education quality and relevance to labor market
Capability Second-chances
3 types of questions asked of each transition: a ‘youth lens’ on policy
Opportunities Capability Second-chances
Policies affecting human capital formation during Youth transitions:
-- Economy widepolicies and insts: macro stability,invest. climate, governance, labor market regulations-- Education-- Training-- Health services -- Welfare & familyservices -- Infrastructure
Youth ‘Lenses’
“Youth friendly”policies
Capable decision-making: % of youth who think they have the most influence on human capital decisions
Capabilities: information
Half of 2,000 Kenyan adolescents chosen from KLPS randomly selected for VET voucher
Half of these receive information intervention targeted to females: -- avg returns from
KLPS -- encouraged to attend
male-dominated trades
Initial results: Large effect on
demand for male trades
Will probably affect earnings since avg earnings on tailoring and computers which some girls enter are high.
14
Source: DHS
Source: DHS
Relieving the information constraint
…Incentives also matter. Positive ones, like
conditional cash transfers: Mexico’s Oportunidades:
• .2 more years of schooling at 13-15• reduced child morbidity and mortality
Bangladesh’s Female Secondary Stipend Program
Cambodia’s secondary scholarship program for girls
involve youth in program design esp those to change attitudes
…Or negative ones like taxes
Impact of a one percent price increase
-2
-1.5
-1
-0.5
0
Perc
en
t ch
an
ge
smoking smoking alcohol binge marijuana use drinking use
China U.S. High school students
Outline Motivation Structure/Framework of the Report Applying Framework: Examples
Opportunity: Capability: Policy targets Govts and now
Parents; lens improve the capacity of youth to decide among opportunities
Second-chances:
3 types of questions asked of each transition: a ‘youth lens’ on policy
Opportunities CapabilitySecond-Chances
Policies affecting human capital formation during Youth transitions:
-- Economy widepolicies and insts: macro stability,invest. climate, governance, labor market regulations-- Education-- Training-- Health services -- Welfare & familyservices -- Infrastructure
Youth ‘Lenses’
“Youth friendly”policies
Second-chances: Recovering from poor outcomes
High costs of not giving young people another chance to recover:
Effects are long-lasting Later recovery as adults is more costly May inhibit investment by others (e.g., high
HIV/AIDS prevalence leads to lower investment)
Examples:
Examples of second-chance programs for RHA
Training for dropouts to re-enter mainstream educ
Child-care services in schools for students Family planning and maternal services for
youth
Policy Framework
Opportunity Capability Second-chances: Prevention; lens
Help young people recover from poor outcomes
Moving forward in Countries
Coordination: youth outcomes require improved multi-sector efforts
Voice: the constituency of youth is weak (which is why for this Report, we had extensive consultation)
Evaluation: many youth-specific initiatives are still new; impact must be studied
Providing school uniforms not only increased enrollment in Kenya – it lowered teenage pregnancy