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Economic, Social and Political Sciences

From measurement to action on adolescent reproductive health

Members of the Department of Social Statistics and Demography have made their research on young adolescent pregnancy and maternal health ‘count’ for teenagers around the world. They provided the first rigorous scientific evidence of the global extent of early adolescent pregnancy for girls aged 10-15, which has influenced a number of global initiatives.

Context

 

Young pregnant girl

Each year an estimated 16 million young women give birth between ages 15 and 19, and a further one million girls give birth before age 15, with 95% of these births taking place in low or middle income countries.

Births for younger adolescents  in these countries risk the lives of both the mother and child. Globally, neonatal deaths now make up 45% of all deaths in children under five.

Research challenge

Since 2010, Dr Sarah Neal and Professor Zoe Matthews have led pioneering research to identify health threats to girls and young women in low-income countries.

Further research found high levels  of childbearing amongst young adolescents (<16 years) in Sub-Saharan Africa. In Guinea, Mali, Mozambique, Niger and Sierra Leone more than ten per cent of girls become mothers before their 16th birthday.

Their research also showed early childbearing is highly concentrated amongst the poorest and rural girls, and in particular geographic “pockets”.

Influencing the adoption of a new UN Sustainable Development Goal (SDG) indicator

In 2014, Neal and Matthews’ research led to an invitation to the UN Expert Consultative Group on Adolescence, part of the UN Secretary General’s Global Strategy for Women and Children’s Health. The Group provided evidence to ensure the inclusion of adolescent health issues in the relaunch of the UN Global Strategy – timed to coincide with the ratification of the SDGs in 2015.

The Southampton research directly influenced the development and adoption of the SDG 3.7.2 indicator: the adolescent birth rate, which now specifically includes an indicator for births to 10-14 year olds.

Prior to being defined as an SDG indicator, an early  adolescent birth rate had not been adopted by any international monitoring system. The new measure provides indirect evidence of the abuse of human rights in adolescence, as fertility at that young age often indicates forced child marriage and sexual abuse.

As a result of countries implementing the new UN SDG, Southampton research is playing a vital role in driving international funding decisions and informing national policy and programmes designed to reduce adolescent births amongst the youngest and most vulnerable. 

Improving adolescent and maternal health through increased accountability and measurement

 

ESRC logo

Using a range of accountability mechanisms, the Southampton team has created online resources to ensure that accurate statistics are available and easily accessible to health workers, journalists, and health policymakers.

Their “Atlas of Birth”, developed in 2010, gives a global picture of maternal health, highlighting preventable maternal deaths as well as the high levels of higher-risk  births to adolescents.

A 2015 award from the University’s ESRC impact acceleration account enabled Neal and Matthews’ Atlas of Birth to be updated and made into a website with hundreds of thousands of visits per year.

A wider group led by Matthews, Dr Louise Hulton and others created MamaYe, a social accountability movement for six African countries. This has been running for over a decade and is now fully locally owned. One of its many benefits is an improvement in the district information system in Ghana, including dashboards and scoresheets now adapted to include a focus on under-16s.

By providing evidence on the extent of very early adolescent pregnancy and its impact, including the heightened risk of neonatal mortality, the body of research at Southampton has meant that adolescent sexual and reproductive health is now firmly on the international agenda.

Importantly, the research is a core component of the UN’s efforts to pass a declaration on adolescent wellbeing at the UN General Assembly in 2022 or 2023.

Related projects:

  • The Atlas of Birth is a clear, accessible guide to the global picture of maternal health, told with maps, graphics and stories from many countries
  • Evidence for Action (E4A) - MamaYe, a programme led by African experts in Kenya and Nigeria to improve the chances of maternal and newborn survival in sub-Saharan Africa

Key Publications

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