205592 Adolescent Girls: The Missing Link in Child Survival and Maternal Health Programs

Wednesday, November 11, 2009: 9:24 AM

Bonnie Shepard, MEd, MPA , Social Sectors Development Strategies, Inc., Brookline, MA
Failure to promote and protect the health, nutrition and development of adolescent girls contributes to high-risk adolescent pregnancies and HIV infection, and thus to high maternal and child morbidity and mortality. This paper presents the evidence to argue that greater investment in prevention of adolescent pregnancies and improved access to health and social services for adolescent mothers would significantly reduce maternal and child morbidity and mortality in developing countries. The sources for the paper include a literature review conducted for UNICEF on key factors in the increased risk of mortality and morbidity for adolescent mothers and their infants, and findings from eight child survival case studies in three world regions conducted for Plan International. In addition, five interviews with child survival and reproductive health specialists identify barriers related to vertical funding streams to integration of adolescent health interventions in maternal and child health programs, and suggest strategies to overcome these barriers.

Analysis of the service models of current child survival program models reveals that two major opportunities to prevent maternal, infant and child mortality are being missed when health-related millennium development goal (MDG) strategies fail to focus on adolescent girls' health and development. First, programs need to classify and treat adolescent pregnancies as high risk for both mother and child, and take actions to ensure proper nutrition and health care during pregnancy and access to obstetric services. Second, programs need to prevent adolescent high-risk unwanted pregnancies and HIV infection through advocacy and communications to delay early marriage and through attention to socio-cultural and financial barriers to access to contraceptive education and services. Finally, increasing girls' access to education post-puberty should be a central prevention strategy; continued schooling delays marriage and first births, and helps make girls less vulnerable to HIV and STDs.

Learning Objectives:
• Identify the linkages between adolescent pregnancy and maternal and infant mortality & morbidity • Analyze the barriers to linkages between programs that promote child and maternal health and those focusing on adolescent girls’ health, including initiatives to reduce early marriage and adolescent pregnancy.

Keywords: Adolescents, International, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a program manager, researcher, and consultant working on adolescent girls' health with a focus on reproductive and sexual health for more than 25 years, with several peer-reviewed publications on this and related topics. Within the last two years, I conducted research for UNICEF and Plan International that is directly related to the topic of the presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.