 John Bongaarts, Vice President, Policy Research Division, Population Council. Barney Cohen, Director, Committee on Population, National Research Council, National Academy of Sciences, 2101 Constitution Avenue, NW, Washington, DC 20418.
Levels and Trends in Reproductive Behavior
Ann K. Blanc, Principal Demographic Expert and Ann A. Way, Deputy Director for Operations, Macro International, Inc., 11785 Beltsville Drive, Calverton, MD 20705.This article offers an overview of sexual behavior and contraceptive knowledge and use among adolescent women across a large number of developing countries. The results demonstrate that almost universally in sub-Saharan Africa and in the majority of countries in other regions, the gap between age at first sexual intercourse and age at first marriage has increased across age cohorts. The predominant pattern is one in which both age at marriage and age at first intercourse have risen, but the increase in age at marriage is greater, resulting in a widening gap. In most countries in sub-Saharan Africa, current contraceptive use is higher among sexually active, unmarried teens than it is among married teens, whereas in Latin America and the Caribbean, current-use levels are higher among married teens. The results also show that adolescents are unlikely to use a contraceptive the first time they have sex and are more likely than older women to experience a contraceptive failure. (Studies in Family Planning 1998: 29[2]: 106–116) Susheela Singh, Director of Research, Alan Guttmacher Institute, 120 Wall Street, New York, NY 10005. This article discusses the current levels and recent trends in the rate of adolescent childbearing, the timing of the first birth, and births to unmarried women for 43 developing countries. Differences in rates of adolescent childbearing by residence and level of education are also examined. The analysis is based on nationally representative fertility surveys. Substantial declines in adolescent fertility have occurred in North Africa and Asia, but levels are still high in some countries. Declines are beginning to occur in sub-Saharan Africa, but current levels are still high in most countries of this region, and the proportion of births to unmarried adolescents is increasing in some countries. In Latin America, where the level of teenage childbearing is moderate, declines are less prevalent and some small increases have occurred. Higher education is associated with lower rates of adolescent childbearing, but other socioeconomic changes cancel or reduce this effect in several countries. (Studies in Family Planning 1998; 29[2]: 117–136)
The Changing Social ContextJohn C. Caldwell, Coordinator and Pat Caldwell, Centre Visitor, Health Transition Centre, Australian National University, Canberra, ACT 0200, Australia. At the time this article was written, Bruce K. Caldwell was Population Council Postdoctoral Fellow, ICDDR,B Extension Project (Rural), Dhaka, and Indrani Pieris was Coordinator, Joint ICDDR,B Extension Project (Rural) Australian National University Project. This article aims to show how the period now known as adolescence came into being and how it was shaped by international economic, institutional, and social influences. It considers premodern societies and argues that traditional culture has shaped contemporary adolescence even more than has global society. Explanations are offered for the enormous differences across the world in adolescent sexuality, reproduction, and marriage. The data are drawn mainly from research programs in Nigeria, Sri Lanka, India, and Bangladesh, and comparisons are made with other countries. (Studies in Family Planning 1998; 29[2]: 137–153)
Anastasia J. Gage, Senior Technical Advisor, Population Leadership Program, Western Consortium for Public Health. Mail should be addressed to her at USAID, G/PHN/POP/P&E, Room 3.06-046, Washington, DC 20523-3601. In light of the social consequences of early childbearing, unplanned pregnancy, and the transmission of AIDS, a great need exists to understand how adolescents make sexual and reproductive decisions. Drawing primarily on literature from sub-Saharan Africa, this article focuses on three behavioral outcomes: nonmarital sexual activity, contraceptive use, and condom use. It explores adolescents’ perceptions of the costs and benefits of engaging in these behaviors, their assessment of their susceptibility to the potential consequences of their actions, and the role of family, peer, and dyadic factors in shaping their reproductive decisions. The literature reveals that cultural values regarding sexuality and gender roles, the power dimensions of adolescents’ lives, and economic disadvantage exert powerful influences on the decisionmaking process. Decisions to engage in unprotected sex may also be based on insufficient knowledge and distorted judgments of the risks of becoming pregnant and acquiring sexually transmitted infections. Nondecisionmaking is found to be fairly common in some contexts. (Studies in Family Planning 1998; 29[2]: 154–166)
Barbara S. Mensch, Associate and Cynthia B. Lloyd, Senior Associate and Director of Social Science Research, Policy Research Division, Population Council. Although a growing proportion of young people is spending some time in school between puberty and marriage, little research on education in developing countries has been focused on adolescent issues. This article examines the school environment in Kenya and the ways it can help or hinder adolescents. Gender differences are considered with a view toward illuminating some factors that may present particular obstacles or opportunities for girls. Using both qualitative and quantitative data, 36 primary schools in rural areas in three districts of Kenya are studied. These schools are chosen to reflect the spectrum of school quality in the country. The focus in this study is on primary schools because the majority of adolescents in school attend primary school. In these schools, where considerable variation in performance and parental educational status is found, disorganization coexists with strict punishment, minimal comforts are lacking, learning materials are scarce, learning is by rote, and sex education is not provided. In the primary-school-leaving exam, girls’ performance is poorer than that of boys. Teachers’ attitudes and behavior reveal lower expectations for adolescent girls, traditional assumptions about gender roles, and a double standard about sexual activity. (Studies in Family Planning 1998; 29[2]: 167–184)
Sajeda Amin, Associate, Policy Research Division, Population Council, New York. Ian Diamond, Dean of Social Sciences, University of Southampton. Ruchira T. Naved, Senior Fellow, Population Council, Dhaka and Research Coordinator, Save-the-Children (USA). Margaret Newby, Research Student, University of Southampton. This article examines data from a study on garment-factory workers in Bangladesh to explore the implications of work for the early socialization of young women. For the first time, large numbers of young Bangladeshi women are being given an alternative to lives in which they move directly from childhood to adulthood through early marriage and childbearing. Employment creates a period of transition in contrast to the abrupt assumption of adult roles at very young ages that marriage and childbearing mandate. This longer transition creates a period of adolescence for young women working in the garment sector that is shown to have strong implications for the women’s long-term reproductive health. (Studies in Family Planning 1998; 29[2]: 185–200)
Consequences of Early Sexuality and ChildbearingMayra Buvinic, Chief, Social Development Division, Inter-American Development Bank, 1300 New York Avenue, NW, Washington, DC 20577. Findings from Chile, Barbados, Guatemala, and Mexico are reviewed in this article to shed light on the consequences of adolescent childbearing for mothers’ economic and social opportunities and the well-being of their first-born children. The studies include retrospective information and a comparison group of adult childbearers to account for the effects of background factors (poverty) and the timing of observations. The findings show that early childbearing is associated with negative economic rather than social effects, occurring for poor rather than for all mothers. Among the poor, adolescent childbearing is associated with lower monthly earnings for mothers and lower nutritional status of children. Also, among this group of women only, improvements in the child’s well-being are associated with mother’s education and her contribution to household income. These findings suggest that social policy that expands the educational and income-earning opportunities of poor women could help to contain the intergenerational poverty associated with early childbearing among the poor. (Studies in Family Planning 1998; 29[2]: 201–209)
Laurie Schwab Zabin, Professor, Department of Population Dynamics and Karungari Kiragu, Senior Program Officer, Center for Communication Programs, Johns Hopkins School of Hygiene and Public Health, 4503 Hygiene, 615 North Wolfe Street, Baltimore, MD 21205. This article reviews the literature on health consequences of adolescent sexual behavior and childbearing in sub–Saharan Africa, and the social and cultural context in which they occur. It suggests that, in addressing the most serious health sequelae, sexual intercourse that occurs in early marriage and premaritally must both be considered. Some limitations of the data are noted. Despite the excess risk to which adolescents are exposed, due both to custom and age-related vulnerability, differences between health effects among adult and adolescent women are often differences in degree. They are attributable to behavioral, social, and biological causes, exist in traditional and nontraditional settings, in union and out of union, and are exacerbated by declining ages at menarche, pressures of HIV/AIDS and STDs, and a dearth of appropriate services—especially for young people. Some current interventions are discussed, and the need for policy as well as medical intervention is stressed. (Studies in Family Planning 1998; 29[2]: 210–232)
Interventions for AdolescentsJane Hughes, Associate Director, Population Services, The Rockefeller Foundation, 420 Fifth Avenue, New York, NY 10018–2702. Ann P. McCauley, Public Health Analyst, International Center for Research on Women, formerly with the FOCUS on Young Adults Program. Demand is growing in developing countries for sexual and reproductive health programs for young people. However, little scientifically based evidence exists about which program approaches are most effective in shaping healthy behaviors. Careful evaluation and research must be increased, but meanwhile, planners need guidance as they expand programming. Research indicates that current programs often do not match the needs and health-seeking behaviors of young people. Behavioral theories and expert opinion agree that adolescents must be taught generic and health-specific skills necessary for adopting healthy behaviors. Constraints on financial and human resources, coupled with the great size of the youth population, highlight the need to find less costly ways to reach young people. These observations generate six programming principles to help planners and communities experiment with a wide variety of programming approaches. (Studies in Family Planning 1998; 29[2]: 233–245)
Frank F. Furstenberg, Jr., Zellerbach Family Professor of Sociology, University of Pennsylvania, 277 McNeil, 3718 Locust Walk, Philadelphia, PA 19104–6299. This article reflects on the process that leads to perceptions of teenage childbearing as a social problem and examines whether that process will occur in developing countries as it has in the United States. In postindustrial Western economies, family and adult control over young peoples’ sexual behavior has loosened, while marriage rates have declined. In the United States, nonmarital births to adolescents, particularly among poor minorities who have few opportunities and reasons to delay childbearing, have become a cause for public concern. However, the economic, educational, and nuptial changes that have occurred in other postindustrial countries have not necessarily led to fertility problems among teenagers, because of a greater willingness to acknowledge their sexual activity and to provide the resources to prevent their childbearing. Although developing nations may undergo changes that result in more schooling and greater autonomy for adolescents, whether nonmarital births will come to constitute a problem will depend on many different factors; the United States provides an example of the conditions they may wish to avoid. (Studies in Family Planning 1998: 29[2]: 246–253)
|
