INDICATOR 17 : ADOLESCENT BIRTH RATE
ADOLESCENT BIRTH RATEADOLESCENT BIRTH RATE | FP2020 THE WAY AHEAD 2016-2017 /en/measurement-section/adolescent-birth-rate-core-indicator-17
Adolescent birth rate
The number of births to adolescent females aged 15–19 occurring during a given reference period per 1,000 adolescent females
The 2017 Family Planning Summit brought together countries, donors, and civil society to shine a spotlight on young people and provide them the tools they need to thrive. Dozens of new and revitalized commitments at the Summit focused on delivering tailored, rights-based, voluntary family planning programs and services to adolescents and youth in FP2020 countries.
Core Indicator 17, the adolescent birth rate (ABR), is a measure of the rate at which adolescent females are bearing children, and is expressed as the number of births per 1,000 adolescents aged 15 to 19 years. This indicator was monitored as part of the ICPD Program of Action, the Millennium Development Goals, and now the Sustainable Development Goals; it is the only FP2020 indicator focused solely on adolescents. Age disaggregated data, including for the 15–19 age group, is available for several indicators in the estimate tables for this report.
Among the 49 FP2020 focus countries with sufficient recent data to produce estimates, the adolescent birth rate ranged widely: from 38 per 1,000 in Indonesia to 179 per 1,000 in Chad. In general, the highest rates are seen in Western Africa, a reflection of the high rates of child marriage and low levels of contraceptive use in that region. High adolescent birth rates may also be attributed to social stigma, provider bias, and policies that limit young people’s access to contraceptives. Over time, improvements in adolescents’ sexual and reproductive health—including comprehensive sexuality education, adolescent-friendly contraceptive information and services, and reduced rates of child marriage—should result in fewer pregnancies among adolescents. But because the adolescent birth rate relies on several years of an interviewed woman’s birth history, it may not change as rapidly as contraceptive behaviors.
Analysis of adolescent birth rates across 30 countries with sufficient datal suggests a downward trend, with 19 of the 30 countries showing a decline in the adolescent birth rate between the previous estimates and the current survey. In most of these countries, however, the decline was marginal, and only 8 countries exhibited a decline of 10 adolescent births per 1,000 or greater: Congo, Indonesia, Kenya, Malawi, Mali, Nepal, Niger, and Sierra Leone. With the exception of Congo, which is not an FP2020 commitment-making country, each of these countries made specific adolescent-focused commitments at the Summit and are among the many countries working to improve the health and wellbeing of adolescents. Of these countries, however, only Malawi and Sierra Leone have seen substantial increases in contraceptive use among the 15 to 19 year old age group.
Improving the sexual and reproductive health of adolescents is a priority across many countries, but the data above illustrate some of the challenges in tracking progress with current indicators. In part this is because the adolescent birth rate measures births rather than pregnancies. Birth rates can decline for several reasons, including a decline in the proportion of adolescents who are sexually active, an increase in the proportion of adolescents using contraception, or an increase in the proportion of adolescents terminating pregnancies through abortion. This suggests that relying solely on tracking adolescent birth rates is insufficient for informing country-specific interventions, policies, and resource allocations for adolescent sexual and reproductive health.16
We need additional data to inform effective policies and programs for adolescents, but there are important data gaps in data collection, reporting, and understanding that limit our ability to monitor progress.17 The Summit focused attention on these data gaps (refer here), and overcoming the challenges will require the collective efforts of country governments, donors, data collection agencies, health providers, and civil society organizations.
30 countries have had a survey reporting ABR since 2013 and have an earlier estimate of ABR from a comparable survey in an earlier year. PMA2020 surveys were not compared to one another due to the short duration of time between surveys.
Hindin, MJ, Tuncalp, O, Gerdts, C, Gipson JD, and L Say. Monitoring adolescent sexual and reproductive health. Bulletin of the World Health Organization 2016;94:159. doi: http://dx.doi.org/10.2471/ BLT.16.170688
Mind the Gap: A commentary on data gaps and opportunities for action in meeting the contraceptive needs of adolescents http://ec2-54-210-230-186.compute-1.amazonaws.com/wp-content/uploads/2017/07/FP2020_Adolescent_Data_Commentary_FINAL-fix.pdf