Motherhood in Childhood

In India, Pathfinder International implemented
a government programme, Prachar
(“Promote”) to change behaviours with the aim
of delaying marriage and promoting healthy
timing and spacing of pregnancies among
adolescents and young couples in Bihar. This
Indian state has the highest prevalence of child
marriage (63 per cent) and the highest share (25
per cent) of girls between the ages of 15 and
19 who have begun childbearing (Pathfinder
International, 2011).
The Prachar programme included life-stagespecific
training in sexual and reproductive
health to unmarried girls between the ages of
12 and 19 and to boys between 15 and 19.
Women change-agents conducted home visits
to young married women, and men changeagents
conducted home visits to boys. Parents
and mothers-in-law were engaged through
community meetings, and mothers-in-law also
participated in the home visits. Young couples
were invited to participate in “newlywed welcome
ceremonies,” which offered information,
education and entertainment to improve knowledge
about sexual and reproductive health, build
life skills and promote couples’ communication
and joint decision-making.
At the conclusion of the programme’s first
phase, young married women were nearly four
times more likely to use contraception as young
married women not participating in the programme.
Also, participants were 44 per cent
less likely to be married and 39 per cent less
likely to have had a child than girls outside
the programme area.
The Ishraq (“Enlightenment”) programme
in Egypt began in 2001 with the aim of transforming
girls’ lives by changing gender norms
and community perceptions about girls’ roles in
society, while bringing them safely and confidently
into the public sphere. The programme
established girl-friendly spaces in communities
to enable girls to meet, learn and play,
and combined literacy classes, life-skills training
and sports (Brady et al., 2007). While an
evaluation of the programme did not address
adolescent pregnancy, it did address a number
of factors associated with child marriage and
early pregnancy. Specifically, literacy improved
(92 per cent of participants who took the government
literacy exam passed) as did school
enrolment (nearly 70 per cent of programme
participants entered or re-entered school).
After the programme, participants expressed
a desire to marry later. Additionally, the
programme was associated with increased
self-confidence: 65 per cent felt “strong and
able to face any problem.”
Consistent long-term, multi-level sexual and
reproductive health programming can also contribute
to prevention of adolescent pregnancy.
An example of one developed country that has
achieved very low levels of adolescent pregnancy
and abortion is the Netherlands, which has
a pragmatic and comprehensive approach to
family planning, especially for young people. It
has resulted in one of the lowest abortion rates
worldwide (UNFPA, 2013d). Since 1971, family
planning has been included in the national
public health insurance system, providing free
contraceptives. Sexuality education is universal
and comprehensive, and girl’s empowerment is
among the highest worldwide. Sexually active
young people display some of the highest rates
of contraceptive use of any youth population,
and as a consequence, the country’s abortion
rate is one of the lowest in the world (Ketting
and Visser, 1994; Sedgh et al., 2007).
THE STATE OF WORLD POPULATION 2013
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