Taking action: achieving gender equality and empowering women

Guarantee sexual and reproductive health and rights
59
Table 4.2
Adolescent fertility
rates by region,
1990–2000
Live births in one year per
1,000 women ages 15–19
a. Few countries have
data for 2000.
Source: WISTAT 1999.
Region 1990 2000
Developed countries 19 16
East Asia and the Pacific 44 38
Europe and Central Asia 45 41
Latin America and the Caribbean 87 76
Middle East and North Africa a 60 25
South and West Asia 71 84
Sub-Saharan Africa 128 133
Figure 4.3
Maternal mortality is
much higher among
young women
Maternal mortality rate
per 100,000 live births
Source: Mathur, Greene,
and Malhotra 2003.
as obstructed labor and the fistula that may result, occur most commonly
among young women (UNFPA and EngenderHealth 2003; Jarret 1994; The
Lancet 2004).
Women who marry young have little negotiating power and are exposed
to greater risk of sexually transmitted infections, especially in the common
instance of having partners who are much older and more sexually experienced.
In Kenya and Zambia, for example, young married women are more
likely to be HIV-positive than their unmarried peers because they have sex
more often, use condoms less often, are unable to refuse sex, and have partners
who are more likely to be HIV-positive (Bruce and Clark 2003; Luke and Kurz
2002).
The costs of poor reproductive health
A recent report by the Alan Guttmacher Institute (AGI) and the United
Nations Population Fund (UNFPA) synthesizes current evidence on the costs
and benefits of sexual and reproductive healthcare (AGI/UNFPA 2004). The
health costs are expressed in disability-adjusted life years (DALYs). 5 According