Draft first regional report on the implementation of the Montevideo Consensus on Population and Development

Chapter III
Economic Commission for Latin America and the Caribbean (ECLAC)
The <strong>first</strong> is that a tendency already visible in the censuses of the 2010 round spread and intensified
from 2013: adolescent fertility fell in most of the countries, and for the <strong>first</strong> time there are countries with
rates below the world average of some 43 per 1,000. 50 Three countries that stand out are Chile, Cuba and
Uruguay, where determined prevention strategies and the expansion and improvement of adolescent-friendly
spaces led to a large increase in access to contraception for adolescents as soon as they initiated sexual
activity (including emergency contraception 51 and effective modern methods such as implants) and access
to abortion. 52 This increase fully offset the stubborn trend towards earlier sexual initiation, and was thus
the key factor behind this historic development (which was stronger in Chile and Uruguay than in Cuba).
Besides these three countries, adolescent fertility fell in a number of others, such as Brazil, Colombia, Costa
Rica, El Salvador, Guyana, Haiti, Peru and the Plurinational State of Bolivia, in some cases sharply, although
it remains above the world average. Active policies to prevent adolescent pregnancy were implemented
in almost all these countries, leading to an increase in contraceptive protection that once again is the
key intermediate variable behind the reduction in adolescent fertility. Colombia is a very good example,
as table III.2 shows. Although sexual initiation and nuptial unions in adolescence (before the age of 20)
increased, adolescent motherhood fell because of the increase in contraceptive protection from sexual
initiation onward and because family planning needs and demand were met using modern methods. In
Peru, the reduction in adolescent motherhood was furthered by a rise in contraception and a reduction in
early unions, as sexual initiation in adolescence increased. In Costa Rica, there is no recent evidence on
intermediate variables, but according to the 2011 Multiple Indicator Cluster Survey (MICS), a substantial
proportion of girls had no access to contraception, and female adolescents were largely uninformed about
sexual matters. One public response to these shortcomings, which was also intended to implement priority
measure 11 of the Montevideo Consensus on Population and Development, was the implementation from
2013 of the Comprehensive Sex and Affectivity syllabus, part of the diversified education level of the third
general education cycle, which was reinforced with expanded and updated material in 2017.
The second is that fertility has fallen only marginally or even increased in a number of countries. Argentina,
Belize, the Dominican Republic, Guatemala, Mexico and Paraguay are in this position. They are very differently
placed from one another, as a number of these countries implemented active prevention policies in the
reference period, Mexico’s ENAPEA of 2015 being a particular case in point, suggesting that it is probably too
soon for these measures to have taken effect. The case of Argentina merits more in-depth research because its
indices of contraception and protected sexual initiation are high, and programmatic and operational advances
have been made with prevention, so that the small increase in the period is surprising and may perhaps be
associated with a hard core of adolescent fertility in a context of acute social inequality.
The third is that many countries do not have indicators on the recent evolution of adolescent fertility
(Bolivarian Republic of Venezuela, Honduras, Nicaragua and Panama) or the specialized sources needed
to estimate the intermediate variables for this fertility and the Montevideo Consensus on Population and
Development follow-up indicators associated with them, at least in recent periods. Ecuador is a special case,
as the official figures on the SDG site suggest a downward trend and levels of the order of 65 per 1,000 in 2009,
something that does not tally with other official sources, such as the 2010 census, which suggests a rate
of the order of 100 per 1,000 for the late 2000s. For part of the reference period, furthermore, the official
prevention policy neglected the contraception component, which is the key to reducing adolescent fertility,
as highlighted earlier. Because of this shortcoming, a number of countries do not appear in the tables of this
chapter and merit special support when it comes to indicators for following up the future implementation of
priority measures 11 to 15 of the Montevideo Consensus on Population and Development.
50
In the 2015-2020 quinquennium (see [online] https://esa.un.org/unpd/wpp/Download/Standard/Fertility).
51
For which no prescription has been required in Chile since 2015.
52
Legal in Cuba and Uruguay and decriminalized in Chile when carried out on three grounds since November 2017, so that it did not have any great effect in the
reference period.
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