Many people consider “family planning” an adult topic.
While it is a topic that affects adults, it should not be an adults-only topic.
Adolescence is a period of major physical and psychological change, as well as great changes in social interactions and relationships. Young people need factual and age-appropriate information about reproductive health and their changing bodies and feelings, and there is international consensus that adolescents have the right to these services and information.1
With the world crossing a new threshold—seven billion inhabitants—the bottom of the population pyramid is also getting bigger. Nearly 35% of people are under age 20.2 Adolescents account for one in every five people globally.1 When you couple this population trend with the dropping age of menarche in many countries,3 there is clearly potential for even greater population growth. There is also a growing need for information and services to support people—particularly young people—to make informed choices about pregnancy and family size.
As public health professionals, health care providers, parents, and teachers, we have an obligation to provide this much-needed information to adolescents. We can help them develop into healthy adults by talking with children early, and often, about their reproductive health and lives. Our conversations will change as their understanding about their roles in society and their physiology change.
As adolescents pass through puberty, they need to understand the importance and value of delaying pregnancy by delaying sexual activity or if initiating, then using contraceptives. Some studies have shown that adolescents consider their parents a trusted source4 and want to be able to discuss concerns and feelings with them or other trusted adults. But, we also know that young people listen to peers who may, or may not, have correct information or know where to get help.
Health providers are another important source of information and guidance for adolescents. In many countries, however, health care providers have biases against offering contraceptives to adolescents. These providers may not feel comfortable speaking to young people for many reasons, including cultural taboos about discussions of sexual behavior between different age groups and across genders. These health providers may also feel they are not well-acquainted with the psychosocial context that adolescents are growing up in or they may not be accustomed to interacting with adolescents. Through training, supervision, and mentoring we can help providers gain the skills they need to be more comfortable and more competent in meeting adolescents’ needs.
In Rwanda and Senegal, IntraHealth has offered in-service training to help providers’ interact with and serve adolescents better. This work relied on the identification of a youth focal point at selected health facilities, building community support for adolescent reproductive health care, and training youth peer educators, who could serve as liaisons between providers, young people, and the community.
We have a chance to make a difference, but we all need to take responsibility—regardless of our role as parent, teacher, or health care worker—to help our adolescents grow up into strong, healthy adults. To do this, we have to talk to young people, early and often, and provide them with factually correct information and referrals to facilities. Once at a facility, we need health care providers who will talk easily and openly with adolescents and encourage them to make informed and safe choices about their reproductive lives.
1. World Health Organization. Child and Adolescent Health and Development. Accessed November 15, 2011.
2. U.S. Census Bureau. 2011 World Population by Age and Sex. Accessed November 15, 2011.
4. M. Weinman, Small E., Buzi R.S., Smith P. 2008. Risk factors, parental communication, self and peers’ beliefs as predictors of condom use among female adolescents attending family planning clinics. Child Adolesc Soc Work J 25:157-170.