This brief provides recommended guidelines for adolescent SRHR initiatives in the following domains: comprehensive sexuality education, contraception counselling, maternal care, abortion care, STIs, HIV, violence against women and girls (VAWG), and harmful traditional practices. It shows that there must be more attention allocated to adolescents, and girls within these areas, through relevant and effective policy, health systems, and social norm change.
Adolescents are a key population in sexual and reproductive health and rights (SRHR) services. Adolescent girls, specifically, face additional barriers within SRHR compared to adult women. This includes less access to safe abortion services, increased susceptibility to child marriage, greater health consequences from STIs, and the belief that SRHR educations among adolescents will increase unsafe sexual behaviour. Adolescents need adequate and specialised SRHR services to support their development and health.
Programmes should build the self-esteem, life skills, and social networks of adolescent girls to help promote their safety and sexual and reproductive health. There needs to be a multi-sectoral response and cultural shift to ensure that the norms around SRHR for adolescents is not a deterrent for healthcare access. What’s more, there are empirically supported initiatives such as prevention of gender-based violence, prevention of harmful traditional practice, and contraception promotion programmes that have yet to be implemented on large scales in key areas.
Parents (and other family members) have an important role in delivering interventions, such as preparing girls and boys for puberty and building equitable gender norms… Almost all parents want their sons and daughters to grow and develop in good health, and contribute to this meaningfully. However, in many places, they feel unprepared and unable to address the sensitive matters around puberty, sexuality and reproduction.
These programmes should be facilitated by trained teachers to prevent early pregnancy and poor sexual and reproductive health outcomes, and to alleviate stressors during puberty, such as fear of menstruation. In particular, adolescents need further education about STIs and HIV protection.
Many SRHR initiatives that do exist are not adolescent-friendly or accessible for this population. They must be updated to address the specific experiences and challenges of adolescents.
Effective policies need to be in place to prohibit child marriage, to make contraceptives available and affordable and to provide options for safe abortions and post-abortion care, specifically for adolescents. Policies cannot exist in isolation, however, and need other stakeholders to drive a cultural shift away from the shame and stigma associated with adolescents accessing SRHR services.
The HPV vaccine should be available for all girls ages 9-13, and psychological services must be made available for women and girls experiencing violence and harmful traditional practices.