Adolescent sexual and reproductive health in sub-Saharan Africa

Who is left behind

Bibliographic Data

ID21880641
AuthorsDessalegn Y Melesse (0000-0003-3917-5329, University of Manitoba, corresponding author), Martin Kavao Mutua (0000-0003-1643-9934, African Population and Health Research Center), Allysha Choudhury (0000-0002-6880-3403, United Nations Children's Fund), Yohannes Dibaba Wado (0000-0002-7200-6116, African Population and Health Research Center), Cheikh Mbacké Faye (0000-0002-4028-0575, African Population and Health Research Center), Sarah Neal (0000-0003-1812-7221, University of Southampton), Ties Boerma (0000-0002-8489-4499, University of Manitoba)
Year2020
Volume5
Issue1
Pagese002231
Publication date2020-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2019-002231
PMID32133182
OpenAlexW3002997900
LanguageEN
Citations received58
References cited33

Adolescent sexual and reproductive health (ASRH) continues to be a major public health challenge in sub-Saharan Africa where child marriage, adolescent childbearing, HIV transmission and low coverage of modern contraceptives are common in many countries. The evidence is still limited on inequalities in ASRH by gender, education, urban–rural residence and household wealth for many critical areas of sexual initiation, fertility, marriage, HIV, condom use and use of modern contraceptives for family planning. We conducted a review of published literature, a synthesis of national representative Demographic and Health Surveys data for 33 countries in sub-Saharan Africa, and analyses of recent trends of 10 countries with surveys in around 2004, 2010 and 2015. Our analysis demonstrates major inequalities and uneven progress in many key ASRH indicators within sub-Saharan Africa. Gender gaps are large with little evidence of change in gaps in age at sexual debut and first marriage, resulting in adolescent girls remaining particularly vulnerable to poor sexual health outcomes. There are also major and persistent inequalities in ASRH indicators by education, urban–rural residence and economic status of the household which need to be addressed to make progress towards the goal of equity as part of the sustainable development goals and universal health coverage. These persistent inequalities suggest the need for multisectoral approaches, which address the structural issues underlying poor ASRH, such as education, poverty, gender-based violence and lack of economic opportunity

Child marriage · Condom · Economic growth · Economics · Environmental health · Family planning · Geography · Population · Poverty · Public health · Reproductive health · Residence · Socioeconomic status · Sociology · Adolescent Sexual and Reproductive Health · Demography · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine