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Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?

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...

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Autores principales: Melesse, Dessalegn Y, Mutua, Martin K, Choudhury, Allysha, Wado, Yohannes D, Faye, Cheikh M, Neal, Sarah, Boerma, Ties
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042602/
https://www.ncbi.nlm.nih.gov/pubmed/32133182
http://dx.doi.org/10.1136/bmjgh-2019-002231
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author Melesse, Dessalegn Y
Mutua, Martin K
Choudhury, Allysha
Wado, Yohannes D
Faye, Cheikh M
Neal, Sarah
Boerma, Ties
author_facet Melesse, Dessalegn Y
Mutua, Martin K
Choudhury, Allysha
Wado, Yohannes D
Faye, Cheikh M
Neal, Sarah
Boerma, Ties
author_sort Melesse, Dessalegn Y
collection PubMed
description 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.
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spelling pubmed-70426022020-03-04 Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? Melesse, Dessalegn Y Mutua, Martin K Choudhury, Allysha Wado, Yohannes D Faye, Cheikh M Neal, Sarah Boerma, Ties BMJ Glob Health Analysis 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. BMJ Publishing Group 2020-01-26 /pmc/articles/PMC7042602/ /pubmed/32133182 http://dx.doi.org/10.1136/bmjgh-2019-002231 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Analysis
Melesse, Dessalegn Y
Mutua, Martin K
Choudhury, Allysha
Wado, Yohannes D
Faye, Cheikh M
Neal, Sarah
Boerma, Ties
Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?
title Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?
title_full Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?
title_fullStr Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?
title_full_unstemmed Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?
title_short Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?
title_sort adolescent sexual and reproductive health in sub-saharan africa: who is left behind?
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042602/
https://www.ncbi.nlm.nih.gov/pubmed/32133182
http://dx.doi.org/10.1136/bmjgh-2019-002231
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