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Situation Analysis of Reproductive Health of Adolescents and Youth in Pakistan

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Situation Analysis of Reproductive Health of Adolescents and Youth in Pakistan 1 Situation Analysis of Reproductive Health of Adolescents and Youth in Pakistan December 2019 i The Population Council confronts critical health and development issues—from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees. Population Council 3rd Floor, NTC Building (North), Sector F-5/1 Islamabad, Pakistan Tel: +92 51 920 5566 Fax: +92 51 282 1401 Email: [email protected] http://www.popcouncil.org ii Table of Contents ACKNOWLEDGEMENTS ............................................................................................................................. VII ACRONYMS ............................................................................................................................................... VIII EXECUTIVE SUMMARY ................................................................................................................................ IX CHAPTER- 1 INTRODUCTION AND METHODOLOGY .................................................................................... 1 Background .................................................................................................................................................... 1 Research Objectives and Questions............................................................................................................. 4 Study Methodology ........................................................................................................................................ 4 Literature Review ...................................................................................................................................... 4 Secondary Analysis ................................................................................................................................... 5 Qualitative Study ....................................................................................................................................... 5 Ethical Standards and Compliance .............................................................................................................. 7 Structure of the Report ................................................................................................................................. 7 CHAPTER- 2 A LITERATURE REVIEW .......................................................................................................... 8 Puberty ........................................................................................................................................................... 9 Marriage among Adolescents and Youth ..................................................................................................... 9 Fertility among Young People .................................................................................................................... 10 Health of Adolescent Mothers and Their Children .................................................................................... 10 Knowledge, Use, and Preferences about Family Planning ...................................................................... 11 Health Seeking Behavior ............................................................................................................................ 11 Knowledge of Sexual Reproductive Health ............................................................................................... 11 Gender-based Violence .............................................................................................................................. 12 CHAPTER- 3 ADOLESCENT AND YOUTH REPRODUCTIVE HEALTH SITUATION IN PAKISTAN ................... 13 Marriage ...................................................................................................................................................... 13 Fertility......................................................................................................................................................... 14 Family Planning .......................................................................................................................................... 15 Utilization of Maternal Health Services ..................................................................................................... 18 Antenatal Care ........................................................................................................................................ 18 Delivery Care .......................................................................................................................................... 19 Awareness of Rights ................................................................................................................................... 22 Gender-based Violence .............................................................................................................................. 23 Gaps in Available Data ............................................................................................................................... 24 CHAPTER- 4 TRANSITION FROM CHILDHOOD TO ADOLESENCE - EXPERIENCES AND ISSUES ................ 26 Prior Knowledge of and Information Channels for Puberty...................................................................... 26 Puberty-related Health Issues ................................................................................................................... 28 How Puberty Affects Adolescent Lives ...................................................................................................... 30 Menstrual Hygiene Management Issues .................................................................................................. 31 General Observations about Respondents with Disabilities .................................................................... 32 CHAPTER- 5 REPRODUCTIVE HEALTH ASPECTS – KNOWLEDGE AND PREFERENCES ............................ 34 Early Marriage ............................................................................................................................................. 34 Definition of Early Marriage ................................................................................................................... 34 Awareness of Issues Related to Early Marriage ................................................................................... 35 Information Channels about Early Marriage ......................................................................................... 37 Perspectives on Contraception .................................................................................................................. 38 iii Knowledge of Concept of Family Planning ........................................................................................... 38 Information Channels on Contraception ............................................................................................... 38 Perceived Importance of Contraception ............................................................................................... 39 Intention to Use Contraception in Future ............................................................................................. 40 Knowledge about Youth Rights.................................................................................................................. 40 General Human Rights ........................................................................................................................... 40 Rights of Youth ....................................................................................................................................... 41 Gender-specific Rights ........................................................................................................................... 42 Protection of Rights in Pakistan ............................................................................................................ 43 Cyberbullying and Harassment .................................................................................................................. 43 Forms of Cyberbullying .......................................................................................................................... 43 Perpetrators and Victims ....................................................................................................................... 44 Effect on Lives of Girls ........................................................................................................................... 44 Preferred Sources for Reproductive Health Information.......................................................................... 46 CHAPTER- 6 DISCUSSION AND RECOMMENDATIONS ............................................................................. 48 Discussion ................................................................................................................................................... 48 Recommendations ..................................................................................................................................... 51 Reach out to adolescents
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