Sexual and Reproductive Health in Early and Later Adolescence
Total Page:16
File Type:pdf, Size:1020Kb
DHS COMPARATIVE REPORTS 45 DHS COMPARATIVE SEXUAL AND REPRODUCTIVE HEALTH IN EARLY AND LATER ADOLESCENCE: DHS DATA ON YOUTH AGE 10-19 SEXUAL AND REPRODUCTIVE HEALTH IN EARLY AND LATER ADOLESCENCE AND LATER IN EARLY SEXUAL AND REPRODUCTIVE HEALTH DHS COMPARATIVE REPORTS 45 AUGUST 2017 This publication was produced for review by the United States Agency for International Development (USAID). The report was prepared by Kerry L.D. MacQuarrie, Lindsay Mallick, and Courtney Allen. DHS Comparative Reports No. 45 Sexual and Reproductive Health in Early and Later Adolescence: DHS Data on Youth Age 10-19 Kerry L.D. MacQuarrie1 Lindsay Mallick1 Courtney Allen2 ICF Rockville, Maryland, USA August 2017 1 The DHS Program, Avenir Health 2 The DHS Program, ICF Corresponding author: Kerry L.D. MacQuarrie, The DHS Program, ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; phone: +1 301-572-0282; fax: +1 301-407-6501; email: [email protected] Acknowledgments: The authors wish to express their gratitude to Thomas Pullum, ICF, for developing a Stata program to produce early adolescent fertility rates, an invaluable contribution to this study. We also extend our appreciation to Jessica Williamson, Avenir Health, for a thoughtful review of an early draft and Erica Nybro, ICF, for recommendations on data visualizations. Their suggestions resulted in numerous improvements. We gratefully acknowledge the assistance of Tom Fish, ICF, who prepared maps for several indicators in the study. The report benefited from the able editing of Diane Stoy and Chris Gramer’s skills with graphics. Thank you. Editor: Diane Stoy Document Production: Chris Gramer This study was carried out with support provided by the United States Agency for International Development (USAID) through The DHS Program (#AID-OAA-C-13-00095). The views expressed are those of the authors and do not necessarily reflect the views of USAID or the United States Government. The DHS Program assists countries worldwide in the collection and use of data to monitor and evaluate population, health, and nutrition programs. For additional information about The DHS Program, contact The DHS Program, ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; phone: 301-407-6500; fax: 301-407-6501; email: [email protected]; Internet: www.dhsprogram.com. Recommended citation: MacQuarrie, Kerry L.D., Lindsay Mallick, and Courtney Allen. 2017. Sexual and Reproductive Health in Early and Later Adolescence: DHS Data on Youth Age 10-19. DHS Comparative Reports No. 45. Rockville, Maryland, USA: ICF. Contents Tables .................................................................................................................................................................... v Figures .................................................................................................................................................................. v Preface ................................................................................................................................................................ vii Abstract ................................................................................................................................................................ ix 1. Introduction ............................................................................................................................................. 1 1.1. Background ................................................................................................................................ 1 1.2. Methods and Data ...................................................................................................................... 1 2. Adolescents and Marriage ....................................................................................................................... 5 2.1. Median Age at First Marriage ................................................................................................... 5 2.2. Age Distribution of First Marriage ............................................................................................ 8 3. Adolescents and Sexual Debut .............................................................................................................. 17 3.1. Median Age at First Sex .......................................................................................................... 17 3.2. Age Distribution of Sexual Debut ........................................................................................... 21 4. Intersections between Marriage and Sex ............................................................................................... 29 4.1. Premarital Sex ......................................................................................................................... 29 4.2. Current Marital and Sexual Activity Status ............................................................................. 32 5. Contraception ........................................................................................................................................ 35 5.1. Contraceptive Use During Adolescence .................................................................................. 35 6. Fertility .................................................................................................................................................. 39 6.1. Adolescent Fertility ................................................................................................................. 39 6.2. The Initiation of Adolescent Fertility ...................................................................................... 43 6.3. Adolescent Fertility Rates and the Total Fertility Rate ........................................................... 45 7. Maternal Health ..................................................................................................................................... 47 7.1. Adolescent Birth ...................................................................................................................... 48 7.2. Antenatal Care ......................................................................................................................... 51 7.3. Delivery Care ........................................................................................................................... 57 7.4. Low Birth Weight .................................................................................................................... 60 7.5. Postnatal Care .......................................................................................................................... 60 8. Violence ................................................................................................................................................ 63 8.1. Physical Violence .................................................................................................................... 64 8.2. Sexual Violence ....................................................................................................................... 69 9. Discussion and Conclusions .................................................................................................................. 75 References ........................................................................................................................................................... 77 Appendix 1. Calculation of Adolescent Fertility Rates ...................................................................................... 81 Appendix 2. School Attendance ......................................................................................................................... 85 Appendix 3. Household Wealth Quintiles .......................................................................................................... 87 Appendix 4. Rural Residence ............................................................................................................................. 89 Appendix 5. Female Headed Households ........................................................................................................... 91 Appendix 6. Adolescent Fertility Curves ............................................................................................................ 93 iii Tables Table 1. Adolescent Data and Survey Attributes............................................................................................ 4 Table 2. Maternal health indicators to be included in the adolescent report ................................................ 47 Table A3.1. Percent of women and men age 10-19 among the poorest and richest wealth quintile .................. 87 Figures Fig 1. Median age at first marriage among women age 20-24 ................................................................... 6 Fig 2. Median age at first marriage among men and women age 25-29 ..................................................... 7 Fig 3. Probability of marriage in West Africa ............................................................................................ 9 Fig 4. Probability of marriage in East Africa ............................................................................................ 10 Fig 5. Probability of marriage in Southern and Middle Africa ................................................................. 11 Fig 6. Probability of marriage in North Africa, West and Central Asia ................................................... 12 Fig 7. Probability of marriage