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Sexual and Reproductive Health and Rights MYMY BODYBODY ISIS MYMY BODY,BODY, MYMY LIFELIFE ISIS MYMY LIFELIFE Sexual and reproductive health and rights of young people in Asia and the Pacific Prepared for UNFPA Asia Pacific Regional Office by: Burnet Institute 85 Commercial Rd, Melbourne, Victoria, Australia +61 3 9282 2111 www.burnet.edu.au The material in this report has been commissioned by the United Nations Population Fund (UNFPA) Asia-Pacific Regional Office. UNFPA accepts no responsibility for errors. The views expressed in this publication are those of the author(s) and do not necessarily represent those of the United Nations or the United Nations Member States. The designations in this work do not imply an opinion on the legal status of any country or territory, or of its authorities, or the delimitation of frontiers. Permission to copy, disseminate or otherwise use information from this publication is granted so long as appropriate acknowledgement is given. Suggested citation: United Nations Population Fund. My Body is My Body, My Life is My Life: Sexual and reproductive health and rights of young people in Asia and the Pacific, UNFPA, Bangkok, 2021. © UNFPA Asia-Pacific Regional Office 2021 MY BODY IS MY BODY, MY LIFE IS MY LIFE Sexual and reproductive health and rights of young people in Asia and the Pacific CONTENTS Foreword vii Acknowledgements viii Abbreviations and acronyms ix Glossary x A snapshot of young people’s sexual and reproductive health in Asia and the Pacific xii OVERVIEW 1 Background 1 Approach and methods 2 Introduction to Asia and the Pacific 6 ADOLESCENT SEXUALITY AND SEXUAL BEHAVIOUR 11 CHILD MARRIAGE AND EARLY UNION 17 RIGHTS VERSUS PROTECTION: LEGAL AGE OF MARRIAGE, CONSENT TO SEX, AND CONSENT TO MEDICAL TREATMENT 27 UNDERSTANDING AND ADDRESSING ADOLESCENT PREGNANCY 35 MEETING THE SEXUAL AND REPRODUCTIVE HEALTH NEEDS OF YOUNG PEOPLE WITH DIVERSE SEXUAL ORIENTATION AND GENDER IDENTITY/EXPRESSION 55 SEXUAL AND REPRODUCTIVE HEALTH IN A DIGITAL AGE 65 COMPREHENSIVE SEXUALITY EDUCATION 65 UNIVERSAL HEALTH COVERAGE AND ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH 91 CONCLUSIONS 105 Appendix: Country-level estimates 107 References 115 LISTLIST OFOF BOXES,BOXES, FIGURESFIGURES ANDAND TABLESTABLES BOXES BOX 1. DEFINITIONS ...................................................................................................................................................................................................................1 BOX 2. SEARCH TERMS ............................................................................................................................................................................................................. 5 BOX 3. CHILD MARRIAGE AND EARLY UNION TYPOLOGIES..................................................................................................................................23 BOX 4. KEY STRATEGIES TO ADDRESS CHILD MARRIAGE AND ASSOCIATED HARMS .............................................................................25 BOX 5. IMPACTS OF HIGH LEGAL AGE OF CONSENT TO SEX .................................................................................................................................31 BOX 6. CRC GENERAL COMMENT NO.20 ON THE IMPLEMENTATION OF THE RIGHTS OF THE CHILD DURING ADOLECENCE, 2016 ........................................................................................................................................................33 BOX 7. KEY ACTIONS ...............................................................................................................................................................................................................33 BOX 8. KEY STRATEGIES TO PREVENT ADOLESCENT PREGNANCYAND POOR HEALTH OUTCOMES ..................................................53 BOX 9. KEY STRATEGIES TO ADDRESS SRH OF YOUNG PEOPLE WITH DIVERSE SOGI/E ......................................................................... 62 BOX 10. DEFINITION OF COMPREHENSIVE SEXUALITY EDUCATION .................................................................................................................. 78 BOX 11. SRH SERVICES FOR ADOLESCENTS .................................................................................................................................................................... 91 BOX 12. WHO GLOBAL STANDARDS FOR QUALITY SERVICES FOR ADOLESCENTS ..................................................................................... 94 BOX 13. KEY ACTIONS TO ADVANCE YOUNG PEOPLE’S SRH AND RIGHTS IN ASIA AND THE PACIFIC............................................. 106 FIGURES FIGURE 1. LOW- AND MIDDLE-INCOME COUNTRIES IN ASIA AND THE PACIFIC, BY SUB-REGION ...................................................... 3 FIGURE 2. TOTAL NUMBER AND PROPORTION OF POPULATION AGED 10-24 YEARS.................................................................................6 FIGURE 3. ADOLESCENT AND YOUTH POPULATION BY SEX, URBANISATION, AND BY POVERTY LEVELS ........................................8 FIGURE 4. EDUCATION AND EMPLOYMENT...................................................................................................................................................................9 FIGURE 5. PROPORTION OF YOUNG PEOPLE WHO HAVE EVER HAD SEX AND HAD SEX BY AGE 15 AND 18 ............................................................................................................................................................................ 11 FIGURE 6. PROPORTION OF NEVER-MARRIED 15-24 YEAR OLDS WHO HAVE EVER HAD SEX .............................................................. 12 FIGURE 7. CONDOM USE AT LAST SEX AMONG 15-24 YEAR OLDS WHO REPORT TWO OR MORE PARTNERS IN THE LAST 12 MONTHS .............................................................................................................................................13 FIGURE 8. INTIMATE PARTNER AND SEXUAL VIOLENCE ........................................................................................................................................ 14 FIGURE 9. PROPORTION OF ADOLESCENTS AGED 15-19 YEARS WHO ARE CURRENTLY MARRIED OR IN UNION ........................ 17 FIGURE 10. PROPORTION OF WOMEN AGED 20-24 YEARS MARRIED/IN UNION BY AGE 15 AND 18 .................................................. 19 FIGURE 11. PROPORTION OF WOMEN AGED 20-24 YEARS MARRIED/IN UNION BY AGE 15 AND 18, 2000 to 2018 .................... 19 FIGURE 12. MATERNAL MORTALITY RATE AND TOTAL NUMBER OF MATERNAL DEATHS AMONG GIRLS AGED 15-19 YEARS (2017) ..................................................................................................................................................................35 FIGURE 13. PROPORTION OF WOMEN AGED 20-24 WHO GAVE BIRTH AS CHILDREN (BY AGE 15 AND 18) ....................................37 FIGURE 14. ADOLESCENT FERTILITY RATES 2000-2020 (MODELLED ESTIMATES) ..................................................................................... 38 FIGURE 15. TRENDS IN ADOLESCENT FERTILITY RATE BY COUNTRY, 2000-2020 (MODELLED ESTIMATES) .................................. 38 FIGURE 16. PROPORTION OF BIRTHS TO 15-19-YEAR-OLD GIRLS THAT WERE UNINTENDED .................................................................. 39 FIGURE 17. TOTAL NUMBER OF SAFE AND UNSAFE ABORTIONS IN 2014 AMONG WOMEN AGED 15-49 YEARS ........................40 FIGURE 18. ABORTION LEGISLATION ................................................................................................................................................................................. 41 FIGURE 19. PREVALENCE OF MODERN CONTRACEPTIVE USE AMONG MARRIED YOUNG WOMEN, AND TOTAL NUMBER OF MODERN CONTRACEPTIVE USERS ........................................................................................................ 43 FIGURE 20. TOTAL NUMBER AND PROPORTION OF MARRIED WOMEN 15-24 YEARS CURRENTLY USING A MODERN METHOD OF CONTRACEPTION .......................................................................................................................................... 43 FIGURE 21. TOTAL NUMBER AND PROPORTION OF 15-24-YEAR-OLD WOMEN WHOSE DEMAND FOR FAMILY PLANNING IS NOT SATISFIED BY MODERN METHODS ...........................................................................................44 FIGURE 22. TOTAL DEMAND FOR FAMILY PLANNING AMONG 15-24-YEAR OLD WOMEN, AND PROPORTION AND TOTAL NUMBER WHOSE DEMAND IS MET AND UNMET BY MODERN METHODS ...................................................44 FIGURE 23. PROPORTION OF MARRIED WOMEN AGED 15-24 WHOSE DEMAND FOR FAMILY PLANNING IS SATISFIED BY MODERN METHODS BY AGE GROUP............................................................................................................................ 45 FIGURE 24. CONTRACEPTIVE USE AMONG MARRIED VERSUS SEXUALLY ACTIVE UNMARRIED WOMEN ....................................... 45 FIGURE 25. PERCENTAGE OF GIRLS AGED 15-19 YEARS WHO HAVE COMMENCED CHILDBEARING, BY WEALTH, EDUCATION AND RESIDENCE, SELECTED COUNTRIES (%) .................................................................................. 49 FIGURE 26. PROPORTION OF ADOLESCENT PREGNANCIES AMONG EVER-MARRIED / IN UNION WOMEN AGED 20-29 THAT WERE CONCEIVED PRIOR TO MARRIAGE / UNION (%)............................................................................ 49 FIGURE 27. PREMARITAL ADOLESCENT CONCEPTIONS AMONG 20-29-YEAR-OLD WOMEN BY RESIDENCE AND WEALTH STATUS ............................................................................................................................................................
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