I am a 20-year-old female and part of the largest generation of youth ever.
My generation is significant because of the specific health challenges that young people (ages 15 to 24) face—challenges that include health impacts from unsafe sex, coercion, violence, and tobacco, drug, or alcohol addiction. My generation has the highest unmet need for contraceptives and represents half of new HIV infections.
Although young people are vulnerable to many risks, we are also open to positive change. Life-long habits and attitudes are formed during childhood; therefore adolescence is an opportunity to influence beliefs and behaviors. If we are healthy, then we can be important contributors to achieving the Millennium Development Goals. If we are given opportunities, then we can improve human development and reduce poverty. Otherwise, the youth will represent a population of political instability and social unrest. If we act now by providing the right information and services, we can create positive change for the future. If we promote youth health issues and protect youth rights, then we can raise the youth to become educated, healthy, and productive adults.
In response to the growing importance of youth health, Youth Health and Rights Coalition held a discussion in June 2011 called “Why International Commitments Matter: The Importance and Implications for the Largest Generation Ever of Young People.” This discussion included panelists from International Women’s Health Coalition, PEPFAR, and a youth representative from Panama for the Global Fund to Fight AIDS, TB, and Malaria. One of the guest speakers used the example of the 1994 International Conference on Population and Development at Cairo to demonstrate the importance of international commitments. The 1994 conference at Cairo represents a significant change in population health priorities and perspective. The focus shifted away from contraceptives used to control population, and instead, the focus shifted to family planning as part of reproductive health and sexual health rights. At Cairo, population discussions expanded to include safe abortion, maternity care, emergency obstetric care, STI/HIV prevention, safe birthing practices, as well as education and economic opportunities. As a result of 1994 ICPD, global health initiatives adopted a human rights perspective, promoted human development, and applied gender mainstreaming.
As a rule, all taxis in Bamako are beaten up and about to fall apart. I am sitting in one of those when I ask the driver, Souleymane Togola, if he is setting aside money on a regular basis (a typically European or American question, by the way!) so that he will be able to replace his taxi one day in the foreseeable future. He explains that there is no way that he will be able to do so, since every cent he earns goes into the basic necessities for his family. His “family” being his wife, three children, and four students–close or distant relatives who have come to Bamako from their native villages to complete their secondary school education since the schools in their own villages do not offer the complete cycle of secondary education. Souleymane takes care of most needs of these students such as food, lodging, and transport, and sometimes clothes, school supplies, and pocket money. At present, there is very little reciprocity by the students’ own families. Souleymane’s wife transforms peanuts into a paste that is widely used in the Malian daily meal, which she sells in the neighborhood market, to supplement the family income. Souleymane hopes that in the future the students he supports will help him buy a new taxi, after they have finished school and hopefully found well-paying jobs.
On Dec. 16, 2010, the United States House of Representatives rejected that same bill.
Although Conor Williams of The Washington Post referred to it as “an easy vote”, the House blocked the proposed bill in a 241-166 vote. The bill would have required the U.S. Government to develop a strategy to reduce the practice of child marriage (with the ultimate goal of eliminating it entirely) and integrate prevention efforts into existing development programs. The Congressional Budget Office estimated that the legislation would cost approximately $67 million over five years to implement.
Despite the disappointing outcome, efforts to end child marriage have garnered broad bipartisan support from Democrats and Republicans alike. Senate Majority Leader Dick Durbin (D-Ill.) and Senator Olympia Snow (R-Maine) sponsored the bill in the Senate while Rep. Betty McCollum (D-Minn.) and Rep. Aaron Schock (R-Ill.) championed the legislation in the House of Representatives. This congressional commitment to protect the health and rights of millions of girls around the world remains strong, even after yesterday’s vote.
At the same time, there is strong global leadership in the fight to eliminate child marriage. The Elders—an independent group of global leaders brought together by Nelson Mandela who work together to address major humanitarian issues—continues to educate and engage national leaders, donors, and global institutions about the issue of child marriage. So far, The Elders have worked with CARE, Equality Now, the International Center for Research on Women (ICRW), International Women’s Health Coalition, NoVo Foundation, Population Council, Tostan, UNICEF, UNFPA, UN Foundation, Vital Voices, and The White Ribbon Alliance for Safe Motherhood, framing child marriage as a global development issue. This type of collaborative effort can have a real impact at the international, national, and local levels and hopefully will lead to the re-introduction and ratification of the International Protecting Girls by Preventing Child Marriage Act next year. Indeed, the future looks promising.
by Alexandra Hervish, policy analyst, International Programs
Image used via Wikimedia Commons
On Dec. 1, 2010, the United States Senate unanimously passed the International Protecting Girls by Preventing Child Marriage Act. The bill, introduced by Assistant Senate Majority Leader Dick Durbin (D-Ill.) and Senator Olympia Snow (R-Maine), would require the U.S. Government to develop an integrated strategy to reduce the practice of child marriage with the ultimate goal of eliminating it entirely. In addition to increasing the government’s role to stop child marriage, the U.S. Department of State would be required to report on child marriage in its annual human rights report and integrate prevention efforts into existing development programs. With broad bipartisan support, the legislation now moves forward to the House of Representatives.
Currently, there are 51 million girls ages 15 to 19 married worldwide and an estimated 100 million girls will be married before age 18 over the next decade. Although the practice is prohibited by a number of international conventions and is a human rights violation, it remains widespread in sub-Saharan Africa, South Asia, and parts of Latin America and the Caribbean and the Middle East. At the same time, child marriage undermines nearly every Millennium Development Goal. It often marks the end of schooling for girls, leads to early childbearing and health risks for the mother and child, and perpetuates the cycle of poverty. These lifelong consequences threaten the economic, health, and social well-being of girls and women, families, communities, and nations.
While the international community has recognized child marriage as a serious development problem, many gender and youth advocates have called for greater political will and commitment from decision and policymakers to end the practice. This bill is an important step and highlights the U.S. Government’s commitment to protect the rights and change the lives of millions of women and girls around the world.
A recent NPR story on the biological basis for the sometimes confrontational, erratic, and seemingly irrational behavior of adolescents reminded me of my own experiences in raising adolescents (and gratitude that this particular stage of life is now behind me).
As Garrison Keillor recently reminded us, to be a parent is to live a life of constant silent prayer — prayer that everything will turn out all right. We know that adolescents don’t always exercise the best judgment, and now, at least, we have a better sense of why this is the case.
The Teen Brain – A Work In Progress
The physical evidence gathered from Magnetic Resonance Imaging (MRI), according to Harvard researchers Frances Jensen and David Urion, shows that the adolescent brain is only about 80 percent as developed as an adult brain.
In adolescence, the brain’s frontal lobe, responsible for such important functions as reasoning, planning and judgment, is not as well-connected to the rest of the brain by myelin, or “white matter,” as it is in an older individual. Because of the immaturity of their brains, adolescents are less capable than adults of rational thought processes.
White matter grows substantially over the course of adolescence, providing insulation that increasingly enables nerve signals to flow freely from one part of the brain to another. When the frontal lobe is fully connected to the rest of the brain, around age 25, the brain is more capable of “connecting the dots,” processing complex notions — such as that actions have consequences.
Brain development from age 5 to 20. Source: Paul Thompson, UCLA School of Medicine
Death and Disability Rates Double During Adolescence
If parents did not already intuit this, the difficulties that adolescents have in controlling their emotions and behaviors lead to a doubling in rates of death and disability during adolescence as compared with rates among younger children.
According to Ronald Dahl, Staunton Professor of Psychiatry and Pediatrics at the University of Pittsburgh Medical Center, increased risk-taking, sensation-seeking, and reckless behavior lead adolescents to higher rates of traffic and other accidents, substance abuse, suicide, eating disorders, depression, violence, and risky sexual behaviors.
Although Dahl does not promote a mechanistic view of biology as destiny, he does note that the life trajectories established in youth can have a major impact on later life, and it is best to alter these trajectories in a positive direction while one can.
Youth Reproductive Health: A Politically Charged Issue
Adolescents who become unintentionally pregnant or become infected with HIV are certainly in for a life-altering experience, and usually not one that will be advantageous.
For at least 15 years, reproductive health advocates have called for “youth friendly services” to enable youth who are, or intend to become sexually active, to obtain the information and services they need to remain healthy.
The concept of reproductive health services for adolescents has been, and remains politically controversial. In 2004, ideologues charged that the Global Health Conference, an international gathering of health professionals held annually in Washington D.C., would be a platform that year to advocate for youth reproductive health services, instigating a last-minute withdrawal of federal funding for the conference from the U.S. Department of Health and Human Services, the Centers for Disease Control (CDC) and the U.S. Agency for International Development (USAID).
While the conference proceeded with funding from other donors, the action had a chilling effect on some federal grantees, who swept their websites clean of any potentially damaging information. U.S. programs for youth in developing countries supported under the President’s Emergency Plan for AIDS Relief, PEPFAR, were firmly grounded in the “ABCs” — Abstain, Be faithful, use Condoms, even as domestic research showed that abstinence-only programs had no long-term health benefits.
Meanwhile, in some African countries, one in five young women is HIV-positive and as many as one in two has been pregnant. In South Africa, 22 percent of young women attending antenatal care are both pregnant and HIV-positive. These astounding statistics have largely been unmoved by the infusion of PEPFAR and other funding for proscriptive youth reproductive health information and services. And politically shaped policies in the United States help maintain pregnancy, birth and abortion rates among adolescents that are the highest in the developed world.
An Evidence-Based Practice
How should societies respond to the knowledge that adolescents may not be capable of obeying our pleas to “just say no,” “abstain until marriage,” or “always use a condom”?
Adolescents are capable of understanding, if not fully controlling, their own immature thought processes. They need realistic, truly “youth-friendly” tools and resources to help them make better decisions and remain healthy and safe.
If, based on brain research, adults come to view adolescence less as a period of self-centered disobedience and more as a period of innate vulnerability, we will do a better job of providing youth with comprehensive, compassionate services and education. We will do whatever we can to help them navigate this vulnerable period without becoming pregnant or HIV-positive, or undergoing an unsafely performed abortion, and if such outcomes occur, we will aim to minimize the harmful life-altering consequences.
Our obligation is to protect as best we can, those who by virtue of their not-fully-realized intellectual capacity, are less able than we previously assumed to look out for themselves.
by Alexandra Hervish, policy analyst, International Programs
Recently, I participated in a PRB Discuss Online session (A Call to Action: Increasing Global Investments in Youth) with two of my esteemed colleagues, Jenny Truong from USAID and Brad Kerner from Save the Children. While the entire conversation was engaging and enthusiastic, one question was particularly important to me: “What strategies are needed to engage young people so that they are active participants of the ‘call’?”
When I think about this question, I immediately recall my days as a high school teacher. Although classroom observations by administrative personnel were routine, I found that the best insight about my teaching style came from my students. The feedback is often immediate, clear, and rarely requires a results framework (glazed eyes and blank stares are very powerful messages). Of course, I did not always agree with my students; but the fact that I listened to them and valued their opinions made our relationship much more productive.
From Washington, DC, hearing the diverse voices of young people from around the world is a bit more challenging—but not impossible. Below, I attempt to answer Mr. Awusabo-Asare’s question, offering some ideas for how we can incorporate young people’s views and voices into our daily work during the International Year of Youth:
Organize an exhibition that features the artistic work of young people from your local area. The exhibition can feature musical performances or visual art.
Host a brown bag or round table discussion with adults and young people to examine young people’s contributions to global issues and hear young people’s perspectives about development.
Create a web “information page” to promote the International Year of Youth and International Youth Day and to provide information about youth development issues (get some ideas from the International Year of Youth website).
Profile youth leaders. Provide an opportunity for young people to explain why they are a leader, an issue they are passionate about, and any success stories or challenges they have experienced (see UNICEF’s youth leadership profile form).
Sponsor a youth writing contest about a particular topic that is important to your organization’s mission. Encourage youth to create an article, play, short story, poem, or letter that focuses this theme (see the International Food Policy Research Institute’s youth writing contest here).
Call attention to a youth-led organization or initiative in a publication or on your website.
Organize a “digital storytelling” forum to encourage youth to tell their stories through the use of multimedia. Digital storytelling can include web-based stories, interactive stories, narrative hypertexts, audio clips, and short films (listen to a young person’s “Digital Diary” about AIDS in Jamaica here).
Visit a youth center or project that targets young people on your next trip to the field. Provide young people with an opportunity to discuss issues that are important to them and share these ideas with your co-workers, policymakers, and other practitioners.
Increase awareness about issues that are important to young people. Create resources for educators, policymakers, advocates, and students based on information that is collected from young people.
This list is hardly exhaustive. That being said, I encourage you to contribute your own creative ideas or share examples from your work. It is my hope that during the International Year of Youth and beyond August 12, 2011, we will find new ways to incorporate the energy and enthusiasm of youth into development initiatives.
On August 12, PRB launched the annual World Population Data Sheetand accompanying Population Bulletin in Washington, DC, highlighting country, regional, and global population, health, and environment data and patterns. This year’s data sheet places special emphasis on youth.
The share of world’s youth population is growing in Africa and shrinking in More Developed Countries (MDCs). In 1950, 9 percent of the world’s youth lived in Africa and 30 percent lived in MDCs (Europe, North America, Australia, New Zealand, and Japan). By 2050, that share will change to 29 percent in Africa and 11 percent in the MDCs. “The great bulk of today’s 1.2 billion youth—nearly 90 percent—are in developing countries,” said Carl Haub, PRB senior demographer and co-author of the data sheet. Eight in 10 of those youth live in Africa and Asia. “During the next few decades, these young people will most likely continue the current trend of moving from rural areas to cities in search of education and training opportunities, gainful employment, and adequate health care.” With the right investments in health, education, agricutlural develomment, and entrepreneurship, a large youth population can be an opportunity for development and change. However, these investments are not being made in many countries. The fundamental question facing many developing countries is whether the needs of their large youth populations will be met. The answer to this question will largely determine the development, stability, and future of developing countries.
The data sheet shows just how stark the contrasts are between rich and poor countries in terms of population growth, life expectancy, income, and other indicators. Stay tuned for a webcast on prb.org of the data sheet launch at the National Press Club over the next week.
We welcome your comments, input, questions on our findings and the implications of this on the world’s future.
Here are just a few stories on the data sheet launch from around the world:
A new report by Duke University, funded by the Foundation for Child Development, paints a dire portrait of U.S. children in 2010. Child poverty is expected to soar to 21 percent, higher than that of the severe recession during the 1980s. The current economic crisis is expected to wipe out any progress in child well-being made within the last 30 years.
The report’s Child Well-Being Index tracks several key child well-being indicators within seven domains: economic, health, behavioral, educational, community connectedness, social relationships and emotional well-being. All are expected to be negatively affected by the current recession.
The report warns against bad health outcomes due to higher rates of obesity, as parents substitute cheaper foods that are high in sugar content and low in nutritional value for higher-priced foods. Income is predicted to decline as parents lose jobs or become underemployed. Crime and victimization rates could increase as budget cuts will mandate less funding for programs aimed at curbing crime. Other budget cuts could reduce preschool and summer school programs for children.
In addition to rising poverty rates, obesity, and homelessness, the report warns against changes in family structure. Financial strain puts emotional stress on families, contributing to increases in divorce and single-parent families. Minority children, including children of immigrants, will inevitably be at a greater disadvantage than others.
You can read more about the 2009 CWI and its findings on the PRB website.
by Farzaneh (Nazy) Roudi, program director, Middle East and North Africa
Iran’s demographic momentum is in favor of those who aspire for social and political change. According to the 2006 Iranian census, one in three people in Iran is between the ages of 15 and 29. Furthermore, half the Iranian population of more than 70 million is under age 30, born around the 1979 Islamic revolution or after (see the age pyramid below). For them, the Islamic revolution is history and they want change now to address today’s needs. By their very nature, young people throughout the world aspire for a life different from and better than their parents, and in fact they are often the force behind changes in their societies.
Source: Statistical Center of Iran
The youth bulge is more evident in Iran than any other country in the world because Iran has experienced the fastest fertility decline in the last two decades or so, according to a recent United Nations report (see table A.14). According to the Iranian Ministry of Health and Medical Education, fertility declined by more than two-thirds, from 6.6 births per woman in the mid-1970s to about 2 births per woman in 2006. The most surprising and impressive decline occurred in rural areas. In one generation (a period of about 30 years), Iranian women living in rural areas moved from giving birth to 8 children to around 2 children, on average.
Iran’s Falling Fertility Rate by Area for Selected Years, 1977-2006
Births per woman
1977
1996
2000
2006
Urban
4.5
2.2
1.8
1.8
Rural
8.1
3.5
2.4
2.1
Total
6.6
2.8
2.0
1.9
Source: Iranian Ministry of Health and Medical Education.
The rapid decline in the total fertility rate is due to simultaneous reduction at all ages: delay in childbearing by young couples, increased spacing of births by married women, and cessation of births by older women. These changes coincided with the revival of the national family planning program, delivered free through a nationwide network of primary health care facilities. Today, nearly 80 percent of married women of reproductive age use family planning and 60 percent of married women use a modern method.
Iranian women have been an accelerating force of development in the country, as manifested in their fertility behavior and desire to improve their life—55 percent of students enrolled in colleges and universities in 2005 were female. Having achieved their reproductive rights, Iranian women are now at the forefront of movements in the country that demand more rights and equality for all its citizens.
Whether Iran will manage to reap the benefits of its demographic dividend (having a large working-age population relative to the younger and older population groups who depend on the working-age population) all depends on how well its economy is equipped to create jobs for its rapidly expanding and mostly educated labor force. The youth unemployment rate (15 to 24 years old) stands at 23 percent, twice that of the total labor force. Finding a job is even more challenging for young women. One in three young Iranian women in the labor force (defined as either working or looking for a job) are unemployed. Young Iranians have been leaving the country in large numbers to find jobs in faraway places as Canada and Australia. The cost to the country for losing its human capital is estimated to be $40 billion a year.
Unemployment and high costs of living, coupled with social and political restrictions, have made it increasingly difficult for young Iranians. The sudden uprising that erupted following the disputed presidential election of June 12 is a manifestation of all the underlying frustrations. Young people’s demands for more political and social freedom and economic security cannot be ignored, not only because they are living at the dawn of 21st century and their demands are legitimate, but also because of their sheer numbers.
by Charlotte Feldman-Jacobs,program director, Gender
Last week, I visited ground zero of hope and it wasn’t in Washington, London, or Geneva. It was 60 kilometers outside of Nairobi, in a small town called Kajiado.
With 15 journalists in a workshop funded by USAID and organized by PRB, I went to the AIC Girls’ Primary School and Rescue Center and although we were hot, dusty, and grumpy from the traffic jams and rough roads when we arrived, we left hopeful and inspired.
While we were there we heard from the headmaster, Nicholas Muniu, and a dedicated staff member named Catherine that change is happening: that girls named Emily and Beatrice were among the girls who had come to the school escaping from certain early marriage and female genital mutilation (FGM); that among the 706 girls now at the school, 217 were rescued from early marriage and FGM; that some were brought by uncles, fathers, and mothers who wanted something better for these daughters. Even more amazing, many came by themselves.
The school began in 1959 with 20 girls and now has more than 700, with a waiting list of girls who want to come. While some of the girls were only rescued after they had already been subjected to FGM or early marriages, the school is now rescuing many before this happens. While the school was formerly viewed with suspicion—and even met with spear-carrying husbands and fathers—the school is gaining respect quickly. The graduates of Kajiado graduate with top academic skills, according to headmaster Muniu. And more importantly, the thinking among chiefs in the region has changed dramatically. “Chiefs now accept that educating girls is more important than getting two cows for them in early marriages,” Muniu says.
It quickly becomes apparent that the school, which runs through grade 8, is more than a shelter for these girls, it’s a doorway to a brighter future. While customs and laws change slowly in this part of the world, these girls quickly grasp that they can be anything they want. They study hard, they live without many of the amenities expected in the West, they sometimes say goodbye forever to families who would force them to undergo old customs and harmful traditional practices. But they have dreams, these girls. When asked what they want to be, they answer doctors and lawyers and pilots. Though they may never have been on an airplane, I know that some day they will be. For this school has given them wings to fly.
