Reproductive Health of Adolescent Girls: Perspectives from WDR07

1. Reproductive Health of Adolescent Girls: Perspectives from WDR07 Emmanuel Jimenez December 1, 2009 www.worldbank.org/wdr2007

2. Motivation • Investing in in the human capital of young people (12-24 years) is key to development: • A higher base on which to build human capital to grow and reduce poverty

3. But new challenges for youth HIV prevalence rate (%) in young (15-24) pregnant women Source: UNAIDS

4. Motivation • Investing in in the human capital of young people (12-24 years) is key to development: • A higher base on which to build human capital to grow and reduce poverty • A large youth cohort is a potential demographic dividend

5. Structure of the WDR • 5 Transitions • 3 Policy Lenses

6. Human capital during 5 youth transitions key for poverty reduction and growth 100 % ofCohort Working Learning in school afterprimary-age Forming families Takinghealth risks Participating in civic life Age 12 24

7. 3 types of questions asked of each transition: a ‘youth lens’ on policy Youth ‘Lenses’ • Policies affecting human capital formation during Youth transitions: • Economy wide policies and institutions: • macro stability, • investment climate, • governance, • labor market regulations • Education and Training • Health services • Welfare & family services • Infrastructure “Youth friendly” policies

8. 3 types of questions asked of each transition: a ‘youth lens’ on policy Youth ‘Lenses’ Policies affecting human capital formation during Youth transitions: -- Economy wide policies and insts: macro stability, invest. climate, governance, labor market regulations -- Education -- Training -- Health services -- Welfare & family services -- Infrastructure “Youth friendly” policies Opportunities Capability Second- chances

9. Opportunities: a good education Percent of young women, 15-24, who can read a simple sentence or know condoms can prevent HIV/AIDS after six years of primary school • Inadequate preparation for adolescence improve quality of basic education • Relevance of education for jobs curriculum reform, flexibility in school systems

10. Opportunities: health services • alternatives to early marriage and childbearing: schooling and work • proper nutrition • access to health services: • reproductive health technology and services • antenatal and obstetric care • child health services • involving young men in SRH

11. Applying the framework: Opportunity • Opportunity: Countries HAVE invested in access to human capital; lens focus on education quality and relevance to labor market • Capability • Second-chances

12. 3 types of questions asked of each transition: a ‘youth lens’ on policy Youth ‘Lenses’ Policies affecting human capital formation during Youth transitions: -- Economy wide policies and insts: macro stability, invest. climate, governance, labor market regulations -- Education -- Training -- Health services -- Welfare & family services -- Infrastructure “Youth friendly” policies Opportunities Capability Second- chances

13. Capable decision-making: % of youth who think they have the most influence on human capital decisions

14. Capabilities: information • Half of 2,000 Kenyan adolescents chosen from KLPS randomly selected for VET voucher • Half of these receive information intervention targeted to females: • -- avg returns from KLPS • -- encouraged to attend male-dominated trades Initial results: • Large effect on demand for male trades • Will probably affect earnings since avg earnings on tailoring and computers which some girls enter are high. Source:DHS Source: DHS

15. Relieving the information constraint

16. …Incentives also matter. Positive ones, like • conditional cash transfers: • Mexico’s Oportunidades: • .2 more years of schooling at 13-15 • reduced child morbidity and mortality • Bangladesh’s Female Secondary Stipend Program • Cambodia’s secondary scholarship program for girls • involve youth in program design esp those to change attitudes

17. …Or negative ones like taxes

18. Outline • Motivation • Structure/Framework of the Report • Applying Framework: Examples • Opportunity: • Capability: Policy targets Govts and now Parents; lens improve the capacity of youth to decide among opportunities • Second-chances:

19. 3 types of questions asked of each transition: a ‘youth lens’ on policy Youth ‘Lenses’ Policies affecting human capital formation during Youth transitions: -- Economy wide policies and insts: macro stability, invest. climate, governance, labor market regulations -- Education -- Training -- Health services -- Welfare & family services -- Infrastructure Second- Chances “Youth friendly” policies Opportunities Capability

20. Second-chances: Recovering from poor outcomes High costs of not giving young people another chance to recover: • Effects are long-lasting • Later recovery as adults is more costly • May inhibit investment by others (e.g., high HIV/AIDS prevalence leads to lower investment) Examples:

21. Examples of second-chance programs for RHA • Training for dropouts to re-enter mainstream educ • Child-care services in schools for students • Family planning and maternal services for youth

22. Policy Framework • Opportunity • Capability • Second-chances: Prevention; lens Help young people recover from poor outcomes

23. Moving forward in Countries Providing school uniforms not only increased enrollment in Kenya – it lowered teenage pregnancy • Coordination: youth outcomes require improved multi-sector efforts • Voice: the constituency of youth is weak (which is why for this Report, we had extensive consultation) • Evaluation: many youth-specific initiatives are still new; impact must be studied