Adolescent pregnancy: a culturally complex issue.

This girl from a village in the Indian state of Gujarat was 16 when her son was born. She delivered at a hospital thanks to an innovative government programme that offers free childbirth and obstetric care for women living below the poverty line. In the primary health care centre in the Kheda district she now receives advice on breastfeeding, family planning and other health issues. Ayana (name changed) was married at the age of 11. Most newly-wed couples in Ethiopia start trying to conceive right away. Three years later, thanks to the Stop Early Marriage campaign, Ayana and her husband (who is five years older than her) are still attending school and have delayed having children, according to Helen Amdemikael, an assistant representative at the United Nations Population Fund (UNFPA) in Ethiopia. The project is run under the auspices of the district’s Ministry of Youth and Sports and assisted by UNFPA and the Population Council, a nongovernmental organization, with policy and technical guidance from the World Health Organization (WHO). It works with families, community leaders and adolescents in the rural Amhara region of Ethiopia where half of all adolescent girls are married before the age of 15 in violation of Ethiopian law, which allows marriage after the age of 18. The project encourages delaying marriage and childbearing, and also supports married adolescent girls by providing literacy, life skills and information on reproductive health. Amdemikael and other health experts are hoping for more stories like Ayana’s. Whether it happens with child brides in India or the Sudan, or unmarried high-school students in industrialized countries, adolescent pregnancy is a major contributor to both infant and maternal health problems and mortality.