We all know that children are the future. We have seen the commercials picturing heartbreaking photos of children in need or adorable youngsters with the brightest of dreams, and asking for donations to support them. Such attention has made a difference. Children globally are healthier and better educated than at any time in human history. According to a 2014 U.N. report on the Millennium Development Goals, the enrollment rate in primary education in developing regions increased from 83 percent to 90 percent over just the last decade. In addition, the child mortality rate has almost halved since 1990, with 6 million fewer children dying in 2012 than in 1990. These are achievements that development organizations — and the taxpayers who support them — should be proud of, having plowed billions into primary education, vaccinations, and other efforts that have helped young boys and girls around the world.
Today, as we observe International Youth Day, we look back on the past eight years of FHI 360’s involvement with the U.S. Agency for International Development (USAID)’s Interagency Youth Working Group (IYWG), the only source of global information about preventing both unintended pregnancy and HIV among youth. Our work managing the technical content for the IYWG was conducted under USAID’s Preventive Technologies Agreement, which ends this month.
During this time, we have made many contributions. The IYWG tools and resources have been used by thousands — more than 30,000 people from 199 countries have visited our website, over 6,000 have participated in our e-forum discussions, and more than 1,000 have attended our annual technical meetings. Since 2007, we have distributed InfoNet twice monthly to approximately 5,000 individuals and developed 21 issues of YouthLens; 1,219 users follow us on Twitter; and 2,444 people like our IYWG and Answer the Call Facebook pages.
We are grateful to the many dedicated individuals who helped us produce, synthesize and disseminate evidence on youth sexual and reproductive health, and to our partners for sharing their work and supporting ours. To all who have helped us provide practical, evidence-based resources and tools in the service of improving the lives of young people around the world, thank you!
To mark the end of the IYWG, we are featuring a few of our favorites from the IYWG blog, Half the World. Though we will not be providing any new content, the website and blog will continue to exist as a rich resource for information on youth reproductive health and HIV/AIDS.
Greg Louganis, a gold-medal-winning Olympic diver and author, provides an honest, inspiring account of his life with HIV.Read More
Joy Cunningham, a senior technical officer at FHI 360, explains why a 2012 U.S. Agency for International Development policy is critical to young people’s sexual and reproductive health.Read More
In honor of this year’s World Population Day, the theme of which is youth engagement and the sustainable development agenda, we are reflecting on youth — our future leaders, parents, entrepreneurs and citizens. Today’s generation of young people is the largest in history: there are 1.8 billion people between the ages of 10 and 24 on the planet. In many countries, more than half of the population is under age 25, creating opportunities for national economic growth but also underscoring the need for greater investment in their health — with consequences that will affect the world’s social, environmental and economic well-being for generations.
Investment in young people’s sexual and reproductive health in particular ensures that young people are not only protected from HIV and other STIs, but also that they have the number of children they desire, when and if they wish to have them. The ability to control one’s fertility increases individuals’ productive capacity and can lead to a decline in a country’s dependency ratio (number of working citizens compared to nonworking citizens). When the dependency ratio declines in conjunction with adequate investments in youth education and economic opportunity, per capita income can increase — a phenomenon known as the demographic dividend.
Unfortunately, many young people do not have access to the critical sexual and reproductive health information and services required to stay healthy and avoid unintended pregnancy. Many young women report not wanting to become pregnant, but the level of unmet need for contraception among adolescents is more than twice that of adults. In some regions of the world, the unmet need for contraception among adolescents is as high as 68 percent. Fulfilling the unmet need for contraceptives among adolescents alone could prevent an estimated 7.4 million unintended pregnancies annually.
An Interview with
What prevents girls in Nigeria from receiving a quality education?
Girls in Nigeria face many obstacles. These include high school fees, gender inequality and other social pressures that cause them to drop out. Security is a big risk for many girls, especially since the recent kidnappings. Some girls are just too afraid to go to class. The conditions at school can also be a challenge. My class has 50 students and no fan. Some classrooms have no ceiling, no fan and even more students. At certain times of the day, like when the sun is directly overhead, it is too hot for students to even sit in the classroom and impossible for them to concentrate and learn.
Some policies also limit girls. If a girl is pregnant, she cannot return to school after she has her baby. One mistake should not be the end of a girl’s education.
In 2012, young people ages 15 to 24 accounted for an estimated 40 percent of new nonpediatric HIV infections worldwide [UNAIDS World AIDS Day Report 2012]. Furthermore, perinatal HIV transmission is a major cause for HIV infection, and given the success of pediatric antiretroviral therapy (ART), many more infants born with HIV are growing up into adolescents and young adults living with HIV.
While care and treatment programs for people living with HIV (PLHIV) can be found in every country, there is a gap in provision of ongoing, supportive counseling for adolescents living with HIV (ALHIV). Adolescence is often when young people begin having sex, which increases chances that adolescents living with HIV might pass the infection to partners who are HIV negative. Another concern is that girls living with HIV may become pregnant; if they do not know about or have access to services for preventing mother-to-child transmission, they can pass the infection to their babies. Given that adolescents are a large sub-group of those living with HIV, there is a need for tailored interventions and support systems that address adolescents’ unique vulnerabilities.
To shed light on the specific health and social support needs of ALHIV, FHI 360 — on behalf of USAID’s Interagency Youth Working Group — developed a resource called Positive Connections: Leading Information and Support Groups for Adolescents Living with HIV. This unique guide provides facilitators with background information about the needs of ALHIV, tips for starting an adult-led information and support group, 14 sessions to follow in a group setting and guidance on tracking a program’s progress.
This year’s International Conference on Family Planning (ICFP) saw the largest youth delegation in its history. Approximately 300 young people between the ages of 18 and 25 attended, doubling the number who participated in 2011. These young family planning activists moderated panels, delivered plenary presentations and assisted in launching ground-breaking publications, such as the United Nations Population Fund’s State of World Population 2013 report on adolescent pregnancy and the International HIV/AIDS Alliance’s paper on young people living with and affected by HIV. Young people’s needs were a major focus of conference presentations, events and press coverage. Government officials publically recognized the importance of young people and encouraged their active participation as emerging leaders in the field of family planning and reproductive health.
The attention to the unique needs of this population could not be more timely. Every day, 20,000 girls under the age of 18 in developing countries give birth. That is roughly 833 girls every hour, or 14 girls each minute. Of the 7.3 million girls who give birth each year, two million are under the age of 15 (UNFPA). Adolescent mothers face devastating social, educational, economic and health outcomes. Girls who become pregnant confront discrimination within their communities and are often forced to drop out of school or get married. Pregnancy during adolescence increases the risk of anemia, postpartum hemorrhage, prolonged obstructed labor, obstetric fistula, malnutrition and mental health disorders. Complications from pregnancy and childbirth are the leading cause of death for 15- to 19-year-old girls (UNFPA). Furthermore, adolescent mothers are more likely to have a lower income and have more children at shorter intervals throughout their lifetime.
It is a common belief that programs designed to increase household income will automatically have positive effects on children. In fact, the evidence shows that this assumption cannot be taken for granted. In some cases, the interventions that increase household economic activities actually lead to greater problems for children and youth, such as more child labor and less school attendance, particularly in the short term.
For the past five years, the Child Protection in Crisis (CPC) Network and the Supporting Transformation by Reducing Insecurity and Vulnerability with Economic Strengthening (STRIVE) project, funded by the U.S. Agency for International Development (USAID) and managed by FHI 360, have sought to understand how economic strengthening programs affect children living in poverty and in humanitarian crises. To better inform practitioners, they collaborated to create Children and Economic Strengthening Projects: Maximizing Benefits and Minimizing Harm, a new guide that explains how economic interventions can achieve better outcomes and impacts for children ages 0–18.
Rooted in field experience, the guide shows how to mitigate the unintended threats to children from economic strengthening activities and ways to maximize benefits to children, whether they are the direct or indirect beneficiaries. The guide draws on the extensive child protection expertise of the CPC Task Force, the STRIVE project’s experience in facilitating cross-sectoral collaborations, and recognized best practices for market-based economic strengthening programming.1
More than half of the world’s population is under the age of 30 and has never lived in a time without AIDS. Despite the steady progress of our collective scientific and community efforts to end the HIV epidemic, the lives of young people continue to be especially vulnerable. To bring attention to this ongoing crisis and to commit ourselves to achieving an AIDS-free generation, today marks the first National Youth HIV and AIDS Awareness Day.
According to the U.S. Centers for Disease Control and Prevention (CDC), 50,000 people in the United States are infected with HIV each year. Of those, one in four is between 13 and 24 years old. Further, CDC reports that nearly 60 percent of new infections in youth occur in African Americans, 20 percent in Latinos and about 20 percent in whites. In 2010, CDC estimates that 87 percent of the 12,000 annual infections in youth occurred among gay and bisexual young men. Nearly half of all new infections among American youth occur in African American males.
In a CDC Vital Signs report released for World AIDS Day 2012, the agency noted that “about 60 percent of youth do not know they are infected and so don’t receive treatment, putting them at risk for sickness and early death. These youth can also unknowingly pass HIV to others.”
An Interview with
Ward Cates, MD, MPH, President of Research, FHI 360
To start, we’d like to know a little about you as a young person. What were you like as a teenager?
Well I’ve never stopped being a teenager…so just like I am now. My priorities then were girls, sports, and grades – and in what order depended on the time of day. Now they’re family, sports and work…ditto.
What were you told about sex when you were a young person? Who gave you this information? What else do you wish you had been told?
The first time I heard about sex was when someone told me that my father put his thing in my mother to create me. I think I was about 7. I didn’t believe them, so I asked my mother. She gave me a book that she had ready for the occasion. My father came by that night and uncomfortably asked if I had any questions; when I said I didn’t, he was relieved. But I keep reading voraciously (for a teen!) and became the age appropriate sex education source for my social network.
We have a few questions for you about the state of the world’s youth today. First, what is the biggest issue currently faced by youth?
Establishing their self-esteem and developing a sense of security in a rapidly changing, increasingly transparent world.
What is the most important thing that could be done to improve the health and well-being of today’s youth?
Providing a supportive environment in which youth feel they can control their own destiny. It’s important to avoid a sense of fatalism where they feel that their future is in the hands of others – from criminal forces to supernatural beings. Hopefully we can empower youth to feel that they can control where they will end up in life. This sense of control is a necessary foundation for all of us, not only youth, to move forward and be accountable for our actions.
Finally, please share a little about your work with youth. Why is the health and well-being of young people especially important to you?
Because youth are the future. Each generation builds upon itself, and today’s youth are tomorrow’s adults. We (the slightly older than teenage generation) need to understand and value that our future is in their hands.
What is one thing about youth that you wish you better understood?
How to better manage their normal impulses so that youth can make better decisions for their future.
How will the growing interest in treatment as prevention impact youth sexual and reproductive health?
Treatment as prevention affects all ages. It’s as important for youth as it is for older persons to be aware of their HIV status. If infected, they can obtain treatment which will not only improve their personal HIV prognosis but will also reduce their capacity to transmit the virus to others.
The Interagency Youth Working Group (IYWG) is a network of nongovernmental agencies, donors, and cooperating agencies with an interest in improving the sexual and reproductive health of young people. As the secretariat for the IYWG, FHI 360 serves as the point of contact for the global dissemination of information on youth sexual and reproductive health research, programs, and materials.