For more information, please get in touch with Malarvili Meganathan, Regional Communications, Voice and Media Advisor IPPF ESEAOR at [email protected].
Photos by: Florence Lee ([email protected])
The International Planned Parenthood Federation (IPPF), in partnership with UNFPA, UNICEF, PLAN International, and Organon, convened a pivotal Regional Policy Dialogue on Unintended Pregnancies in Southeast Asia. This two-day event, held in Bali, Indonesia, from October 19-20, brought together over 100 key stakeholders, including youth leaders, youth networks, government representatives, development partners and private institutions.
The discussions during the two-day event were multifaceted, encompassing topics such as analysing data and trends related to unintended pregnancy among adolescents in Southeast Asia, exploring evidence-based approaches to tackle this challenge, and evaluating existing policies while identifying gaps and opportunities. All of this was done through a youth-oriented and intergenerational lens. The event aimed to foster collaboration, partnerships, and greater accountability among stakeholders to collectively address adolescent pregnancy, recognising the importance of a unified effort in ensuring the well-being of young individuals in the region.
Tomoko Fukuda, Regional Director, IPPF East, Southeast Asia and Oceania Region (ESEAOR), emphasised unwavering commitment to addressing the sexual and reproductive health challenges young people face in the region. She stated, "Our focus goes beyond mere statistics; it's about ensuring every girl has the choice, the right, and the support she needs. Unintended pregnancies are a stark reminder of broader systemic gaps, and we are dedicated to addressing them.
Anjali Sen, Country Representative, UNFPA Indonesia, said, “Adolescent pregnancy is a global concern, but its impact is profoundly felt in Southeast Asia. It is a challenge that affects not only the health and well-being of young girls but also the socio-economic development of our nations.”
Adolescent pregnancy, particularly adolescent girls, significantly affects young individuals' health and well-being. It often leads to reduced educational opportunities and limited employment and economic advancement prospects. This perpetuates cycles of disadvantage, inequality, poverty, and adverse health outcomes that impact young girls, their families, and their communities.
The Burden of Unintended Pregnancies in the Region
A significant demographic shift has drawn attention to pressing challenges in Southeast Asia and the Pacific, home to over 60% of the world's young population. This vast region encompasses 32 low- and middle-income countries.
Within this landscape, the issue of adolescent pregnancies is prominent, with a significant number being unintended. These pregnancies occur amidst a backdrop of unmet needs for modern contraception among adolescents. In 2019, the region recorded over 3.7 million births to adolescent girls. Adding to the complexity of the issue, approximately 1 in 8 births to adolescent girls are unintended, highlighting gaps in access to and knowledge about contraceptive options.
The region also experiences an estimated 3.6 million unsafe abortions annually among women, underscoring the urgent demand for comprehensive sexual and reproductive health services. Disorders related to pregnancy and childbirth remain the leading causes of mortality among adolescent girls, emphasising the imperative for concerted efforts to address these diverse challenges.
Strategic Approach to Addressing Unintended Pregnancies
Guided by a well-defined conceptual framework, IPPF focuses on providing high-quality sexual and reproductive health care, fostering supportive community environments, ensuring universal access to contraception and abortion care, and building an evidence-based foundation for continuous improvement. These pillars collectively work to tackle unintended pregnancy and promote reproductive health and rights.
Understanding the multiple and intersecting forms of discrimination and vulnerability, IPPF provided comprehensive SRH services to marginalised and vulnerable communities across the region amidst the significant challenges brought by the COVID-19 pandemic, which also prompted a focus on building resilience.
In 2020, IPPF ESEAOR reached an impressive milestone by providing vital SRHR services to 5.2 million clients, offering 15.7 million services. 8 out of 10 clients were women and girls, with 38 per cent of services provided to young people. In 2021, IPPF continued to adapt and innovate in the face of ongoing challenges, embracing alternative methods of service delivery, such as telehealth. This strategic move proved instrumental in averting 272,686 unintended pregnancies and preventing 39,508 unsafe abortions.
Improving Access to Comprehensive Sexuality Education (CSE)
Advocates emphasised the necessity of incorporating mandatory CSE into national laws, ensuring its provision from early primary to secondary school levels. To achieve this, developing country-specific curricula for teacher training is a priority, enabling effective, learner-centred CSE delivery.
Additionally, strategies must be devised to engage out-of-school and vulnerable learners. Building competent teachers is crucial, involving comprehensive pre-service, in-service, and refresher training and creating supportive supervision and learning platforms for educators. Collaboration across sectors is encouraged to deliver consistent CSE and youth-friendly sexual and reproductive health services while addressing social resistance through community inclusion and support. Needs and gap assessments are key to ensuring the delivery of high-quality, age-appropriate CSE throughout the region.
Snapshots of Sexual and Reproductive Health and Rights of Adolescents in Asia and the Pacific.
Shreyasi Jha, Regional Gender and Adolescent Advisor at UNICEF East Asia and Pacific Regional Office, in her presentation, highlighted that effective strategies to address early marriages and pregnancies require a nuanced approach. This approach aims to comprehend the intricate pathways leading to adolescent pregnancy in Southeast Asia. It underscores the necessity of tailoring interventions to address the unique drivers and patterns in each context.
Sylvia Wong, Technical Adviser, Adolescents and Youth at UNFPA Asia Pacific Regional Office, emphasised enhancing young people's Sexual and Reproductive Health and Rights (SRHR) in Asia-Pacific. She urged the integration of adolescent SRH into universal health coverage policies, plans, and financing mechanisms while advocating for rights. The provision of a comprehensive SRH package, competency-based training for providers, and effective monitoring of national Adolescent-Friendly Health Service (AFHS) standards to ensure accessible and quality care for adolescents.
Shifting Harmful Norms through Country-Led Efforts and Multi-Organizational Partnerships
In Vietnam, Plan International's initiative from 2020 to 2023 has highlighted the significant role of digital spaces in empowering ethnic minority girls and young women to assert their rights, access crucial support services, and amplify their voices in influencing policymakers. Key lessons from this endeavour underscore the importance of actively involving youths in shaping digital tools and online platforms, building the capacity of local partners in specialised skills, engaging local and national agencies early in the project, allocating time and resources for child-friendly and ethnic minority-oriented design and content, and utilising the platform for multiple purposes, including advocacy and fostering autonomy and participation among girls. Additionally, a strong emphasis was placed on technical design and solutions to ensure accessibility for the most vulnerable communities with limited internet connectivity.
Indonesia has developed a comprehensive national strategy to prevent child marriage and address unintended adolescent pregnancies. This strategy has proven instrumental in accelerating progress toward national targets while strengthening stakeholder collaborations. Qurrota A’yun, Acting Director for Families, Women, Children and sports at the Ministry of National Development Planning, emphasised the importance of cooperation with youth organisations and development partners, including IPPF, in reaching out to the most vulnerable communities in the country and effectively responding to critical issues.
In Laos, limited access to sexual and reproductive health services contributes to the significant challenge of unintended pregnancies among adolescent girls. The Lao Youth Union actively engages in social and behavioural change initiatives focused on children and youth, aiming to reduce child marriages and unintended pregnancies. Vatsalinh Bounmixay, Head of Youth and Adolescent Counseling at Lao Youth Union, underscores the collective vision of creating a world where every child can reach their full potential, free from the constraints of child marriage and adolescent pregnancy. "Together, we can create a world where these challenges are no longer the norm."
In the Philippines, challenges related to sexual and reproductive health among adolescents persist. Jackylin D. Robel, Acting Regional Director of the Commission on Population and Development, National Capital Region, emphasised the critical need for a comprehensive approach. This approach seeks to foster collaboration between national and local government units, recognising that effective solutions must transcend bureaucratic boundaries. The overarching goal is to ensure that essential services reach adolescents residing in remote island municipalities, upland communities, and other hard-to-reach areas where healthcare resources are often limited. Central to this strategy is the commitment to educate young people about sexual and reproductive health, extending this education beyond the formal schooling system.
Charting the Path Forward
Dadchaneeya Ruttanasiri, Chair of the Youth SRHR Network in East & South Asia and the Pacific, stressed the importance of involving adolescent girls in decision-making processes and creating inclusive spaces for active participation. The mobilisation of youth activism was highlighted as a catalyst for driving policy change, ensuring that the perspectives and experiences of those directly affected by these issues are heard and integrated into solutions.
Sadia Rahman, FP2030's Youth and Adolescent Partnerships Manager, underscored the importance of moving beyond tokenism by involving youth meaningfully in decision-making. This approach emphasises embedding youth perspectives in programs and aligning values, ensuring their genuine contribution rather than mere symbolic representation.
These multifaceted approaches offer hope for meaningful progress in dismantling the intricate web of factors perpetuating the region's adolescent pregnancy and child marriage. Stakeholders across sectors were encouraged to collaborate and channel resources toward a common goal. The vision is clear: to create a future where every adolescent girl in Southeast Asia has the right, resources, and support to make informed decisions about her body and future.
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