Geneva: The World Health Organization (WHO) today released a new guideline to prevent adolescent pregnancy, a leading cause of death among girls aged 15-19 globally, and to address its significant health complications. The guideline emphasises rapid action to end child marriage, extend girls’ schooling, and improve access to sexual and reproductive health services and information to reduce early pregnancies worldwide.
The guideline calls for ending child marriage through laws prohibiting marriage below 18, consistent with human rights standards, and community engagement to prevent the practice. It also recommends providing viable alternatives to child marriage by strengthening girls’ education, savings, and employment prospects. For girls at highest risk, targeted financial stipends or scholarships to support secondary school completion are proposed, as completing secondary education could reduce child marriages by up to two-thirds.
More than 21 million adolescent girls in low- and middle-income countries become pregnant annually, with about half of these pregnancies unintended. Early pregnancy impacts girls’ education, social connections, and employment prospects, perpetuating cycles of intergenerational poverty. It also poses serious health risks, including higher rates of infections, preterm births, and complications from unsafe abortions due to challenges in accessing safe, respectful care.
“Early pregnancies can have serious physical and psychological consequences for girls and young women, and often reflect fundamental inequalities that affect their ability to shape their relationships and their lives,” said Dr Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO and the United Nations’ Special Programme in Human Reproduction (HRP). “Tackling this issue, therefore, means creating conditions where girls and young women can thrive—by ensuring they can stay in school, be protected from violence and coercion, access sexual and reproductive health services that uphold their rights, and have real choices about their futures.”
The guideline stresses the need for adolescents to access high-quality, adolescent-responsive sexual and reproductive health services, including contraception, without barriers like requiring adult consent. Pregnant adolescents need stigma-free, respectful healthcare during and after pregnancy, including safe abortion care. Comprehensive sexuality education for both boys and girls is also critical to reduce early pregnancies, delay sexual activity, and improve knowledge about reproductive health and contraception.
“Early marriage denies girls their childhood and has severe consequences for their health,” said Dr Sheri Bastien, Scientist for Adolescent Sexual and Reproductive Health at WHO. “Education is critical to change the future for young girls, while empowering adolescents – both boys and girls – to understand consent, take charge of their health, and challenge the major gender inequalities that continue to drive high rates of child marriage and early pregnancy in many parts of the world.”
Reasons for early pregnancy are complex, including gender inequities, poverty, lack of opportunity, and limited access to sexual and reproductive health services. In low- and middle-income countries, 9 in 10 adolescent births occur among girls married before 18. This guideline updates a 2011 version, focusing on ending child marriage and improving contraception access, and complements WHO’s guidance on adolescent health services, comprehensive sexuality education, and gender-based violence.
Globally, adolescent pregnancies and births have declined. In 2021, 1 in 25 girls gave birth before age 20, compared to 1 in 15 two decades ago. However, disparities persist, with some countries seeing nearly 1 in 10 adolescent girls (15-19) giving birth annually.
– global bihari bureau
