Addressing Adolescent Women’s
Sexual and Reproductive Health Needs
in Mexico: Challenges and
Opportunities
Fátima Juárez, José Luis Palma, Susheela Singh
y Akinrinola Bankole
Introduction
• For decades, reproductive health has been
of high priority to policymakers in Mexico
(1970,1980, 1990)
• More recently, decision makers started to be
concerned with the reproductive health of
young people (1990)
• Adolescent pregnancy and motherhood
(within
or
outside
marriage)
have
disadvantages to young women in terms of
their reproductive health and the future
wellbeing of their families.
Objetives
a) To analyze trends of reproductive health of
young Mexican women
b) To examine the social and health policies
and services directed to improve RH of young
people
c) To identify the gap between policies and
services and the changes in the reproductive
health conditions of young people.
Project goal
To stimulate responsive programs, policies
and resource allocation to improve
reproductive health of young people, in
particular, the prevention of unplanned
pregnancies, through documenting the
current situation of young people.
Methodology and data
Methodology and data
• Data: ENADID 1997 & ENADID 2006
• Pop. of study: women 15-19 years.
• Estimates provided for: National,
urban/rural, region by degree of
development*, and state
* Index includes: Education, poverty, health insurance, and
household amenities
Results
Context of young peoples’ lives
• Mexico continues to have a large youth
population -- currently estimated at 27 million
young people 15-24 yrs (25% of the total)
• The services of FP are free nationally but are
NOT designed for young people
• There have been gains in schooling among young
people
• But, great inequalities persist in wealth
distribution -- almost half (45%) of workers live in
poverty (i.e. earn 2 or less the minimum salary )
Marriage and fertility in the last
decade
• Marriage is low among adolescent women (15-19
yrs.)
• The adolescent fertility rate has continued to
decline (24% over 1997-2006)
• Women are having their first birth at a younger
age now than earlier
• Having children before age 18 still is common
• Sexual activity before marriage is increasing in
almost all parts of the country
Before their 18th birthday, closely linked to
marriage, almost one in five young Mexican
women have given birth
% of women 20–24 who had experienced each event before given age
Had sex
Had married
Had given birth
100
90
80
70
60
50
40
30
20
10
0
Before age Before age Before age
15
16
17
Before
age18
Before age Before age
19
20
The gap between age at first sexual
relationship and first marriage is large
Interval in yrs. between 1st Sexual Relationship and 1st Marriage
7
5.8
6
5
ENADID 2006
4
3
3.5
3
2.7
2.9
2.4
1.9
2
1
0
Mexico
Reg 1 Reg 2 Reg 3 Reg 4 Reg 5 Reg 6
Contraception
Relevant questions about the use of
contraceptives
1) How adequate is young people's knowledge
about contraception?
2) Are they using contraception?
3) Does their use vary by socio-economic level of
the region?
4) Where do they obtain services and methods?
% of married women 15–24 yrs by
contraceptive use
About half of married young women
were not using a method in 2006
34
30
39
41
43
49
48
51
42
44
49
63
60
6
62
8
52
9
55
4
49
8
45
6
40
12
59
46
44
6
46
48
12
3
30
7
Region 2
Region 3
Traditional
Region 4
Region 5
Modern
48
37
4
1997 2006 1997 2006 1997 2006 1997 2006 1997 2006 1997 2006
Region 1
47
Region 6
No use
9
5
1997 2006
Total
Between 1997 and 2006, unmet need for contraceptives
among married women 15-24
increased substantially
% of married women 15–24 with unmet need
50
45
40
35
30
1997
2006
25
20
15
10
5
0
Mexico
Urb.
Rur.
Reg 1 Reg 2 Reg 3 Reg 4 Reg 5 Reg 6
The role of the public sector as provider
of modern contraceptive methods has
dropped
Where the
method was
obtained
% of 15–24 year-old users of modern
methods
% Change
1997
2006
Public sector
70.5
59.9
-18.1
Private medical
sector
6.4
8.8
32.7
Pharmacy or Store
22.2
30.5
32.6
1997-2006
Conclusions and Recommendations (1)
The most acute problems identified among young
people are:
• High level of unprotected sex
• High and rising unmet need for contraception
• Reduction of the public sector as provider of
services and contraceptive methods
But the most dramatic finding is the large difference
observed between the more developed and less
developed areas of the country in terms of level of
poverty, schooling, general conditions of life and
sexual, marital and reproductive behavior.
Conclusions and Recommendations (2)
Key obstacles identified:
• Services of FP are free of charge in the country but
are not designed for young people; lack of youth
friendly services and inadequate sex education.
• The lack of communications through mass media.
(banned)
• Since decentralization, lack of compulsory budget
line by local governments to warranty FP services
and free contraceptives.
Conclusions and Recommendations (3)
Cont. Key obstacles identified:
• The lack of institutional consolidations of policies in
this field. Changes of administration and personnel
have resulted in cancelation of activities and
instability of certain programs.
• And the worse consequence is the lack of a complete
geographical coverage of adolescent programs of
sexual and reproductive health. (NGOs)
Thanks
This research was developed with
the support of MacArthur
Foundation
For more information, visit www.guttmacher.org