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Access to RH services helps women to have fewer children, and improve their health and offer hopes for a better future for their families.
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Youth
Youth
Adolescent and youth (10-24 years) form the biggest segment of the population of Bangladesh. Of them approximately 23 percent of total population falls in the age bracket of 10-19, classified as adolescents, a distinct segment of young people (Bangladesh Bureau of Statistics 2003). Among them, girls constitute a distinct segment in terms of the magnitude of the problems they face.
The 1999-2000 Bangladesh Demographic Health Survey (BDHS) reported 78 percent females get married before reaching age 18, which is the legal age of marriage. The median age at marriage being 14 for females of 10-24 years (NIPORT, Mitra Associates and ORC Macro 2001). Fifty nine percent of females at the age of 19 years begun childbearing (NIPORT, ORC Macro, JHU and ICDDR,B 2003). As many as 69 percent of the pregnant women under the age of 20 receive no antenatal care. Therefore, the age specific fertility rate is high for 15-19 age group being 144 births per 1000 female population (NIPORT, Mitra Associates and ORC Macro 2001). Ninety two percent of the births occur at home. Fifty seven percent of young couples do not use contraceptives, after over two decades of aggressive social marketing campaign, condom use is still less than one percent among this group and 77 percent have no access to health care services. One-fifth of adolescent mothers do not have any knowledge about life-threatening conditions during pregnancy (NIPORT, Mitra Associates and ORC Macro 2001). The situation is even worse for unmarried girls as the existing health facilities do not cater to their needs. The wide gap between menarche and marriage leaves them vulnerable to increasingly risky behaviors. Findings suggest that the reproductive health knowledge among young people is very poor (Bhuiya et al. 2003, Barkat et al. 2000, Nahar et al. 1999, Haider et al. 1997). Consequently, they engaged in risky behavior, including engaging in sex, suffering from STIs, and having sex with commercial sex workers, in addition to having limited knowledge regarding HIV/AIDS and limited access to RH services (Bhuiya et al. 2003, Barkat et al. 2000; Nahar et al. 1999; Haider et al. 1997). Furthermore, adolescents get involved in the sex trade (National AIDS/STD Programme, Bangladesh 2003), taking drugs (Panda et al. 2002), and migrating to other countries where they are exposed to risky situations (Chowdhury, Choudhury, and Lazzari 1995). Clinical evidence also confirms their risky behavior. For instance, national HIV surveillance data indicated that 55 percent of STI patients identified were below 24 years of age (National AIDS/STD Programme, Bangladesh 2002).
Unfortunately, neither the family nor the schools provide any reproductive health (RH) information to them. Research showed that schools are the best avenue for reaching a large volume of adolescents and youths in an effective way, in terms of cost, creating enabling environment in the community and disseminating quality information (Bhuiya et al 2003). Another research revealed that RH education along with livelihood initiative avert early marriage in the community (Amin et al. 2004).
Gender gap is wide across all sectors including education, health, and employment. Regarding education sector, half of the young population is illiterate. Despite increased enrollment in schools in both urban and rural areas in recent years, the BDHS 1999-2000 results suggest that the proportion of adolescents dropping out from school continues to be high. Between the ages of 6-15 years the proportion of boys and girls attending school are indistinguishable, but by age 16-20, boys are more likely than girls to stay in school (40 vs. 27 percent).
Migration is problem that puts adolescents and youths at risk. Findings indicate that more than half of the boys working in the urban areas were rural migrants, and one of the main complaints the adolescents had was the various kinds of abuse they faced (NIPORT, Mitra Associates and ORC Macro 2001).
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