1. Schooling and Adolescent Reproductive Behavior in Developing Countries
Cynthia B. Lloyd
Population Council
Many tables and charts are derived from DHS data prepared for
forthcoming NAS panel report, Growing Up Global: Transitions
to Adulthood in Developing Countries

2. Outline Schooling among adolescents
Adolescent reproductive health and behavior
Adolescent reproductive health by schooling status
School girl pregnancy
Implications

3. Percent Ever Attended School, by Cohort
Girls
Boys
Africa
Latin
America
Asia
40-44 yrs old
10-14 yrs old

4. Percent Completed 6 or More Years of School, by Cohort
Girls
Boys
Africa
Latin
America
Asia
40-44 yrs old
20-24 yrs old

5. Percent Currently Enrolled (15 year olds)
Africa
Latin
America
Asia

6. Percent Currently Enrolled, 9 Latin American Countries
(median, quartiles, range)
Boys
Girls 12 15 18
Age

7. Percent Currently Enrolled, 13 Asian Countries
(median, quartiles, range)
Boys
Girls 12 15 18
Age

8. Percent Currently Enrolled, 28 African Countries
(median, quartiles, range)
Boys
Girls 12 15 18
Age

9. Percent of Students Aged 12-14 Enrolled in Primary vs
Percent of Students Aged Enrolled in Primary vs. Secondary and Above

10. Percent of Students Aged 15-17 Enrolled in Secondary and Above vs
Percent of Students Aged Enrolled in Secondary and Above vs. Primary

11. Percent of Students Aged 15-17 Currently Enrolled, by Socio-Economic Status
Kenya
Tanzania
Latin America (7)
Asia (12)
Africa (28)

12. Conclusions: Schooling among adolescents
Rapid growth in attendance and attainment
Recent growth rates more rapid for girls
Majority of 15 year-olds are students
In many countries, majority of adolescent students attend primary school
Poverty compromises school attendance

13. Outline Schooling among adolescents
Adolescent reproductive health and behavior
Adolescent reproductive health by schooling status
School girl pregnancy
Implications

14. Percent Distribution of Deaths in Developing Countries
at Ages by Cause, According to Sex and Region
Source: WHO (2001)
Females
Males
World

15. Percent of Women Giving Birth by Age 18, by Cohort
20% % % % %
Africa (28)
Latin
America (9)
Asia (13)

16. Recent trends in percent marrying, having premarital sex, and having sex by 18
Direction of Change
Marriage
Premarital Sex
Sex
ASIA
Kazakhstan
Philippines
LATIN AMERICA
Bolivia
Colombia
Dom. Republic
Guatemala
Haiti
Nicaragua
Peru
Source: Mensch, Grant, Blanc, forthcoming

17. Recent trends in percent marrying, having premarital sex, and having sex by 18
AFRICA
Direction of Change
Marriage
Premarital Sex
Sex
Benin
Burkina Faso
Cameroon
Cote d’Ivoire
Kenya
Madagascar
Mali
Niger
Nigeria
Rwanda
Senegal
Tanzania
Uganda
Zambia
Zimbabwe

18. Percent Aged 15-17 Sexually Active, by Socio-Economic Status
Latin America
Asia
Africa
Note: Not age standardized

19. Conclusions: Reproductive health and behavior among adolescents
HIV/AIDS is the leading cause of mortality and morbidity in Sub-Saharan Africa
Death rates due to HIV/AIDS in Sub-Saharan Africa are highest among young women
Overall, roughly 15 percent of deaths among young women are due to maternal causes

20. Conclusions: Reproductive health and behavior among adolescents (continued)
Child marriage remains prevalent in many countries
In most countries during the 1990s, percent having sex before 18 has not risen but the context is changing
Poor adolescent girls are more likely to be sexually active than their better off peers

21. Outline Schooling among adolescents
Adolescent reproductive health and behavior
Adolescent reproductive health by schooling status
School girl pregnancy
Implications

22. Possible pathways of association: School attendance and adolescent reproductive behavior
Sex
Risky sexual behaviors (unprotected sex, multiple partners, sex in exchange for money or favors, coercive sex)
Contraceptive (in particular condom) use among sexually active
Abortion among those experiencing unwanted pregnancy
Early marriage leading to early childbearing

23. Percent Ever Had Sex, Aged 15-17, by Enrollment Status
Latin America
Asia
Africa
Note: Boys not age standardized, Girls age standardized

24. Aged 15-17 (Not in school/In school) Proportion who ever had sex
Ratio of Proportion of Unmarried Women Aged Who Ever Had Sex Among Those Not Currently Enrolled vs. Enrolled, by Overall Proportion in School Source: DHS Surveys,
Aged (Not in school/In school)
Proportion who ever had sex
Guatemala
Zimbabwe
Bolivia
Proportion in school
Latin America
Africa
Note: Age standardized

25. Sex among unmarried adolescents aged 15-17 by school status
For unmarried girls, 25% of students or less have ever had sex; percent having had sex is lower among students
For unmarried boys, levels of sexual activity vary much more widely; in majority of cases, levels of sex are lower among students
Among unmarried girls, ratio of percent having sex among non-enrolled relative to the enrolled exceeds one in almost all countries and does not vary by enrollment level

26. Percent Aged 15-17 Using Any Contraception, by Enrollment Status
Latin America
Africa
Note: Not age standardized

27. Percent Using Condoms Among Those Aged 15-17 Who Ever Had Sex, by Enrollment Status
Latin America
Africa
Note: Not age standardized

28. Contraceptive (condom) use among unmarried sexually active adolescents by school status
Relatively few unmarried year olds have ever had sex; often sample sizes are too small to estimate rates
Where rates can be calculated, contraceptive use is notably higher among students
Association between school enrollment and contraceptive use appears stronger for girls
Patterns are similar for condom use

29. School exit and marriage timing
A mechanistic relationship? Unlikely
A causal relationship? A weaker cross-country association between inter-cohort change in educational attainment and the inter-cohort change in rates of early marriage (below 18) than might be expected (R = -0.46)
Source: Mensch, Casterline, Singh (forthcoming)

30. Outline Schooling among adolescents
Adolescent reproductive health and behavior
Adolescent reproductive health by schooling status
School girl pregnancy
Implications

32. Percent reporting pregnancy as reason for dropout (women 20-24 who ever attended school)
Asia
Latin
America
Africa
Percent

33. School Girl Pregnancy
Rise in percent of girls attending school after puberty leads to a rise in percent of girls exposed to risk of pregnancy as students
Whether pregnancy leads to dropout depends on whether or not a student chooses to continue with pregnancy; studies show that girls often express their desire to stay in school as a reason for seeking abortion

34. School Girl Pregnancy
Percent reporting pregnancy as a reason for dropout are a selective sample of those who become pregnant while students; in many cases pregnancy may be an ex post rationalization for dropout rather than the underlying cause
In only few countries with data do the percent of young women who ever attended school report rates of dropout due to pregnancy exceeding 10 percent. In half the countries, reported rates of dropout due to pregnancy are less than 5 percent.

35. Conclusions
Sexual maturation is increasingly likely to occur while in school
Being in school as an adolescent is likely to have important implications for adolescent reproductive health
Expansion of opportunities for secondary schooling could represent one of the most significant reproductive health interventions for youth

36. Unanswered Questions
What features of primary, secondary schools are most likely to:
Encourage delays in sexual initiation
Reduce incidence of risky sexual behaviors
Encourage contraception and protection among the sexually active
Delay marriage and childbearing among young women