'I Have Seen My Friends Die': Why We Need to Talk Frankly About Girls' Reproductive Health

In virtually every country in the world, there are disproportionate barriers for young people -- particularly young women -- when they seek contraception or access to information and commodities to practice safer sex. And this must stop.
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Last year, on World Population Day, I was in London with a range of world leaders for the Family Planning Summit. There, a global movement was catalyzed to focus on renewed commitments to ending the unmet need for contraception. Our goal: ensure 120 million more women and girls have access to contraception by 2020. Now, on the one year anniversary, there is one group in particular that needs increased focus for contraception: adolescent girls.

This World Population Day 2013, the focus is on adolescent pregnancy. Complications in pregnancy and childbirth are the leading causes of death among adolescent girls ages 15-19 in low- and middle-income countries.

As if that statistic wasn't sobering enough: one in three of girls under 18 in the developing world are married; many without their consent. And 15 percent of all unsafe abortions in low- and middle-income countries are among adolescent girls aged 15-19 years.

These statistics show: we need to talk frankly and openly about young people's sexual and reproductive health. We cannot shy away from tough conversations when girls are at risk.

In virtually every country in the world, there are disproportionate barriers for young people -- particularly young women -- when they seek contraception or access to information and commodities to practice safer sex. And this must stop. Girls and young women must have access to contraception and information -- no exceptions.

And young women the world over are calling out for these barriers to end as well.

"I have seen my friends die," Haregnesh Abetneh, a young woman in Ethiopia said about girls she knows who have been married and starting having children, young. "I have seen educated people and I saw the difference in their lives. I also had friends who were in early marriages and began having children very young. I watched as they had no food to eat or feed their children and they just kept getting pregnant and having babies. I could see that they were suffering and I wanted to go to school."

Haregnesh is part of a Pathfinder International program that supports girls in Amhara, Ethiopia to continue their studies. Her strength and resolve to stay in school, as well as talk openly about girls' education, early marriage, and childbirth, has shifted the approach to girls' education in her family and in her community.

"I was not an educated person and I did not want my daughter to attend school," Haregnesh's father said. "Haregnesh is our third child and she made all the change happen in our family. My three younger children now attend school as well."

This World Population Day, I hope we will think of girls like Haregnesh and her friends and recommit ourselves to addressing the unique needs of young women and girls. That starts with frankly and openly discussing girls' sexual and reproductive health needs.

If we are truly going to meet the goals we ambitiously set forth for 2020 at the Family Planning Summit in London, we must commit to ensuring adolescent girls have the support and resources they need to delay marriage and childbirth, stay in school, and start their adult lives the way each of them want to.

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