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Demystifying Data: A Guide to Using Evidence to Improve ...

Demystifying DATA: A Guide to Using Evidence to Improve young people s Sexual Health and Rights 2014 Demystifying Data: A Guide to Using Evidence to Improve young people s Sexual Health and RightsRagnar AndersonChristine PanchaudSusheela SinghKatherine WatsonThis Guide was written by Ragnar Anderson, Guttmacher Institute, Christine Panchaud, independent consultant, Susheela Singh, Guttmacher Institute and Katherine Watson, International Planned Parenthood Federation. Lori Ashford, independent consultant, edited the Guide , and Kathleen Randall, Guttmacher Institute, supervised authors thank Guttmacher colleagues Suzette Audam, for data processing, and Alyssa Brown, Amelia Bucek, Marjorie Crowell, Michelle Eilers, Vivian Gor, Joon Lee and Jesse Philbin for research assistance.

A Guide to Using Evidence to Improve Young People’s Sexual Health and Rights 2014. DEMYSTIFYING DATA: A Guide to Using Evidence to Improve ... young people’s needs for sexual and reproductive health, education and services, and information on sexual and reproductive rights.

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1 Demystifying DATA: A Guide to Using Evidence to Improve young people s Sexual Health and Rights 2014 Demystifying Data: A Guide to Using Evidence to Improve young people s Sexual Health and RightsRagnar AndersonChristine PanchaudSusheela SinghKatherine WatsonThis Guide was written by Ragnar Anderson, Guttmacher Institute, Christine Panchaud, independent consultant, Susheela Singh, Guttmacher Institute and Katherine Watson, International Planned Parenthood Federation. Lori Ashford, independent consultant, edited the Guide , and Kathleen Randall, Guttmacher Institute, supervised authors thank Guttmacher colleagues Suzette Audam, for data processing, and Alyssa Brown, Amelia Bucek, Marjorie Crowell, Michelle Eilers, Vivian Gor, Joon Lee and Jesse Philbin for research assistance.

2 They acknowledge the following Guttmacher colleagues who reviewed drafts of the report: Haley Ball, Akinrinola Bankole, Heather Boonstra, Patricia Donovan, Lisa Remez and Gustavo Suarez. In addition, the authors are grateful to Claudia Marchena, Albert Themme and Binyam Woldemicheal of MEASURE DHS, ICF International, for producing special tabulations of data on adolescent and young men, school attendance and population proportions Using the Demographic and Health Surveys. The MEASURE DHS project is a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries authors thank Doortje Braeken, of the International Planned Parenthood Federation s (IPPF) Central Office, for providing guidance throughout the project and providing technical input and reviewing drafts of the authors also thank Shadia Abdel-Rahim, Abdul Muniem Abu-Nuwar, Samia Adada, Faten Bakri, Katie Chau, Jessie Clyde, Fatma Dakrony, Kori Dawson, Jessica Dietrich, Rabab Hassen, Mohamed Hossam, Elona Gjebrea Hoxha, Mithkal Jaber, Alison McKinley, Nadine Naboulsi, Jayamalar Samuel, Yen Sim, Amina Stavridis and Mykal Welch, all of the IPPF Regional Offices and Member Associations for reviewing drafts of the Guide .

3 The Guttmacher Institute gratefully acknowledges the gen-eral support it receives from individuals and foundations including major grants from The William and Flora Hewlett Foundation, the David and Lucile Packard Foundation and the Ford Foundation which undergirds all of the Institute s Guide was funded by a grant from the Dutch Ministry of Foreign Affairs under the Choices and Opportunities Fund; IPPF provided a subgrant to Guttmacher under this fund to support this publication. The findings and conclusions are those of the authors and do not necessarily reflect the posi-tions and policies of the donor. ACKNOWLEDGMENTS Guttmacher Institute, 2013, reprinted 2014 Suggested citation: Anderson R, Panchaud C, Singh S and Watson K, Demystifying Data: A Guide to Using Evidence to Improve young people s Sexual Health and Rights, New York: Guttmacher Institute, 1: INTRODUCTIONWhy Do We Need this Guide ?

4 5 What Are the Guide s Goals and Objectives? ..6 Who Are the Intended Audiences? ..6 What is the Geographic Coverage? ..7 How Were the Data Selected? ..7 Using this Guide ..7 Structure of the Guide ..7 CHAPTER 2: DATA AND METHODSData Sources ..9 Coverage ..9 From Data Files to Country Tables ..10 Important Gaps in the Data ..10 CHAPTER 3: SEXUAL AND REPRODUCTIVE HEALTHS ection 1: Sexual Activity and Marriage ..12 Section 2: Contraceptive Knowledge, Use and Need ..19 Section 3: Childbearing ..23 National Level Data Tables, indicators 1 37 ..26 CHAPTER 4: SEXUAL RIGHTS AND GENDER EQUALITYS ection 1: Sexuality Education in Schools ..34 Section 2: Adults Attitudes About Sexual Health Information ..37 Section 3: Self-Efficacy Related to Sexual Health.

5 39 Section 4: Women s Autonomy, Societal Norms and Gender Equality ..42 National Level Data Tables, indicators 38 55 ..47 CHAPTER 5: REACHING young PEOPLES ection 1: Demographic Information ..54 Section 2: School Attendance ..55 Section 3: Exposure to Media ..57 National Level Data Tables, indicators 56 70 ..60 CONTENTST able of contents continues next pageCHAPTER 6: CONCLUSIONHow Far Is the Guide Able to Go? ..64 Country Example: Uganda ..65 Remaining Gaps in Evidence and Research Needs ..64 Country Example: Dominican Republic ..66 Looking to the Future ..67 GLOSSARY ..69 REFERENCES ..72 ABBREVIATIONSCDC: Centers for Disease Control and PreventionCSE: Comprehensive sexuality educationDHS: Demographic and Health Survey STI: Sexually transmitted infectionUSAID: United States Agency for International DevelopmentUNGASS: United Nations General Assembly Special Session on HIV/AIDSITALICIZED GLOSSARY TERMS Terms defined in the Glossary are italicized the first time they appear in each Data Guttmacher InstituteWhy do we need this Guide ?

6 The sexual and reproductive health and rights of young people are a pressing concern everywhere in the world. The world s billion adolescents aged 10 19 account for 18% of the global While their situation differs across regions and countries, adolescents share basic rights pertaining to sexual and reproductive health, such as equality, privacy, dignity, freedom from harm and freedom to choose whether or not to marry. They also need information and services to support healthy decision-making related to sexuality and needs vary depending on many fac-tors: their stage of physical and emotional development, whether they are married, whether they have become mothers or fathers, whether they are sexually active, and what type of sexual activity and relationship they are engaged in.

7 For example, an estimated one in four women aged 15 19 in the developing world is married or in union that is, living with a Marriage that takes place during adolescence is often not decided by the ado-lescents themselves, and young women in particular may lack power relative to older partners. Moreover, unmarried adolescents who engage in sexual activity typically face societal disapproval, which can prevent them from receiv-ing the information and services that they need to protect their health. Many women become mothers during their ado-lescent years: In 2012, an estimated 15 million babies worldwide were born to mothers aged 15 This is important in light of the fact that adolescents aged 15 and younger can have a somewhat higher risk of ill-health from pregnancy, and substantially higher risk of maternal death, compared with women who give birth in their early On average, only one-third of adolescents in develop-ing countries who want to avoid pregnancy are Using a modern contraceptive method; the remaining two-thirds risk having unintended pregnancies and, sometimes, unsafe Unsafe abortion is most prevalent in de-veloping countries and is common among young women.

8 41% of unsafe abortions occur among women aged 15 Also, the risk of sexually transmitted infections (STIs), including HIV, accompanies any sexual intercourse including oral and anal sex. Evidence suggests that those who are younger than 25 are more likely to be infected than those aged 25 and Although adolescents sexual activity is difficult to measure, the available data highlight young people s urgent need for sexual and repro-ductive health information and services beginning from early barriers prevent young people from obtaining comprehensive information and quality services. Some key obstacles include poor in-school curricula, inadequate training of teachers and inadequate outreach to those who are not attending school.

9 In addition, health care infra-structure is often weak, especially in poor and rural areas, and some providers exhibit judgmental attitudes about sexual activity among unmarried youth. Sexual activity among young people is highly stigma-tized and even criminalized in many countries. Marriage is often considered the only context in which it is permis-sible for young people to be sexually active. As a result, unmarried, sexually active young people are often denied access to sexual health services and information, either because of formal barriers or social taboos. Despite these prohibitions, many young people engage in sexual activity, driven by their curiosity and desire. This reality should be incorporated into any program or policy to Improve the sexual well-being of adolescents and young people .

10 Comprehensive sexuality education is an integral component of such efforts and critical to ensuring that young people are aware of the respect due to them as individuals. Without such education, young people are less likely to be aware of their rights and the ways in which established custom, tradition and law may infringe on those rights. To this end, scientific Evidence on the sexual and reproductive knowledge, attitudes, behaviors and health of young people can strengthen the work of health care providers, educators and advocates as they work toward meeting young people s needs for information, education and services. Reliable statistics based on nationally rep-1 Introduction6 Guttmacher Institute Demystifying DataIntroductionand services.


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