Sexual and Reproductive Health in Early and Later Adolescence: DHS Data on Youth Age 10-19

Adolescence is a period of transition from childhood to adulthood when many behaviors and events set the stage for adult health. Demographic and Health Surveys (DHS) data are often used to describe adolescents age 15-19 but are infrequently used to examine younger adolescents age 10-14. This study employs retrospective data from women and men age 15-24—the most recent cohort that experienced adolescence in the 5 years preceding the survey—to investigate health outcomes during the full range of adolescent years from age 10-19. For 52 countries, this study compiles adolescent sexual and reproductive health indicators in the areas of marriage, sexual activity, contraceptive use, fertility, maternal health, and genderbased violence. We find marriage among women occurs during adolescence in most countries in West and East Africa while men marry after adolescence. Except for South and Southeast Asia, sexual debut occurs during adolescence for men and women. Contraceptive use is rare during early adolescence (except in some Latin American countries) but increases with age to about 20% among women age 15-19. Age-specific fertility rates are imperceptible among the youngest adolescents; even in the country with the highest early fertility rates (Mali), there are only 17 births per 1,000 women age 10-14. The earliest detectable adolescent fertility occurs at age 13-14 in Mali, Bangladesh, Angola, and Gabon. Overall, roughly 20% of women began childbearing before age 20. Over half of all adolescent women in Chad and Niger, and over half of evermarried adolescent women in Afghanistan and Bangladesh have begun childbearing, which is concerning given these countries demonstrated some of the lowest use of maternal health care. Physical violence during adolescence ranges from around 6% (Kyrgyz Republic) to 53% (Uganda); the experience of sexual violence similarly varies. These retrospective data provide useful insights on very young adolescents and reveal reproductive events rarely occur prior to age 15.