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The world is rapidly shifting towards a sustainable future, and the factors like climate action, economic growth, and technological innovation are receiving immense traction. However, the progress towards better sexual and reproductive <keyword id="6354750" type="General" weightage="20" keywordseo="health" source="Orion">health</keyword> and rights seems to have halted across the globe while deteriorating in a few parts. As per a recent assessment, the adolescent pregnancy rate is rising alarmingly in developing countries in contrast to the falling global fertility rate. Nearly half of the mothers in developing countries were 19 years of age when they had their first child, and roughly one-third of them had a child by the age of 17 and less, says a recently published report by <keyword id="73046" type="General" weightage="80" keywordseo="united-nations-population-fund" source="Orion">United Nations Population Fund</keyword> (UNFPA). Adolescent pregnancies and birth rates are commonly reported as the age-specific fertility rate for ages 15-19 years and are usually higher in marginalised communities. In low- and middle-income countries, adolescent girls have an estimated 21 million pregnancies annually, 10 million of which are unintended. An estimated 5.7 million of those 21 million pregnancies end in abortions, most of which occur in risky circumstances, as per the report. "When nearly a third of all women in developing countries are becoming mothers during adolescence, it is clear the world is failing adolescent girls," said <keyword id="14432364" type="General" weightage="80" keywordseo="unfpa-executive" source="Orion">UNFPA Executive</keyword> Director <keyword id="14432363" type="General" weightage="80" keywordseo="dr-natalia" source="Orion">Dr Natalia</keyword> Kanem, raising concern over alarming pregnancy rates. "The repeat pregnancies we see among adolescent mothers are a glaring signpost that they desperately need sexual and reproductive health information and services." Among the 17 <keyword id="3374594" type="General" weightage="80" keywordseo="un-sustainable-development-goals" source="Orion">UN Sustainable Development Goals</keyword> (SDGs), goal 3 is to “Ensure healthy lives and promote well-being for all at all ages”. Low- and middle-income countries have continued to battle financial crises, poverty, hunger, insufficient health care facilities, and lack of literacy for many centuries. The pandemic has acted as a catalyst that deprived girls of their fundamental human rights and left them vulnerable to child marriage and pregnancy, increasing economic and social precarity and turmoil among teenage girls. In developing nations, girls continue to experience excess maternal mortality and morbidity, frequently due to poverty and a lack of access to education and employment. There is also a higher prevalence of STDs, unwanted pregnancies brought on by rape, and forced child marriages to lessen the financial burden and food insecurity on a family or to shield girls from sexual assault during the time of pandemic, wars and conflicts in many parts of the global south. Lack of focus on literacy, education, health care, and gender inequality among many developing countries are shown to be the primary reasons for a rise in adolescent pregnancies. “According to research, a girl with some secondary education is about six times less likely to be married as a child than a girl with only primary education. Women’s empowerment and a more gender-equitable environment will help women to complete education and enter the labour force. Women’s empowerment is often inversely correlated with fertility rates,” <a href="https://www.businessinsider.in/sustainability/article/world-population-day-population-growth-and-sustainable-developmentturning-the-risk-into-opportunity-in-india6/articleshow/92800866.cms">explains</a> <keyword id="1221171" type="General" weightage="80" keywordseo="alok-vajpeyi" source="Orion">Alok Vajpeyi</keyword>, Lead—Core Grants &amp; Knowledge Management, Population Foundation of <keyword id="3658" type="General" weightage="20" keywordseo="india" source="Orion">India</keyword>. Adolescent pregnancy entails devastating consequences for girls, and conflict against such harassment increases the risks of sexual violations and ill health. Apart from pregnancy, the girls suffer from grave human rights violations and severe social consequences, such as child marriage, intimate-partner violence, and mental health issues. And much worse, many girls tragically die, during the delivery, or after due to inadequate health care provisions and, in some cases, outright neglect. ALSO SEE <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/sustainability/article/opinion-priorities-for-building-an-energy-efficient-indian-economy/articleshow/92804706.cms">OPINION: Priorities for building an energy-efficient Indian economy</a> <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/sustainability/article/world-population-day-population-growth-and-sustainable-developmentturning-the-risk-into-opportunity-in-india6/articleshow/92800866.cms">World Population Day: Population growth and sustainable development—turning the risk into opportunity in India</a>

At 21 million per year, teenage pregnancy rates remain distressingly high in low- and middle-income countries

The fifth round of the National Family Health Survey (2019-21), or NFHS-5, reveals that <keyword id="3658" type="General" weightage="80" keywordseo="india" source="Orion">India</keyword>’s Total Fertility rate (TFR) has dropped below replacement level—the level of fertility at which a population exactly replaces itself from one generation to the next. This indicates that the country is on course to achieving population stabilisation. However, the number of people in the country will continue to grow for some time due to a high proportion of young people across India. With over 36 crore people aged between 10 and 24, according to the 2011 Census, India has the world's largest young population. According to the <keyword id="224361" type="General" weightage="50" keywordseo="unfpa" source="Orion">UNFPA</keyword>’s World Population Report, <keyword id="1334" type="General" weightage="50" keywordseo="china" source="Orion">China</keyword> is second with nearly 27 crore young people, followed by Indonesia (6.7 crore) and the US (6.5 crore). Today, every fifth person in India is an adolescent (10-19 years), and every third is a young person (10-24 years). Every year, more than 1.2 crore people enter the workforce in India, largely from northern states. There is ample evidence that the population momentum, given the country's large base of young people, is the primary driver of India’s population growth. <cmsannotation type="cmsannotation" annotationid="Demographic divident" comment="subhead" text="Demographic divident">Demographic divident</cmsannotation> The world’s population is growing older, having a high dependency ratio—a measure of the number of dependents aged zero to 14 and over the age of 65, compared with the total population aged 15 to 64. India certainly has a window of opportunity and will continue to enjoy a distinct advantage of having a younger population for some time, which will influence the country’s development and economic and social investment decisions. The sheer size of the adolescent and youth population reflects the wealth of human resources in the country. This advantage is termed ‘demographic dividend’, which means the working-age population has numerically overtaken the non-working-age population. India’s dependency ratio has fallen from 75% in 2001 to 65% in 2011. It is projected to fall further to 50% in 2021 and remain around that level for the next 20 years. This window of opportunity will slowly narrow in 2041 and close in 2061 when the dependency ratio likely rises to 67%. For India to leverage this opportunity and achieve sustainable social and economic development, we will have to urgently and greatly step up investments into the health, nutrition, education, vocational training, skills and employability of the working-age population. In addition, we must ensure appropriate labour and migration policies and good governance. The country will have to place adolescents and youths at the centre of its policies, investments and programmes and align them with the demographic shifts in the states to leverage the demographic dividend. <cmsannotation type="cmsannotation" annotationid="Priorities for sustainable economic growth" comment="subhead" text="Priorities for sustainable economic growth">Priorities for sustainable economic growth</cmsannotation> 1. Health The evidence shows that demographic dividend significantly contributed to the economic growth in China, Korea and Japan. These countries invested in the young population's health, education and capacity-building. Though India has made significant progress, China is ahead on health, particularly reproductive health indicators. China reports an infant mortality rate of 12 deaths per 1,000 live births, while the number stands at 30 for India. At 27 deaths per 100,000 live births, China’s maternal mortality rate is also much lower than that of India, which sees 103 deaths per 100,000 live births. China reports a stunting rate of 8 per cent among children under the age of 5 years against India’s 36 per cent. India needs to ramp up its efforts towards ensuring <keyword id="3279397" type="General" weightage="50" keywordseo="universal-health" source="Orion">Universal Health</keyword> Coverage. 2. Education Quality education, skill-building initiatives and increasing employment could make the working-age population more productive. With greater labour force participation rates and increased per capita resources for investment in poverty reduction and human capital development, India can witness economic growth and better living standards even with a high population. It is also essential to ensure an investment climate and labour policies to expand and sustain safe and secure employment. 3. Women empowerment We must also invest in girls’ education, particularly ensuring that all girls complete secondary school education. Global evidence suggests that this helps girls to delay marriage and pregnancy. According to research, a girl with some secondary education is about six times less likely to be married as a child than a girl with only primary education. Women’s empowerment and a more gender-equitable environment will help women to complete education and enter the labour force. Women’s empowerment is often inversely correlated with fertility rates. All these require increased public spending towards universal access to primary, secondary and tertiary education, skilling programmes, quality health services, including sexual and reproductive and mental health services, and nutrition. Providing comprehensive sexuality education for all young people is essential. Investing in strengthening mechanisms for improving access to these services for adolescents will greatly impact savings and capital formation, which will translate to higher economic growth. A study in The Lancet concludes, “improving the physical, sexual, and mental health of adolescents aged 10 to 19 years at the cost of about $4.60 per person per year could bring a ten-fold economic benefit by averting more than 12 million adolescent deaths and preventing more than 30 million unintended pregnancies over a span of 15 years”. Since a fifth of India’s population is adolescents, their development is also an economic opportunity. It would also enable the country to achieve many Sustainable Development Goals by 2030. <keyword id="1221171" type="General" weightage="50" keywordseo="alok-vajpeyi" source="Orion">Alok Vajpeyi</keyword> is the Lead—Core Grants &amp; Knowledge Management at the Population Foundation of India. This column is part of a year-long (2022-23) campaign on the theme “Only One Earth: Sustaining People, Planet and Prosperity” by Business Insider India’s <a href="https://www.businessinsider.in/sustainability">Sustainability Insider</a>. Disclaimer: The opinions expressed by the author/interviewee do not necessarily reflect the views of Business Insider India. The article has been partly edited for length and clarity.

World Population Day: Population growth and sustainable development—turning the risk into opportunity in India

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At 21 million per year, teenage pregnancy rates remain distressingly high in low- and middle-income countries

Varnika Srivastava

World Population Day: Population growth and sustainable development—turning the risk into opportunity in India

Alok Vajpeyi

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