Adolescents and Youth

The Port of Spain Declaration states that CDCC countries “…acknowledge the need to address adolescent reproductive health issues, through the promotion of responsible and healthy reproductive and sexual behaviour”. Similarly, the Caribbean Plan of Action on Population and Development identified specific issues to be addressed with regard to adolescents in the Caribbean, including the limited awareness of adolescent reproductive health issues and weak political support for adequately addressing such needs.

Although the MDGs do not directly address the reproductive health of adolescents, it is recognized throughout the region that immediate attention to these needs will contribute to the successful accomplishment of the majority of these goals, in particular the one on HIV/AIDS. Furthermore, the goal of poverty reduction is based on the capacity of future generations – today’s adolescents – to make the choice that will enable them to lead full and productive lives, including the exercise of their reproductive rights.

Of the 35 million people living in the Caribbean, approximately eight million are between the ages of 10 and 24. Although net enrolment rates at both primary and secondary levels have steadily increased in most countries for the past ten years, for both sexes, dropout rates have also increased  This, combined with high unemployment  among young people and limited opportunities for personal development characterize the life of the majority of youth in the region.  Poor families continue to count more children and adolescents than better-off families, and many adolescents grow up in single-parent households, which tend to be poorer than those with both parents present.  Unemployment particularly increases the vulnerability of young women between 15 and 19, as it fuels their dependency and limits opportunities for personal development.

The transition years from childhood to adulthood, while presenting tremendous opportunities for learning and self-development, may also be a time of narrowing life chances and choices.  Poverty exposes young people to a variety of challenges.  Boys and girls often drop out of school to supplement family income.  Poor educational and economic opportunities, gender inequality and sexual exploitation and abuse are important factors in the high levels of adolescent pregnancies, and sexually transmitted  infections, including HIV/AIDS:  as adolescent girls are faced with few choices, opportunities and resources, they are especially vulnerable to risks from unprotected sexual activity.  Typically poorly informed about ways to protect themselves, young people in the Caribbean are increasingly at risk of contracting and transmitting sexually transmitted diseases, including HIV/AIDS.

Recent studies indicate that attention to the reproductive and sexual health of young people is urgently needed.  A Pan American Health Organization (PAHO)/World Health Organization (WHO) study ¹³  on adolescent health in the Caribbean reports that as many as a quarter of adolescents, both boys and girls , declare having initiated sexual activities as early as 10-12 years of age.  While fertility rates in the other segments of the population have steadily declined, adolescent pregnancy rates have remained relatively stable.

Youth policies have been enacted in a number of countries, and legislative initiatives have sought to codify or review the laws governing national approaches to adolescent rights and development.  Various administrative and policy initiatives to facilitate return to school after pregnancy are being put in place.

Over the past decade, countries in the Caribbean have seen many of the ICPD-generated strategies implemented to varying degrees of success.  Programmes for adolescents have proven most effective when and where they have secured the full involvement of adolescents in identifying their development and health needs, including reproductive and sexual health.  Additionally, among the most successful programmes and initiatives are those which are gender-sensitive and include a wide array of persons in a position to provide guidance to adolescents concerning responsible sexual and reproductive behaviour, particularly parents and families, as well as communities, religious institutions, schools, the mass media and peer groups.

All countries in the sub-region are implementing programmes aimed at addressing the life skills and reproductive health needs of adolescents and youth within a framework of adolescent development.  Such programmes, which are gender-sensitive, include support mechanisms for the education and counseling of adolescents in the areas of responsible sexual behaviour, life skills, reproductive health, sexually transmitted infections, and HIV/AIDS prevention.  Some countries have started initiatives to empower young people in the exercise of their rights, in particular as they relate to the prevention and treatment of incest and sexual abuse.

Often, the scope of many of the programmes is constrained by insufficient funding and trained human resources.  The Health and Family Life Education (HFLE) curriculum used by most CARICOM member countries is an important step in the direction of universal education in this area.  However, while HFLE has been introduced as part of the school curriculum in primary and secondary levels, scheduling priority given to the subject and the comfort levels of the teachers delivering the curriculum still remain important challenges.

Many programmes have increased the institutionalization of adolescent education programmes.  Some countries have made mandatory the implementation of HFLE and have developed a teacher-resource manual for adolescent health.  Some countries have developed resource tools for teachers while others have established partnerships between government, civil society and international organizations to include adolescent modules in national strategic reproductive health plans.

Several non-government organizations throughout the Caribbean provide youth-friendly reproductive health services including counseling, information and clinical services. Programmes for adolescent mothers are also available in many countries of the region.

Initiatives are beginning to provide a body of knowledge that may yield evidence-based guidelines for the provision of gender-sensitive quality reproductive health information, education and services for adolescents.  Many of the countries have noted the various impediments for the successful provision of comprehensive health education, information and services for young people, while at the same time reporting on significant unmet needs, such as lack of age and sex-specific adolescent-friendly services, or services that address the fragile self-esteem of adolescents who fall prey to violence, abuse and exploitation, often without knowledgeable or sympathetic adults to turn to.

Source:  Background document – Review of the Implementation of the Cairo Programme of Action in the Caribbean (1994-2004):  Achievements and Constraints, UNECLAC/UNFPA (LACD)