UNFPAs State of the World Population 2013 highlighted some of the socio-economic consequences associated with adolescent pregnancies. These included missed educational and other opportunities, perpetuation of poverty and exclusion, basic human rights denied and the ongoing unfulfilment of girls’ potential. UNFPA argues that the action taken by many countries have been focused primarily on changing the behaviour of the girl and not addressing the underlying determinants. Among the main determinants identified are child marriages, gender inequality, poverty, sexual violence and coercion, lack of access to education and reproductive health services and national policies restricting access to contraception. It is the view of the UNFPA (2013, ix) that the action taken by many countries, aimed at preventing adolescent pregnancy, and in some cases to support girls who have become pregnant, have been primarily about changing the behaviour of the girl rather than addressing the underlying determinants outlined.
A 2017 joint report by Pan American Health Organization (PAHO), UNFPA, and the United Nations Children Fund (UNICEF) informed that Latin America and the Caribbean (LAC) was the only region in the world reporting an increase in adolescent pregnancy over time. The United Nations estimates for the period 2015–2020 show a rate of 63.0 per 1,000 girls 15–19 years old in LAC, compared to a global average of 42.5 per 1,000 girls. For Guyana, the rate estimated for 2015–2020 is 74.4 per 1,000 girls 15–19 years old, about 1.2 times greater than the average for the LAC region.
The goal of this report is to assess the economic impact of Adolescent Pregnancy (AP) and Early Motherhood (EM) using the methodology MILENA 1.0 developed by the UNFPA. The application of the method with respect to Guyana aims to produce quantifiable evidence of the cost of adolescent motherhood for women and for the society. This evidence highlights the adverse consequences of early motherhood and by so doing should lead to the development and implementation of national policies and programmes geared to its prevention.
The analysis is based on the 2019 quarterly labour force surveys of Guyana and the measurements are derived from the use of a control group for comparison, comprising women who became mothers in adulthood, defined for this study as ages 20–29 years. For the women who became mothers as adolescents (10–19 years) and the control group, profiles of educational attainment, labour market participation and income are measured. For each of these dimensions, gaps are then calculated and their monetary values estimated to calculate the opportunity cost. The opportunity cost represents the resources a country allocates to welfare expenditure for adolescent pregnancy, as well as revenue lost by both the State and the adolescent mothers.
The MILENA methodology has revealed important economic and social implications of adolescent pregnancy in Guyana. The main findings based on the analysis of the quarterly labour force surveys conducted in 2019 are as follows:
- Adolescent mothers are 13% more likely than mothers who delay pregnancy until early adulthood, to withdraw from the labour market. This inactivity carries an estimated loss of annual income of $166,714, 064 the equivalent of USD 799,588 for 2019.
- The unemployment rate for the adolescent mothers is 32%, approximately 45% higher than the 22% rate of unemployment for women who were mothers at an adult age, a gap of 10 percentage points. The higher unemployment rate for adolescent mothers observed for 2019 implies a loss of revenue estimated at $295,958,250 or USD 1,419,464.
- The labour income gap between the adolescent mothers and those who delayed childbearing shows that the income of the adolescent mothers is about 10% lower than that of women who had a child in adulthood. The loss represents on average $6,250 (USD 29.98) per month for each adolescent mother during 2019. The estimated loss based on the gap in earnings between the two groups of mothers is $264,290,730 with equivalent USD 1,267,581.
- At every educational level the average income for the older mothers exceed that for the adolescent mothers. Tertiary and university studies significantly increase the earning potential of both groups of mothers. Based on the observed gaps in the education levels and the resulting income difference between the two groups of mothers at 2019, the opportunity cost of education, indicating the loss of income is $230,777,890 the equivalent of USD 1,106,848.
- With 3 deaths from pregnancy related causes among adolescents the adolescent maternal mortality ratio for Guyana for 2019 is estimated at 103 per 100,000 live births. ith a life expectancy for women of 73 years these 3 deaths with an average age at death due to pregnancy estimated at 17.5 years result in approximately 166 years of potential life lost. With an age of entry into the workforce of 15 years and a retirement age of 60 years, the potential productive years lost is estimated at 128 years. Bearing in mind therefore, that for each year of productive life women who had a child in adolescence earn an average of $687,000, maternal mortality among adolescents results in an economic loss of $ 87,592,500 (USD 420,108) each year.
- For 2019, the estimated budget for the Family Health Care programme of the Ministry of Public Health was $1,668,625,000 (USD 8,002,998) representing 0.7% of the total budget for the Ministry of Public Health. Maternal and Child Health Services and Adolescent Health Services are sub-programmes within the Family Health Care Services programme. Direct costs associated with normal pregnancies estimated for 2019 was $248,568,646 (USD 1,192,176). It should be noted that these latter costs relate to normal pregnancies only. Considering that adolescent mothers face high risks of pregnancy complications which jeopardize not just their health but also the health of their newborns, the true costs of health care associated with adolescent pregnancy is understated here.
- Decreases in labour participation, employment and income resulting from adolescent pregnancy and early motherhood withhold taxes in the form of value-added tax (VAT) and personal income taxes. Total revenues forgone by the State during 2019 from VAT and for personal income tax due to inactivity, unemployment and reduced income levels among women who became mothers in adolescence amount to $216,056,850 equivalent to USD 1,036,244.
