Adolescent and youth srh
Various studies indicate that adolescents and youth in Ethiopia are vulnerable to different forms of sexual reproductive health problems (Mirgissa, 2012, Desalegn, 2012, Anabel, 2010). While all young people are affected by the different forms of sexual reproductive health problems, the rights of adolescents and most particularly younger adolescents is often violated or neglected.
Evidence still shows that early marriage, sexual coercion, female genital cutting, unplanned pregnancies and consequent STIs, including HIV, and abortion are still prevailing in Ethiopia.
Age at marriage and childbearing
Early sexual debut is associated with early marriage and consequently early childbearing. In Ethiopia, marriage is an institution that heralds socially acceptable engagement in sexual activity that justifies children bearing. The age at which marriage takes place for first time often determines the number of children the family would have. This has an important impact on women as this exposes her to the risk of repeated pregnancy and increased childbearing in her lifetime. Early sexual debut and teenage pregnancies are common owing to the high rate of child marriages and the subsequent family and societal pressure on girls to prove their fertility.
The median age at first sex for women is 16.4 years (PMA, 2015). Uneducated, poor and rural girls start sex at younger age compared to the educated, well-to-do and urban. About 40% of girls marry before the age of 18 years and 20% before 15. About of half (45%) of girls in Amhara marry before the age of 18. The consequences of child marriage are many. Above all, early initiation of sexual intercourse is a risk for unintended pregnancy which in turn is the major reason for undesirable health and socioeconomic consequences mainly induced/unsafe abortion, high fertility, obstructed labor and its complications such as obstetric fistula, and hypertensive disorders of pregnancy.
Preventing Unsafe Abortion
It is estimated that there are 3.27 million pregnancies in Ethiopia every year, of which approximately 500,000 ends in either spontaneous or unsafely induced abortion. The maternal mortality rate in Ethiopia is 1.68 per 1,000 women aged 15 to 49 years. Similarly, unsafe abortion is the most common cause of maternal mortality, accounting for up to 32% of all maternal deaths in the country.