Over 6 500 adolescent girls die giving birth every year across South Asia Study

South Asian Association for Regional Cooperation and United Nations call for commitment to support millions of pregnant girls and young mothers in South Asia

Across South Asia, over 6,500 adolescent girls die giving birth every year, according to an analysis by UNICEF, WHO and UNFPA

Kathmandu | 12 July 2024: SAARC, UNICEF South Asia, UNFPA and WHO called for increased commitment for critical services for over 2.2 million adolescent girls that give birth yearly in South Asia.

This call came at the Regional Dialogue on Adolescent Pregnancy in South Asia, which is being held in Kathmandu over 11-12 July 2024. Jointly organized by the agencies, the event was inaugurated by the Secretary General of SAARC, Ambassador Golam Sarwar.

“I appreciate the role of governments, UN agencies, NGOs and civil society for the improvements made by the SAARC region over the years in reducing teenage pregnancy,” said Ambassador Golam Sarwar, the Secretary General of SAARC. “But the region still has a long way to go. I call upon everyone to resolutely address the root causes including child marriage, access to adolescent health education, and removing social stigma in managing teenage population of SAARC region.”

Every year, nearly 6,500 adolescent girls die in childbirth in South Asia, as per an analysis by UNCEF, WHO and UNFPA. Most of them are child brides who have limited power over their reproductive health or lives. In fact, South Asia accounts for 290 million child brides – nearly half of the world’s burden. In three countries of South Asia, they are also four times more likely to be out of school than their unmarried peers. One of them is Geetu Kumari who addressed the participants at the regional dialogue.

”I never got the strength back after my caesarean section operation,” said Geetu Kumari from Nepal who got married at 16 and was pregnant soon after. “I still feel weak and find it difficult to do housework and take care of my baby. I just want to be healthy again. I also want to work and earn money. I’ve studied till 10th grade, so I am ready to continue my studies or find work.”

When young girls give birth, their lives can be at risk as they are not yet physically ready to give birth. Thousands more girls are forced to drop out of school, face stigma, rejection, violence, unemployment as well as lifelong social challenges. Forty-nine per cent of young girls in South Asia are not in education, employment or training – the highest in the world.

“We must do better for adolescent girls, particularly those who are married, pregnant or parents. In addition to hurdles to learn, get good healthcare and eat nutritious food, they are denied the opportunity to build skills and start businesses — everything they need as parents to thrive and fulfil their potential,” said Sanjay Wijesekera, UNICEF Regional Director for South Asia. “We must work together and invest in opportunities to unleash the promise of more than 170 million adolescent girls in South Asia. Doing so would be transformative for this region.”

Government and UN officials, adolescent girls, as well as civil society representatives from Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka have participated in the dialogue and reaffirmed their commitment in providing better services to support pregnant adolescent girls and young mothers. This includes opportunities to learn, set up their own businesses, and earn a living.

Adolescent mothers have a much higher risk of dying from maternal causes, compared to women in their 20s and 30s. These risks increase greatly as maternal age decreases, with adolescents under 16 years facing four times the risk of maternal death compared to women over 20 years. Babies born to adolescents also face a significantly higher risk of death compared to babies born to older women. Evidence shows that pregnant adolescents face poorer health coverage than adults. These include antenatal care, postnatal care, delivering with a skilled birth attendant, and family planning. Even if they do have care, these adolescents often lack the confidence to express their needs. They face greater humiliation and disrespect and receive poorer quality care than adults.

“It is high time that we reverse this trend. The unique physical, cognitive, social, emotional, and sexual development during adolescence necessitates special attention in national and international policies. Effective strategies to tackle adolescent pregnancy require cross-sectoral collaboration and equitable access to a variety of services,” said Ms Saima Wazed, Regional Director, WHO South-East Asia. “Investments in adolescent health are essential for promoting healthy socio-economic development and preventing health risks and problems before their onset. This supports the wellbeing of the youth of today – who are the human capital of tomorrow.”

Programmes to combat child marriage and improve care for pregnant adolescents and young mothers have gained momentum across South Asia. But more needs to be done, including programmes to challenge entrenched social norms, build their confidence, help them get the right education, work opportunities, and knowledge on family planning.

“In many of our countries, major demographic shifts are taking place and have created a temporary ‘youth bulge’, for which, when we invest in adolescents and youth’s education, health, life skills, and employment opportunities, countries can build their young people’s capabilities and human capital,” said Dr Aleksandar Sasha Bodiroza, the Deputy Regional Director of UNFPA in the Asia and Pacific. “When their rights are upheld, healthy, educated, and skilled young women become a driving force for their countries’ sustainable development and build a better future for all. Quite simply, empowering girls is both the smart and right thing to do.”

To deliver on the rights of every adolescent girl who is pregnant, married or a parent, SAARC members, UNICEF, UNFPA, WHO, non-governmental and civil society organizations are calling for better data collection and analysis to design policies and programmes; improved care; opportunities for educational and vocational skills training; and information on family planning.

”My request to organizations is that you should continue to raise awareness about child marriage and teenage pregnancy. It is not good for our health and our lives stop as soon as we become mothers,” adds Geetu Kumari. “Please work with both men and women to create opportunities for girls.”