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      A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it

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          Abstract

          Background

          Increasingly, the health and rights of adolescents are being recognized and prioritized on the global agenda. This presents us with a “never-before” opportunity to address adolescent contraception. This is timely, as there are enormous numbers of adolescents who are currently unable to obtain and use contraceptives. From research evidence and programmatic experience, it is clear that we need to do things differently to meet their needs/fulfil their rights.

          Main body

          In this commentary, we call for action in several key areas to address adolescents’ persistent inability to obtain and use contraceptives. We must move away from one-size-fits-all approaches, from a ‘condoms-only’ mind set, from separate services for adolescents, from ignoring the appeal of pharmacies and shops, and from one-off-training to make health workers adolescent friendly. Our efforts to expand access to quality contraceptive services to adolescents must be combined with efforts to build their desire and ability to use them, and to do so consistently. In order for these changes to be made, action must be taken on several levels. This includes the formulation of sound national policies and strategies, robust programme implementation with monitoring, regular programmatic reviews, and implementation research. Further, high-quality collection, analysis, and dissemination of data must underlie all of our efforts. As we move ahead, we must also recognize and draw lessons from positive examples of large scale and sustained programmes in countries that have led the way in increasing contraceptive use by adolescents.

          Conclusion

          This unprecedented moment in history gives us a real opportunity to bring about transformational change, particularly when there is so much at stake.

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          Most cited references33

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          Cash or Condition? Evidence from a Cash Transfer Experiment

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            WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries.

            Adolescent pregnancy and its consequences represent a major public health concern in many low-middle income countries of the world. The World Health Organization has recently developed evidence-based guidelines addressing six areas: preventing early marriage; preventing early pregnancy through sexuality education, increasing education opportunities and economic and social support programs; increasing the use of contraception; reducing coerced sex; preventing unsafe abortion; and increasing the use of prenatal care childbirth and postpartum care. In each of these areas, World Health Organization recommends directions for future research. The summary concludes with a brief look at global and regional initiatives that provide a window of opportunity for stepping up action in this important area.
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              What Does Not Work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions Commonly Accepted as Best Practices

              Youth centers, peer education, and one-off public meetings have generally been ineffective in facilitating young people’s access to sexual and reproductive health (SRH) services, changing their behaviors, or influencing social norms around adolescent SRH. Approaches that have been found to be effective when well implemented, such as comprehensive sexuality education and youth-friendly services, have tended to flounder as they have considerable implementation requirements that are seldom met. For adolescent SRH programs to be effective, we need substantial effort through coordinated and complementary approaches. Unproductive approaches should be abandoned, proven approaches should be implemented with adequate fidelity to those factors that ensure effectiveness, and new approaches should be explored, to include greater attention to prevention science, engagement of the private sector, and expanding access to a wider range of contraceptive methods that respond to adolescents’ needs.
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                Author and article information

                Contributors
                +41 22 791 4814 , chandramouliv@who.int
                poojap@ucla.edu
                parrym@who.int
                clane@usaid.gov
                Gwyn.Hainsworth@gatesfoundation.org
                wong@unfpa.org
                lindsay@torchlightcollective.org
                Beth-Scott@dfid.gov.uk
                esullivan@familyplanning2020.org
                MKemplay@ciff.org
                sayl@who.int
                Journal
                Reprod Health
                Reprod Health
                Reproductive Health
                BioMed Central (London )
                1742-4755
                20 July 2017
                20 July 2017
                2017
                : 14
                : 85
                Affiliations
                [1 ]ISNI 0000000121633745, GRID grid.3575.4, , Adolescent Sexual and Reproductive Health, Department of Reproductive Health and Research, World Health Organization, ; 20 Avenue Appia, 1211, 27 Geneva, Switzerland
                [2 ]ISNI 0000 0001 1955 0561, GRID grid.420285.9, , United States Agency for International Development, ; Washington, USA
                [3 ]ISNI 0000 0000 8990 8592, GRID grid.418309.7, , Bill and Melinda Gates Foundation, ; Seattle, USA
                [4 ]ISNI 0000 0001 1941 1748, GRID grid.452898.a, , United Nations Population Fund, ; New York, USA
                [5 ]Torchlight Collective, Nashville, USA
                [6 ]ISNI 0000 0001 1018 290X, GRID grid.433527.4, , Department for International Development, ; Westminster, UK
                [7 ]Family Planning 2020, Washington D.C., USA
                [8 ]Children’s Investment Fund Foundation, London, UK
                Article
                347
                10.1186/s12978-017-0347-9
                5520341
                28728586
                4d2fb28c-b7c1-4172-9396-bf280f28e2ad
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 June 2017
                : 5 July 2017
                Categories
                Commentary
                Custom metadata
                © The Author(s) 2017

                Obstetrics & Gynecology
                adolescent health,adolescent pregnancy,contraceptive availability,contraceptive distribution,adolescent health services,sustainable development goals,family planning,sexual health,reproductive health

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