Sexual and reproductive health
Adolescent sexual and reproductive health (ASRH) is a common concern and health need of the Nepali youth. Teen sex, sexually transmitted infections, birth control, sexual education and teen pregnancy are clinical and social issues. Some of the challenges faced by adolescents across the county include early pregnancy and parenthood, difficulties accessing contraception, unsafe abortion and sexually transmitted infections (STIs).
In Nepal adolescent constitute 24 per cent of the total population. The practice of early marriage and child bearing is very common. Among girls aged between15-19 years, 29 per cent are already married and 17 per cent are already mothers or pregnant. Pregnancy among very young age is a significant problem in our country facing higher risk of complications and death.
Adolescent sexual activity within or outside of marriage can lead to negative reproductive health outcomes. Unprotected sexual activity can expose teens to the risk of accidental pregnancy, unwanted child conceiving, abortion, HIV/AIDS and other STIs. Adolescent people are currently the group most severely impacted by HIV. Rates of STIs also show the highest prevalence among 20-24 years followed by 15-19 years. A series of obstacles currently prohibit good reproductive health for adolescents. At the political level, ASRH is low priority and there are often limiting laws and policies. Various societal, cultural and religious factors create an inhibitive environment for discussion of ASRH. In some regions, practices of early marriage, childbearing, societal pressure prohibiting use of contraceptives may also exist. Poor ASRH is due to service related barriers, lack of schooling, poor health systems for sexual health, family planning, and maternal health.
Today’s adolescent will determine the reproductive health and wellbeing of nation in the coming decades. Communications and other interventions designed to improve the sexual and reproductive health of adolescents must respond appropriately to the changing global context. Nepali adolescents are at chaos of demographic, cultural and social shifts.
The service mechanisms available are not sufficiently institutionalised to address the need of young people; hence there is an urgent need to scale up youth-friendly services. Despite improvements in lives of young people, their vulnerability regarding reproductive health is also increasing.