The adolescent birth rate (ABR) (SDG target 3.7.2) is an important indicator of both gender equality and the level of equity within a country. Reducing the ABR and addressing the multiple factors underlying it are essential for improving sexual and reproductive health and the social and economic well-being of adolescents (197). Women who become pregnant and give birth very early are subject to higher risks of complications or even death during pregnancy and birth and their children are also more vulnerable (198,199). Therefore, reducing the ABR is an important measure to track the improvement of both maternal health and reduce infant mortality. It is also an important indicator of gender inequality in all countries across the world because a high ABR indicates reduced opportunities for education, workforce participation and empowerment.
The adolescent birth rate also provides indirect evidence on access to pertinent health services since young people, and in particular unmarried adolescent women, often experience difficulties in access to sexual and reproductive health services (see Box 6 also) (197). In the WPR, Vanuatu and Lao have quite high adolescent birth rates at 78 and 75.6 births per 1000 women aged 15-19 years (see Table 4) followed by high rates in the Philippines, Cambodia and Kiribati. This is important given direct links to maternal and infant health outcomes as well as opportunities to be healthy in the long term through improved opportunities for education and employment. Figure 15 maps the relationship (if any) between the ABR and levels of secondary education (35,190,191). This is shown only where data is available for both indicators for the relevant countries.
The data on secondary education relates to the percentage of females aged 25 years or older in a country with at least some level of secondary education. While the ABR focuses on females who are 15-19 years, the indicator for secondary education is an overall measure of gender (in)equality in a country contributing to the Gender Inequality Index (see Figure 1).
Figure 1: Gender Inequality Index, selected countries, Western Pacific Region, 2017 (34)
Figure 15 shows that both Lao (75.6) and Cambodia (57) have high ABR and a low percentage of the female population has at least some secondary education at 33.6% and 15.1% for Lao and Cambodia respectively. Given Cambodia has a much lower percentage of females with secondary education and a lower ABR than Lao, this suggests other factors (potentially ethnicity and regional differences) are important for influencing the ABR within both countries in addition to improving levels of female educational attainment. For example, adolescent birth rates in Viet Nam in 2014 were 45 births per 1000 girls aged 15 to 19. This rate however, increased steadily from a low of below 30 prior to 2005 and was found to be more than twice as high among girls in ethnic minority groups (200).
Figure 15. Adolescent birth rate and female population with at least some secondary education, selected countries, Western Pacific Region, 2015 (35,190,191)
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