This article offers an overview of sexual behavior and contraceptive knowledge and use among adolescent women across a large number of developing countries. The results demonstrate that almost universally in sub-Saharan Africa and in the majority of countries in other regions, the gap between age at first sexual intercourse and age at first marriage has increased across age cohorts. The predominant pattern is one in which both age at marriage and age at first intercourse have risen, but the increase in age at marriage is greater, resulting in a widening gap. In most countries in sub-Saharan Africa, current contraceptive use is higher among sexually active, unmarried teens than it is among married teens, whereas in Latin America and the Caribbean, current-use levels are higher among married teens. The results also show that adolescents are unlikely to use a contraceptive the first time they have sex and are more likely than older women to experience a contraceptive failure.
After the collapse of the Taliban regime in 2002, Afghanistan adopted a new development path and billions of dollars were invested in rebuilding the country's economy and health systems with the help of donors. These investments have led to substantial improvements in maternal and child health in recent years and ultimately to a decrease in maternal and child mortality. The 2010 Afghanistan Mortality Survey (AMS) provides important new information on the levels and trends in these indicators. The AMS estimated that there are 327 maternal deaths for every 100,000 live births (95% confidence interval = 260-394) and 97 deaths before the age of five years for every 1000 children born. Decreases in these mortality rates are consistent with changes in key determinants of mortality, including an increasing age at marriage, higher contraceptive use, lower fertility, better immunisation coverage, improvements in the percentage of women delivering in health facilities and receiving antenatal and postnatal care, involvement of community health workers and increasing access to the Basic Package of Health Services. Despite the impressive gains in these areas, many challenges remain. Further improvements in health services in Afghanistan will require sustained efforts on the part of both the Government of Afghanistan and international donors.
This analysis demonstrates that HIV is a multidimensional epidemic, with demographic, residential, social, biological, and behavioral factors all exerting influence on individual probability of becoming infected with HIV. Although all of these factors contribute to the risk profile for a given individual, the results suggest that differences in biological factors such as circumcision and sexually transmitted infections may be more important in assessing risk for HIV than differences in sexual behavior.
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