Understanding the adolescent family planning evidence base.

The International Center for Research on Women (ICRW) reviewed the literature to identify what is known about adolescents’ demand for and access to family planning information and services. The review aimed to identify the barriers to and programmatic approaches for increasing adolescents’ access to and use of family planning services and to identify gaps in the evidence that require further research and/or investment. The literature search was limited to articles and reports published since 2000 with a particular emphasis on systematic reviews of evaluations of interventions that include the provision of adolescents with family planning information or services. For the purposes of this study adolescents are identified as aged 10-24 in order to capture the most comprehensive range in the literature. One limitation of this research is the fact that interventions with adolescents may not demonstrate measureable behavioral results until after the end of the program or evaluation. Further few adolescent initiatives are specifically defined as “family planning” programs and instead fall within a more comprehensive framework of sexual and reproductive health and rights. Our analysis took these constraints into account. A conceptual framework was developed to guide our analysis of the evidence based on past conceptualizations of reproductive health barriers and programmatic approaches including ICRW’s “Women’s Demand for Reproductive Control” paper. It postulates that adolescents must achieve three demand-side objectives and two supply-side ones in no particular sequence in order to reach the ultimate goal of sustainably and effectively using family planning to achieve their desired reproductive outcomes. These are: Demand-side Objectives: 1) Desire to avoid delay space or limit childbearing; 2) Desire to use family planning; 3) Agency to use family planning; Supply-side Objectives: 4) Access to family planning services; 5) Provision of quality youth-friendly services. For each objective we identified both key barriers that adolescents face and rigorously evaluated programmatic approaches (both direct and indirect) that were designed to address and in some cases have been shown to overcome barriers specific to the objective. (Excerpt)