Chile

Chilean adolescents partner with their government to prevent teen pregnancy

"I was just 18 when I found out I was pregnant. Everything seemed terrible when it all began," says 20-year-old Danitza Riquelme of El Bosque, Chile.

Teen pregnancy is associated with myriad health risks with long-term effects for both mothers and babies, including higher risk of maternal death, pelvic floor problems, and mental illness for moms and low birthweight for their children.

"Maternal mortality is one of the top causes of death among young females in the Americas," said Sonja Caffe, adolescent health advisor for the Pan American Health Organization (PAHO). "At the global level, the risk of maternal death is doubled in mothers younger than 15 years in low- and middle-income countries. Perinatal deaths are 50% higher among infants born to mothers under 20 years when compared to those born to mothers 20–29 years old.""

For this reason, Chile has been working to decrease the fertility rate among adolescents younger than 19. Between 2011 and 2015, the country lowered its adolescent fertility rate by more than 10%. In 2015, it stood at 21.11 per 1,000 women of reproductive age, lower than the 24.4 average among countries belonging to the Organisation for Economic Co-operation and Development (OECD). However, young women of certain regions and socioeconomic statuses are still more likely to become pregnant, keeping adolescent pregnancy a top national priority.

Adolescents and youth take action for sexual and reproductive health

In order to decrease adolescent pregnancy throughout the country, Chile is working to involve young people in the planning and development of policies geared at preventing it. As part of the Andean Plan for Adolescent Pregnancy Prevention (PLANEA, for its acronym in Spanish), PAHO and the United Nations Population Fund (UNFPA) have been working with Chile to include adolescent and youth participation in policy development related to this subject.

A group of young people ages 10-24 years now forms the Adolescent and Youth Advisory Council, which works with ministry authorities on policies and health services geared at young people. They often work specifically on sexual and reproductive health, with an emphasis on unplanned adolescent pregnancy.

Between 2010 and 2017, the Advisory Council held eight national seminars with youth from all regions of Chile. During these events, the young people present what they've achieved in their respective parts of the country, while sharing their opinions and offering suggestions to authorities in the ministry of health. These dialogues have included discussions on sexual and reproductive rights, quality health services, teen pregnancy prevention, sex education in school, and partnering with other sectors.

Involving young people in this way is a win-win situation, notes Felipe Hasan of the Comprehensive Adolescent and Youth Health National Program within the Chilean Ministry of Health. Not only are the youth exercising their right to participate in government, but they are also making the policies addressing risk factors for teen pregnancy more effective. Additionally, their participation "strengthens the relationships between communities and health workers and creates a place for reflection, dialogue and feedback," says Hasan. "Everyone learns."

A mixed approach to pregnancy prevention lowers adolescent fertility rates

Chile credits its success in decreasing teen pregnancy on a mix of projects and policies; among them, laws and decrees directing the State to ensure that all people receive education, information, guidance and access to contraception.

Also among them is the "Friendly Spaces in Primary Health Care" project, which aims to improve youth ages 10-19 years' access to health services by offering them comprehensive care focused on their specific health needs.

"These friendly spaces serve as a gateway for adolescents to access primary health care," says Macarena Valdés, Head of Chile's Comprehensive Adolescent and Youth Health National Program. "It meets the different health needs adolescents have in terms of sexual and reproductive health, pregnancy prevention, and drug and alcohol use."

These initiatives and others have allowed young people to access family planning methods – including long-term and emergency contraception and condoms – through primary health care.

The end results are fewer teen pregnancies and an overall healthier, more involved youth population in Chile.

Photo: Representatives from the Chilean Ministry of Health´s Adolescent and Youth Advisory Council