CAPPD: In a world of 1.2 billion young people, the issue of adolescent pregnancy (the topic of UNFPA’s 2013 State of the World Population Report) is extremely relevant. Comprehensive sexuality education can be an effective strategy for empowering young people with the knowledge to make informed decisions regarding their sexual and reproductive lives, which can contribute to reducing unwanted pregnancies. Can you discuss the importance of ensuring that comprehensive sexuality education curriculums integrate a gender perspective and are rights-based?
Bruce Campbell (B. C.:) UNFPA’s work in sexuality education is rooted in the ICPD and in its mission to “ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect.” UNFPA works to ensure that sexuality education programmes embrace the following core principles: promote equity and respect for human rights and diversity; recognize sexuality education as a right, foster critical thinking skills, promote young people’s participation, and strengthen their capacities for citizenship, foster norms and attitudes that promote gender equality, address vulnerabilities and fight exclusion and promote local ownership and cultural relevance.
Sexuality education is key to achieving many goals: the promotion of sexual health and the prevention of sexually transmitted infections, including HIV, and of unwanted pregnancies among young people. Numerous studies show that curricula that provide accurate information about condoms and contraception (as well as other key topics) can lead to reductions in risk behaviours reported by young people. Repeated evaluations have further demonstrated that such education does not foster earlier sexual debut or unsafe sexual activity. In contrast, programs that teach only abstinence have not proven effective (UNESCO 2009). Moreover, reviews have identified a number of characteristics that contribute to behaviour change.
Particularly salient, however, are those evaluation studies that demonstrate not only self-reported behaviour change, but also actual reductions in unintended pregnancy or STIs. Evidence has emerged demonstrating that “gender-focused” curricula were substantially more effective than “gender-blind” programs at achieving these health outcomes. These important findings echo research demonstrating that young people who, compared to their peers, adopt egalitarian attitudes about gender roles (or who form relatively more equal intimate heterosexual relationships) are more likely to delay sexual debut, use condoms, and practice contraception; they also have lower rates of STIs, HIV, and unintended pregnancy and are less likely to be in relationships characterized by violence. Hence, integrating a gender perspective into sexuality education is more than a matter of human rights: It matters urgently for young people’s sexual health. Moreover, by emphasizing rights and gender issues, programs can aim to influence a wider range of outcomes, such as reducing gender-based violence and bullying, promoting safe schools, empowering young people to advocate for their own rights, and advancing gender equality more broadly.
CAPPD: The report recognizes that 9 out of 10 pregnancies among adolescent girls between the ages of 15-19 occur within a marriage or union. What strategies is UNFPA undertaking to address the underlying causes of early and forced marriage (including structural inequalities, negative gender norms and stereotypes, and discrimination in legal, social and economic structures)?
B. C.: Indeed, child marriage is a key driver of adolescent pregnancy, and we must address the root causes of child marriage if we want to see progress for girls. UNFPA has been an early champion in the UN system working on many fronts to promote gender equality, girls’ empowerment and human rights. With parliamentarians, policy makers, and youth activists, we advocate for the re-alignment of national and customary laws with international human rights norms. We know that laws are essential, but alone are not enough. Working in communities is crucial. UNFPA supports national partners to engage elders, parents, and other community leaders in dialogue on the equal value of girls, the need to change harmful norms that perpetuate the practice, and community-owned solutions to reduce pressures that families face to marry off their girls at early ages. In conjunction, we invest directly in girl-centered programmes that build up girls’ skills and capacities to avoid risks such as school dropout, the threat of violence and coercion, child marriage, and adolescent pregnancy. Through these programmes, we are able to see girls stay in school, say no to child marriage, delay pregnancy, engage actively in their communities, gain friends and social support, and access critical information and services, including sexual and reproductive health. UNFPA advocates for girls’ rights to be realized, including their rights to education, health, live free of violence, and to be respected and heard. We are building up a cadre of girl leaders to advocate on their behalf in their communities.
CAPPD: The Programme of Action of the International Conference on Population and Development (ICPD) states that all young people have the right to obtain the highest attainable standard of health, which includes their right to sexual and reproductive health. What are some of the central sexual and reproductive health needs of adolescent girls, including those in early and forced marriages, and how can programmes and policies be strengthened to effectively meet their needs?
B. C.: All young people have sexual and reproductive health needs, but the needs of girls are particularly acute given their gender and the social norms that put them at a disadvantage vis-à-vis boys. Adolescent girls need comprehensive sexuality education that imparts critical knowledge and skills about their bodies and how to be in safe and satisfying relationships. They need—and have a right to—critical information and health services so they can make safe and informed choices. This includes access to safe, affordable and reliable contraception. Adolescents have a higher unmet need for contraception compared to older women. When it comes to married girls – imagine being only 14 years old, married and often to an older spouse, with little power in the relationship. You’re pregnant for the first time, having scant knowledge about how your body is changing, or where you can turn to for support. UNFPA estimates that 39,000 girls are married before their 18th birthday each year, often with little say in the matter. We need to put these girls at the center of our efforts. Married girls especially need social support and services, with dedicated outreach efforts, given their low status in the household, intense social pressures to bear children, their lack of mobility, and overall isolation. We need stronger policies and programmes with a sharper focus on adolescent girls’ rights and realities. Universal access to sexual and reproductive health remains an unfinished agenda, and quite simply we won’t see progress on this front unless girls are brought into the picture. This means removing legal barriers that prevent adolescent girls (and boys) from accessing contraception simply because they are unmarried, young and sexually active. One of the most important things that can be done is overcoming the stigma these young people face in communities. UNFPA is working to address this. We need action outside the health sector, for example, advocating for policies that protect girls’ rights to education, and to support secondary education. It also means policies that do not expel girls when they get pregnant, but can help find pathways for girls to continue their education while pregnant and also in light of their new parenting responsibilities.
CAPPD: The Statements of Commitment emerging from the bi-annual International Parliamentarians Conference on the Implementation of the ICPD (IPCI) establishes a clear role for Parliamentarians. What role can Parliamentarians, in Canada and abroad, play in eliminating early and forced marriage?
B. C.: Parliamentarians represent the voices of their constituents and can play a hugely powerful role in eliminating child marriage in this generation. Certainly the Canadian Association of Parliamentarians on Population and Development (CAPPD) can provide such an important forum. Inter-parliamentarian networks can also serve to build strategic alliances across countries to raise awareness of the dangers of child marriage and to apply collective pressure to put in place policies and programmes that support girls at risk and married girls. In countries where child marriage is prevalent, Parliamentarians should bring the issue front and center through public debates and putting in place laws that protect the rights of vulnerable girls. This can include laws that raise the legal minimum age of marriage to 18, that enact civil registration and vital statistics systems, and of course, laws that ensure girls’ access to education, health and critical social support programmes.
CAPPD: The Programme of Action of the International Conference on Population and Development (ICPD) states that all young people have the right to obtain the highest attainable standard of health, which includes their right to sexual and reproductive health (SRH). What are some of the central SRH needs of adolescent girls, including those in early and forced marriages, and how can programmes and policies be strengthened to effectively meet their needs?
B. C.: All young people have SRH needs, but the needs of girls are particularly acute given their gender and the social norms that put them at a disadvantage vis-à-vis boys. Adolescent girls need CSE that imparts critical knowledge and skills about their bodies and how to be in safe and satisfying relationships.
CAPPD: Canada has a strong track record in supporting multilateral initiatives, including providing UNFPA with $16 million in institutional support in 2013. Looking ahead to the Post-2015 development agenda, what role can donor countries play in building a gender-equitable world in which early and forced marriage is eliminated and where girls are educated, healthy, empowered to make decisions about their futures, and able to exercise their rights?
B. C.: UNFPA is extremely honored to count Canada as a close and strategic partner in support of our global development agenda. Empowering adolescent girls and ending child marriage is part and parcel of the world we want. We also rely on Canada and other partners to proactively engage in political processes such as the Post-2015 negotiations, to elevate these issues. Canada and other donor countries can continue to support programmes on the ground. This includes programmes in communities to change harmful norms perpetuating child marriage. Crucially, this involves directly building girls’ capacities with the knowledge, skills and opportunities they need to fulfill their potential. It involves supporting moves by national governments, communities, and young people for a stronger stance on violence against women and girls.
 UNESCO. 2009. International Technical Guidance on Sexuality Education.