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|INDICATOR 8: Adolescent birth rate (disaggregated by 10-14; 15-19 years) per 1,000 women in each age group|
| Why this indicator? What will it measure and provide information for?
Early childbearing is associated with decrease in woman’s decision-making power in areas related to her own reproductive health. The rate of adolescents giving birth measures the extent to which community norms and societal structures support adolescent girls delaying first childbirth. Factors influencing adolescent birth rate include pressure for early marriage, provision of reproductive health services to adolescents, support for girls’ completion of secondary school, pressure for early childbearing and access to education and economic participation.
| What Sustainable Development Goal is the indicator connected to?
This indicator is linked to SDG 3 “Ensure healthy lives and promote well-being for all at all ages” and SDG 5 “Achieve gender equity and empower all women and girls.” It is listed as one of the indicators for tracking this SDG. Specifically this indicator is linked to the SDG targets “By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live birth,” “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all” and “Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation.”
| Definitions and key terms
Adolescent girls are girls from 10 to 19 years of age. The birth rate measures all births to adolescent girls per 1000 adolescent girls. This indicator should be collected to allow for disaggregation by age into adolescent girls 10 – 14 and those 15 – 19. The standard indicator likely to be available from secondary data covers adolescent girls from 15 – 19. However if data are available for adolescent girls 10 – 14 they should be analyzed as well.
| Data and information required to calculate the indicator
* Numerator: number of live birth occurring among women aged 15-19 (and 10 – 14 if available) in the reference time period
* Denominator: total person years represented among women aged 15-19 (and 10 – 14 if available) in the reference time period
* See specific DHS question numbers and wording to calculate this indicator.
| Suggested method for data collection
* This information is collected via surveys, typically DHS surveys which include standard questions for obtaining data for this indicator.
* See Annex 1 for specific DHS question numbers and wording to calculate this indicator.
| Possible data sources
* Household surveys (DHS) conducted typically every 3 or 5 years. In some cases, data are available for disaggregation at sub-national level. Ministries of Health may have estimates available for regions or provinces.
* Data from national-level sources are compiled in the UNICEF global database. Latest available estimates of adolescent birth rate are available on www.undata.un.org
* If feasible and appropriate, CARE may also conduct household surveys, especially if sampling to represent marginalized impact populations or specific geographic areas
Both the likely sample size of a survey conducted by CARE and the complexity of the calculations required to calculate person-years of exposure (adolescent age) and the total number of births (allowing for multiple births to one individual during the reference year) mean that this indicator is not feasible to calculate from a household survey on the scale appropriate for CARE to implement directly, thus this indicator is available only through secondary sources.
ALTERNATIVE INDICATOR: If CARE is collecting data related to this indicator, we recommend instead that you use an alternative indicator: Age at first birth. This can be asked directly of survey respondents. Delay of first birth is associated with positive outcomes for adolescent girls and women.
| Resources needed for data collection
If the information will be gathered from secondary data sources, no investment is required for gathering this indicator at the national level. However, your evaluation may want to assess this directly in specific geographic areas or sub-populations or include questions on CARE’s contribution to the change, which will require resources for conducting interviews or focus groups.
| Reporting results for this indicator: number of people for which the change happened
* Has there been an improvement in the rate of childbirth among adolescents (or in age of first birth) since the past measurement, has it stayed the same or worsened? In the broadest interpretation, all adolescent girls who delay first childbirth benefit from improvements in this indicator.
* Given CARE’s role and presence, to what extent has CARE contributed to this change and at which level (national, in a particular region or part of the country, marginally)? Please explain.
| Questions for guiding the analysis and interpretation of data (explaining the how and why the change happened, and how CARE contributed to the change)
* How has CARE contributed to the change? What were CARE’s main strategies for contributing to this change (e.g. capacity building of health staff, community awareness raising, advocacy and policy change, supporting the scale up of proven solutions, a combination of strategies, other ways)?
* Is the change in births among adolescents influenced by increased concern for the health risk of premature childbearing, increased value placed on girl’s completion of secondary school or other community norms?
* Is the change in births to adolescents influenced by new or amended policies, legislation, programs, accountability spaces and/or budgets responsive to increasing adolescent’s access to reproductive health care including contraceptive information, services or supplies?