Adolescent fertility in low- and middle-income countries presents a severe impediment to development and can lead to school dropout, lost productivity, and the intergenerational transmission of poverty. However, there is debate about whether adolescent pregnancy is a problem in and of itself or merely symptomatic of deeper, ingrained disadvantage.

To inform policy choices and create a revised research agenda for population and development, Kate McQueston, Rachel Silverman, and Amanda Glassman review recent research on teenage pregnancy in the developing world and the policies implemented to reduce it. The body of research examines many kinds of interventions (such as peer education, health services and counseling) and many indicators (including knowledge or attitude, sexual activity, contraceptive use, and fertility rates). The authors find mixed results overall with the partial exception of knowledge-based indicators, which increased in response to almost all interventions, although it is not clear whether they lead to short- or long term-behavior change.

The evidence base supporting the effectiveness of conditional cash transfers was relatively strong in comparison to other interventions. Similarly, programs that lowered barriers to attending school or increased the opportunity cost of school absence are also supported by the literature. On the basis of these findings, the authors argue that donors should adopt a rights-based approach to adolescent fertility and shift their focus to more intermediate causes of pregnancy, including human rights abuses, gender inequality, child marriage, and socioeconomic marginalization. They highlight three implications for practice and recommendations for policy change:

  1. Lowering the barriers of attending school or increasing the opportunity costs of leaving school can affect adolescent fertility.
  2. Better matching of adolescent pregnancy interventions with the true causes of adolescent fertility is needed.
  3. The evidence base for conditional cash transfers is relatively strong in comparison to other mechanisms.

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