The Challenge Initiative's Business Unusual Approach to Adolescent and Youth Sexual and Reproductive Health Programming and Reducing Teenage Pregnancies

Teenage pregnancy, or teenage childbearing, is when a girl aged 15–19 is pregnant with her first child or gives birth. Globally, an estimated 15% of young women give birth before the age of 18. In East Africa, teenage pregnancy rates surpass the global average to stand at 18% in Kenya and 25% in both Uganda and Tanzania. Pregnancy in the adolescent period is linked with higher occurrences of adverse maternal and perinatal outcomes. Limited access to adolescent- and youth-friendly sexual and reproductive health services (AYSRH) is a significant driver of teenage pregnancies. The Challenge Initiative (TCI) supported subnational governments in East Africa to implement AYSRH high-impact interventions in urban poor settings aimed at reducing too early, unintended pregnancies, delaying the first birth and increasing spacing after the first birth.

Investing in Our Future: Developing a Multidimensional Service Package to Support Return to School of Pregnant and Mothering Learners 

The education sector is well-placed to respond to the support needs of adolescent mothers, as recognised in the South African Department of Basic Education (DBE)'s recently launched Policy on the Prevention and Management of Learner Pregnancy. In collaboration with the DBE, this project aims to develop an evidence- and stakeholder-informed, multidimensional service package for pregnant and mothering learners in South African secondary schools, focused on achieving school retention during pregnancy and return post-birth, school progression, and timing future pregnancies.

Influence of Expectations and Intentions during Pregnancy on Postnatal Care Utilization among Adolescent and Young First-Time Mothers: Lessons from a Qualitative Study in Bangladesh 

In Bangladesh, 43% of women have started childbearing before turning 18. Despite high antenatal care (ANC) coverage, less than a third of adolescent and young mothers receive postnatal care (PNC) services. We explored the intention to seek PNC for 15–24 year-old first-time mothers (FTMs), their expectations of postnatal services, and how expectations influence service utilization.