Adolescent pregnancy contributes to maternal, perinatal and infant mortality, and to a vicious cycle of poverty and ill-health. Reducing adolescent pregnancy is vital for achieving the Millennium Development Goals that relate to childhood and maternal mortality, and to the overall goal of poverty reduction. National reproductive health policies of a growing number of countries have identified tackling adolescent pregnancy as a priority. However, the approaches adopted are – in many cases – not as comprehensive as they should be and often not based on sound evidence.

WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries provides a robust evidence base to help develop or reshape national policies and strategies. The guidelines help to ensure that available resources are spent on optimal approaches to prevent early pregnancies among adolescents, and on reducing morbidity and mortality associated with pregnancy and childbirth.

Contents

• Contributors and Acknowledgements
• Foreword
• Executive Summary
• Introduction
• I. Detailed Methodology: Overview of the guidelines development process
  • Overview of the guidelines development process
  • Proposal for WHO Guidelines Review committee
  • Scoping
  • Peer review plan
  • Systematic review by outcome and institution commissioned
  • Developing search strategies
  • Implementing search strategies
  • GRADE evidence profiles and evidence for expert review
  • Expert meeting
  • Summary of the decision-making process
  • Management of group process and methods for resolving disagreements
  • Peer review process
  • Planned dissemination of guidelines
  • Evaluation of guidelines
  • References
• II. Recommendations
  • OUTCOME 1 Reduce marriage before the age of 18 years
  • OUTCOME 2 Reduce pregnancy before the age of 20 years
  • OUTCOME 3 Increase use of contraception by adolescents at risk of unintended pregnancy
  • OUTCOME 4 Reduce coerced sex among adolescents
  • OUTCOME 5 Reduce unsafe abortion among adolescents
  • OUTCOME 6A and 6B Increased use of skilled antenatal care among adolescents
    Increased use of skilled care during childbirth among adolescents
  • OUTCOME 6C Increased use of skilled antenatal, childbirth and postnatal care among adolescents
• III Appendix: GRADE Tables
• Annexes
  • ANNEX 1 Participant list
  • ANNEX 2 Report of the expert panel
  • ANNEX 3 Key questions by outcome
  • ANNEX 4 Search results by outcome
  • ANNEX 5 Search terms for each outcome
  • ANNEX 6 Protocol applied to generate the summary of evidence for each outcome
• Call to Action
• Evidence Brief

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