Risk and protective factors that affect adolescent reproductive health in developing countries: A structured literature review

Abstract

The primary focus of this article is to determine which risk and protective factors are most important to adolescent reproductive health in developing countries. A comprehensive and systematic literature search was conducted on studies that examined factors in relation to the following outcomes: ever had premarital sex, condom use, pregnancy, early childbearing, sexually transmitted infections, and HIV. While the search identified over 11,000 publications, only 61 were retained for the final analysis. The results show that factors which were significantly associated to the outcomes were primarily related to the adolescents themselves. In fact, very few factors outside the individual were found to be related to sexual risk behaviours. This contrasts to similar research conducted among youth samples in the US. While this review confirms the strong need for a broader research base on the risk and protective factors related to adolescent sexual and reproductive health in developing countries, it also does identify key factors that can be addressed through innovative programmes and policies to help improve adolescent reproductive health in the developing world.

Keywords:

• developing countries
• risk and protective factors
• adolescent sexual and reproductive health

Acknowledgements

The authors wish to thank Doug Kirby, of ETR Associates, for his assistance with establishing the inclusionary criteria and Phase 1 screening of articles. In addition, Jane Ferguson of the World Health Organisation was instrumental in all phases of this work.

This manuscript was supported under contract #C637014A from the World Health Organisation and the William H. Gates Sr. Endowment, Johns Hopkins Bloomberg School of Public Health.

Notes

1. All reproductive health outcomes were considered for this review. Outcomes, such as sexual coercion and abortion, ended up and not being included because of the limited number of studies that matched our criteria on these outcomes.

2. ETR Associates is a private, non-profit organisation in Scotts Valley, CA that aims at enhancing the well-being of individuals, families and communities by providing leadership, training and research in health promotion with an emphasis on sexuality and health education.

3. These colleagues were primarily Western researchers, who were working in developing country contexts and were known by either of the two authors.