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5.4 Adolescent birth rate

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Modified on 2012/03/05 16:08 by MDG Wiki Handbook Categorized as Goal 5
Contents

GOAL AND TARGET ADDRESSED

Goal 5. Improve maternal health
Target 5.B: Achieve, by 2015, universal access to reproductive health

DEFINITION AND METHOD OF COMPUTATION

Definition
The adolescent birth rate is the annual number of live births to adolescent women per 1,000 adolescent women.

Concepts
The adolescent birth rate is also referred to as the age-specific fertility rate for women aged 15–19.

A live birth is the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life—such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles—whether or not the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered a live birth.

Adolescent women are for the purpose of this indicator defined as women 15 to 19 years of age.

Method of computation
The adolescent birth rate is calculated as the number of live births to adolescent women divided by the total number of adolescent women and multiplied by 1,000.

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The indicator is calculated differently depending on whether data from civil registrations, surveys or censuses are used.
  1. Civil registration:
    • Number of live births to adolescent women is the registered number of live births by women 15 to 19 years of age during a given year.
    • Number of adolescent women is the estimated population of women aged 15 to 19 as of 1 July of a given year. For purposes of monitoring this indicator at the national level, population figures may be taken from reliable national sources or from the population estimates published by the United Nations Population Division in World Population Prospects. In cases where the numerator does not cover the complete de facto population, an alternative appropriate population estimate may be used if available.
  2. Survey data: The adolescent birth rate is generally computed based on retrospective birth histories. Whenever possible, the reference period corresponds to the 5 years preceding the survey. The reported observation year corresponds to the middle of the reference period.
    • Number of live births to adolescent women refers to live births to women that were 15 to 19 years of age at the time of the birth during a reference period before the interview.
    • Number of adolescent women refers to person-years lived between the ages of 15 and 19 by the interviewed women during the same reference period.
  3. In surveys where no retrospective birth histories are available, the number of births can be estimated based on the questions on the date of last birth or the number of births in the 12 months preceding the survey.

    • Census data: The adolescent birth rate is generally computed based on the date of the last birth or the number of births in the 12 months preceding the enumeration. The census data provide both the numerator and the denominator. In some cases, rates based on censuses are adjusted for under registration. In some cases, where no other reliable data exists, the own-children method of indirect estimation could be used for obtaining estimates of the adolescent birth rate for a number of years before the census (for more information see Manual X: Indirect Techniques for Demographic Estimation, United Nations (1983)).

RATIONALE AND INTERPRETATION

The adolescent birth rate is an essential indicator for the design of policies aiming to achieve an overall improvement of maternal health. Maternal mortality for younger adolescent women (below age 18) tends to be much higher than for older women or older adolescents (ages 18 and 19). When the overall maternal mortality for adolescent women is high, reducing adolescent fertility contributes to improving maternal health by reducing overall maternal mortality rates.

Very early motherhood not only increases the risk of dying in childbirth, it jeopardizes the well-being of mothers and their children as well. Young mothers frequently forego education and socio-economic opportunities; and children born to adolescent mothers are at greater risk of dying in infancy or childhood and, if they survive, have fewer opportunities to participate in education.

Levels of the adolescent birth rate range from less than 2 to approximately 230 births per 1000 adolescent women. Values of 50 or more per 1000 women are considered high and values of 10 or less per 1000 women are regarded as low. Higher values of the adolescent birth rate might indicate an unmet need for family planning among young women, many of whom may want to delay their pregnancies.

SOURCES AND DATA COLLECTION

Data on births by age of mother are usually obtained from civil registration systems, as long as the latter cover 90 per cent or more of all live births. Census or survey estimates can supplement registry data for periods when civil registration data are not available. In countries lacking a civil registration system or where the coverage is lower than 90 per cent, the adolescent birth rate can be obtained from household survey and census data. In countries with multiple survey programmes, large sample surveys conducted on an annual or biennial basis are given precedence.

Surveys from which the data can usually be obtained are: Demographic and Health Surveys (DHS), Reproductive Health Surveys (RHS) conducted with assistance from the United States Centers for Disease Control and Prevention, Multiple Indicator Cluster Surveys (MICS) and other nationally sponsored surveys. When estimates are available in a survey report, they should be extracted directly. Otherwise, if microdata are available, estimates should be produced using an appropriate method of calculation. For census data, the estimates should be the same as in census reports, including any adjustment undertaken by the national statistical office.

DISAGGREGATION

The disaggregation of adolescent birth rates by geographical area, rural or urban residence, women’s level of education, poverty status and other characteristics that are relevant in the national context help identify population sub-groups where levels of adolescent birth rates are highest and formulate policies for the reduction of maternal mortality and the improvement of reproductive health of adolescent girls and for the reduction of child mortality.

COMMENTS AND LIMITATIONS

There are a number of limitations when it comes to the calculation of this indicator. When using civil registration data, adolescent birth rates are subject to limitations which depend on the completeness of birth registration; the treatment of infants born alive but dead before registration or within the first 24 hours of life; the precision of the reported age of the mother; and the inclusion of births from previous periods. Population estimates may suffer from limitations connected to age misreporting and coverage. Another limitation is that the number of live births may also include births to women below age 15 (e.g., live births by age of mother are for women 12 to 19 years of age) or that the indicator is calculated for different age groups for both the number of live births and the number of women (e.g., women 16 to 19 years of age). In countries where the civil registration system registers births by the place of occurrence, rather than by the place of usual residence of the mother, the number of adolescent births may be inflated in urban areas with a hospital infrastructure that serves women from surrounding rural areas. This affects the accuracy of the indicator when it is reported separately for rural and urban areas. When using survey and census data, both the number of live births to adolescent women and the number of adolescents come from the same population. Nonetheless the data can be skewed due to age misreporting, birth omissions, misreporting the date of birth of the child, and sampling variability in the case of surveys. Another limitation is that the adolescent birth rate is commonly reported as the percentage of total fertility contributed by women aged 15–19. The adolescent birth rate, however, is to be preferred over the latter because the percentage of total fertility contributed by women aged 15–19 can vary significantly as a result of changes in fertility rates for other age groups even when the fertility rate of adolescents remains constant.

GENDER EQUALITY ISSUES

Women who become mothers very early frequently miss out on education and socio-economic opportunities. Thus, high adolescent birth rates may contribute to a large gender gap in education. High adolescent birth rates also indicate a prevalence of early marriages among women, and are often a sign of a social structure in which women are expected to affirm their adulthood by assuming their social role as mothers as early as possible. As such, declining adolescent birth rates can indicate increasing gender equality and women’s empowerment. A high adolescent birth rate can also contribute to high maternal mortality.

DATA FOR GLOBAL AND REGIONAL MONITORING

At the global level, data for this indicator are compiled by the United Nations Population Division (UNPD). Whenever possible, civil registration data are used. For adolescent birth rates, the figures used are the ones reported by National Statistical Offices to the United Nations Statistics Division. When these are not available or reliable, data are obtained from other regional statistical units, or collected from the country directly. Adolescent population figures are those published in the World Population Prospects produced by UNPD. In cases where either the numerator or denominator is missing, the estimate of the rate produced by the country statistical office is used.

When data from civil registration are unavailable, survey or census data are examined. For survey data, DHS, RHS and MICS are the usual references. Whenever the estimates are available in the survey report, they are taken directly from it. In other cases, the national microdata are used by the UNPD to produce the estimates. For census data, estimates are preferably obtained directly from census reports, including the adjustments done by the national statistical office. In other cases, the adolescent birth rate is produced using appropriate methods of calculation. In some cases, the rates based on censuses are adjusted for under registration based on indirect methods of estimation. For countries with no other reliable data, the own-children method of indirect estimation provides estimates of the adolescent birth rate for a number of years before the census.

UNPD calculates regional and global estimates for the indicator. For reference years with missing data, the closest data point is used. Averages are produced using the number of women 15-19 years of age in the reference year as the weight. The figures are taken from the latest revision of World Population Prospects. Regional averages are provided only when more than 50 per cent of the women 15-19 years of age in the region are covered. For most regions coverage exceeds 95 per cent.

SUPPLEMENTARY INFORMATION



EXAMPLES



REFERENCES

United Nations (2008). World Fertility Patterns 2007. Wallchart. New York. Available from http://www.un.org/esa/population/publications/worldfertility2007/worldfertility2007.htm.

United Nations (2011). World Population Prospects: The 2010 Revision. On-line Database. New York. Available from http://esa.un.org/unpd/wpp/index.htm.

United Nations (2004). Handbook on the Collection of Fertility and Mortality Data. New York. Available from http://unstats.un.org/unsd/publication/SeriesF/SeriesF_92E.pdf.

United Nations (1983). Manual X: Indirect Techniques for Demographic Estimation. New York. Available from http://www.un.org/esa/population/publications/Manual_X/Manual_X.htm.

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