Today’s generation of young people is the largest in human history: globally, 1.8 billion people are aged between 10-24 years, accounting for a quarter of the world’s population. The overwhelming majority of young people live in low and middle-income countries, and 60% live in Asia and the Pacific.
Adolescence (box 1) is a formative life phase, characterised by substantial physical, emotional, cognitive and social growth and development, during which foundations for health and wellbeing in later life, and for the next generation, are established. This critical transition has significant implications for sexual and reproductive health (SRH). Not only do the physical and hormonal changes of puberty lead to sexual maturity and the physical capacity to have sex and reproduce, but adolescence is also a period of intense social and emotional development during which sexuality, sexual identity, and gender norms, roles and identities are crystalised. It is during this time that many young people first form romantic relationships and commence sexual activity, and when many enter marriage and parenthood.
For these reasons, adolescence brings a heightened need for comprehensive sexuality education, accessible and high quality services, and an enabling policy, legislative and community environment to support a healthy transition into adulthood. Investment in SRH during this life stage brings a triple dividend of benefits, presenting a unique window in which to address norms, behaviours and risks that are not only important for the health and development of young people, but also for SRH across the life course, and for the health of the next generation. Enabling young people to achieve the highest attainable standard of SRH is also a fundamental human right, reflected in international and regional agreements and commitments, and also the focus of several targets of the Sustainable Development Goals (SDGs).
Despite these imperatives, young people globally experience a disproportionate burden of poor SRH including high rates of early and unintended pregnancy, sexually transmitted infections (STIs), including HIV, and violence. Two thirds of young people in Asia and the Pacific live in countries where adolescents face a large and complex burden of disease, including a high burden and mortality from poor SRH.
Substantial intersecting barriers limit young people’s access to essential information and services, and contribute to SRH risks and harmful practices. These include sociocultural, legislative, regulatory and policy barriers, as well as rigid gender norms impacting on girls, boys and young people with diverse gender identities and expression. Excess SRH risk and poor outcomes have significant implications not only for health, but considerable consequences for education, poverty reduction, and gender equality, for this and future generations.