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      Improving access to and use of contraception by adolescents: What progress has been made, what lessons have been learnt, and what are the implications for action?

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          Abstract

          This article sets out the progress that has been made in reducing levels of adolescent childbearing and in meeting adolescent contraceptive needs, over the last 25 years, and also makes the public health, economic, and human rights rationale for continued attention to and investment in these areas. Using an analytic framework that covers the perspectives of both the use and the provision of contraception, it examines the factors that make it difficult for adolescents to obtain and use contraceptives to avoid unintended pregnancies, and outlines what could be done to address these factors, drawing from research evidence and programmatic experience. In doing this, the article provides concrete examples from low- and middle-countries that have made tangible progress in these areas.

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          Most cited references16

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          What Does Not Work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions Commonly Accepted as Best Practices

          Youth centers, peer education, and one-off public meetings have generally been ineffective in facilitating young people’s access to sexual and reproductive health (SRH) services, changing their behaviors, or influencing social norms around adolescent SRH. Approaches that have been found to be effective when well implemented, such as comprehensive sexuality education and youth-friendly services, have tended to flounder as they have considerable implementation requirements that are seldom met. For adolescent SRH programs to be effective, we need substantial effort through coordinated and complementary approaches. Unproductive approaches should be abandoned, proven approaches should be implemented with adequate fidelity to those factors that ensure effectiveness, and new approaches should be explored, to include greater attention to prevention science, engagement of the private sector, and expanding access to a wider range of contraceptive methods that respond to adolescents’ needs.
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            The State of Adolescent Sexual and Reproductive Health

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              Provider Bias in Family Planning Services: A Review of Its Meaning and Manifestations

              Provider bias, including bias regarding client age, parity, and marital status, persists as an important barrier to contraceptive choice and access. Newer approaches to mitigate bias that have moved beyond training and guideline development to more fundamental behavior change show promise.
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                Author and article information

                Contributors
                Role: Scientist, MBBS MSc
                Role: Independent consultant, PhD
                Journal
                Best Pract Res Clin Obstet Gynaecol
                Best Pract Res Clin Obstet Gynaecol
                Best Practice & Research. Clinical Obstetrics & Gynaecology
                Elsevier
                1521-6934
                1532-1932
                1 July 2020
                July 2020
                : 66
                : 107-118
                Affiliations
                [1]Department of Sexual and Reproductive Health and Research, World Health Organization/Human Reproduction Programme, Switzerland
                Author notes
                []Corresponding author. chandramouliv@ 123456who.int
                Article
                S1521-6934(20)30067-5
                10.1016/j.bpobgyn.2020.04.003
                7438971
                32527659
                c35c0132-c702-4994-8cf3-ba305daf9b5a
                © 2020 Published by Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

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                Obstetrics & Gynecology
                adolescent contraception,unmet need for modern contraception,comprehensive sexuality education

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