Executive Summary

The transition to adulthood is a critical stage of human development during which young people leave childhood behind and take on new roles and responsibilities. It is a period of social, psychological, economic, and biological transitions, and for many young people it involves demanding emotional challenges and important choices. To a large degree, the nature and quality of young people’s future lives depend on how successfully they negotiate through this critical period. Yet in many developing countries, it is a stage of life that has only recently begun to receive focused attention.

The challenges for young people making the transition to adulthood are greater today than ever before. Globalization, with its power to reach across national boundaries and into the smallest communities, carries with it the transformative power of new markets and new technology. At the same time, globalization brings with it new ideas and lifestyles that can conflict with traditional norms and values. And while the economic benefits are potentially enormous, the actual course of globalization has not been without its critics who charge that, to date, the gains have been very unevenly distributed, generating a new set of problems associated with rising inequality and social polarization. Regardless of how the globalization debate is resolved, it is clear that as broad global forces transform the world in which the next generation will live and work, the choices that today’s young people make or others make on their behalf will facilitate or constrain their success as adults. Traditional expectations regarding future employment prospects and life experiences are no longer valid.

Concerns about how global forces are altering the passage into adult-



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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries Executive Summary The transition to adulthood is a critical stage of human development during which young people leave childhood behind and take on new roles and responsibilities. It is a period of social, psychological, economic, and biological transitions, and for many young people it involves demanding emotional challenges and important choices. To a large degree, the nature and quality of young people’s future lives depend on how successfully they negotiate through this critical period. Yet in many developing countries, it is a stage of life that has only recently begun to receive focused attention. The challenges for young people making the transition to adulthood are greater today than ever before. Globalization, with its power to reach across national boundaries and into the smallest communities, carries with it the transformative power of new markets and new technology. At the same time, globalization brings with it new ideas and lifestyles that can conflict with traditional norms and values. And while the economic benefits are potentially enormous, the actual course of globalization has not been without its critics who charge that, to date, the gains have been very unevenly distributed, generating a new set of problems associated with rising inequality and social polarization. Regardless of how the globalization debate is resolved, it is clear that as broad global forces transform the world in which the next generation will live and work, the choices that today’s young people make or others make on their behalf will facilitate or constrain their success as adults. Traditional expectations regarding future employment prospects and life experiences are no longer valid. Concerns about how global forces are altering the passage into adult-

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries hood are all the more urgent because of the changing demographic profile of many developing countries. The acceleration of these global changes has coincided with unprecedented growth in the size of the population of young people in developing countries. By 2005, the total number of 10-24-year-olds is estimated to have reached 1.5 billion, constituting nearly 30 percent of the population of these regions and 86 percent of all young people in the world. And each subsequent cohort of young people in the developing world is projected to continue to increase until 2035, as rapid growth in Africa and parts of Asia counteracts some slow declines in absolute numbers elsewhere in Asia and in Latin America and the Caribbean. Recognizing the need to learn more about this crucial period of life, the National Research Council convened a panel of experts to examine how the transition to adulthood is changing in developing countries, and what the implications of these changes might be for those responsible for designing youth policies and programs, in particular, those affecting adolescent reproductive health. According to the panel’s findings, important transformations in young peoples’ lives are under way. In much of the developing world, adolescence is a stage of life that is gaining in significance. In the past, young men and women tended to move directly from childhood to adult roles. But today the interval between childhood and the assumption of adult roles is lengthening. Compared to the situation 20 years ago, young people are entering adolescence earlier and healthier, more likely to spend their adolescence in school, more likely to postpone entry into the labor force, and more likely to delay marriage and childbearing. As a result of these changes, on average, young people in the developing world now have more time and opportunities than ever before to acquire the information and skills necessary to become effective participants in decisions about their own lives and futures. These broad statements capture only the average tendencies for young people in developing countries, which tend to be statistically dominated by trends in developing Asia, where 70 percent of young people in developing counties live, 42 percent in India and China alone. Differential rates of change have led, in some cases, to growing differences among adolescents within and across countries, as some young people experience progress while others are left behind. Over the past 20 years, economic growth rates in Latin America and the Caribbean and in sub-Saharan Africa have diverged negatively from economic growth rates in developed countries, while growth rates in East and South Asia, where the majority of young people live, have converged toward economic growth rates in developed countries.

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries These very different circumstances across regions mean that the experiences of today’s young people, as well as the implications of globalization for them, vary enormously. And even in countries in which the rate of economic growth has been very high, for some young people, particularly those in rural areas, the outward patterns and rhythms of life may appear to be largely unaffected. Because of rapid population growth, young people who are poor are about as numerous today as they were in the past despite declining poverty rates; current estimates imply that roughly 325 million young people in developing countries are growing up on less than $1 a day. Furthermore, the continuing growth in the absolute numbers of young people as well as the lengthening period of years spent unmarried (and in many cases sexually active) ensure a rapid and continuing growth in young peoples’ need for education, as well as for reproductive and other health services. Further challenges include relatively poor learning outcomes in school among enrolled students and persistent disadvantages for young women, young people from low-income families, and young people living in the least developed countries. Sub-Saharan Africa is a region of special concern. Not only are poverty rates rising and population growth rates proceeding at unprecedented levels, but also the risks of HIV/AIDS for young people are very high and increasing. Furthermore, recent data on school participation suggest that, in some settings during the 1990s, school attendance rates for boys fell as the prevalence of child labor rose. Growing pressures on school systems may further compromise school quality, which is already poor. While fewer African young people marry or bear children during adolescence relative to previous generations, many lack opportunities to use this lengthening adolescent phase of their lives to acquire needed education and training. CRITERIA FOR SUCCESS The panel’s policy and program recommendations emerge from a conceptual framework that we developed to organize and guide this report. The framework identifies criteria for successful transitions in the context of contemporary global changes. We identified the importance of adequate preparation for five key adult roles: adult worker, citizen and community participant, spouse, parent, and household manager. The defining attributes of such a conceptualization of successful transitions to adulthood, which must be seen within the constraints of personal endowments and capabilities, include at least the following: Good mental and physical health, including reproductive health, and the knowledge and means to sustain health during adulthood.

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries An appropriate stock of human and social capital to be a productive adult member of society. The acquisition of prosocial values and the ability to contribute to the collective well-being as citizen and community participant. Adequate preparation for the assumption of adult social roles and obligations, including the roles of spouse or partner, parent, and household and family manager. The capability to make choices through the acquisition of a sense of self and a sense of personal competence. A sense of well-being. While success is ultimately measured at the individual level, societies and their institutions at the international, national, and local levels, including governments of developed countries, can enhance successful transitions to adulthood. In the panel’s view, policies that support universal primary schooling of adequate quality, that support the expansion of good secondary schooling, and that promote good health during this phase of the life cycle are essential in their own right but also important because of their role in promoting success in these other domains. In the panel’s judgment, poverty is the greatest enemy of successful transitions. PREPARATION FOR ADULT ROLES Schooling Young people in developing countries are spending more of their adolescence in school than ever before. Recent growth rates in all indicators of school participation and grade attainment have been substantial, historically unprecedented, and greater for girls than for boys. For example, on the basis of survey data representing 60 percent of the population of the developing world, mean grades attained have risen over the past 20 years from 6.0 to 7.4 (23 percent) for young men ages 20-24 on average and from 3.8 to 6.0 (58 percent) for young women ages 20-24. Furthermore, the percentage who have never attended school has fallen from 21 to 11 percent for boys ages 10-14 and from 39 to 18 percent for girls of the same age over the same period. These positive overall trends in schooling, while typical, are not universal. Despite these trends, there remain large differences in school attendance rates according to wealth and residential status, with poor girls suffering particular disadvantage. Recent well-designed evaluation studies have shown that conditional grants or targeted subsidies can be effective strategies for increasing school attendance and progression rates among economically disadvantaged groups.

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries Global trends in population, health, urbanization, and education have all contributed positively to the growth in the demand for schooling. In most parts of the developing world today, young people live within reasonable proximity of a primary school—a notable achievement given the rapid growth in the school-age population. The results of recent internationally comparable standardized tests, however, raise serious concerns about how much students are actually learning in school—and therefore about school quality. Poor school quality and poverty remain major factors limiting enrollments, encouraging dropout, and compromising learning outcomes. Health The health of young people in developing countries is improving. Young people are entering the transition to adulthood healthier and with improved chances of surviving to old age. And continued reductions in mortality seem likely, with the major exception of countries strongly affected by the HIV/AIDS epidemic. HIV/AIDS is now the leading cause of death among young people in sub-Saharan Africa. In other regions, it is among the least significant causes of death; instead, noncommunicable diseases predominate as well as injuries for men. Nevertheless, given the much higher mortality rates in sub-Saharan Africa than in the rest of the world, HIV/AIDS is now the leading cause of death for women ages 15-29 for the world as a whole and one of the leading causes of death for men in the same age group. Moreover, given the much larger population of young people in Asia, an increase in the epidemic there, which is projected by many, would mean that the numbers of young people affected would increase substantially. Mortality and morbidity related to pregnancy and childbirth (particularly in sub-Saharan Africa and South Asia, where levels of early childbearing remain high) and as a direct consequence of unsafe abortion across all developing regions remain among the most significant risks to young women’s health. Although young women appear less likely than older women to seek abortion, they are more likely to have the abortion later in the pregnancy and to choose an unsafe provider, thus putting them at greater risk. Behaviors that young people adopt at this age have critical implications for their future health and mortality. In particular, unprotected sex is one of the riskiest behaviors that young people can undertake, particularly in settings in which HIV/AIDS is widespread. Evidence from Latin America and sub-Saharan Africa suggest that contraceptive use rates are increasing among sexually active young women, especially unmarried ones. Condom use, however, remains relatively low but is increasing rapidly in Latin America and the Caribbean as well as Eastern and Southern Africa. Poverty

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries and economic vulnerability enhance the likelihood that young people will engage in risky sexual behaviors. Furthermore, there is growing evidence that coercive sex is not an uncommon experience for many girls and young women. However, sex is not being initiated at an earlier age relative to the past in most countries. While there has been an increase in the percentage having premarital sex before age 18 in many countries over the past 20 years, delays in the age of marriage in most countries have meant that, on balance relative to 20 years ago, fewer young women report themselves to have been sexually active before age 18. Thus while sex is being delayed, the context of first sexual experience is changing, with a greater likelihood now than in the past that first sex will be experienced prior to marriage. Other adolescent behaviors with compromising long-term implications for health include smoking, drinking, and using illicit drugs. Across the developing world, tobacco use is increasing, and the gender gap in smoking prevalence is closing rapidly. There is also evidence that the prevalence of illicit drug use among young people is rising slowly. Alcohol intake is highest among affluent and urban young people and thus is also expected to increase with continued urbanization. THE TRANSITION TO ADULT ROLES The Transition to Work The rise in school enrollment and the delay in the timing of school exit have resulted in a delay in the timing of labor force entry and a concomitant decline in the percentage of young people participating in the labor force, particularly at younger ages. Household poverty is strongly associated with the likelihood that children will participate in the labor force; thus a global decline in poverty is an important explanation for declines in the prevalence of labor market work among children. Rising poverty rates in sub-Saharan Africa imply a less positive outlook for trends in children’s labor force participation, however. The rise in school enrollment and attainment and the rapidly closing gender gap in schooling is leading to a growing equalization of work burdens between young men and women during their adolescent years. This is because students spend relatively little time in the labor market, and gender differences in mean daily hours spent by students in noneconomic household work (e.g., household chores) are relatively small. This equalization in work roles is further reinforced by the rise in the proportion of young women entering the labor force, in particular the paid labor force. The economic returns to schooling at the secondary and tertiary levels

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries are consistently high (and differentially high for young women). The gap between the returns to higher and lower levels of schooling is widening, thus putting an increasing premium on secondary and tertiary schooling for later success in the labor market. It is not known the extent to which this shift in rates of return is due to globalization or other factors, such as declines in primary school quality resulting from rapid growth in the student population. Nevertheless, young people with secondary or tertiary schooling are increasingly advantaged in the labor market relative to their less educated peers not only in terms of earnings but also in terms of job stability and upward mobility. In many parts of Asia, as well as in Latin America and the Caribbean, increased numbers of young people, including a rising percentage of young women, have been absorbed into the formal or informal labor market without any large increase in unemployment rates among young people. Indeed, some countries, particularly in Asia, have succeeded in maintaining strong economic growth at the same time that the labor force has been increasing rapidly, thus reaping an economic dividend as a result of these demographic shifts. However, youth unemployment is still a substantial challenge in some of the poorer countries of Asia, sub-Saharan Africa, and the Middle East, which continue to experience unprecedented growth in the size of their 10-24-year-old populations even though in many cases rates of population growth have now peaked. The Transition to Citizenship Globalization, trends toward greater democratization, rising school enrollment, and greater access to media have all increased opportunities for young people to engage in civic and political life. Recent survey data show that a majority of young men in many Latin American and Asian countries express an interest in politics and a willingness to engage in political activism, whereas young women appear somewhat less inclined to express these views. At the same time that young people are expressing greater voice at the local, national, and international levels, they are becoming increasingly aware of the growth of global diversity and inequality. Various forms of participation in the life of the community, beyond political participation, are embraced in concepts of citizenship. A variety of institutions and programs, among them schools, employers, national service programs (including military service), sports, other nonformal programs, and the media are increasingly viewed as potentially important in citizenship formation. However, comparative data are lacking on the extent and nature of community participation among young people or on the roles that various institutions play in encouraging or discouraging participation.

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries The Transition to Marriage While the transition into marriage is a key component of the transition to adulthood in most contexts, marriage, in and of itself, is not necessarily a marker of adulthood, particularly for the numerous young women who wed during the teenage years. Substantial delays in the timing of marriage among most young people, however, are contributing to an overall lengthening of the interval between childhood and the assumption of adult roles. Compared with previous generations, a smaller proportion of young women and men are married in most regions. Men still marry at older ages than women. While only one-third of men in the developing world are married by ages 20-24, nearly two-thirds of women are married in this age group. Moreover, in certain regions, most notably the Middle East, a large fraction of men now postpone marriage until their 30s. The minimum legal age of marriage for both men and women has risen in many countries in the past decade, and women are less likely to be married during the teenage years than in the past. However, child marriage, defined as marriage prior to age 18, is still widespread and viewed by many as a major violation of human rights. On the basis of survey data representing 60 percent of the population of the developing world, 38 percent of young women ages 20-24 married before age 18 (down from 52 percent 20 years ago), with the highest rates of child marriage currently occurring in Western and Middle Africa and South Asia. Young women who marry as minors are more likely to come from poor households and rural areas and to have relatively few, if any, years of schooling. The age gap between spouses—often thought of as a measure of the degree of equality in marriage—appears to be narrowing, especially in sub-Saharan Africa and South Asia. There is also some evidence of growing agency on the part of young women with regard to choice of marriage partner, suggesting that the nature of marriage itself is changing. The Transition to Parenthood As in the past, entry into marriage is strongly associated with entry into parenthood. Over 90 percent of first births occur within marriage, and this percentage has changed only minimally over the past 20 years. With rising ages of marriage, the age of parenthood has been rising, but the gap between age at marriage and age at first birth has narrowed, falling from 22 to 16 months on average over the past 20 years. These postponements of marriage and parenthood allow young people more time to prepare for adult roles and provide an increasing number of young women with the opportunity to participate in the labor force prior to becoming a parent. Rates of early childbearing remain high in many parts of the developing world because of high rates of early marriage, as noted above. Based on

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries survey data representing 60 percent of the population of the developing world, 23 percent of young people ages 20-24 gave birth before age 18 (down from 30 percent 20 years ago). As a result of declines in early marriage, there has been a slight rise in the percentage of births to young women that are premarital. The level of premarital childbearing varies substantially across regions: from 14 percent having a premarital birth by the age of 20 in Eastern and Southern Africa to less than 1 percent in Asia and the Middle East. While Eastern and Southern Africa and Latin America and the Caribbean have seen recent small increases in the rates of premarital childbearing, the rates in other regions appear very low, but measurement is more difficult given continuing reluctance to interview unmarried women in Asia. Although there is plentiful evidence that early childbearing is correlated with various negative outcomes, rigorous research confirming a causal role for age at birth in producing these outcomes does not exist. Major global changes, such as increasing school enrollment during late adolescence, rising rates of labor force participation among young women, and rising HIV/AIDS prevalence among young women in Africa, are likely to have important implications for the transition to parenthood, but little is known about the implications of these trends for first parenthood. POLICY AND PROGRAM RECOMMENDATIONS Policies and programs designed to achieve positive and sustainable development and combat poverty confront both the opportunity and the challenge of promoting successful transitions to adulthood for a steadily growing population of young people living in developing countries. Substantial investments in the health and schooling of young people, if designed and targeted effectively, will position these young people to participate constructively in shaping their own and their countries’ futures. The panel’s policy and program recommendations were derived from a careful sifting of the empirical evidence. They address areas that are potentially encompassed by the scope of the United Nations (UN) Millennium Development Goals as well as others that are not within their current scope but are nonetheless of vital importance for young people. In the panel’s view, policies and programs, if they are to be effective, will need to be evidence-based, appropriate to the local context, and developed in cooperation with developing country governments and local communities. Poverty The UN Millennium Development Goals, the international community’s unprecedented agreement on targets toward the elimination of extreme

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries poverty, were not originally developed with a particular focus on young people. Nevertheless, the successful achievement by 2015 or beyond of many of these goals will require that policy makers center their attention on young people. Young people currently growing up in poverty face much greater health risks in both the short and longer term and are much less likely to attend schools of adequate quality, to complete primary school, to find secure and productive employment, to have opportunities for community participation, to marry well, or to be able to provide good care and support to their children. Policies and programs designed to enhance successful transitions for young people, whether they are reproductive health programs, programs to enhance school quality or reduce dropout rates, job training programs, livelihood or civic education programs, or programs for first-time parents—should be targeted to the poor, particularly poor young women, who are often doubly disadvantaged. Evaluation research shows that important actors in the system—parents, students, teachers, employers, and administrators—can be very responsive to well-designed incentive programs. Schooling At their best, schools have the capacity to enhance success in all transitions to adulthood through the acquisition of literacy in a commonly spoken language and the transmission of knowledge and means to sustain health, prosocial values and citizenship knowledge and skills, decision-making, negotiating, and leadership skills and skills for lifelong learning. While the panel supports the UN Millennium Development Goals for education, it does not see the achievement of these goals—universal primary school completion rates and the elimination of gender disparities at all levels of schooling—as sufficient for the next generation of young people to acquire the skills necessary for successful transitions to adulthood. The rapidity of global change and changing patterns of employment require that policy makers give equal attention to investments in school quality in order to ensure adequate learning outcomes at the primary level as well as to create a stronger base for further expansions in enrollment at the secondary level. The panel also identified carefully targeted subsidies as a particularly promising way to increase enrollment and reduce the prevalence of child labor among the poor. Declines in fertility and improvements in child health have been shown to have contributed to past increases in the demand for schooling. Policies and programs supporting further progress in these areas are likely to continue to contribute to future growth in school enrollment and attainment.

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries Gender Equality and the Empowerment of Women Throughout its report, the panel documents systematic gender differences in pathways to adulthood as well as the universal persistence of dual social norms relating to the sexual behavior of young people. The panel’s recommendations on gender equality emphasize the promotion of equitable treatment in the classroom through gender training for teachers and school administrators, the development of compensatory educational and training programs for disadvantaged and out of school youth, particularly girls, and the adoption of policies and programs that support delays in marriage in places where girls still marry before age 18. Addressing gender problems in society will call for interventions that affect all social classes and that give as much attention to boys’ attitudes and behaviors as to girls’. Health, Particularly Reproductive Health In developing recommendations, the panel focused on policies and programs for young people in the area of sexual and reproductive health as specified in the panel’s original charge. We also documented the emergence of other areas of health and health behaviors that need policy and program attention, including mental health and health compromising behaviors such as smoking. The panel identified maternal mortality as one of the major causes of death and morbidity for young women in all developing regions except Eastern Asia and HIV/AIDS as the major cause of death and morbidity for young people in sub-Saharan Africa. The provision of information and services for young people, married and unmarried, in the area of sexual and reproductive health is generally limited to small-scale efforts that reach a fraction of the population of young people. The panel recommends that policy makers give priority to increasing the provision of general health information and sex education, including negotiating skills, in school and out of school for all young people and to increasing the availability of services for those who are sexually active. No single approach is likely to serve the needs of all young people, however, given their diversity of life circumstances. In the view of the panel, programs designed to reduce risky and unprotected sex among young people are critical to successful transitions and will require multipronged and multisectoral approaches that are culturally appropriate, community based, and sensitive to the needs and preferences of young people, including active collaboration between the health and education sectors. Indeed, some of the most important reproductive health interventions for young people may lie outside the health sector. For example, school participation and attainment appear to have important and mostly

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries positive associations with young people’s health; both male and female students who remain enrolled during their teens are substantially less likely to have had sex than their unmarried nonenrolled peers. Thus resources spent on expanding opportunities for secondary schooling may have a direct impact on the reproductive health of both young men and women. Youth Employment Policies and programs with implications for young people’s successful transition to work in developing countries exist at all levels of action. However, regulations that are commonly enacted in developing countries for the purpose of improving the terms and conditions of employment put young people at a disadvantage in competing for jobs in the formal labor market and encourage the growth of an informal, unregulated sector. Young people are likely to fare better in a labor market in which employers do not face excessive regulation or in which government incentives encourage firms to invest in training. The panel has also noted that too often policies affecting aid and trade are not coordinated. For example, trade sanctions against products produced with child labor or against countries known to violate international labor standards relating to child labor are likely to do more harm than good in contexts in which poverty is persistent and the family economy still relies on child labor. While the focus of this report has been on policies and programs directly targeted to young people, the panel notes that agricultural and trade policies aimed at reducing nonmarket imperfections in the terms of trade between developed and developing countries could potentially be a far more effective means of helping the world’s poor. KNOWLEDGE GAPS AND DIRECTIONS FOR FUTURE RESEARCH Much more is known about basic patterns and trends than about the determinants or the consequences of these trends or about the extensive variability among young people in developing countries. Gaps in knowledge that emerge from the juxtaposition of our conceptual framework and our compilation of solid evidence form the basis of research questions that are provided at the end of each chapter. From these, many additional cross-cutting questions emerge. From the very rich experience of researchers in industrialized countries, we have learned how much there is to be gained from building multidisciplinary research teams, following cohorts over prolonged periods of time, and measuring a full range of social, psychological, health, and economic outcomes while deploying a mix of research methods. In the final chapter, we recommend specific ways that existing data

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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries collection and compilation operations can be enhanced, identify promising quantitative and qualitative research approaches (not always new but underutilized) that would significantly deepen understanding of transitions to adulthood and suggest how findings from research and program and policy evaluation can be more effectively integrated into innovative and large-scale interventions. In particular, the panel recommends that evaluation should be adopted as an integral part of policy and program innovation for all interventions designed to enhance successful transitions to adulthood.

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