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Growing Up Global: The Changing Transitions to Adulthood in Developing Countries
ing countries, so we have not been able to incorporate these myriad differences as much as those for gender and socioeconomic status, which are more common across societies.
Young people born recently have, for the most part, seen dramatic improvements in their health, education, and employment opportunities compared with those born earlier. These changes have been supported by significant parental and social investments and have also been accelerated by rapid globalization. The challenge for the future is to see that young people in the poorest countries, in which demographic transitions have begun more recently, as well as poor young people residing in countries in which demographic transitions are much further along, will experience at least the same level of progress; otherwise existing global inequalities will widen further.
CHANGING TRANSITIONS TO ADULTHOOD
For most young people growing up in developing countries (except in sub-Saharan Africa), health conditions for young people are continuing to improve steadily, as they have over the past 20 years. However, behavioral choices that adolescents make at this age have critical implications for their health and mortality in early and later phases of their adulthood, particularly in the context of HIV/AIDS.
HIV/AIDS is now the leading cause of death among 15-29-year-old young women in sub-Saharan Africa. And, because of the heavy weight of deaths in Africa in the global total of deaths at this age, HIV/AIDS is also the leading cause of death among this age group globally. For this reason, unprotected sex during these years is one of the most dangerous behaviors for young people, given its potential consequences for later health and mortality.
Promising new program models are beginning to emerge to address the reproductive health needs of adolescents. These include multicomponent community-based programs as well as youth development and livelihood programs.
School participation and attainment have important and mostly positive associations with young people’s health. Across almost 50 countries with varying levels of enrollment and very different school environments, the panel found that girls who are currently enrolled in school are substantially less likely to have had sex than their unmarried peers who are not currently enrolled. While many adolescent reproductive health programs have yet to prove their effectiveness, policies enabling more young people to remain in school and progress to secondary school emerge as particularly promising for the achievement of better health during the teenage years as well as over the life cycle.