teenpregnancyinsouthasia

[teenpregnancyinsouthasia]

Topic Overview

Teenage pregnancy is a term recognized and observed universally. Albeit, its connotation can greatly differ across various countries. For example, teenage pregnancy is heavily stigmatized in the United States, and teen mothers are often shamed or looked down upon in American society (Chamber 2015). However, not all societies establish teenage pregnancy as a negative event. In some regions, early motherhood is often encouraged and even celebrated. South Asia, in particular, is a region that is notorious for having high rates of early marriages (EM) and early child-bearing (ECB), which are terms used to describe marriages and live births that occur before the ages of 18 and 20, respectively (Scott et al. 2021). There are several factors that contribute to the alarmingly high rates of EM and ECB, and these will be discussed intensively throughout the project. However, it is known that there are a plethora of multi-dimensional, intertwined factors, deeply ingrained in South Asian culture, which have contributed to the high levels of EM and ECB. 

Though studies have shown that these rates have fallen over the past decade, South Asia is known to have one of the highest rates of teenage pregnancy, only second to Sub-Saharan Africa (Poudel et al. 2018) . Thus, it is clear that teenage pregnancy is a pressing issue, and must be addressed. Not only is it important to discuss the issue because of its magnitude, but also because of the adverse consequences that are imposed onto young mothers and their offspring. Some of these include health problems arising during pregnancy and childbirth, as well as the deterioration of the social and mental wellbeing of young South Asian women. However, it is not feasible to justify this as a “women's problem”, because any issue that carries such widespread effects will surely be a human rights issue, as the entirety of the society is affected by such a phenomenon. 

As aforementioned, South Asia is not the leading country in terms of the highest rate of teenage pregnancy. Thus, one might wonder why the focus of this project is South Asia rather than Sub-Saharan Africa, where the rates of teen pregnancy are the highest in the world. Here I would like to state that I chose to focus on South Asia because it is more relatable and personal to me. As someone who is South Asian myself, I have seen some of my cousins and dear family friends get married and have children at fairly young ages. I have seen them affected by the abrupt transition into marriage, and shortly after, into motherhood. I have seen what they sacrificed, be it a job or their education, to put their husbands and their children first. I have also seen how the society around them encouraged and celebrated their early marriages and pregnancies, rather than stipulating these as occasions that can wait until they have accomplished their personal goals. Apart from my own family and friends, I have seen young girls parenting their newborn children in the streets of Pakistan. The reality of children parenting younger children is very real across South Asia societies which only encourage this, thus creating a cycle of EM and ECB perpetuated by extrinsic factors rather than the women themselves. 

Furthermore, South Asia is one of the most densely populated regions in the world. The area, consisting of India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, Maldives, and Afghanistan, constitutes nearly 2 billion individuals, or 25% of the global population (Worldometer 2022). Thus, an issue affecting such a large portion of the global population cannot be dismissed, and it must absolutely be addressed as a global public health crisis. Through this project, I hope to explore the factors contributing to high ECB in South Asia, as well as proposing some solutions that may mitigate the issue. 

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Putting South Asia on a Map

The region consists of Afghanistan, Pakistan, India, Nepal, Bhutan, Bangladesh, Sri Lanka and the Maldives. 

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Prevalence of Teen Pregnancy In South Asia

World Bank, World Development Indicators. 2021. Adolescent fertility rate (births per 1,000 women ages 15-19). [Data File].

According to 2020 WorldBank data on adolescent fertility rates (average births per/ 1000 women aged 15-19), the average number of teenage pregnancies for various South Asian countries are as follows: 

Afghanistan: 58          Bangladesh: 81 Bhutan: 16 India: 10 Maldives: 7 Nepal: 63 Pakistan: 37 Sri Lanka: 20

Though these numbers might not seem very large, we must remember that some of these countries, such as India and Pakistan are very heavily populated. Albeit, the ratio might not be seemingly large, if it were multiplied by the total (thousand) number of women in these countries, these values would be much more alarming. Let's take India for example. 10 teenage pregnancies out of 1000 women might not seem like a lot, but considering that the total number of women in India has been reported to be roughly 56 million (IPPF 2014), this results in a total of over 560,000 adolescent pregnancies in a single year!

Secondly, if these values are compared to those of developed countries, it becomes more evident just how high these numbers really are. 

United States: 16 Australia: 11 China: 8 France: 5 Japan: 3

Loaiza, E., & Liang, M. 2013. Adolescent pregnancy: a review of the evidence.

South Asia has one of the highest rates of adolescent pregnancy. Although African regions generally display higher rates, South Asia has a larger quantity of teenage pregnancies due to the immense population density of the region (Loaiza & Liang 2013). 

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What Causes High Rates of Teen Pregnancy in South Asia

It is difficult to pinpoint one sole cause for this phenomenon. Thus, it is more reasonable to say that a combination of several intertwined factors contribute to and encourage teen pregnancy across South Asian countries. Some of the major factors, that will later be discussed in detail, include:

Socioeconomic Status (SES)

Educational Background

Cultural/Societal Norms

Early Marriage as a Precursor for Teenage Pregnancy

Weak Enforcement of Marriage Laws

The “Role” and Status of Women in South Asian Societies

The Value and Importance of Purity

The Economic Cost of Having Daughters

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SES as a Driver for Teen Pregnancy

Several studies have shown that women of a lower SES are more likely to experience pregnancy before the age of 20 in comparison to their wealthier counterparts. This can further be extended to one's place of residence. As such, women in rural or village communities are more likely to experience teen pregnancy than women living in urban areas.

A holistic study on the teenage pregnancy rates between 1990 and 2018 in Pakistan found that nearly half of all teenage pregnancies occurred amongst women from the poorest wealth quintile, and roughly 61% of teenage pregnancies occurred amongst women from rural areas (Ali et al. 2021). 

A study on the teenage pregnancy drivers in Nepal also concluded that residing in rural areas was strongly correlated with teenage pregnancy and “adolescents who belonged to middle or poor household had higher odds of being pregnant compared to those who belonged to rich household.” (Poudel et al. 2018)

Researchers exploring the trends and factors contributing to teenage pregnancy in Sri Lanka found that “there was a consistently declining trend in the teenage pregnancy rate with increasing wealth quintiles...ranging from a teenage pregnancy rate of 10.6% among the women belonging to the lowest wealth quintile to 2.8% among those in the highest wealth quintile” (Fernando et al. 2012).

There are several reasons for this correlation. Firstly, young women from poor, rural backgrounds lack access to the proper resources needed to delay pregnancy. For example, they might not be able to access or afford contraceptives, family planning services, or gynecological visits. Furthermore, poor women residing in rural areas might be married off at a young age since many families might not be able to afford having an additional member in the household. Having an extra person means there must be additional food, water, clothes, and various other necessities. Poverty-stricken families that cannot meet the financial needs of all their children might find it to be in the best interest of themselves and their daughters to get them married off at young ages (Scott et al. 2020). These young wives, in turn, become pregnant at much younger ages which elevates rates of teenage pregnancy. 

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Educational Background as a Driver for Teen Pregnancy

A young woman's level of education may also play a role in when she gets pregnant. More specifically, girls with lower levels of education are more likely to experience teenage pregnancy. 

The same study conducted in Pakistan found that 71% of teenage mothers had no education. Only 2.3% of teen mothers had education beyond secondary school, which would be considered 10th grade in America (Ali et al. 2021). The authors attribute these findings to the fact that “less educated women and their partners lack adequate knowledge regarding early pregnancy and contraception, including misconceptions about the short- and long-term adverse effects of using contraceptives, lack of exposure to mass media and lack of knowledge concerning the negative consequences of early childbearing on their own health, as well as that of their children” (Ali et al. 2021). 

From the aforementioned study on factors contributing to the teenage pregnancy rates in Sri Lanka, it was determined that “the rate of teenage pregnancy was highest among the women who had not had a school education or had only a primary education (16.9%) and lowest among those who had an education up to GCE Advanced Level or above (2.3%)” (Fernando et al. 2011).

In India, “teenage pregnancies is significantly higher in the lower social classes (52%) than in the higher social classes (26%)” and majority of teenage mothers are less likely to have obtained higher education (Dev et al. 2010).

In Bhutan, it is has been found that “the variables that positively [correlate] with an early age pregnancy for most samples are: (1) a rural location, (2) poor background of the household where a young woman lived, (3) low education of a woman” (Dorji 2009)

Without going to school, it would be nearly impossible for these young girls to access reliable, quality sexual education. Thus, if young girls are not educated on their reproductive health and the consequences that may arise from ECB, they will not be able to make informed decisions in order to delay their pregnancy. It is also important to note that SES and educational background are very closely related. Women with little to no education will have difficulty finding decent-paying jobs, which only perpetuates their life of poverty. Their fundamental lack of education, coupled with their inability to escape poverty creates conditions that may present early motherhood as the most meaningful and sensible option. 

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Social and Cultural Drivers for Teen Pregnancy: Establishing the Grounds for Pregnancy

When discussing teenage pregnancy amongst South Asian girls, it is important to understand the premise for their pregnancies. Many of these teenage girls who become pregnant do not happen to become pregnant as the result of a short-term relationship, or brief hookup. Rather, the majority of the teenage girls who become pregnant are, in fact, married. This is because pregnancy is not common outside of wedlock in these culturally and religiously conservative countries. According to a 2020 article exploring the trends, inequalities and drivers of EM and ECB, “in India, less than 1% of pregnancies occur out of wedlock in contrast with more than 40% in the United States, the United Kingdom, and Sweden for example” (Scott et al. 2020). In general, pre-marital sex is considered disgraceful, but pre-marital pregnancy is heavily considered taboo and is stigmatized throughout South Asian countries. For example, “unmarried pregnant women in a similar setting in South India are often advised to give up their children for adoption in order to continue their lives and become ‘respected’, married women” (Jordal, Wijewardena & Olsson 2013). This makes it clear that marriage is a crucial stepping stone in the lives of South Asian women, especially in terms of family planning. Furthermore, it establishes the grounds for most teenage pregnancies in South Asia, which is that most teenagers who become pregnant are first and foremost, married. 

It has already been established that the rates of teenage pregnancy in South Asia are quite high, and that most teenage pregnancies occur amongst married girls. This implies that girls are also married at extremely young ages. This is due to several factors, such as SES and educational background aforementioned, but also some unique cultural and societal reasons as well. For one, there are few barriers that stand in the way of early marriage in South Asian countries. Political laws regarding marriage permit early marriage in several South Asian countries, particularly in ones where Shariah law may be used to “trump” laws that require a higher age requirement for marriage. This, in turn, indicates how culture and religion play a role in encouraging early marriage. For example, in most South Asian countries, the minimum age for a girl to marry is 18. However, in the Muslim-majority countries of Afghanistan and Pakistan, the age requirement  is significantly lower. 

According to an international report published by the International Center for Research on Womens’ Health (ICRWH) in 2012,  girls can legally get married at the age of:

Afghanistan: 15 (with her fathers discretion), otherwise at 16 Pakistan: 16 Bangladesh, Bhutan, India, Nepal, Sri Lanka: 18 

However, these marriage laws are very weak and hardly enforced (International Center for Research on Womens’ Health 2012).  At the time of marriage, it is neccessary for the age of the bride and groom to be confirmed in order to ascertain that they meet the age requirement. However, officials can frequently be bribed or lied to, which allows the cases of under-aged marriage to go unnoticed. Thus, marriages often occur at earlier ages. Unicef reports that roughly ½ of all South Asian women are married before the age of 18 and approximately ⅕ are married before the age of 15 (”Child Marriage” 2019). Thus, it is clear that these laws do not dedicate much, and the consequences of breaking them are not dire.

‘“The kazi [Muslim marriage registrar] came here to perform my marriage,” Soraya A., age 18, who married at age 15, told Human Rights Watch. “He said, ‘She’s not 18 so you need to change that [birth] certificate.’ We got it changed and then I got married.” Soraya explained that her family had her birth certificate changed by the Union Parishad (local council) office and paid an official 500 taka [$6.49] to change it“’

Barr, H. & Human Rights Watch, I. B. 2015. Marry Before Your House is Swept Away: Child Marriage in Bangladesh. [New York, N.Y.: Human Rights Watch, ©] [Web.] Retrieved from the Library of Congress

‘“The kazi came to my house to do my marriage. He asked my age and my parents said 18. He didn’t ask for a document,” said Mala D., who married at age 13.”’

Barr, H. & Human Rights Watch, I. B. 2015. Marry Before Your House is Swept Away: Child Marriage in Bangladesh. [New York, N.Y.: Human Rights Watch, ©] [Web.] Retrieved from the Library of Congress

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Early Marriages: The Social and Cultural Role of a Woman

One might argue that, just because the legislature permits girls to get married at young ages, it does not necessarily mean that they MUST get married early. For example, the legal age to get married in most parts of the United States is 18, however the instances of early marriage are much less than that of South Asia. However, many South Asian girls do not have any choice when it comes to their own marriage. Oftentimes, these young girls are forced into arranged marriages by their parents. Because of their young age, and their “role” as a woman, they do not have the power to oppose or reject these marriages. In fact, one article examining the factors associated with teen pregnancies in South Asia determined that “most adolescent marriages (80%) were arranged by parents without the girl’s consent” (Dev et al. 2010). Though marrying off your own daughter at an unreasonably young age might seem cruel, South Asian families justify this practice through several cultural and social reasons. Culturally, marriages are seen as a way of protecting a girl’s chastity and purity. If a girls virginity were to be lost before her marriage, it would destroy the family’s honor and result in public shame for the family and the daughter. Thus, marriage is seen as a way of combatting pre-marital sexual activity. 

Socially, daughters have less “value” than sons. Sons are thought of as assets to the family, as they bring in income and take care of the family in more tangible ways. Daughters, on the other hand, are seen as “financial burdens” that increase the family’s expenditure on food, water, clothes, and other necessities. This is corroborated by the authors of an article on the health implications of teen pregnancies amongst South Asian girls. They explain that in “resource-constrained households, girls may represent a liability for the limited economic budget and food security for the entire household; the sooner these responsibilities are passed onto the husband’s family the better” (Marphatia, Ambale & Reid 2017). Thus, by marrying them off and placing the financial responsibility on the husband, early marriage is one way for families to alleviate financial stress.  

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I was 14 and wanted to continue my education.…but my parents did not inform me about my marriage. One day, one of my grandfathers brought me here with a motorcycle and asked me to sign a paper and, I signed that. Then after coming back to home, I came to know that it was a registration for marriage. After some days they came to put on nose pin then I understood that I am married

 A 15 year old pregnant Bengali girl.

Shahabuddin, A. S., Nöstlinger, C., Delvaux, T., Sarker, M., Bardají, A., Brouwere, V. D., & Broerse, J. E. (2016). What influences adolescent girls’ decision-making regarding contraceptive methods use and childbearing? A qualitative exploratory study in Rangpur District, Bangladesh. PLOS ONE, 11(6).

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The Expectation for Pregnancy Immediately After Marriage

As if getting married at an incredibly young age would not carry enough stress and anxiety on its own, girls are often met with an immediate expectation to produce children after marriage. These teenage girls hardly have the time to mentally and physically adjust to married life before making another grand adjustment to motherhood, despite being children themselves. 

“Early age at marriage is culturally acceptable in South Asian culture, which seems to add the risk of teenage pregnancy. It is also taken as a licence or social expectation for a woman to enter into reproductive life and to become pregnant immediately after marriage.” (Dev et al. 2010)

“As I am a child, how will I be able to care for my own child? I don’t even know how to take care of a child.”

 - A 16 year old married Bengali girl

Samandari, G., Sarker, B. K., Grant, C., Huq, N. L., Talukder, A., Mahfuz, S. N., Brent, L., Nitu, S. N., Aziz, H., & Gullo, S. (2020). Understanding Individual, Family and Community Perspectives on Delaying Early Birth Among Adolescent Girls: Findings From a Formative Evaluation in Rural Bangladesh. BMC Women's Health, 20(1).

“They’ve already asked me to have children,” Azima B., who is 14 and married a year ago, said of her in-laws. “I am thinking I will have to have children. I live in their house— I have to keep them happy. My husband has also asked me to have children. I said I wanted to wait for two years, but they said, ‘No, you should have children now.’ So I guess I will have to have children now.” 

Barr, H. & Human Rights Watch, I. B. 2015. Marry Before Your House is Swept Away: Child Marriage in Bangladesh. [New York, N.Y.: Human Rights Watch, ©] [Web.] Retrieved from the Library of Congress

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Risks of ECB on the Overall Wellbeing of Young Mothers

Health Consequences

Though many studies have shown that women are most fertile at younger ages, and are thus more suited to bear children, this does not mean that young girls should be encouraged to get married and have children, especially in third world countries where risk of pregnancy complications are high. The risk of complications are already higher in third world countries, but for a teen mother, who is most likely not fully developed herself, there are additional risks that may arise. For example, some health consequences accompanying teen births include eclampsia, which are seizures that may lead to a coma or cardiac arrest. Furthermore, peripleural infection (a type of uterine infection), and fistula formation are also more common amongst pregnant teenagers (Marphatia et al. 2017). 

In Afghanistan:

“A 2010 report states that early marriage and pregnancy contribute to Afghanistan having the second highest maternal mortality rate in the world, with 24,000 deaths each year, many of them under the age of 18. The same report brings to light the shocking fact that in Afghanistan, maternal mortality is ten times higher than conflict-related civilian deaths” (International Center for Research on Womens Health 2012).

According to UNICEF figures on child marriage in Southern Asia girls between the ages of 15 and 19 are twice as likely to die of pregnancy-related reasons as women between the ages of 20 and 24  (International Center for Research on Womens Health 2012).

“I conceived at 17 years, just after 11 months of my marriage. After my childbirth, I found that I was anemic, and I took medicine. During my delivery, I faced severe complications, and I had to be admitted to the hospital.” 

- 17 year old married Bengali girl

Samandari, G., Sarker, B.K., Grant, C. et al. Understanding individual, family and community perspectives on delaying early birth among adolescent girls: findings from a formative evaluation in rural Bangladesh. BMC Women's Health 20, 169 (2020).

However the consequences of ECB are not limited to health risks, but social and mental issues may ensue as well.

Mental Health Consequences/Social Consequences

Getting married and having children at extremely young ages propels young girls into womanhood, forcing them to mature much earlier than necessary. These girls miss out on the opportunity to develop important psychological, emotional and personal relationships, as they are too busy catering to their husbands and children. Furthermore, EM and ECB may leave girls with the feeling that their sole purpose is to be a wife, mother, caregiver, or nurturer. This can be quite detrimental to their confidence and autonomy. Women may feel as though they are not fit to be educated, or part of the working class-simply because they are women. Instead, they might feel an immense pressure to uphold their domestic responsibilities in order to fit into the “role of a woman”. Ultimately, “ the fulfillment of these diverse domestic roles often implies physical and social isolation from the maternal household, peers, and wider society, which may have knock-on effects on their mental health (e.g., susceptibility to depression), nutritional status, and their own and their children’s health outcomes” (Marphatia et al. 2017).

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Risks of ECB on the Offspring of Teen Mothers

Early pregnancy can be just as dangerous for the fetus, as it is for the young mother. Often, young girls are not fully developed, anatomically and physically, to have safe childbirths. As a result, many complications can occur and affect the wellbeing of the offspring. One study found that “in comparison with mothers aged 20–24 years, younger maternal age at first birth (≤19 years) had a 20–30% increased risk of low-birth-weight (LBW) and preterm birth, a 30–40% increased risk of stunting (low height-for-age) of children at 2 years, and failure of children to complete secondary schooling” (Marphatia, Ambale & Reid 2017). Thus, not only are these children affected at birth, but the consequences of teenage pregnancy carry on into their young years and inhibit their ability to receive proper education. This shows that the consequences of teenage pregnancy are everlasting. 

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Ways of Combatting Teenage Pregnancy in South Asia

Pass and Enforce Stronger Marriage Laws 

In various South Asian countries, policies have been established to push back the minimum age of marriage, but as aforementioned, these laws are rarely enforced. In countries such as Bangladesh and Pakistan, policy must be modified in order to increase the minimum age of marriage to 18. In all South Asian countries, law enforcement must abide by these marriage laws and ensure that children are not being married off at younger ages. Special attention should be given to marriages occurring in rural areas, where law enforcement rarely interferes in matters of child-marriages. It is necessary to hold politicians and law enforcement accountable, as they are in the primary position to bring about meaningful change.

Advocate and Campaign for Girls’ Education

Another source of legislature modification is in terms of education policies. For example, creating education laws that make it compulsory for girls to complete a minimum amount of schooling could potentially delay the age at which they get married. “According to a 2011 report, girls who attend school are better shielded from child marriage largely because adults continue to view them as children in this setting, and because they have greater access to social networks, skills and ideas” (International Center For Research on Women's Health 2012).  According to Nepal’s 2011 Demographic Health Survey, girls who stay in school at least until they complete the School Leaving Certificate examination at the end of grade 10, marry five years later than those who have not received any education at all (Poudel et al. 2018).

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Conclusion

It is clear that South Asian countries have some of the highest rates of teenage pregnancy across the world, due to socioeconomic status, educational background, and a wide variety of societal and cultural norms. Due to these norms, young South Asian girls are forced into the roles of “wives”, “mothers”, “caregivers”, or “nurturers” without choice. However, taking on these roles in one's teenage years is extremely dangerous. Not only does it present consequences to the health and mental wellbeing of these young mothers, but the consequences to their childrens’ wellbeing is everlasting as well. Because South Asian countries encourage and celebrate early marriage and pregnancy, it is unfortunate, yet inevitable that women will not be able to escape this fate unless meaningful changes are implemented within South Asian society. 

As individuals who are living thousands of miles away from these societies, it can be easy to dismiss these issues. However, South Asia is not the only region in the world that experiences high rates of teenage pregnancy. In the global context, Sub-saharan Africa has the highest rates of teenage pregnancy, and Latin America and Southeast Asia are also experiencing increased levels of teenage pregnancy. Thus, it is important to recognize that, albeit the focus of this project was teenage pregnancy in South Asia, the issue of teenage pregnancy, itself, is one that is global. It is necessary and vital to recognize this as a global public health issue, and every country experiencing elevated levels of teen pregnancy must implement changes that will mitigate the issue. Furthermore, it might be wildly optimistic to hope that single individuals or small groups of individuals may be able to bring about tangible change for a worldwide issue. It is impossible for us to fight for every possible issue. However, we can always stand to learn and spread awareness for emerging and alarming issues. Thus, the teenage pregnancy phenomenon in South Asia is one that, perhaps not all of us can fight for, but we may all certainly learn something from it. 

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References

Ali, A., Khaliq, A., Lokeesan, L., Meherali, S., & Lassi, Z. S. 2021. Prevalence and Predictors of Teenage Pregnancy in Pakistan: A Trend Analysis from Pakistan Demographic and Health Survey Datasets from 1990 to 2018. International Health, 14(2), 176–182. 

Barr, H. & Human Rights Watch, I. B. 2015. Marry Before Your House is Swept Away: Child Marriage in Bangladesh. [New York, N.Y.: Human Rights Watch, ©] [Web.] Retrieved from the Library of Congress

Chambers, B. D. 2015. Taking the stigma out of adolescent pregnancy and parenthood: What schools can do. ETR Blog. 

“Child Marriage”. 2019. Unicef South Asia. Retrieved November 14th, 2022 (https://www.unicef.org/rosa/what-we-do/child-protection/child-marriage)

Dev, Acharya & Rabi, Bhattarai & Poobalan, Amudha & Van Teijlingen, Edwin & Chapman, Glyn. 2010. Factors associated with teenage pregnancy in South Asia: A systematic review. GR – HEALTH SCIENCE JOURNAL, 3-14.

Dorji, Lham. 2009. Sexual and Reproductive Health of Adolescents and Youth in Bhutan. Monograph No. 7. National Statistics Bureau & UNFPA: Thimphu Bhutan.

International Center For Research on Women's Health. 2012. Child Marriage In Southern Asia--Policy Options for Action. 

Jordal, M., Wijewardena, K., & Olsson, P. 2013. Unmarried Women’s Ways of Facing Single Motherhood in Sri Lanka – a Qualitative Interview Study. BMC Women's Health, 13(1).

Loaiza, E., & Liang, M. 2013. Adolescent Pregnancy: A Review of the Evidence.

Marphatia AA, Gabriel S. Ambale, and Alice M. Reid. 2017. “Women’s Marriage Age Matters for Public Health: A Review of the Broader Health and Social Implications in South Asia”. Front. Public Health 5(269).

Poudel, S., Upadhaya, N., Khatri, R. B., & Ghimire, P. R. 2018. Trends and Factors Associated with Pregnancies Among Adolescent Women in Nepal: Pooled Analysis of Nepal Demographic and Health Surveys (2006, 2011 and 2016). PLOS ONE, 13(8). 

Samandari, G., Sarker, B. K., Grant, C., Huq, N. L., Talukder, A., Mahfuz, S. N., Brent, L., Nitu, S. N., Aziz, H., & Gullo, S. (2020). Understanding Individual, Family and Community Perspectives on Delaying Early Birth Among Adolescent Girls: Findings From a Formative Evaluation in Rural Bangladesh. BMC Women's Health, 20(1). 

Scott, S., Nguyen, P. H., Neupane, S., Pramanik, P., Nanda, P., Bhutta, Z. A., Afsana, K., Menon, P. 2020. Early Marriage and Early Childbearing in South Asia: Trends, Inequalities, and Drivers from 2005 to 2018. Annals of the New York Academy of Sciences.

Shahabuddin, A. S., Nöstlinger, C., Delvaux, T., Sarker, M., Bardají, A., Brouwere, V. D., & Broerse, J. E. 2016. What Influences Adolescent Girls’ Decision-Making Regarding Contraceptive Methods Use and Childbearing? A Qualitative Exploratory Study in Rangpur District, Bangladesh. PLOS ONE, 11(6). 

“Southern Asia Population (Live)”. 2022. Worldometer. Retrieved November 14, 2022. (https://www.worldometers.info/world-population/southern-asia-population/#:~:text=The%20current%20population%20of%20Southern,of%20the%20total%20world%20population).

World Bank, World Development Indicators 2020. Adolescent Fertility Rate (births per 1,000 women ages 15-19). [Data File].

Media References

https://www.abington.k12.pa.us/durand/south-asia-maps/

https://www.youtube.com/watch?v=pttHSJCl4Ks&t=10s