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					Reaching the Girls Left Behind:
Investing in Adolescent Girls in

Why is investing in adolescent girls so important?
• What little policy attention and investment there is in
adolescents does not reach the most vulnerable girls
• Investing in the most vulnerable adolescent girls is a key
development and social justice strategy; investments in girls are
particularly urgent if national Millennium Development Goals
are to be met with respect to:
   •   Building a strong economic base, reversing inter-generational
       poverty (Increased female control of income has far stronger returns to human capital and other investments
       than comparable income under male control)

   •   Achieving universal primary education (the most deprived sector is rural girls)
   •   Promoting gender equality (gender based violence and harmful traditional practices drive high
       and unwanted fertility, maternal mortality, and HIV)

   •   Reducing maternal mortality and related infant mortality (selective of
       youngest and first time mothers)

   •   Reversing the rising tide of HIV in young people (girls and young women,
       including child mothers, are likely to bear an increasing and disproportionate share of HIV infections)

   •   Reducing rapid population growth (eliminating child marriage could have a synergistic
       impact on all three elements of future population growth)
        Policy Context and Legal
• Convention on the Rights of the Child (CRC) signatory
• Convention on the Elimination of all forms of
  Discrimination against Women (CEDAW) signatory
• Ghana Poverty Reduction Strategy
  • Ghana Vision 2020
  • Youth centered policy attention toward education and
Who are the most vulnerable girls?
• Girls (10-14) who are not in school and not living with either
• Girls (10-14) living with neither parent or living only with one
  parent (usually their mother)
• Girls who are not in school, not at grade for age, or otherwise at
  risk for leaving school
• Married girls (10-19)
• Girls living in districts where a significant proportion of girls are
  married as children (e.g. 10% under 15; 40% under 18)
• Girls living in districts where a high proportion of first sex is forced
  (e.g. over 10%)
• Girls living in districts with high rates of HIV or other serious
  illness—putting them at risk of disease; having to cope with social
  and economic stressors of disease
• Girls in domestic service or other potentially exploitative work
       PHOTO of beneficiaries or

• All data, graphs and maps are drawn from the 2003
  Ghana Demographic and Health Survey, unless
  otherwise noted
   Where are the girls living, and with
         whom do they live?
• In Ghana, most 10-19            • 29% of girls, and 23% of
  year olds live in rural           boys 10-14 live apart
  areas                             from both their parents
   – Girls 10-14:                 • 32% of girls, and 33% of
      • 58% live in rural areas
                                    boys 10-14 live with
   – Boys 10-14:
      • 61% live in rural areas     only one parent (usually
   – Girls 15-19:                   with their mother)
      • 47% live in rural areas
   – Boys 15-19:
      • 54% live in rural areas
Social isolation among young girls greatly increases
          their vulnerability to exploitation

• In Ghana:
    – 7% of girls 10-14 are not in
      school and not living with either
    – In some regions up to 15% are
      not in school and not living with
      either parent
• In general:
    – Social isolation increases the
      vulnerability to exploitation
    – Girls not in school and not living
      with either parent are at
      exceptionally high risk of poor
      health an d social outcomes and
      have less access to social and
      youth services¹
    ¹ Bruce, Judith and Kelly Hallman. 2008. "Reaching the girls left
          behind," Gender and Development 16(2): 227–245
    In addition to the educational experience, out-of-school
girls lose out on critical social opportunities and friendships
                                          with same sex peers
                                    • In Ghana:
                                       – 37% of all school-aged
                                         girls are not in school
                                       – In some regions up to
                                         60% of school-aged girls
                                         are not in school
                                       – In all regions, girls are
                                         more likely than boys to
                                         be out of school
School enrollment differs—often drastically—by
      gender, age, and area of residence
                      (Percent Enrolled in School)

• Rural girls have the lowest school enrollment overall
• School drop-out increases among both rural and urban girls
  around age 13
 School Enrollment among 15-19 Year Olds

          Urban females                              Rural females

                          Not in school
                                                                     Not in school
    47%         48%
                          Attending primary
                                                                     Attending primary
                                               10%                   secondary

• In Ghana, only 34% of rural girls are attending secondary
• Over half of all girls 15-19 are not in school
            Percent of 15 Year Old Girls In Grade 6 or Below

•      In Ghana, 28% of 15 year olds are in grade 6 or below
•      In general, girls who are significantly behind are more likely to be married and have children,
       engage in sexual activity and less likely to access basic health and other services²
²Lloyd, Cynthia B. 2004. “Schooling and Adolescent Reproductive Behavior in Developing Countries,” paper commissioned for the United Nations Millennium Project. New
        York: Population Council.
Child Marriage among 20-24 Year Old Females
                      •   Marriage under age 18 is considered
                          illegal child marriage according to CRC
                          and CEDAW- Ghana is signatory to both
                      • In Ghana:
                           – 12% of girls are married by age 15 in
                             some regions
                           – 39% of rural and 18% of urban girls are
                             married by age 18
                      • In general:
                           – Child marriage is often justified by
                             gender norms and economic conditions
                           – Being out of school at 10-14 is a risk
                             factor for child marriage in some
                           – What investment there is in girls usually
                             stops at marriage
                           – Married girls are rarely in school and the
                             youngest first time mothers and their
                             children are at particularly high risk of
                             poor outcomes³
                           ³Haberland, Nicole. 2007. “Supporting Married Girls, Calling Attention to a Neglected
                                 Group” Transitions to Adulthood, Brief 3. Population Council
    Illiteracy among Females (20-24) Married by 15

•    In Ghana, the illiteracy rate among girls married by 15 is as high as 82%; 34% of 15-19 year
     olds and 52% of 20-24 year olds are illiterate
•    In general, illiteracy rates are higher for girls married by 15 than for their unmarried peers
•    Policy has often given more attention to unmarried girls than to the rights of schooling for
     married girls
HIV Prevalence and Testing among Females
             15-24 Years Old
                            (Percent of girls 15-24 who have had an HIV test in the past year)

•     In Ghana, HIV prevalence among adults 15-49 is 1.9%; prevalence among 15-24 year old
      females is 1.3%, while for men it is 0.4% (a ratio of 3:1)⁴
•     Only 1.5% of 15-19 year olds and 3.5% of 20-24 year olds had an HIV test in the past year
•     In general, in Sub-Saharan Africa the HIV epidemic is increasingly affecting young, poorer
⁴Epidemiological Fact Sheet on HIV and AIDS: Ghana 2008
    Delivery Assistance among 20-24 Year Olds
         Varies by the Mother’s Residence









                      Urban                                                Rural

                              delivery assistance by health professional

• In Ghana, only 31% of 20-24 year olds and 77% of urban 20-24 year olds
  received assistance from a health professional at their last birth
Our Mission
 The Girls We Are Most Interested In, and
• Who are they?

• What are the conditions and status that most
  concern the organization?
The Specific Conditions our Program
 Addresses at the Level of the Girl:
      Our Interventions Include:
• Input:
• Intensity: (How often, how many girls)
  At the Level of Girls We Hope to:
• Expected Results at the level of the girls
Resources Needed to Do Our
Additional Resources:

Bruce, Judith and Erica Chong. 2006. "The diverse universe of adolescents, and the girls and boys left
behind: A note on research, program and policy priorities," background paper to the report Public Choices,
Private Decisions: Sexual and Reproductive Health and the Millennium Development Goals. New York: UN
Millennium Project. offsite PDF:

Chong, Erica, Kelly Hallman, and Martha Brady. 2006. Investing When it Counts Generating the evidence
base for policies and programmes for very young adolescents. New York : UNFPA and Population Council.

Lloyd, Cynthia B. 2004. “Schooling and Adolescent Reproductive Behavior in Developing Countries,” paper
commissioned for the United Nations Millennium Project. New York: Population Council.

Meyers, Carey. 2000. Adolescent Girls' Livelihoods. Essential Questions, Essential Tools: A Report on a
Workshop. New York and Washington, DC: Population Council and the International Center for Research on

Building Assets for Safe, Productive Lives: A Report on a Workshop on Adolescent Girls'

Promoting Healthy, Safe, and Productive Transitions to Adulthood, series of briefs all available at

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