Adolescent pregnancy, public policies, and targeted programs in Latin America and the Caribbean: a systematic review
- PMID: 34934413
- PMCID: PMC8678105
- DOI: 10.26633/RPSP.2021.144
Adolescent pregnancy, public policies, and targeted programs in Latin America and the Caribbean: a systematic review
Abstract
Objective: To present and assess evidence from Latin America and the Caribbean (LAC) on public policies and targeted programs which may have influenced variations in adolescent pregnancy or its proximate determinants, and to identify knowledge gaps that require further research.
Methods: A systematic review was performed based on the 2015 PRISMA protocol. Five databases were searched for articles published between 2000 and 2019 that refer to at least one country in LAC. The outcomes of interest were adolescent pregnancy or its proximate determinants (sexual behavior, contraceptive use, and/ or abortion). Only studies exploring correlations between the outcomes of interest and public policies or targeted programs were included in the analysis.
Results: Thirty studies spanning 14 countries were selected for analysis. Twenty-three of these (77%) were not included in prior systematic reviews on adolescent pregnancy. Public policies related to conditional cash transfers and compulsory education have the strongest evidence of correlation with adolescent pregnancy prevention. Emerging research points to the potential positive impact of life-skills programs for adolescents. Evidence from public health policies and programs was limited.
Conclusions: Further research which incorporates an intersectional analysis is needed to better understand which policies and programs could lead to steeper declines in adolescent pregnancy in the region. Evidence on effects of expanded family planning services and secondary school attainment upon adolescent pregnancy are particularly absent.
Objetivo: Presentar y evaluar evidencia de América Latina y el Caribe sobre las políticas públicas y los programas específicos que pueden haber influido en las variaciones en el embarazo en adolescentes o los factores determinantes relacionados, e identificar lagunas en el conocimiento que requieren más investigación.
Métodos: Se realizó una revisión sistemática de acuerdo con el protocolo PRISMA del 2015. Se llevaron a cabo búsquedas en cinco bases de datos en busca de artículos publicados entre el 2000 y el 2019 que se refirieran al menos a un país en América Latina y el Caribe. Los resultados de interés fueron embarazos en adolescentes o los factores determinantes relacionados (comportamiento sexual, uso de métodos anticonceptivos o aborto). Solo se incluyeron en el análisis estudios que exploraban las correlaciones entre los resultados de interés y las políticas públicas o programas específicos.
Resultados: Se seleccionaron para el análisis 30 estudios que abarcaban catorce países. Veintitrés de estos (77%) no estaban incluidos en revisiones sistemáticas anteriores sobre el embarazo en adolescentes. Las políticas públicas relacionadas con las transferencias monetarias condicionadas y la educación obligatoria arrojan la evidencia más fuerte de su correlación con la prevención de embarazos en la adolescencia. La investigación emergente indica una posible repercusión positiva de los programas para el desarrollo de aptitudes para la vida cotidiana dirigidos a adolescentes. La evidencia de las políticas de salud pública y los programas era limitada.
Conclusiones: Es necesario realizar investigaciones adicionales que incorporen un análisis interseccional para comprender mejor qué políticas y programas podrían conducir a un descenso más pronunciado del embarazo de adolescentes en la Región. La evidencia sobre los efectos de la ampliación de los servicios de planificación familiar y el nivel de estudios secundarios tras los embarazos en adolescentes es especialmente escasa.
Objetivo: Apresentar e avaliar evidências da América Latina e do Caribe (ALC) sobre políticas públicas e programas direcionados que podem ter influenciado as variações na gravidez na adolescência ou em seus determinantes imediatos e identificar lacunas de conhecimento que requerem mais pesquisas.
Métodos: Foi realizada uma revisão sistemática com base no protocolo PRISMA de 2015. Buscas foram feitas em cinco bases de dados de artigos publicados entre 2000 e 2019 que se referem a pelo menos um país da ALC. Os resultados de interesse foram a gravidez na adolescência ou seus determinantes imediatos (comportamento sexual, uso de métodos anticoncepcionais e/ou aborto). Somente os estudos que analisavam as correlações entre os resultados de interesse e políticas públicas ou programas direcionados foram incluídos nesta análise.
Resultados: Trinta estudos englobando 14 países foram selecionados para a análise. Vinte e três deles (77%) não foram incluídos em revisões sistemáticas prévias sobre gravidez na adolescência. As políticas públicas relacionadas a transferências monetárias condicionais e à educação obrigatória têm as evidências mais sólidas de correlação com a prevenção de gravidez na adolescência. Pesquisas recentes apontam para o potencial impacto positivo de programas de habilidades para a vida para adolescentes. As evidências de políticas e programas de saúde pública foram limitadas.
Conclusões: São necessárias mais pesquisas que incorporem uma análise cruzada para entender melhor quais políticas e programas levariam a uma maior diminuição da gravidez na adolescência na região. Particularmente, faltam evidências sobre os efeitos dos serviços ampliados de planejamento familiar e da conclusão do ensino médio na gravidez na adolescência.
Keywords: Americas; Pregnancy in adolescence; evidence-informed policy; public policy; sexual and reproductive health.
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