RHO: Reproductive Health Outlook

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Table 1. Factors That Influence Youth Reproductive Health Outcomes

Research from the United States has found that programs that identify and, when possible, modify the social context that influences young people's lives are more likely to improve health. Following are examples of factors that influence how adolescents make decisions about sexual and health behaviors. Depending on the particular context, these factors can have positive or negative influences.


Household and Family

  • Age and gender
  • Place of residence
  • Knowledge, attitudes, and beliefs
  • Religiosity
  • Self-efficacy
  • Skills
    • motivated to do well in school
    • actively engaged in learning
    • places high value on helping other people
    • accepts and takes responsibility
  • Alcohol and drug use, smoking
  • Other related risky behavior
    • depression, stress, loneliness
    • running away from home
  • Sexual and physical abuse
  • Low educational and economic level of family
  • Family attitudes
    • devaluing education
    • supporting early marriage and childbearing
    • discouraging young people's access to information and services
  • Harmonious relationship with family
    • quality interaction with family
    • family's values are communicated to youth
    • supervision by adult family members

Peers and Partners


  • Perception of peer behavior
    • perception that peers are sexually active
    • perception that peers are using alcohol or drugs
  • Relationship with partner(s)
    • age and income differentials
    • exchange of money or goods for sex
    • sexual pressure
  • Sense of commitment with partner
  • Connectedness with religious organizations
  • Connectedness with schools
    • availability of education
    • a safe school environment
    • academic performance and aspirations
  • Availability of youth programs
    • leisure activities
    • counseling
    • sexual abuse services
  • Relationships with other adults through community institutions


  • Disorganization: high unemployment, poverty, low educational levels, political instability, war, crime, high migration
  • Social norms: gender discrimination, restrictions on girls' mobility, early marriage
  • Lack of opportunities: education, economic opportunities, health and contraceptive services, youth programs
  • Policy: legality of contraceptives, minimum age of legal marriage, health and education services for youth
  • Policy: illegality of abortion, weak enforcement of rape laws
  • Mass media: media that provides role models and encourages responsibility
  • Mass media: pornography, sexually permissive and violent media

Source: Adapted from Adamchak et al.,2000.

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