Q:是什么使青少年避孕药使用重大的全球健康问题？

A:世界卫生组织（WHO）报告说，每年15-19岁的15-19岁青少年分娩，主要是在低收入和中等收入国家。许多人的意图，而其他人则被弄乱。2300万青少年想使用避孕措施，但不是。早期，误以为怀孕可能会导致孕产妇的病态和死亡率，以及限制年轻妇女潜力的社会后果。

联合国秘书长班基金（Ban Ki-Moon）表示，青少年“对我们想要实现的一切都是核心。”如果我们要达到FP2020的目标，即满足69个国家 /地区的1.2亿妇女和女孩的避孕需求，那么对青少年的关注就是开创性的。已经出现了一个“从未有”的机会来优先考虑青少年的避孕需求和权利，我们必须迅速而果断地采取行动。

Q:为什么许多青少年仍然无法获得和使用避孕药具？

尽管避孕药的吸收几乎没有影响，但仍广泛实施促进青少年避孕药的流行方法，例如青年中心或同伴教育计划。

A:The International Conference on Population and Development spotlighted adolescents and contraception, yet 23 years later, little progress has been made. Barriers persist: restrictive laws, poorly implemented policies, reluctant providers and deeply held social norms, disproportionately affecting adolescent ability to use contraception to delay first pregnancy or space subsequent pregnancies.

Adolescents may not know where to obtain contraception or cannot afford services, yet even when there is easy access, uptake may be constrained by stigma around non-marital sexual activity, pressures to demonstrate fertility and overall lack of agency to make choices.

Incorrect use and discontinuation rates are also higher among adolescents. Popular approaches to promote adolescent contraceptive use such as youth centers or peer education programs are still widely implemented, despite little or no effect in contraceptive uptake.

Q:应该采取什么措施来增加青少年的正确和一致的避孕作用？

A:“照常业务”的方法不再足够了。我们对需要做什么，必须在该国一级共享和支持的事情有更深入的了解，因为为改善青少年避孕药的努力取决于政治意愿。如果各国愿意：可扩展和可持续的响应是可能的：

• 反对青少年多样性的计划；
• ensure adolescent access to all methods;
• 放弃分开的服务，并提供已经为青少年“青年友好”服务的服务；
• 与药房和药店合作，作为避孕的来源；和
• support all health workers to provide “youth friendly” care.

To further “bend the curve”, supportive laws and policies must be enacted, evidence-based interventions and monitoring systems must be implemented, and implementation research must be conducted.

在青少年可以良好获取避孕，足够信息并得到社会文化环境支持的地方，意外怀孕的率低。Adolescents can and do make responsible decisions when they have the tools and resources to do so.

Q:哪些国家在增加青少年获得和使用避孕药具方面取得了重大进展？

在青少年可以良好获取避孕，足够信息并得到社会文化环境支持的地方，意外怀孕的率低。

A:葱头的经验opia and Estonia in increasing adolescent contraceptive use and scaling up programs are instructive and inspirational:

Ethiopia’s National Health Extension Program (HEP) deployed 35,000 well-trained Health Extension Workers and ensured a steady supply of contraceptives. The HEP was intended to reach all Ethiopians, but the program substantially increased contraceptive use among married adolescents.

HEP success with adolescents was facilitated by policies that supported adolescent contraceptive use regardless of marital status, decentralization of implementation to the regions vis a vis planning and budgeting, and health management information systems that collected and reported relevant data.

爱沙尼亚（Estonia）受青少年意外怀孕，堕胎和性传播感染的高水平驱动的，在学校中扩大了全面的性教育和青年友好临床服务网络。爱沙尼亚的努力是通过支持性的社会和政治气氛促进的，通过国家健康保险以及国际计划生育联合会欧洲网络的帮助以及其他斯堪的纳维亚国家的例子。

Q:What new opportunities now exist for improving adolescent health?

A:Without a doubt it is possible to increase adolescent contraceptive use and ensure positive outcomes for young people through effective programs, political will and a commitment to partnership with young people. The Global Financing Facility (GFF) is an exciting opportunity to translate rhetoric into action, bolstered by the Sustainable Development Goals and the Global Strategy for Women, Children and Adolescents, and reinforced by the recommendations of the 2016 Lancet Commission and WHO’s Accelerating Action for the Health of Adolescents Framework.

与艾滋病，结核病和疟疾作斗争的全球基金也表现出对加强其在青少年健康的投资的兴趣。最近，参加2017年伦敦峰会的许多FP2020国家都表达了对增加青少年避孕药使用的坚定承诺。我们从来没有更好的机会来确保满足青少年的生殖健康需求和权利，我们绝不能浪费这个机会。