This study examines the reproductive health status of adolescent girls and boys in Matlab, a rural area in Bangladesh. To date, about 25 per cent of the population of Bangladesh are adolescents. Adolescents’ reproductive health status comprises a physical and a mental component. The main outcome indicators in this study are timing of menarche (the first menstruation) and knowledge and perceptions about reproduction. This study adopts a lifecourse approach and seeks to assess the relative contribution of contemporary and early childhood nutritional status to age at menarche. This requires analyses of longitudinal data. The study population comprises under-five children who were enrolled in a (baseline) study conducted in1988-1989 by Dr. Baqui. We followed these under-fives up in 2001 when they were between 12 and 16 years old. Information was collected through a survey and in-depth interviews.
Over half of the postmenarcheal girls in the sample reach menarche at an age of 14 years or older. Lifetable analyses revealed that the expected median age at menarche is 15.1 years. In societies that are characterised by early marriage and childbirth, as is the case in Bangladesh, late onset of menarche implies that relatively little time remains for a girl to mature. This may have detrimental consequences for the course and outcome of her pregnancy. Contemporary malnutrition may enhance the reproductive risks for both mother and child. The level of stunting (being short for age) in adolescence stands out as the most important determinant of age at menarche. Stunting in adolescence resonates from the effect of stunting in early childhood. Girls appear to be relatively more often malnourished than boys in early childhood.
A relatively high proportion of the adolescent girls and boys are not prepared for the main reproductive events in adolescence and lack substantial knowledge about reproduction. The adolescents in the sample display a great eagerness to learn more about the basic facts of reproductive life.
Alinda Bosch (1971) received her Master Degree in Non-western Demography from the University of Groningen and her PhD in Demography from the same university, on the basis of this book. The study was carried out as a part of the larger research programme ‘HEalthy reproduction: Research for Action’ (HERA), a joint initiative of the Population Research Centre of the University of Groningen and the Netherlands Interdisciplinary Demographic Institute (NIDI) in The Hague. Mrs. Bosch is a researcher at the NIDI.
