Existing evidences show that the major sexual and reproductive health problems of adolescents and youth in Ethiopia include risky sexual practices, child marriage, early child bearing, unintended pregnancy, unsafe abortion and its complications and STIs including HIV. Early sexual debut and teenage pregnancies are common owing to the high rate of child marriages and the subsequent family and societal pressure on girls to prove their fertility. The median age at first sex for women is 16.4 years (PMA, 2015). Uneducated, poor and rural girls start sex at younger age compared to the educated, well-to-do and urban. About 40% of girls marry before the age of 18 years and 20% before 15. About of half (45%) of girls in Amhara marry before the age of 18. The consequences of child marriage are many. Above all, early initiation of sexual intercourse is a risk for unintended pregnancy which in turn is the major reason for undesirable health and socioeconomic consequences mainly induced/unsafe abortion, high fertility, obstructed labor and its complications such as obstetric fistula, and hypertensive disorders of pregnancy. High rate of unintended pregnancy is also associated with the low utilization of family planning services by young people. The current contraceptive prevalence rate of 9% and unmet need of 30% among teenage girls (15-19) are among the lowest in sub-Saharan Africa. This is due to low access to adolescent and youth friendly services including family planning in this age group compared to older women.
Furthermore, lack of skilled care during pregnancy and delivery in this age group also poses significant health risk to the mothers and their children compared to older women in the reproductive age group. Adolescences particularly characterized by menarche among girls. In Ethiopia, most girls are in school between the ages 10-14 years, coinciding with menarche. Although menstrual management is included, many girls do not always have the right information on how to deal with it. Studies indicate that only 51% of school girls know about menstruation and its management, only one-third use sanitary napkins as menstrual absorbent during menstruation and, a high proportion (>50%) avoid going to school at the time of menstruation (Tegene et. al, 2014).