Number/percent of married women under age 18 exposed to HTSP counseling/education who subsequently adopted a family planning method to delay first pregnancy

Number/percent of married women under age 18 exposed to HTSP counseling/education who subsequently adopted a family planning method to delay first pregnancy

Number/percent of married women under age 18 exposed to HTSP counseling/education who subsequently adopted a family planning method to delay first pregnancy

Number/percent of married women ≤17 years of age who have never been pregnant; who have seen, heard, or read healthy timing and spacing of pregnancy (HTSP) messages that have been promoted either through an information, education, or communication (IEC) campaign, interpersonal communication or community outreach; and who subsequently adopted a family planning (FP) method to delay first pregnancy.

To calculate this indicator, the women surveyed/interviewed must answer affirmatively to both questions:

  • In the past (specified period of time, e.g., 12 months), have you heard or read about messages related to HTSP through the radio, TV, brochures, other media or from a health provider, community leader, or other individual?
  • Since hearing about HTSP, have you adopted an FP method to delay your first pregnancy?

As a proportion, this indicator is calculated as:

(Number of married women under age 18 exposed to HTSP counseling/education surveyed/interviewed who subsequently adopted an FP method to delay first pregnancy / total number of married women under age 18 exposed to HTSP counseling/education surveyed/interviewed) x 100

Marital status, gravida, age of woman, confirmation of exposure to HTSP counseling/education, verification that respondent adopted an FP method post-exposure to HTSP counseling/education

Some may wish to collect additional information and disaggregate data by age of respondent, site, underserved population, vulnerable group, FP method adopted, or type of counseling/education.

Program records; special survey; interviews

When first pregnancies occur to adolescents less than 18 years old, the mothers and their newborns face increased risks of health complications compared to women 20-24 years old. Adolescents are at a higher risk of developing pregnancy-induced hypertension, anemia, and prolonged or obstructed labor.  Controlling for all other factors, compared to women aged 20-24, a 16-17 year old is 1.25 times more likely to hemorrhage or experience very pre-term delivery and an adolescent under 15 is four times more likely to die giving birth and 1.5 times more likely to hemorrhage or experience very pre-term delivery. Newborns may die, be born too soon, too small, or with a low birth weight.  The younger a woman is when she first gives birth, the longer her total child-bearing period and the more children she is likely to have which increases the risks to the life and health of both mothers and children.

In populations where communication programs related to HTSP are implemented using IEC techniques, interpersonal communication channels and community outreach workers, program managers and evaluators may want to know the extent to which the intended audience adopts the HTSP recommendations.  This outcome indicator measures the extent to which a specific population targeted by HTSP messages becomes knowledgeable about the implications of early childbearing and actively takes steps to delay first pregnancy.

The adoption of an FP method by a married woman under age 18 who has been exposed to HTSP messages may imply, but not prove that the decision to use FP was a result of the HTSP counseling/education.

The indicator does not specify if the adopted FP method is modern or traditional, nor does it capture information about the chosen method being practiced correctly and consistently. 


communication, healthy timing and spacing of pregnancies (HTSP), family planning, adolescent

“Healthy Timing and Spacing of Pregnancy: A Trainer’s Reference Guide”, 2008.  USAID and ESD Project

“Healthy Timing and Spacing of Pregnancies: A Pocket Guide for Health Practitioners, Program Managers, and Community Leaders”, 2006.  USAID and ESD Project

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