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Rural adolescents give birth at twice the rate of urban adolescents (144 vs. Moreover, the rate of teenage childbearing increased in rural areas (from 120–125 births per 1,000 in 19 to 144 births per 1,000 in 2011), whereas in urban areas it declined between 19 (from 93 to 70), and has not fallen since.The proportion of current 15–19-year-olds who have started childbearing (i.e., those who are pregnant plus those who have already given birth) has risen slightly, from 21% in 19, to 24% in 2011.[7,8,10] Since Zimbabwean social mores strongly condemn childbirth outside of marriage, many unmarried adolescents’ pregnancies are likely to be unintended.

Unfortunately, the maternal health goal does not take into account the extent of a country’s HIV epidemic and the weight of its contribution to maternal mortality.

This proportion has not changed much over the past decade among women, but it has declined slightly among men.[7,8,10] A related measure— the proportion of 20–24-yearolds who have had sex by their 18th birthday—shows a similar trend: No decline among young women between 19 (35–38%), but a drop among young men (from 31% to 23%— Figure 1).

These national-level findings are echoed in smallerscale studies (e.g., in the most populous province, Manicaland), one of which showed a recent decline in the proportion of 15–17-year-old males who had ever had sex, but no decline among their female counterparts.

Many obstacles prevent young Zimbabweans from acting on their desire to postpone parenthood and stay HIV-free.

Protecting adolescents from unintended pregnancy and HIV infection by providing them with essential sexual and reproductive health information and services will be critical if Zimbabwe is to fulfill its long-term economic development goals.

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