BOUAKÉ DEPARTMENT, Côte d’Ivoire — Thérèse, 18, is the eldest of five siblings from the N’Gattakro district, in Côte d’Ivoire’s central Bouaké Department.
Raised by her grandmother, Thérèse left school at just 14 to take a cleaning job in the capital, Abidjan, to help pay family expenses. Before she turned 18, she had already gone through two pregnancies close together.
“I gave birth to my two children by cesarean section at the University Hospital in Bouaké,” she told UNFPA, the United Nations sexual and reproductive health agency. “The first was in 2023, a girl who’s now more than one year old, and then my son in October 2024. After I gave birth to the first, I wanted to use contraception but I couldn’t make up my mind. When I went to see the midwife, she told me to wait until my period came.”
“But I didn’t see my period at all,” continued Thérèse. “Then I noticed something moving in my belly—that’s when I went to the hospital and found out I was six months pregnant.”
Expanding Access to Reproductive Health Education
Warned by her doctor about the dangers of early and closely spaced pregnancies, Thérèse began searching for a reliable contraceptive solution. She discovered that the local school health service offered a range of free contraception options tailored to young people, even those no longer in school.
“I’d heard about it but had never been there before,” Thérèse said. “It was a local woman who advised me to come to the school clinic for contraceptive methods and said that it’s free. I don’t want to be surprised by another pregnancy, so I quickly came to get the implant.”
UNFPA supports 98 school health initiatives and 135 high school infirmaries as part of a program to expand access to sexual and reproductive health for young people. Together, school health initiatives like the one Thérèse visited and high school infirmaries offer education and prevention programs, counseling and safe-space discussions in youth clubs, and an app with information and advice on reproductive health and family planning.
Regular medical checkups and free family planning services are also provided, along with consultations, medical care for young mothers, and support for people living with HIV/AIDS.
These services are offered through both fixed health facilities and mobile outreach units—part of UNFPA’s effort to reach young people wherever they are. This work is vital, as surveys show many girls don’t know where or how to access youth-friendly health services. According to the latest data, nearly one-quarter of adolescent girls in Côte d’Ivoire become pregnant before age 19, with rates twice as high in rural areas as in urban ones.
Treating Young People with Respect and Dignity
“Our mission is to provide a nonjudgmental welcome and solutions to help young people regain their self-confidence,” said Dr. Aoura, Deputy Chief Medical Officer of the school health service in Bouaké’s Commerce District.
That was exactly the kind of care Thérèse received. She was welcomed by midwife Sylvie, who explained the different contraceptive options available. After weighing her options, Thérèse chose a long-acting contraceptive implant, and the midwife inserted the device into her arm.
“It’s different from the hospitals I went to when I was pregnant,” Thérèse said. “Here the midwife was kind. She didn’t talk down to me, she didn’t shout at me, she gave me advice and took good care of me.” She said she would recommend the health center to other young women seeking family planning or contraceptive counseling.
Achieving reproductive freedom for women and girls depends on access to high-quality, affordable reproductive health care and contraception. Yet globally, more than 257 million women who want to avoid pregnancy are not using safe or effective methods—often because of limited access to information, cultural barriers, or resistance from partners and communities.
UNFPA is working closely with local governments to ensure teenagers and young adults can access the supportive, youth-friendly services they need to fulfill their potential. For Thérèse, that support means she can now work part-time jobs to pay for evening classes—and move toward her dream of becoming a care assistant.