Why Malaysia’s teenage pregnancy crisis demands urgent action now

Amar-Singh HSS

The recent media coverage of teenage pregnancies is important as this issue requires a lot more attention and action.

Based on data from the Ministry of Health, as reported by the women, family and community development minister, between 2020 and 2024, 41,842 girls aged 19 and below were recorded as pregnant at MoH health facilities. Of these 16,951 involved unmarried girls.

We need to view this data in a wider context. Note that the data is only from MoH health facilities and the problem is much larger. Most teenage pregnancies are unplanned and may end up as abortions, for which we have no data. We can probably double the numbers quoted here.

Let’s look at data from the National Health and Morbidity Survey 2022, which evaluated a national, representative sample of over 30,000 students aged 13 to 17 years.

The survey showed that 7.6% admitted to having had sex and 5.7% were currently having sex.

The rates were higher in younger children (11% Form One students) and 33% had sex before the age of 14. Some (11%) admitted to having more than one sexual partner and the majority (88%) did not use any birth control method.

The survey also showed that knowledge among Malaysian teens regarding sexual and reproductive health was poor.

Finally, while the concern is regarding teenage pregnancies in unmarried girls, we must not forget another reality. Any teenage pregnancy, even among those married, carries much higher health risks. It impairs the girl’s academic and economic future; often resulting in school dropout.

It is extremely worrying that 24,873 children were married and had babies between 2020 and 2024.

Understanding the root causes

To understand teenage pregnancies, it is vital that the government shares granular data on all these children with teenage pregnancies, married or unmarried. This will enable us to plan appropriate measures to reduce teenage pregnancies and marriage in society.

Some key factors we need to understand include:

• Poverty: Adolescents in poorer communities are more likely to become pregnant.
• Education: School dropouts due to educational challenges pose a higher risk.
• Community support: Did these girls receive any sex education or contraception access? Were they involved in any community youth programmes?
• Sexual abuse – were any of those in child marriage sexually abused?
• Substance use: Drug use can lead to unsafe sexual behaviour.

Preventing teenagers from engaging in sexual activity requires a combination of formal sex education, open communication in families, setting boundaries and fostering healthy attitudes towards relationships and sexuality; with governmental protection to ensure online safety for children.

We must focus not just on girls but also on boys.

A huge body of data and research shows that comprehensive sex education reduces sexual activity and teenage pregnancies. Children and teenagers need age-appropriate information about their sexuality and how it relates to their bodies and relationships with others.

This will help them develop a safe and positive view of sexuality; build healthy relationships, and make informed, safe, positive choices about their sexuality.

Of concern is how widespread and effective our communication about sexual and reproductive health is to adolescents? Is it reaching high-risk groups?

Government initiatives like KafeTEEN that focus on reproductive health education and counselling are important. But has the reach been adequate?

Data from the National Population and Family Development Board (LPPKN) showed that, from 2006 to 2023, close to a million teenagers benefited from sexual and reproductive health advocacy programmes.

While this is a commendable effort, remember that, in that same time period, we would have had seven to eight million adolescents aged 12 to 17.

Hence, the majority of teens, and probably the high-risk groups, remain unreached as shown by the 2022 healthy and morbidity survey data. The only really effective reach is through the national education programme, both government and private, starting once children approach puberty.

Creating safe spaces for open dialogue 

With teens, we require open and honest communication and a safe environment. They need to feel comfortable asking questions and relationships and discussing their concerns about sex and relationships – without fear of judgement.

Ideally this should be the home. But in my many assessments over the years, the vast majority of parents fail to discuss sex education with their children. Hence, we have to rely on schools.

The support teens require includes how to navigate peer pressure related to sex, developing refusal skills and setting healthy boundaries in relationships.

It is good to hear that the government has a reproductive and social health education Policy and action plan (Pekerti), which aims to raise awareness and promote responsible, resilient behaviour among young people.

But as the welfare minister emphasised, it is important that all-of-society plays a role in supporting children and teenagers in the country. We cannot afford to do too little too late. We must ramp up our support for teenagers.

Dato’ Dr Amar-Singh HSS is a consultant paediatrician and child-disability activist.

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