Sexual and reproductive health among adolescents in vulnerable contexts in Mexico: Needs, knowledge, and rights.

Ensuring sexual and reproductive health, and rights for adolescents entails the prevention of early pregnancies, which are widely recognized as a public health problem. Based on the ecological model for early pregnancy, this article identifies the healthcare requirements for preventing unintended adolescent pregnancies in predominantly indigenous communities in Chiapas, Mexico. Using a convergent parallel mixed-methods study design, we surveyed adolescents (12-15 years old) and health personnel, organized focus groups with adolescents and their parents, and conducted in-depth interviews at the individual, family, school and community levels. Results showed that adolescents recognized their right to receive sexuality education (64.5%) as well as information on contraceptive methods (53.0%), with indigenous language speakers and individuals living in overcrowded households less likely to know about these rights. Parents of adolescents knew little about contraception and pregnancy. School teachers lacked necessary tools for offering comprehensive sexuality education. A traditional, patriarchal perspective predominated among participants, fostering gender inequalities. In conclusion, it is essential to implement multifocal strategies under a human-rights, intercultural, and health-equity approach. Special attention should be directed to the spheres in which adolescents interact, and efforts should focus on improving knowledge, empowering adolescents, and enhancing their access to sexual and reproductive health resources.