Systematic review and network meta-analysis of the efficacy, safety and tolerability of xanomeline plus trospium chloride compared with eight oral antipsychotics for the acute treatment of schizophren

This study estimated the return-on-investment from scaling up evidence-based interventions to prevent adolescent pregnancy and child marriage in Cambodia, Indonesia, the Philippines, Lao People’s Democratic Republic and Malaysia, to inform investment decisions. It extends previous work by considering demand generation interventions rather than just the supply side, by having a focus on adolescents only, and by considering adolescent pregnancy and child marriage together, capturing their complex interdependencies. Investing in evidence-based interventions to reduce adolescent pregnancy and child marriage is likely to have substantial health and economic benefits. There are significant gaps in the literature for interventions to reduce adolescent pregnancies and child marriage, suggesting that additional programme impact evaluation studies would be valuable. Adolescent pregnancy and child marriage are associated with adverse health and socioeconomic outcomes for girls and their children, including higher rates of maternal and perinatal morbidity and mortality, lower educational attainment and reduced workforce participation and productivity. It is estimated that annually, there are over 3.7 million births to girls aged 15–19 years in the Asia and Pacific region. In low- and middle-income countries (LMICs) in Southeast Asia, adolescent fertility rates are relatively high (43 births per 1000 girls aged 15–19 years), and 1 in 14 adolescent girls have begun childbearing by 18 years of age. In Southeast Asia, 43% of pregnancies among adolescent girls are unintended, and a considerable proportion of them end in induced abortion, which is legally restricted and mostly unsafe, causing significant maternal morbidity and mortality. In 2020, the maternal mortality ratio (MMR) was estimated at 134 women per 100 000 live births in Southeast Asia.