«Suggested citation: Panday, S., Makiwane, M., Ranchod, C., & Letsoalo, T. (2009). Teenage pregnancy in South Africa - with a speciﬁc focus on ...»
TEENAGE PREGNANCY IN SOUTH AFRICA -
WITH A SPECIFIC FOCUS ON
SCHOOL - GOING LEARNERS
Produced by the Human Sciences Research Council on behalf of
the Department of Basic Education, with support from UNICEF.
Panday, S., Makiwane, M., Ranchod, C., & Letsoalo, T. (2009). Teenage pregnancy in South Africa
- with a speciﬁc focus on school-going learners. Child, Youth, Family and Social Development, Human Sciences Research Council. Pretoria: Department of Basic Education.
August 2009 ISBN No.: 978-0-620-44701-0 Department of Basic Education Private Bag X895, Pretoria, 0001, Tel: 012 312 5911, Fax: 012 312 5218 www.education.gov.za Toll Free: 0800 202 933 ISBN: 978-0-620-44701-0 Teenage pregnancy in South Africa - with a speciﬁc focus on school-going learners Teenage pregnancy in South Africa - with a speciﬁc focus on school-going learners 1 Teenage pregnancy in South Africa - with a speciﬁc focus on school-going learners 2 Teenage pregnancy in South Africa - with a speciﬁc focus on school-going learners
FOREWORD BY MINISTER: BASIC EDUCATION
The Department of Basic Education has taken an active role in seeking to understand and effectively address this challenge, as it impacts signiﬁcantly on learners. In 2008, the Department commissioned a desktop study to document, review and critically analyze literature on teenage pregnancy with a focus on school-going adolescents.
The study analyzes both the prevalence of teenage pregnancy and its determinants. It is my privilege to present the report of this study ‘Teenage Pregnancy in South Africa, with a Speciﬁc Focus on School–Going Learners’.
Findings from this study are that teenage fertility in South Africa has been declining over time. Declines in overall fertility rates have been attributed to, amongst others, increased access to information on reproductive health and rights and improved contraceptive use. The study has further identiﬁed that learner pregnancies are more concentrated in the provinces of Eastern Cape, Limpopo and KwaZulu Natal; thereby necessitating targeted interventions in these areas.
In addition, the study states that learner pregnancies are higher in schools located in poorer neighbourhoods.
Despite the reported decline in teenage fertility rates, the high proportion of unintended pregnancies for teenagers in South Africa remains a serious problem. Pregnant teenagers face serious health, socio-economic and educational challenges. One teenage learner pregnant is one too many, and the Department therefore does not take comfort in the reported decline of teenage fertility, but seeks to strengthen efforts towards addressing this challenge. To this end, the Department will develop a comprehensive strategy towards addressing learner pregnancy in South Africa, outlining deﬁnitive interventions for implementation through the schooling system. The report also notes that remaining in the education system is a strong factor in preventing teenagers from falling pregnant, and we must therefore continue to work to keep young women in school.
However, we are mindful of the fact that addressing teenage pregnancy is not a challenge facing only one department.
Addressing teenage pregnancy is a battle that requires the active involvement of all stakeholders, if it is to be well fought. These stakeholders include other government departments, key organisations in the non-governmental sector; the research community, the religious sector, community leaders and more importantly, parents and the learners themselves. It is for this reason that we invite all stakeholders to study the report, and draw from it that which can assist them to respond better to the challenges in their respective sectors.
Thank you to the HSRC researchers who worked on this report. I also offer my sincere thanks to our partner UNICEF, who provided the funding that made the study possible.
Mrs AM Motshekga Minister of Basic Education August 2009
Table of Contents Executive Summary
Terms of reference
Approach to the study
Secondary data analysis
Trends in Teenage Fertility
Fertility history in South Africa
Teenage fertility in relation to overall fertility
Case A: Trends in fertility in the Eastern Cape
Case B: South African fertility trends, 1980-2001
Lessons from analysis of trends in fertility
Barriers to legal abortion
Consequences of Early Childbearing
Educational and economic consequences
5 Teenage pregnancy in South Africa - with a speciﬁc focus on school-going learners Knowledge, beliefs and attitudes about contraception
Attitudes towards teenage pregnancy
Childhood sexual and physical abuse
Parental values and role-modelling
Parental style, monitoring and support
Socio-economic status and poverty
Proﬁle of male partners
Who are young fathers?
Attitudes towards early fatherhood
Barriers to teen fatherhood
Policy and Programmes
School-based sex education
School based/linked health services
Sexual and reproductive health services
Access to family planning services
Adolescent friendly services
Termination of pregnancy services
Mass media campaigns
Youth development programmes
Second chance programmes
Flexible school policies
What works best for second chance programmes
Child support grant
Conclusions and Recommendations
6 Teenage pregnancy in South Africa - with a speciﬁc focus on school-going learners Role of education
Sexual risk factors
Universal implementation of sex education
Targeted interventions for high risk groups
Non-sexual risk factors
Interventions to retain girls in school
Scope and coverage of research
Appendix 1: Literature search strategy
Appendix 2: The HSRC 2003 Status of the Youth Survey – Methods
List of Tables Table 1: Fertility trends in Transkei by marital status and age, 1980-1994
Table 2: Teenage fertility rates (per 1000 women) by population group, 1996-2001
Table 3: Adolescent pregnancy and motherhood, South Africa, 1998
Table 4: Learner pregnancy rates, 2004-2008
Table 5: Learner pregnancy rates per province, 2004-2008
Table 6: Selected variables and the proportion of missing data
Table 7: Distribution of learner pregnancy by institutional phase
Table 8: Distribution of learner pregnancy by level of specialisation
Table 9: Distribution of learner pregnancy by school fees
Table 10: Distribution of learner pregnancy by school land ownership
Table 11: Consequences of early childbearing
Table 12: An ecological perspective: levels of inﬂuence
Table 13: Selected social factors related to early pregnancy among women in SA, 2003
Table 14: Selected social factors related to early pregnancy among young men in SA, 2003
Table 15: Factors affecting young father’s wellbeing and participation in parenting
Table 16: Characteristics of effective curriculum-based programmes
Table 17: Sources of information related to HIV and AIDS for young people in SA
Table 18: Cumulative odds of behaviour change with increased exposure to communication campaigns...96
List of Figures
Figure 1: Births to women aged 15-19 per thousand women, 1990, 2000 and 2005
Figure 2: Overall fertility trends in South Africa
Figure 3: Trends in teenage fertility, 1980-2007
Figure 4: Trends in teenage fertility-Africa Centre Demographic Surveillance System, 1990-2005..............33 Figure 5: Pregnancy among 15-19 year olds by age, 2003
Figure 6: Percentage of women aged 15-19 who are mothers per province, 1998
Figure 7: HIV prevalence by geography type among 15-24 year olds in South Africa, 2003
Figure 8: Teenage fertility by population group, 1996-2001
Figure 9: Increasing teenage pregnancy rates among those who are not at school
Figure 10: Reasons for teenage pregnancy among young women who have ever been pregnant................56 Figure 11: Perception of the most important issues facing youth in South Africa, 2003
Figure 12: Perception of risk for unplanned pregnancy, STIs, HIV and sexual assault, 2003
Figure 13: Proportion of 15-24 year olds who know of Soul City, loveLife and Khomanani
List of Boxes Box 1: Description of three national HIV and AIDS campaigns in SA
Executive Summary The transition to parenthood is a major event in the lifespan of any individual, but takes on special signiﬁcance when it precedes the transition to education, work, citizenship and marriage that offer the skills, resources and social stock necessary to succeed as parents. Although alternative pathways to parenthood occur and are tolerated to some extent, institutional support for parenthood is still geared towards a traditional sequencing of transitions.
HIV/AIDS is now recognised as the primary reproductive health concern for adolescents, overtaking the longstanding emphasis on adolescent fertility. Yet childbearing among teenagers remains a common social and public health concern worldwide, affecting nearly every society. Teenage fertility, establishes the pace and level of fertility over a woman’s entire reproductive life span. This has an impact not only on women’s health, but on the socio-economic status and general wellbeing of the population. Despite public health literature and family planning services treating HIV and pregnancy as distinct, they share many common antecedents chief amongst which is unprotected sex. What is more, there is evidence that pregnancy and lactation increase the susceptibility to HIV infection through immunological changes induced during pregnancy.
Even though teenage fertility has been the subject of substantial debate in the social science research and policy circles, concern has not emanated from the increased risk that pregnancy confers to HIV. While current political and media depictions imply that SA is confronted with an escalating epidemic of teenage pregnancies, available data suggests that it is an area in which substantial progress has been made since democracy. Yet teenage pregnancy has grown in signiﬁcance as a social construct and come to represent one of several indicators of burgeoning adolescent delinquency, sexual permissiveness and moral decay.
Education is central to the development of young people as it prepares them for the world of work and for life. As young people spend longer periods in education, as part of the natural course of development, sexual experimentation and maturity is increasingly coinciding with secondary schooling. For most, it remains at the level of experimentation and if sex occurs, indications are that it is more likely to be protected when young people are still at school. However, for a minority, it results in unwanted pregnancy, HIV and other sexually transmitted infections. This has implications for continued educational opportunities.
In a rights-based society, young girls who fall pregnant should not be denied access to education and this is entrenched in law in SA through the Constitution and Schools Act of 1996. In 2007, the Department of Education released Measures for the Prevention and Management of Learner Pregnancy. Not without controversy, the guidelines continue to advocate for the right of pregnant girls to remain in school, but suggests up to a two year waiting period before girls can return to school in the interest of the rights of the child. Any proposed shift in policy and practice needs to be informed by a well-rounded understanding of the context of teenage pregnancy.
Purpose The purpose of the study was to document, review and critically analyse literature on teenage pregnancy with
a focus on school-going adolescents. The speciﬁc objectives were as follows:
• To review existing literature and conduct statistical analyses to establish the prevalence and determinants of teenage pregnancy;