Community interventions to help reduce teen pregnancies

According to a BBC programme, some 182,000 female high school students, mostly poor and black, become pregnant every year in South Africa. How does a community deal with a problem like this?

Identifying the problem

Local NGO health workers report that in certain rural areas of South Africa, 65% of the mothers are teenagers between 13 and 19 years old and some are as young as ten years old.

Young, teenage mothers not only endanger their health by becoming pregnant before age 18 (more than one third of all maternal deaths are teenage mothers) but also sabotage any hopes of an education and career, the very things that could afford them the opportunity of becoming financially independent. So, how does a community deal with a problem like this?

Identify the root causes

There are various reasons and causes for this phenomenon, including:

1. Extreme poverty

Although the government disputes these claims, desperately impoverished women and their daughters have a strong incentive to get pregnant to obtain the monthly child support grants handed out by the government. Other measures used to obtain an income include money for sex (usually unprotected) or marrying off girls under the legal marriage age of 16 (child brides) to older men who can provide for them. Drug and alcohol abuse by uneducated, unemployed and bored teens exacerbate these problems.

2. Ignorance and lack of sex education

Despite all the efforts by schools, NGOs and the government to supply life orientation and sex education to young people and to make cheap and effective contraceptives available to them, a survey done by LoveLife (South Africa’s national HIV prevention campaign for young people) yielded some surprising results. The results indicated that 74.1% fell pregnant due to lack of knowledge and 55% the first time they had sex. This situation is further complicated by partners who refuse to use condoms and parents in certain sectors of the population who believe that teaching children about sex is an invitation to them to experiment with sex.

3. Peer and cultural pressures

Sometimes engaging in sex at a young age is seen as something the “cool” kids at school do. However, when the girls do get pregnant, they are mocked and usually abandoned by their boyfriends. A study conducted by the Limpopo provincial government reported that in 16.3% cases of teenage pregnancy family pressure to get pregnant also played a role. They also point out that in some communities families want the teens to prove their fertility by becoming pregnant and that there is a general community attitude that teenage pregnancy was “normal”.

What the community can do

Fortunately, not all South African communities agree that teenage pregnancies are “normal”. The following community-based strategies proposed by the N’wamitwa community in Tzaneen, Limpopo Province (with the help of Ibis Reproductive Health) give an overview of typical challenges and the strategies that can be implemented to reduce teen pregnancies.

Organising education and awareness raising activities, such as workshops with parents about youth sexual reproductive health (SRH) and rights (SRHR)

Improving communication between parents and children

Giving evidence-based sex education at primary schools

Organising safer sex community campaigns

Organising substance and alcohol abuse workshops

Addressing the negative influence of alcohol abuse by reducing the number of liquor licenses approved, encouraging sobriety, enforcing tavern closing times and the age restriction on selling alcohol to minors

Obtaining new community resources and recreational facilities such as a cinema, parks, swimming pool, community garden, youth clubs, etc

Obtaining more health care facilities in the area to decrease the large distances that people have to travel to reach and access health services. Young women pointed out that existing clinics closed early and were not confidential, which prompted them to visit traditional healers when in trouble

To create more jobs including opening small businesses

Talking to government officials regarding certain sexual and reproductive health rights (SRHR) policies such as child grants and suggesting that age restrictions (eg grants only for women aged 25 years and older) be implemented

Reconsideration of certain other child rights policies such as providing 12 year olds with contraceptives because it limits parental control and interferes with how parents want to raise their children.

Community involvement is crucial

The government and other NGOs and youth-serving organisations toil in vain trying to reduce teen pregnancies without the help of the communities involved. Fortunately, parents and communities all over South Africa are realising that teen pregnancies are a breach of their girls’ fundamental human rights to education, health and life opportunities, and that they can and must address the root problems that cause this phenomenon.

Sources
Adolescent Pregnancy: a review of the evidence. Retrieved from: http://www.unfpa.org/webdav/site/global/shared/swp2013/ADOLESCENT%20PREGNANCY_UNFPA.pdf
Engaging Communities to address teenage pregnancy in South Africa: a summary report from the N’wamitwa Community in Tzaneen, Limpopo Province. Retrieved from: http://www.rmchsa.org/wp-content/uploads/2013/08/Engaging-Communities-to-Address-Teenage-Pregnancy-in-Nwamitwa-Limpopo-2012.pdf
Ghosh, P. 2013. Teenage pregnancies destroying lives, futures of South African girls. Retrieved from: http://www.cdc.gov/Features/TeenPregnancy/
Jewkes R. et.al. Empowering teenagers to prevent pregnancy: lessons from South Africa. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/19459086
Larsen, MV. Pupil and pregnant: young mothers in South Africa.Retrieved from: http://www.capechameleon.co.za/printed-version/issue-10/cover-story/
Mchunu,, G. et.al. Adolescent pregnancy and associated factors in South African youth. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598281/
Mkalipi, M. 2013. The fight to stop teenage pregnancy. Retrieved from: http://www.mediaclubsouthafrica.com/youth-and-education/3465-the-fight-to-stop-teenage-pregnancy
Reducing teen pregnancy: engaging communities. Retrieved from: http://www.cdc.gov/Features/TeenPregnancy/