Teenage Pregnancy Research Analysis of the Problem
Introduction
To start with, this is one pf the teenage pregnancy research papers in which the current problem is analysed. According to The World Health Organization, 12 million girls aged 15-19 years and at least 777,000 girls under 15 years give birth each year in developing countries and at least 10 million of these unintended pregnancies occur each year among adolescent girls aged 15-19 years in the developing world. Complications during pregnancy and childbirth are the leading cause of death for 15–19-year-old girls globally, of the estimated 5.6 million abortions that occur each year among adolescent girls aged 15-19 years, 3.9 million are unsafe which contribute to maternal mortality, morbidity, and lasting health problems. Adolescent mothers ages 10-19 mostly face higher risks of eclampsia and systemic infections than women aged 20-24 years and the babies of adolescent mothers face higher risks of low birth weight, pre-term delivery and severe neonatal conditions.
Teenage pregnancy is a major health problem within South African society, especially in Gauteng, recently it has been reported that teenage pregnancies increased by 60% during covid-19 pandemic more than 23,000 girls gave birth between April 2020 and March 2021; 934 babies were delivered by girls between the age of 10 and 14 years; 19,000 babies were delivered by girls between the ages of 15 and 19 and 3000 girls between the ages of 10 and 19 chose to terminate their pregnancy of these numbers some of these girls were victims of statutory rape. Teenage pregnancy in Gauteng is a multi-faceted health issue with many contributing factors such as poverty, lack of education, lack of information about sexual reproductive health and rights, limited access to healthcare services, gender inequalities, gender-based violence, substance abuse, poor access to contraceptive methods and issues with termination of pregnancy.
Although there is a large number of family planning clinics and reproductive health services exist, the use of these services is limited among the youth for various reasons such as societal values and morals, judgmental and negative attitudes of healthcare workers (especially in the matter of accessing contraceptives) and financial constraints. The issue of teenage pregnancy persists even though there has been a number of initiatives and programmes have been launched nationally to increase youth access to education, reproductive and health services, and information, but there still remains significant barriers that need to be addressed.
Demographics
The figure 1.1 below shows a pyramid of the south African population by age and sex in 2016. The figure indicates that 10 294 894 adolescents (10-19) were living in south Africa in 2016, of the adolescents 9,3% were 10-14 years old and 9,1% were 15–19-year-olds. These adolescents made up 18,5% of the total population in 2016. Figure 1.2 shows the adolescent population of 5,160,084 (18,9%) were males and 5, 134,202(18,1%) were females. In Gauteng the adolescent birth rate per 1000 women aged 15-19 years went from 48 to 57 from 2001 to 2011, in 2012 19,2% of female youth had an adolescent pregnancy of which 16,2% had an unwanted pregnancy and only 6.7% terminated a pregnancy. Adolescents aged 10-19 years make 14.1% of the total population, from 2018 to 2019 approximately 5% of females aged 14-19 in south Africa had been pregnant within 12 months. As of 2021 Gauteng had the highest number of births among all the other provinces. Almost 130,000 babies were delivered to girls aged 10-19 in South African public health facilities in 2019, this number figure increased to 136,386 deliveries for girls in the same age in 2020.
Epidemiology
51,5% of adolescents who are mothers were reported to be attending school in South Africa, aged 10-24 reported 8% of them were raped, another factor was hazardous levels of alcohol use were reported by 27% of adolescent young mothers. The odds for ever been pregnant were higher for girls who had 2 or more sexual partners this is specific to school-going female adolescents.
Service Usage
Adolescent girls and young women (aged 10-24) reported that 52% have access to a male condom, 27% have access to female condom, 41% have access to another form of contraceptive. Among these girls only 48% had ever used a modern contraceptive method to prevent pregnancy.
Possible Resources and Opportunities For Action
There are many resources and partners needed to prevent teenage pregnancy, of the identified resources for action to address the needs related to this health issue which are felt and expressed needs include availability to access contraceptives, accessibility to quality education both academic and sexual, keeping enrollment of young mothers in school and counselling and guiding young girls to make the right decision to stay in school. It would be extremely beneficial to partner with the governmental sector especially the department of health and department of education. The department of education is an important partner because the girls are at the ages of 10-19 and most of them will have take time off from school to focus on their pregnancy and so partnering with the department of education to provide comprehensive education is important on educating young girls ways of preventing pregnancy and supporting them should they fall pregnant whilst in school.
Provincial governments should be encouraged to build relationships with other departments like health and social development to ensure that professionals such as nurses and social workers are assigned to clusters of schools.
Partnering with the department of health will allow us to improve the health of the young girls, as the health of these mothers is at risk, we would advocate to implement antenatal care among young mothers. Healthcare workers will assist in developing a plan that is suitable for the young girl and the baby during antenatal, delivery and postnatal and provide counselling. Healthcare workers will also the young girls with access to contraceptive methods to prevent pregnancy and to protect themselves from sexually transmitted infections.
Gaps and Support in Policyservices
A study conducted to help focus the public’s attention on the involvement of men’s involvement in teenage pregnancy found that many unintended pregnancies among teenage girls in south Africa has remained a public concern, however studies and interventions do not consider the young men’s involvement in teenage pregnancies. Reducing teenage pregnancy has been on the agender for decades although the numbers of teenage pregnancies has reduced drastically in developed countries it remains high in developing countries such as South Africa. In south Africa more than 30% of teenage girls fall pregnant and between 65% and 71% of these pregnancies are unplanned, despite the adolescent pregnancy rate declining from 30% in 1984 to 23% in 2008, adolescents still contributed to 13,6% of registered births in country in 2016 a rate that is higher than in other income countries. The Department of Basic Education observed that about 68000 of school going children had given birth to at least one child in 2013 compared with 50 000 in 2009 and an additional 21000 were pregnant in 2013.
There have been several initiatives aimed at curbing teenage pregnancy for example, the 1994 International Conference on Population Development called for countries to undertake education initiatives for girls to provide services to adolescents that would allow them to deal with their sexuality and make more responsible decisions about their sexual relationships. The 1992 Forum for African Women Educationalists said to promote education of girls in several African countries and supported policies to be reformed to permit pregnant girls and adolescent mothers to complete their education. The Convention on the Elimination of All Forms of Discrimination against Women also advocated for education programs that focused on sexuality, reproductive health, and women’s right, this initiative included awareness campaigns around unplanned teenage pregnancies and sexually transmitted disease, the most recent initiatives now include the Sustainable Development Goal (SDG’s) to tackle teenage pregnancy. Local initiatives to address teenage pregnancies include the Men as partners programme, the Gender policy Framework of South Africa, the Love Life campaign and the Born Free dialogue, these initiatives have been used to curb HIV infections among the youth. Despite the amount of programmes, financial investments, studies and reports on teenage pregnancy, the increasing proportion of unintended pregnancies among teenagers has remained a huge public health concern, several factors including limited use of contraceptives, low abortion rates, age of sexual debut, girls limited access to education and other socioeconomic factors and the involvement of men have not been considered as the biggest contributing factor to the high teenage pregnancy in South Africa.
Teenage pregnancy involves both the girl and her male partner, and the characteristics of these men is crucial in understanding factors in teenage pregnancy it should not be ignored, despite the government’s involvement and support for a number of laws and policies related to gender-based violence, paternity, child support and gender equality there is still no clear policy to engage men who are the drivers of teenage pregnancy. To date there has been no initiatives to sensitize men about the implication of impregnating young girls, teenage pregnancy has often been described as a female adolescent problem however men’s sexual involvement with a young girl is a contributing factor to teenage pregnancy, focusing on only the girls when investigating factors that contribute to teenage pregnancy would not only make treatment of the outcome(pregnancy) scientifically skewed but it can be beneficial in eradicating teenage pregnancy.
Strengths and Limitations of Information Presented
The strengths that we see is that policy provides pregnancy prevention programs to educate adolescents and young women about being safe and about sexual advances. The information presented states that the key to success in teenage pregnancy reduction is to empower social policy agenda to work with young people, making them aware of their rights and risks of sexual intercourse. Evidence shows that teenage pregnancy prevention programs reduce sexual activity and increase the use of contraceptives and reduce teenage pregnancy however additional evidence is needed to confirm effects as they vary by program.
What is absent from the literature is the disruptive effects that schooling has on early parenting on males, the reason presumably is that it is assumed to have none which leaves the gendered issue of access to education and childcare arrangements unquestioned. A major concern with regards to school completion is its association with socio-economic status, the argument states that teenage pregnancy leads to school disruption which leads to many socio-economic disadvantages. However other literature states that despite the evidence that there is a correlation between long-term lower socio-economic status and teenage pregnancy, this does not mean that teenage pregnancy in and itself contributed to the poor outcome in fact a major shortcoming in the literature of teenage pregnancy has been a failure to incorporate a comprehensive understanding of the effects of a world marked by severely compromised health and shortened life expectancy may have towards moulding population patterns of early fertility. Some of literature interviewed students about the use of contraceptives stated that some felt that contraceptives would ruin their wombs and that they would not be able to have children in the future, many lacked social support to use contraceptives from their parents or caregivers. They also said that healthcare workers mistreated them and asked them embarrassing question which made them leave without accessing the services.
Conclusion
In order to prevent or reduce and manage teenage pregnancy, there needs to be a collective partnership at a multi-stakeholder, multi-sectoral approach that will include key partners in schools, hospitals, and clinics, traditional leaders, community-based organizations, family, caregivers, the community, and the government. Also, we need appropriate awareness programmes to be initiated among young men about the consequences of their sexual behaviour in effort to reduce the incidence of teenage pregnancy in South Africa. Lastly school-based interventions should be a part of the effort to prevent sexual violence and raise awareness about adolescent’s sexual and reproductive health rights, the health system interventions and education campaigns to address the socio-cultural beliefs and misinformation that undermines the use of contraceptives is also needed, free contraceptives should be made available not only in health facilities but in settings such as school, community, and retail pharmacies. Health workers should also discuss the concerns and needs of adolescent girls and young women with them and help them find the best contraceptive method for them.
To end up one of research papers on teen pregnancy, there is evidence that shows that provision of incentives to promote adherence to medication is a promising strategy, for example, people could get money for transport or data to get health information. This can promote access and consistent use of contraceptives among adolescent girls and young women.
