Adolescent learner pregnancy in KwaZulu-Natal, South Africa : an exploration of modifiable psycho-socioeconomic risk factors

Abstract

Background Adolescence is widely accepted as one of the most difficult periods in one’s life-span and it is characterised by significant life events, health risks and maturational challenges. Teenagers globally and most notably within South Africa, have a range of age-specific health risks that include an increased risk of being a victim of violence, suicide, accidental death and an unplanned pregnancy for female adolescent girls. On average, within South Africa, up to 11% of teenagers have an unplanned pregnancy and this is inspite of the number of national interventions that have been implemented over the last 20 years. Aim /Objective The aim of the study was to explore the range of socioeconomic influences that contribute to teenage pregnancy in schools in order to generate research evidence to support the development of contextually relevant recommendations and/or policy interventions related to the management of teenage pregnancy in Kwa-Zulu Natal specifically and South Africa general. Methods This study was based on a multi-approach qualitative design in which data was collected over three empirical phases. Phase 1 involve In-depth interviews of policy makers, young mothers, young fathers and community leaders who were purposively sampled until data saturation was reached. Phase 2 involved five-hybrid focus group discussions each made up of young parents, community leaders, policy makers, pregnant and non-pregnant female teenagers (each having between 8-10 participants). Phase 3 made up of in-depth individual interviews of (n=15) pregnant teenagers, In-depth individual interviews of (n=6) non-pregnant teenagers and In-depth individual interviews of (n=15) young mothers and fathers using purposive sampling until saturation was reached. The Final phase was a theory-development and validation exercise in which stakeholders were engaged in Delphi-type discussions.

Findings The results of the study revealed that teenagers were of the opinion that socioeconomic and cultural practices both acted to encourage and discourage sexual activities. A notable view expressed by the participants was that teenage pregnancy was seen with different levels of seriousness by different types of teenagers and many did not always appreciate the seriousness of resulting consequences. Furthermore, similarly, teenage participants highlighted a number of perceptions about contraceptive use that demonstrated a serious lack of appropriate health education. Lack of parental supervision, high consumption of alcohol and loss of moral values were cited as contributory influences towards increased risk of pregnancy. Conclusions and Recommendations: Implications for practice Policy makers need to take into account non-traditional contributory factors (poverty, peer pressure, parental neglect, early marriages) to teenage pregnancy in the development and implementation of relevant policies. It is also important that apart from the influence of the socio-economic and cultural factors, the strong influence of the external environment (local, national and international environment), the media and information technology (IT) should be considered in developing new policies and the review of existing policies for the control of teenage pregnancy in South Africa.