The Gauteng health department has, again, raised concern over the increase in teenage pregnancy in the province. 

According to the department 24,941 births and abortions were recorded among girls and adolescents aged 10-19 in the 2022/23 financial year. This is higher than the previous year’s 24,445 cases. 

The drivers behind these numbers are multi-faceted. And so, efforts to address teen pregnancy must also be multi-faceted. To this end, the Health MEC, Nomantu Nkomo-Ralehoko, unveiled an intervention plan at an event hosted in Ekurhuleni on Tuesday. 

“The plan is crafted from insights gained through extensive consultations with youth and from data gathered in our health workshops and initiatives. We are introducing a series of strategic actions, including educational workshops, health screenings, and rights-based discussions, which are crucial for fostering informed choices among our youth,” says Nkomo-Ralehoko.  

 “We are also planning the establishment of purpose-built youth centres across each health district. These centres will be key in providing spaces where young people can access dedicated health services and information. Equipped with the necessary facilities to address the health and educational needs of our youth, these centres will play a critical role in the long-term success of our preventive efforts.”

In attendance at the event were learners from schools around the province. Katlego Mashaba (15) from Benoni says she believes that the plan will play a good role in the lives of the youth when they visit healthcare facilities because they will no longer feel ashamed or afraid to ask the nurses about contraceptives and other issues that they are facing.

“The government is trying so much to reduce the rates of teenage pregnancy. We should also play our part in reducing these rates by abstaining and also encouraging one another not to engage in sexual activities at a young age,” says Amogetswe Thupi (18) from Soshanguve, north of Pretoria. 

At this stage it’s not clear when or where these centres will be built or opened. 

Drivers of teen pregnancy 

Social justice organisations suggest that factors such as inadequate sexual education, socioeconomic challenges, and limited access to reproductive health services play significant roles in the high rates of teenage pregnancy in the province. 

Phinah Kodisang, CEO of advocacy organisation Soul City Institute for Social Justice, says lack of comprehensive sex education which includes the messages on delaying sexual debut plays is a major contributor to the problem. 

“Our messaging on prevention should also include encouraging young people to abstain or delay sexual debut as far as they can. We need to ensure that an environment is created for them to access reproductive services that are free of stigma and judgement.” 

Kodisang says limited access to contraceptives is a compounding factor. 

“There are clearly many youths that are not well informed on the methods or where to obtain them. Teenagers are less likely than older women to seek contraception from a clinic due to lack of independence, fears of breach of confidentiality or judgement, and negative attitudes from healthcare providers.” 

Gauteng provincial programmes and operations manager Thilivhali Livhali from the youth health advocacy organisation Love Life, adds that sometimes health workers aren’t giving young people the information they need. 

“For example you’d find nurses telling teenagers about contraceptive methods but only giving them oral contraceptives while there are injectables, so if the young person is not comfortable with oral contraceptives they will then stop taking the contraceptive method.”

Socioeconomic factors also play a huge role in the increase in teenage pregnancy, says Livhali, especially in informal settlements. 

“You find the whole family living in a single room, with their children, where sometimes parents engage in activities that tend to make the children think they are normal and they copy them.” 

Livhadi says lack of extramural activities at school and no access to safe parks also plays a huge role in the increase of teenage pregnancy. “As a result of these factors, the young people then resort to sexual activities and substance abuse.” 

Gaps in existing policies 

According to Kodisang, most teenagers report dissatisfaction in the quality of sexual and reproductive education that they get in school. To address this, the department of education should ensure that teachers receive adequate training. 

“Collaboration with parents needs to be strengthened so that the parents also entrench messaging that seeks to promote healthy sexual behaviour among their adolescents.” 

She explains some programmes are not in touch with the current sexual norms such as the issue of coercion and consent.

“The most critical gap in sex education is the lack of information and education on sexual communication and negotiation, and the skill building necessary to resist peer pressure and to have a healthy relationship,” she says.

Ongoing efforts 

Kodisang says Soul City, Department of Health and other organisations are working hard to ensure that these issues are addressed by supporting the rolling out of youth friendly services in health facilities. 

“[Addressing teen pregnancy] is not a once-off activity, it requires continued mobilisation of young people and advocacy with the department to ensure the healthcare providers are also capacitated and held to account where there is a failure to provide the services required,” she adds. – Health-e News