Health e News

Pregnancy itself is a potential mental health stressor, even for older women. Generally, women are twice as likely to experience mental health challenges as their male counterparts. According to a research article published in 2022, although research on maternal mental health in Africa is sparse, some studies estimate the prevalence of postpartum depression in Africa to range between 15 to 25%.30,31. The prevalence of postpartum depression among adolescent mothers ranges from 14% to 53%. This is more than double that observed in older mothers (7–17%). The article also states that teenage mothers with untreated depression have a far greater likelihood of having a second pregnancy within two years. According to the South African Medical Journal, the number of births to young teenagers aged 10 - 14 years increased by 48.7% (from a baseline of 2 726, which is very high by developed-country standards) and the birth rate per 1 000 girls in this age category increased from 1.1 to 1.5. SAMJ analysed the data available in the public sector database, the District Health Information System, from 2017 to 2021. In adolescent girls aged 15 - 19, the number of births increased by 17.9% (from a baseline of 114 329) and the birth rate per 1 000 girls in this age category increased from 49.6 to 55.6. These increases also occurred year on year in a continuous upward trend as well as in all provinces, but at different rates. Generally, rates were higher in the more rural provinces such as Limpopo, Mpumalanga and Eastern Cape than in more urban provinces such as Gauteng and Western Cape. Londeka and Patience are both mothers who fell pregnant whilst teens. They shared their mental health struggles as well as what being pregnant whilst still a teenager is like. Londeka Ngcongo, is a 17 year old mother of a 1 year 4 months old girl. She fell pregnant in August 2020 and I gave birth in May 2021. “I was nervous; I thought that I will be kicked out at home but I didn't think of having an abortion. I first told my boyfriend that I was pregnant. He was shocked but he gave me a lot of support and took care of me. I was 3 months pregnant at the time when he told his family. They gave me much support, love as well and they love the baby too. Our relationship is good”, she says. The teen mum who is from Inanda, Durban, lives with her mother’s family. “At home everything is bad, I’m being insulted, they are talking behind my back, gossiping. I feel like a prisoner. Everything that I do is not appreciated, I feel like I am useless and I am not a member of the family, I feel like an outcast, life is difficult”, she says. Ngcongo says that her father’s side of the family is a bit more supportive. “My father’s family is okay, they are supporting me they understand that I am a child and I also do mistake as other teenagers, I even wished if I could live with them but I can’t because they live in rural area northern KZN plus I am still studying I can’t just go and live in rural area”, she says. Ngcongo had to skip school last year because her baby was very sick. “We stayed at the hospital for 2 months, and even this year my baby is still in and out of the hospital, which is a difficult thing for me as a young mother”. She says that she is grateful that her boyfriend's family is still supporting them, which she is not experiencing from her family. “In my family, it seems as if they don’t even care about my suffering; they don’t ask me anything regarding myself and or the child’s wellbeing. Ngcongo says being in school, as a young mother is not easy. “Not because I have a child but because of the depression and trauma I have. My high school life has been difficult since Grade 9 because I had no support from home, even the school uniform that I had was not in a good condition. It became worse when they found out that I was pregnant, even my mother she didn’t support me not to mention my friends as well who also turned their backs on me which is the thing I didn’t expect honestly, but I told myself that life goes on I have to be strong for myself and for my child”, she says. During the week, Ngcongo’s child stays with her grandmother (her boyfriend's mother) because she is still at school but during the weekends, holidays and school holidays, she makes sure that she fetches her child. Though Ngcongo does receive a social grant, she says it is not enough for a child who is always sick because most of the time she needs to see a doctor or be sent to hospital. “Life is tough but I try by all means to take it one step at a time”, she says. Ngcongo gets her income from hair braiding, hair styling and manicures. “My dream one day is to have my own salon in town, because to tell you the truth I don’t see myself as a career woman but I see myself as a business woman one day”, she says. 21 year-old mother to twins, Patience Mentoor, also gets income through manicures. Mentoor, who lives in Delft, Cape Town fell pregnant in Grade 11 and felt like her life was over. “It wasn’t easy at all, but I love my children. Finding out that you are pregnant at 17 isn’t easy but now finding out that it was twins was even worse. The first thing that crossed my mind was my parents, I knew that they were going to be disappointed. I gave birth in June (matric year) and dropped out of school, so I don’t even have matric”, she says. Mentoor says that the pregnancy was not easy and she was depressed throughout it. “Getting through the day was hard. Both of our parents agreed that I should stay at home until the babies were born but the environment at home wasn’t nice, especially with my father. There was also a time when suicide crossed my mind because I felt like a burden and unworthy.”, she says. I was lucky that I fell pregnant towards the end of Grade 11 so I didn’t really have to face people’s comments and stares at school but I knew that when matric started I’d have to face it eventually because my bump was growing”, she says. Mentoor says that a social worker in the community encouraged her to join a support group for teen mothers, because she could see how it was affecting her mental health. “Aunty Lydia (social worker) was actually more supportive than my family, in terms of emotional support, so that did help in a way. She really guided me and told me that I need to speak about how I am feeling and not keep it inside. I am grateful to her because it really helped with the mental health struggles I was having and still have sometimes”, she says. Mentoor started doing people’s nails as a way to make income. “My boyfriend’s and his family do help financially but I just wanted to make sure that I am making money of my own, so I started with something simple. It’s not a lot but it’s a start. I really hope to study someday. I didn’t finish matric but I still hope that I can do something to secure my future.” she says. A 2020 study explores the intersection between mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa. In South Africa, adolescent girls and young women (AGYW) are at risk of poor mental health, HIV infection and early pregnancy. Poor mental health in AGYW is associated with increased sexual risk behaviours, and impeded HIV testing and care. Using in-depth interviews and focus group discussions, the study explored subjective experiences of mental health and sexual and reproductive health (SRH) amongst 237 AGYW aged 15–24 years in five South African districts. Respondents shared narratives of stress, emotional isolation, feelings of depression, and suicidal ideation, interconnected with HIV, pregnancy and violence in relationships. In the South African context, pregnancy may exacerbate existing social and contextual stressors, adding additional stressors such as interpersonal relationship challenges, regret around ‘unintended’ pregnancies, and depression. Respondents suggested that due to social stigma attached to teenage pregnancy, pregnant AGYW fear being judged and gossiped about: “Pregnant girls feel sad, some even contemplate suicide (azive efuna ukuzibulala) because of hearing unpleasant things about their life being spoken by other people”. (15–18 years, WC, isiXhosa) “Pregnant girls are teased, and then they drop out of school, they don't finish; here at school, we gossip about each other in the toilets.” (15–18 years, WC). The emotional ‘burden’ of teenage pregnancy was described as a key contributing factor to poor mental health: “They say having a child is a good thing, but as a teenager it is a burden, it’s difficult to cope” (15–18 years, EC). The study also revealed that a lack of emotional support from partners/fathers of children also contributed to stress and depression amongst young mothers. Lacking a supportive social environment negatively impacted on mental health and self-esteem. Suggestions from this study include addressing the burden of unplanned teenage pregnancy. Sex education needs to be incorporated into discussions at school, home, and health facilities. Further, safe, stigma-free access to contraceptives needs to be provided for adolescents. Authors from the study also suggest that the sociocultural stigma and taboo associated with discussions about sex at school and within the community needs to be mitigated to provide a safe environment for teens to engage. Community health workers, who are typically lay members of the community who work either for pay or as volunteers with the local health care system, can be trained to provide sex education community members (including teenagers and their families). “Teens are more comfortable learning from teens. Trained peer counsellors and support groups have been used to provide safe environment for adolescents to have healthy conversations on sexual and reproductive health”. There are several organisations throughout South Africa that provide support for teenage mothers and their families. A few include: Mamkhulu.org in Mpumalanga, Teen Moms Youth Development run by Options Care Centre in George, The Parent Centre in Wynberg, Cape Town, Lifeline Pregnancy Support and Girl Pride Africa . - Health-e News

Teen mums in South Africa: largest ever study explores what it takes to go back to school

Kathryn Steventon Roberts, University of Oxford and Janina Jochim, University of Oxford Imagine the weight of responsibility for caring for a child when you are not yet fully grown yourself, and the fear of being shamed by parents, fellow learners, and even strangers within the community? Vast numbers of adolescent mothers, many of them very vulnerable, exist across Africa, but there remains little research on their challenges and what can be done to support them and their children. Policies and programmes are often small scale, poorly implemented, or not inclusive of adolescent parents. Detailing findings from the largest adolescent mother cohort study in sub-Saharan Africa, this article sheds light on some of the challenges they face, potential entry points for interventions and programmes, and opportunities to support adolescent mothers and their children. Some adolescent mothers from sub-Saharan Africa say they did not realise they could get pregnant or how to

EBF: New moms in dire need of support, education

Let’s make breastfeeding and work, work!

Lerato Mthunzi, Health and Allied Workers Indaba Trade Union (HAITU) General Secretary Breastfeeding is one of the most effective ways to ensure long term child health and survival. But fewer than half of infants under 6 months old are exclusively breastfed – contrary to the recommendations of the World Health Organisation.  Breastfeeding has many benefits for both the mother and the baby. It should be supported and promoted by health professionals, family members, employers and society at large.  Breastfeeding is the natural and optimal way of feeding infants. It provides them with the best nutrition they need for their growth and development. It also has positive effects on the mother’s health, well-being, and  allows for the mother and baby to bond.  Despite these advantages, many mothers face barriers and challenges that prevent them from initiating or continuing breastfeeding. These include lack of information, support, confidence, time, facilities and a lack

For a bright future, invest in Africa’s young

Bill Gates Last month, I visited Nigeria for the first time in five years, and, everywhere I went, perhaps more than on any of my previous trips, I felt the immense energy and boundless potential of its rising generation. I met with young scientists and researchers working on innovative solutions to some of the country’s most difficult challenges in health and development. I also listened to young entrepreneurs talk aboutleveraging new digital technologies to improve health care and financial literacy. Nigeria has one of the largest youth populations in the world, and 19 of the youngest 20 countries, in terms of median age, are in Africa. That represents a lot of potential skills and passion to solve big problems. In fact, Africa’s growing and talented young population is the continent’s most powerful asset for the future, and when I met with Nigeria’s leaders, I re-emphasized how much they could achieve

Male fertility crisis: what environmental contaminants have got to do with it

Daniel Marcu, University of East Anglia; Liana Maree, University of the Western Cape, and Shannen Keyser, University of the Western Cape The World Health Organisation (WHO) recently reported that around one in six couples globally are affected by infertility. For many years people tended to blame women for a couple’s infertility – especially in African countries. But it’s now known that male factor infertility contributes about 50% of total cases. And men worldwide – Africa included – are experiencing a worrying trend of decreased sperm count and quality. There are multiple causes of male infertility. However, it is clear that environmental contaminants play a large part in declining fertility worldwide. Concern is rising about substances such as per- and polyfluoroalkyl substances, nanomaterials and endocrine disrupting compounds. These substances are found everywhere in modern everyday lives. Most are present in personal-care products such as soaps, shampoos and hair sprays, as well

Malnutrition in South Africa: how one community wants resources to be spent

Agnes Erzse, University of the Witwatersrand and Aviva Tugendhaft, University of the Witwatersrand South Africa has persistently high rates of hunger and malnutrition among mothers and children. More than a quarter – 27% – of children under five are stunted and 61% of children are iron-deficient. Sixty-nine percent of women of reproductive age are overweight or obese, and 31% are iron-deficient. These figures paint a worrying picture. They suggest gaps in the country’s evidence-based nutrition policies and services. One way to accelerate progress on malnutrition is through engaging with the people who are directly affected by policies. South Africa’s health system strategy does include public consultation. But public participation is mostly limited to public meetings once a policy has already been drafted. This leaves little opportunity for substantial revisions. The lack of meaningful public engagement is also evident in how funds for mother and child nutrition are allocated. Decisions are

Gauteng has third case of cholera

Cholera: vaccines can stop the spread, but the biggest deterrent is clean water

By Edina Amponsah-Dacosta, University of Cape Town and Julie Copelyn, University of Cape Town South Africa has experienced outbreaks of cholera since January. The worst was in May in Hammanskraal, north of Pretoria, where nearly 30 people died. Cholera is a bacterial disease which spreads via the faecal-oral route mostly through ingestion of contaminated food and water. It causes severe diarrhoea and dehydration and in extreme cases death. The source of the outbreak in Hammanskraal is still not known. The World Health Organization (WHO) recommendations for responding to a cholera outbreak include ensuring that communities have access to safe drinking water and sanitation and treating sick people quickly. Oral cholera vaccines may be considered to contain ongoing outbreaks and to limit the spread. These vaccines have not been administered during the current outbreak in South Africa. The Conversation Africa spoke to vaccinologists Edina Amponsah-Dacosta and Julie Copelyn about the cholera

Women standing on dry soil and fishing gear,

Weather experts issue alert over looming El Niño as sea surface temperatures hit record highs

by Onke Ngcuka, Daily MaverickWeather experts have sent out an alert about the possible impacts of an El Niño manifesting in the central Pacific Ocean, but they are uncertain what effect it will have across southern Africa. El Niño is a weather phenomenon that typically brings with it higher temperatures and lower rainfall as a result of warm sea surface temperatures along the South American coast and towards the central Pacific Ocean, caused by weaker trade winds (easterly winds near the equator). Speaking at an El Niño summit hosted by the University of Pretoria on Monday, weather phenomenon observers said there had been record high sea surface temperatures, but it was still unclear what effect El Niño would have in southern Africa.  Dr Neville Sweijd, a senior researcher at the Council for Scientific and Industrial Research (CSIR), was one of the experts at the summit. He said that this year,

Dry January: Say cheers to the beers

Alcohol use a potent threat to youth development

Youth Month calls us to reflect both on the historic debt we owe previous generations of young people who fought for our freedom and on the challenge of breathing hope and self-belief into the hearts of the current generation. The debate, quite rightly, centres on skills and jobs for young people in order to enable them to enjoy a better life than previous generations. But we cannot afford to neglect social ills that also erode the quality of life of our youth. Among these is the widespread use of alcohol by people under the age of 18, and a society that not only tolerates this but sometimes enables it. The issue is not whether it is morally right or wrong for adolescents and teenagers to drink. The fact is that it is damaging to their bodies and endangers their lives. The effect of alcohol on the brain is more marked

VIDEO: Cholera in Southern Africa: What you need to know

Reflecting on progress towards tackling period poverty in SA

Gender inequality, discriminatory social norms, cultural taboos, poverty and lack of basic services like toilets and sanitary products can all cause menstrual health and hygiene needs to go unmet.
Gauteng has third case of cholera

Cholera Outbreak: Death toll rises to 15

The death toll from the cholera outbreak in Hammanskraal climbed to 15t, the Gauteng Health Department confirmed Monday. The outbreak in the area was confirmed on Sunday. “By Sunday night 37 people were admitted to hospital. Another update will be given at midday,” says Gauteng Health Department Spokesman Motalatale Modiba. He urged anyone exhibiting symptoms of diarrhoea, nausea, vomiting, or stomach cramps to visit their nearest clinic or hospital immediately. Cholera typically causes acute watery diarrhoea and can affect people of all ages. It mainly spreads through contaminated/polluted water. People can become infected directly through drinking contaminated water or indirectly through eating contaminated food.  The infection is often mild or without symptoms but can sometimes be severe and life-threatening. An outbreak usually occurs in settings with inadequate sanitation and insufficient access to safe drinking water. Modiba says 95 people with similar symptoms from Kanana, Suurman, Majaneng, Green Field, Carousel View,

Climate change, characterized by heavy rains and an increase in temperatures, set to trigger malaria infections across the globe.

Spike in malaria cases

South Africa is experiencing a rise in malaria cases in the endemic provinces and Gauteng. The National Institute of Communicable Diseases says there have been a number of severe cases due to late detection.  “Undiagnosed and untreated malaria rapidly progresses to severe illness, with a potentially fatal outcome,” the NICD says in a statement.  It says anyone with fever and flu-like illness, who has travelled to malaria-risk areas of Limpopo, KwaZulu-Natal and Mpumalanga in the last six weeks, must test for malaria. Recent heavy rains and more people travelling during the recent Easter holidays possibly caused the rise in cases. Let your doctor know of travel to malaria-risk areas “(They) must be tested for malaria by blood smear microscopy or malaria rapid diagnostic test. If they test positive for malaria, the patient must start on malaria treatment immediately.” Malaria is a potentially life-threatening disease. The blood parasites of the genus

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