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‘Die mense sal dit nog aanvaar, …’: Perceptions of teenage
                   pregnancy in South Africa

Authors:Nancy Phaswana-Mafuya, Cily Tabane, Adlai Davids & Ntombizodwa Mbelle


                          Presenter: Cily Tabane,PhD
                         Socio-cultural responses to HIV
                         5th SAHARA Conference, 2009
                          th

                       30 November – 3 December 2009
                    Gallagher Estate, Midrand, South Africa


                                                                         1
INTRODUCTION
• For many teenagers, sexual activities result in unplanned
  pregnancies (Richter & Mlambo, 2005).
• Pregnancy among 15 -16 year olds accounts for 7% of all teen
  pregnancy while 17-19 year olds account for 93% of teen
  pregnancies (Reproductive Health Research Unit,2004)
• The recent (2009) South African household survey reported high
  levels of condom use at last sex among people aged 15–24
  years,
• The national HIV prevalence in this group is just under nine per
  cent (8.7%) (Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S,
  Pillay-van Wyk et al, 2009)




                                                                     2
INTRODUCTION (Cont)
• Teenage pregnancies are of significant interest in the
  age of HIV/AIDS for researchers in public health as the
  risk of HIV transmission is high
• The HIV & AIDS and STI Strategic Plan for South
  Africa 2007-2011 (South Africa National AIDS Council,
  2007), lists the median age of sexual partner among
  pregnant 15-19 year olds and the teenage pregnancy
  rate as two indicators in its prevention priority area.
• It is important to understand the social values and
  norms that encourage or sustain such behaviour or
  practices, especially given the fact that they may
  increase HIV risk.
• In order to contribute to the refinement of teenage
  pregnancy intervention strategies, views on the
  acceptability of teenage pregnancy and its causes
  need to be established.


                                                            3
MAIN OBJECTIVE

  This study/paper explored perceptions of teenage
pregnancy in as far as its acceptability, unacceptability
             and causes are concerned




                                                        4
METHODOLOGY
• Exploratory qualitative focus group study was
  conducted among diverse groups of individuals in
  terms of race, age, gender and geotype throughout the
  nine South African provinces
• A total of 17 focus group discussions
• A diversity of participants (193) was recruited and
  participated in focus groups ranging from 7 to 15
  participants.
• Data Analysis included-Thematic content analysis




                                                          5
GUIDING QUESTIONS
•   Does teenage pregnancy happen in your
    community?
•   Is this an acceptable or unacceptable
    behaviour in your community?
•   Why do some people find it acceptable?
•   Why do some people find it unacceptable?
•   What are the causes of teenage
    pregnancy?




                                               6
RESULTS (Cont)
•   Occurrence of teenage pregnancy-teenage pregnancy is
    common in their community (“I think it is the norm, because girls
    have children before they are fifteen years of age”KZN Teenagers,
    Mixed Group FGD)

•   Acceptability of teenage pregnancy:

•   Parents, relatives and community have become more
    accommodative(“These days parents agree to a lot of things, even
    wrong things.” - Male & female teenagers, Duduza, Gauteng)

•   Peer, Family and Community Pressure and Role Models-
    (“These days if you are our age and without a child you are looked
    down upon”. - Adult men, Galeshewe, Northern Cape

•   Family history of teenage pregnancy- “And then sometimes it’s
    also alright because they, there they have brothers and sisters that
    also started from a young age, now they become pregnant home,
    the mother may do nothing”. - Male teenagers, Kensington,
    Western Cape
                                                                           7
RESULTS (Cont)
•   Economic gain – (“Families sometimes do support this kind
    of practice in a way that they study the background of their
    daughter’s boyfriend, if he is from a wealthier family the
    chances of pregnancy are high. Mothers in particular are the
    ones who are behind this kind of a mission” - Adult men,
    Polokwane, Limpopo)
•   Teenage mothers are capable of looking after their
    children – (“I think one other thing that communities accept
    them is because these teenage mothers do take care of their
    children.” - Male & female teenagers, Durban, KwaZulu-
    Natal)
•   Human rights – (“…sometimes parents themselves get
    threatened by their children and have no other solution
    except going with their children’s wishes”. - Adult women,
    Port Elizabeth, Eastern Cape)

                                                                   8
RESULTS (Cont)
•   Teenage pregnancy perceived as an unacceptable
    behaviour in the community:

•   It is embarrassing, inappropriate and taboo for the teenage life
    stage –“Just imagine a child taking care of a child that is a bad
    experience”. - Adult women, Potchefstroom, North West)

•   It is contrary to widely held religious views and morals- (‘Okay,
    die mense sal dit nog aanvaar maar as jy daar bo kom een van die
    dae dan dis reguit hel toe.....(“OK, the community will accept it but
    when you die then you will go straight to hell”). - Female
    teenagers, Keimoes, Northern Cape )

•   It is done for economic gain- (“…One girl might fall pregnant
    coming from a disadvantaged family, relying on the money for grant
    to support her family…” - Adult men, Polokwane, Limpopo)



                                                                            9
RESULTS (Cont)
•   It creates relationship difficulties between mother and child-
    (“…and you also don’t have respect for your mother because your
    mother is then, what, fifteen years older than you” - Female
    teenagers, Keimoes, Northern Cape)
•   It leads to a loss of reputation as pregnant teenagers often
    become objects of scorn – (“…You are taken as very cheap and
    uncontrollable” - Male & female adult Zimbabweans, Thembisa,
    Gauteng)
•   It affects relationship between parents and the pregnant child –
    (“If you think you are big enough to have children, then you don’t
    have to be in the house anymore” - Female teenagers, Keimoes,
    Northern Cape)
•   It has a negative impact on scholastic performance – (“...like say
    ‘look at you, you so young, what do you want to become one day,
    what did you tell me, you want to be a dancer, you want to be an
    actress or this and that but look you falling pregnant which is going
    to prevent you from reaching your goal’, then they are, they are
    going to be harder on them” - Male teenagers, Kensington,
    Western Cape)

                                                                            10
RESULTS (Cont)
•   It leads to relationship problems in later life – (“Because that is
    why you marry. You marry to now have children of your own....” -
    Female teenagers, Keimoes, Northern Cape)

•   Perceived causes of teenage pregnancy:

•   Economic reasons-(“They discourage it and others encourage it.
    Some are just direct, they send a girl to love so and so to get
    money”. White River, Mpumalanaga, Mixed Adult Male and
    Female FGD)

•   Lack of education, knowledge or access to relevant
    information- (“Lack of knowledge is a problem on this issue”.
    White River, Mpumalanaga, Mixed Adult Male and Female FGD)

•   Social Pressure – (“Peer pressure plays a role because they tell
    themselves that if she can then I can also do it”. Northern Cape,
    Adult Males FGD)



                                                                          11
RESULTS (Cont)
• Teenagers think they won’t get pregnant –(”Haa, no
  I don’t think any teenager wants a child. It is just a
  mistake. People do not think they will be pregnant just
  after the first time of sleeping with a man”. -
  Leromolle, Informal settlements Free State, Female
  Teenagers FGD)

• Lack of recreational activities –(“Young people have
  no activities to keep them busy. There is no sport or
  anything, than sex is the only way to keep busy”.
  Rustenburg formal, Adult Women FGD)

• Lack of parental guidance, inability to perform
  parental role, parental pressure or non exemplary
  parental behaviour – (“I heard one mother
  complaining that her young girl was carrying her
  friend’s child, she asked her when is she going to carry
  hers”. White River, Mpumalanaga, Mixed Adult
  Male and Female FGD)                                       12
RESULTS (Cont)

• Wanting to experiment – (“…It sometimes happen
  because our children want to experiment …”
  Potchefstroom Informal settlements, Adult Women FGD.
• Empty promises from boyfriends – (“The boyfriends
  can lie so much and tell you that you are the only girl in
  his life whereas you are number ten on the list of his
  girlfriends”. Limpopo, Adult Male FGD)
• Desire for marriage, to keep boyfriend and to have
  a baby – (“Some they get pregnant to impress their
  boy friend or the family of a boy friend”.White River,
   Mpumalanaga, Mixed Adult Male and Female FGD)
• Sexual coercion –(“In rural areas there are these
  rapists that the community is afraid of, they will rape
  these young girls and as a result the girl will fall
  pregnant.” Limpopo, Adult Male FGD)
                                                               13
DISCUSSION
• Economic reasons such as unemployment and poverty
  are seen as playing a major role in teenage
  pregnancy. Money is exchanged for sex (Kunene,
  1995 & Were, 2007).

• Teenagers lack knowledge about contraception and
  pregnancy and this often result in teenage pregnancy
  (Richter & Mlambo, 2005; Were,2007 & Ehlers, 2003)

• Poor sex education causes teenage pregnancy.
  Parents and schools are neglecting sex education.
  Parents also fear that if they educate their children
  about sex, they will be seen as giving them permission
  to engage in sexual activities.

                                                           14
DISCUSSION (Cont)
• Lack of recreational actives - contribute to teenage
  pregnancy. Sex is the only thing that teenagers keep
  themselves busy with.

• Teenagers think that they will never fall pregnant from
  having sex once. Ignorance about physiological
  aspects of conception led the teenagers believe that
  first- time sex or irregular sex could not cause
  pregnancy. They think that sex is a play (Vundule et al,
  2000)

• Teenagers engage in life experiments and therefore
  will want to experiment with sex because they lack
  knowledge about sex. Risk taking is increasingly
  accepted as a normal component of adolescent
  development.

                                                             15
DISCUSSION (Cont)
• Discipline by parents is difficult because of the
  children’s and human rights.

• There seems to be a strong desire from the girls to
  keep the boyfriend, have a baby and get married. In a
  study conducted by Kunene (1995) girls also fell
  pregnant to keep their boyfriends




                                                          16
CONCLUSION
• It is evident from these results that teenage pregnancy
   is in existence and its causes are varied.

• Studies indicate that teenagers become sexually
  active in early puberty and are not using any form of
  contraceptives (Reproductive Health Research Unit,
   2004 & Jewkes, Vundule, Maforah & Jordaan, 2000).

• Teenage pregnancy prevention efforts should address
  identified causes of teenage pregnancy.




                                                            17
Social Determinants of Health
            Unit


                                18

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Cily Teenage Pregnancy

  • 1. ‘Die mense sal dit nog aanvaar, …’: Perceptions of teenage pregnancy in South Africa Authors:Nancy Phaswana-Mafuya, Cily Tabane, Adlai Davids & Ntombizodwa Mbelle Presenter: Cily Tabane,PhD Socio-cultural responses to HIV 5th SAHARA Conference, 2009 th 30 November – 3 December 2009 Gallagher Estate, Midrand, South Africa 1
  • 2. INTRODUCTION • For many teenagers, sexual activities result in unplanned pregnancies (Richter & Mlambo, 2005). • Pregnancy among 15 -16 year olds accounts for 7% of all teen pregnancy while 17-19 year olds account for 93% of teen pregnancies (Reproductive Health Research Unit,2004) • The recent (2009) South African household survey reported high levels of condom use at last sex among people aged 15–24 years, • The national HIV prevalence in this group is just under nine per cent (8.7%) (Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Pillay-van Wyk et al, 2009) 2
  • 3. INTRODUCTION (Cont) • Teenage pregnancies are of significant interest in the age of HIV/AIDS for researchers in public health as the risk of HIV transmission is high • The HIV & AIDS and STI Strategic Plan for South Africa 2007-2011 (South Africa National AIDS Council, 2007), lists the median age of sexual partner among pregnant 15-19 year olds and the teenage pregnancy rate as two indicators in its prevention priority area. • It is important to understand the social values and norms that encourage or sustain such behaviour or practices, especially given the fact that they may increase HIV risk. • In order to contribute to the refinement of teenage pregnancy intervention strategies, views on the acceptability of teenage pregnancy and its causes need to be established. 3
  • 4. MAIN OBJECTIVE This study/paper explored perceptions of teenage pregnancy in as far as its acceptability, unacceptability and causes are concerned 4
  • 5. METHODOLOGY • Exploratory qualitative focus group study was conducted among diverse groups of individuals in terms of race, age, gender and geotype throughout the nine South African provinces • A total of 17 focus group discussions • A diversity of participants (193) was recruited and participated in focus groups ranging from 7 to 15 participants. • Data Analysis included-Thematic content analysis 5
  • 6. GUIDING QUESTIONS • Does teenage pregnancy happen in your community? • Is this an acceptable or unacceptable behaviour in your community? • Why do some people find it acceptable? • Why do some people find it unacceptable? • What are the causes of teenage pregnancy? 6
  • 7. RESULTS (Cont) • Occurrence of teenage pregnancy-teenage pregnancy is common in their community (“I think it is the norm, because girls have children before they are fifteen years of age”KZN Teenagers, Mixed Group FGD) • Acceptability of teenage pregnancy: • Parents, relatives and community have become more accommodative(“These days parents agree to a lot of things, even wrong things.” - Male & female teenagers, Duduza, Gauteng) • Peer, Family and Community Pressure and Role Models- (“These days if you are our age and without a child you are looked down upon”. - Adult men, Galeshewe, Northern Cape • Family history of teenage pregnancy- “And then sometimes it’s also alright because they, there they have brothers and sisters that also started from a young age, now they become pregnant home, the mother may do nothing”. - Male teenagers, Kensington, Western Cape 7
  • 8. RESULTS (Cont) • Economic gain – (“Families sometimes do support this kind of practice in a way that they study the background of their daughter’s boyfriend, if he is from a wealthier family the chances of pregnancy are high. Mothers in particular are the ones who are behind this kind of a mission” - Adult men, Polokwane, Limpopo) • Teenage mothers are capable of looking after their children – (“I think one other thing that communities accept them is because these teenage mothers do take care of their children.” - Male & female teenagers, Durban, KwaZulu- Natal) • Human rights – (“…sometimes parents themselves get threatened by their children and have no other solution except going with their children’s wishes”. - Adult women, Port Elizabeth, Eastern Cape) 8
  • 9. RESULTS (Cont) • Teenage pregnancy perceived as an unacceptable behaviour in the community: • It is embarrassing, inappropriate and taboo for the teenage life stage –“Just imagine a child taking care of a child that is a bad experience”. - Adult women, Potchefstroom, North West) • It is contrary to widely held religious views and morals- (‘Okay, die mense sal dit nog aanvaar maar as jy daar bo kom een van die dae dan dis reguit hel toe.....(“OK, the community will accept it but when you die then you will go straight to hell”). - Female teenagers, Keimoes, Northern Cape ) • It is done for economic gain- (“…One girl might fall pregnant coming from a disadvantaged family, relying on the money for grant to support her family…” - Adult men, Polokwane, Limpopo) 9
  • 10. RESULTS (Cont) • It creates relationship difficulties between mother and child- (“…and you also don’t have respect for your mother because your mother is then, what, fifteen years older than you” - Female teenagers, Keimoes, Northern Cape) • It leads to a loss of reputation as pregnant teenagers often become objects of scorn – (“…You are taken as very cheap and uncontrollable” - Male & female adult Zimbabweans, Thembisa, Gauteng) • It affects relationship between parents and the pregnant child – (“If you think you are big enough to have children, then you don’t have to be in the house anymore” - Female teenagers, Keimoes, Northern Cape) • It has a negative impact on scholastic performance – (“...like say ‘look at you, you so young, what do you want to become one day, what did you tell me, you want to be a dancer, you want to be an actress or this and that but look you falling pregnant which is going to prevent you from reaching your goal’, then they are, they are going to be harder on them” - Male teenagers, Kensington, Western Cape) 10
  • 11. RESULTS (Cont) • It leads to relationship problems in later life – (“Because that is why you marry. You marry to now have children of your own....” - Female teenagers, Keimoes, Northern Cape) • Perceived causes of teenage pregnancy: • Economic reasons-(“They discourage it and others encourage it. Some are just direct, they send a girl to love so and so to get money”. White River, Mpumalanaga, Mixed Adult Male and Female FGD) • Lack of education, knowledge or access to relevant information- (“Lack of knowledge is a problem on this issue”. White River, Mpumalanaga, Mixed Adult Male and Female FGD) • Social Pressure – (“Peer pressure plays a role because they tell themselves that if she can then I can also do it”. Northern Cape, Adult Males FGD) 11
  • 12. RESULTS (Cont) • Teenagers think they won’t get pregnant –(”Haa, no I don’t think any teenager wants a child. It is just a mistake. People do not think they will be pregnant just after the first time of sleeping with a man”. - Leromolle, Informal settlements Free State, Female Teenagers FGD) • Lack of recreational activities –(“Young people have no activities to keep them busy. There is no sport or anything, than sex is the only way to keep busy”. Rustenburg formal, Adult Women FGD) • Lack of parental guidance, inability to perform parental role, parental pressure or non exemplary parental behaviour – (“I heard one mother complaining that her young girl was carrying her friend’s child, she asked her when is she going to carry hers”. White River, Mpumalanaga, Mixed Adult Male and Female FGD) 12
  • 13. RESULTS (Cont) • Wanting to experiment – (“…It sometimes happen because our children want to experiment …” Potchefstroom Informal settlements, Adult Women FGD. • Empty promises from boyfriends – (“The boyfriends can lie so much and tell you that you are the only girl in his life whereas you are number ten on the list of his girlfriends”. Limpopo, Adult Male FGD) • Desire for marriage, to keep boyfriend and to have a baby – (“Some they get pregnant to impress their boy friend or the family of a boy friend”.White River, Mpumalanaga, Mixed Adult Male and Female FGD) • Sexual coercion –(“In rural areas there are these rapists that the community is afraid of, they will rape these young girls and as a result the girl will fall pregnant.” Limpopo, Adult Male FGD) 13
  • 14. DISCUSSION • Economic reasons such as unemployment and poverty are seen as playing a major role in teenage pregnancy. Money is exchanged for sex (Kunene, 1995 & Were, 2007). • Teenagers lack knowledge about contraception and pregnancy and this often result in teenage pregnancy (Richter & Mlambo, 2005; Were,2007 & Ehlers, 2003) • Poor sex education causes teenage pregnancy. Parents and schools are neglecting sex education. Parents also fear that if they educate their children about sex, they will be seen as giving them permission to engage in sexual activities. 14
  • 15. DISCUSSION (Cont) • Lack of recreational actives - contribute to teenage pregnancy. Sex is the only thing that teenagers keep themselves busy with. • Teenagers think that they will never fall pregnant from having sex once. Ignorance about physiological aspects of conception led the teenagers believe that first- time sex or irregular sex could not cause pregnancy. They think that sex is a play (Vundule et al, 2000) • Teenagers engage in life experiments and therefore will want to experiment with sex because they lack knowledge about sex. Risk taking is increasingly accepted as a normal component of adolescent development. 15
  • 16. DISCUSSION (Cont) • Discipline by parents is difficult because of the children’s and human rights. • There seems to be a strong desire from the girls to keep the boyfriend, have a baby and get married. In a study conducted by Kunene (1995) girls also fell pregnant to keep their boyfriends 16
  • 17. CONCLUSION • It is evident from these results that teenage pregnancy is in existence and its causes are varied. • Studies indicate that teenagers become sexually active in early puberty and are not using any form of contraceptives (Reproductive Health Research Unit, 2004 & Jewkes, Vundule, Maforah & Jordaan, 2000). • Teenage pregnancy prevention efforts should address identified causes of teenage pregnancy. 17
  • 18. Social Determinants of Health Unit 18