Teenage pregnancy in South Africa: with a specific focus on school-going learners

Commissioned by UNICEF, JulyThe transition to parenthood is a major event in the lifespan of any individual, but takes on special significance when it precedes the transition to education, work, citizenship and marriage that collectively offer the skills, resources and social stock necessary for individuals to succeed as parents. Although alternative pathways to parenthood occur and are tolerated to some extent, institutional support for parenthood is still geared towards a traditional sequencing of transitions. HIV and AIDS is now recognised as the primary reproductive health concern for adolescents, overtaking the long-standing emphasis on adolescent fertility. Yet childbearing among teenagers remains a common social and public health concern worldwide, affecting nearly every society. Teenage fertility establishes the pace and level of fertility over a woman's entire reproductive life span. This has an impact not only on women's health, but on the socio-economic status and general well-being of the population. Despite public health literature and family planning services treating HIV and pregnancy as distinct, they share many common antecedents, chief amongst which is unprotected sex. Furthermore, there is evidence that pregnancy and lactation increase the susceptibility to HIV infection through immunological changes induced during pregnancy. Even though teenage fertility has been the subject of substantial debate in the social science research and policy circles, concern has not emanated from the increased risk that pregnancy confers to HIV. While current political and media depictions imply that South Africa (hereafter referred to as SA) is confronted with an escalating epidemic of teenage pregnancies, available data suggests that it is an area in which substantial progress has been made since democracy. Yet teenage pregnancy has grown in significance as a social construct and come to represent one of several indicators of burgeoning adolescent delinquency, sexual permissiveness and moral decay. Education is central to the development of young people as it prepares them for the world of work and for life. As young people spend longer periods in education, as part of the natural course of development, sexual experimentation and maturity is increasingly coinciding with secondary schooling. For most, it remains at the level of experimentation and if sex occurs, indications are that it is more likely to be protected when young people are still at school. However, for a minority, it results in unwanted pregnancy, HIV and other sexually transmitted infections. This has implications for continued educational opportunities. In a rights-based society, young girls who fall pregnant should not be denied access to education and this is entrenched in law in SA through the Constitution and Schools Act of 1996. In 2007, the Department of Education released Measures for the Prevention and Management of Learner Pregnancy. Not without controversy, the guidelines continue to advocate for the right of pregnant girls to remain in school, but suggests up to a two-year waiting period before girls can return to school in the interest of the rights of the child. Any proposed shift in policy and practice needs to be informed by a well-rounded understanding of the context of teenage pregnancy. The purpose of the study was to document, review and critically analyse literature on teenage pregnancy with a focus on school-going adolescents. The specific objectives were as follows: * To review existing literature and conduct statistical analyses to establish the prevalence and determinants of teenage pregnancy; * To assess the individual, familial and educative impact of teenage pregnancy; * To identify and assess the impact of interventions for teenage pregnancy; and * To propose a conceptual framework for research and interventions to prevent and mitigate the impact of teen pregnancy