In most cases, older men are coercing girls into having sex with them in exchange for material favours. These encounters are often unplanned, which means condoms or contraceptives are generally not used. File photo
The increase in the number of pregnancies among young girls, particularly in rural areas, has been flagged as a national crisis by the Rural Health Advocacy Project (RHAP).
At the launch of the RHAP’s policy brief, titled Rural Realities Navigating Early Pregnancy in Vulnerable Communities, researcher and author Celene Coleman said the increase in adolescent birth and pregnancy rates highlights the need to address pregnancy prevention among 10- to 19-year-old girls.
She noted that birth rates in sub-Saharan Africa were more than double the world average, and the reality in South Africa is just as worrying.
According to the 2022-23 District Health Barometer, there has been a 6.1% increase in the number of deliveries by girls and women aged 10 to 19 over the past five years, with an average 1.5% annual increase.
During the period, there were 132 280 deliveries by adolescents below the age of 20 in public sector hospitals and clinics in South Africa, and at least 2.6% of these were by girls aged 10 to 14.
Coleman said there was a major disparity between rural and urban districts, with young women living in the former being severely affected.
Statistics show that during the five-year period, Gauteng recorded the smallest number of deliveries at 9.6% for girls aged 10 to 19, while the Eastern Cape recorded the highest deliveries at 17.6%.
Notably, the five districts with the highest deliveries in the said age group were all in rural districts: Alfred Nzo (23.4%) and OR Tambo (20.7%) in the Eastern Cape and Harry Gwala (21.6%), uMkhanyakude (20.7%) and Zululand (20.6%) in KwaZulu-Natal.
Mathildah Mokgatle, the head of department of public health at Sefako Makgatho Health Sciences University, said teen pregnancy, particularly in the rural areas, was a “pandemic”.
“The number of cases are even more than the Covid-19 cases that we ever had, despite the fact that there are few deaths, but we know that there are adverse effects of children being born by teenage mothers. In the end, that pregnancy is dangerous for both the child and the mother,” she said.
The dynamics surrounding teenage pregnancy in the rural areas are a result of “risky sexual behaviour and sexual coercion”.
Mokgatle said in most cases older men are coercing girls into having sex with them in exchange for material favours. These encounters are often unplanned, which means condoms or contraceptives are generally not used.
Mokgatle, however, said that at the same time men did not understand that coercing a young women into sexual activity was statutory rape.
“Our justice system does not take statutory rape seriously, because impregnating a high school child who is 18 and below is already part of statutory rape.
“So, when an older person who is 18 and above impregnates someone who is in a secondary school, primary school level, nothing happens. It’s just a pregnancy. There’s no recourse for the adult male who is responsible for it.”
Statutory rape is any sexual contact between an adult and a minor, who is by definition not able to consent.
She added that in rural areas, the prevalence was exacerbated by a lack of practical knowledge — while women and girls are educated on sexual and reproductive health, they are not given the tools to use the information appropriately or make autonomous decisions.
“We don’t have health promotion interventions that can empower young girls at the right age, when they’re still young, to learn about the risks of having unprotected sex or engaging in risky sexual behaviour.
“Policy is to give them content but not the tools to prevent a pregnancy, and there’s no good education for negotiation skills of anything: negotiating sex, negotiating condom use.
“There are no skills to take ownership of preventing risky sexual behaviour, just knowledge. That knowledge is not even emphasised in rural communities, where sex is regarded as a topic that parents cannot articulate freely with the children in most cases,” Mokgatle said.
In 2021, the department of basic education gazetted the policy on the Prevention and Management of Learner Pregnancy in Schools. The policy aims to promote learners’ rights to basic education despite pregnancy and childbirth, and mandates schools to ensure the environment is enabling and encourages learners to return and stay in school.
But Mokgatle said this was merely policy that she has not seen being promoted or implemented in schools, and is not “consumable”.
In its policy brief, the RHAP made recommendations to prevent early pregnancy, which included health services that understand the needs and fears of young women; improved access to services and resources including contraceptives at schools; teaching both girls and boys about the risks and consequences of unintended pregnancy; changing attitudes and decreasing stigma; and more collaboration between health, education and social services departments.
Coleman said that at a local level, they recommend counselling services, the provision of safe spaces to discuss sex-related topics and the inclusion of sex education through media campaigns.
Mokgatle added that although stigma is attached to early pregnancy, in rural areas it has become more of an “unacceptable” norm.
“It’s common that girls get pregnant earlier while they’re still in high school. They just don’t get stigmatised. But there’s no excitement about this pregnancy and baby that comes from it.”
She said a new baby from a teen mother also affects a family’s financial and care-giving dynamics, because a family member would have to leave their job to take care of the baby if the mother goes back to school.
“We know that perpetuation of generational poverty stays with teenage pregnancies because of the lack of economic and financial resources that will enable the mother and the baby to survive materially and to access social services,” Mokgatle said.
The basic education department did not respond to requests for comment.