Attitudes, perceptions and understanding amongst teenagers regarding teenage pregnancy, sexuality and contraception in Taung
Thesis (MFamMed)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: Background Teenage pregnancy is a socio-economic challenge and an important public health problem for communities in South Africa. Teenage pregnancy is a risk factor for disruption of education, unemployment, sexually transmitted infections, HIV, preterm birth and poor mental health. In the rural town of Taung, North-West Province, the teenage pregnancy rate is approximately 13% and this study aimed to explore the attitudes and perceptions of teenagers regarding teenage pregnancy and to explore their understanding of sexuality and contraception. Methods A qualitative study involving 13 in-depth interviews with pregnant teenagers and 3 focus groups with women aged 19 -25 years who had a baby as a teenager, teenage girls aged 14-19 years who had never been pregnant and males aged 14-25 years. Results Factors influencing teenage pregnancy were found to be broad and complex: 1) Socio economic factors included poverty, the controversial influence of the child support grant, trans-generational sex and financial support from older partner to secure income for the teenage girl or her family. 2) Substance abuse, particularly alcohol, in either the teenager or her parents was found to have a critical influence. A lack of alternative entertainments and social infrastructure made taverns a normal part of teenage social life. 3) Peer pressure from boyfriends and the broader social network. 4) Other factors included the right to motherhood before catching HIV, poor sexual negotiation skills, the need to prove one’s fertility, sexual coercion and low self-esteem and hope. Understanding of contraceptives and reproductive health was poor, condoms were the contraceptive method most known by teenagers and their understanding of the menstrual cycle was inaccurate. Most teenagers perceived falling pregnant as a negative event with consequences such as unemployment, loss of boyfriend, blame from friends and family members, feeling guilty, difficulty at school, complications during pregnancy or delivery, risk of HIV, secondary infertility if abortion is done and not being prepared for motherhood. A number of teenagers however perceived benefits and saw that it could be a positive event depending on the circumstances. Conclusion Social cognitive theory provides a useful framework to make sense of the various factors uncovered in this study that influence behaviour leading to teenage pregnancy. A model utilizing this theory is presented. Strategies to reduce teenage pregnancy should focus on building social capital for teenagers in communities, exploring further the influence of the child support grant, targeting trans-generational sexual norms, applying the law on underage drinking, making information on contraception more accessible and offering programmes that empower girls in the area of sexuality. Multifaceted and inter-sectoral approaches are required and it is likely that strategies to reduce teenage pregnancy will also impact on HIV and other sexually transmitted infections.
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