Alarming figures released by a South African provincial education department indicate that schoolgirl pregnancies have doubled in the past year, despite a decade of spending on sex education and AIDS awareness.
The number of pregnant schoolgirls jumped from 1,169 in 2005 to 2,336 in 2006 in Gauteng, the country's economic heartland and most populous province, according to statistics released in the provincial parliament.
"South Africa has a huge teen pregnancy problem - one in three girls has had a baby by the age of 20," David Harrison, Chief Executive Officer of LoveLife, South Africa's largest youth-targeted HIV/AIDS campaign, told IRIN.
In a country where HIV prevalence is 18.8 percent, the high level of teenage pregnancy has heightened concerns. According to the South African Medical Research Council (MRC), "The latest national survey into HIV prevalence recorded that 16 percent of pregnant women under the age of 20 tested HIV positive."
The problem is not equally serious in all parts of the country: on average, two to three girls fall pregnant in a typical school with 1,200 to 1,400 pupils. "But what is clear is that there are hotspots where things are horribly wrong," Harrison said. The Gauteng figures showed 71 percent of pupils pregnant at one school in Soweto, a huge township on the outskirts of Johannesburg.
"Somehow there are schools where 60 to 70 percent of pupils were pregnant. There is no doubt that this is associated with things like gang activity, coercion and substance abuse," Harrison said, adding that according to a 2006 survey, 30 percent of girls in South Africa said "their first sexual experience was forced or under threat of force".
But other factors are also driving the high teenage pregnancy rate in some areas. According to a recent MRC study, 'Blood Blockages and Scolding Nurses: Barriers to Adolescent Contraceptive Use in South Africa', "Nurses' attitudes were a major barrier to teenagers getting hold of contraception. The nurses were uncomfortable about providing teenagers with contraception, as they felt they should not be having sex. They responded to requests for contraception in a manner that was highly judgmental and unhelpful. The girls described it as 'harassment'".
The study also found that social pressures often prevented young women from using contraception: "The girls felt they would only be accepted as women once they had proved their fertility - many mothers wanted their teenage daughters to become pregnant so they could have a baby at home again."
Some observers have suggested that the child support grant provided by the state was an incentive to young girls to fall pregnant, but according to Harrison, "A recent survey of 1,500 girls aged between 15 and 24 indicated that only 2 percent cited the child-care grant as an incentive. About 25 percent just said they wanted to have a baby." Other influencing factors - accounting for 20 percent - were "social pressures and self-affirmation".
Hassan Lorgat, coordinator of the South African chapter of the Global Campaign for Education (GCE), said it was important to understand the causes of these "disappointing figures", and stressed the need for more research. "There are no studies about the role of males in the problem," he commented.
Education is fundamental
The MRC study recommended "sex education at school before the age of 14, when young people become sexually active".
This should include "information for teenagers about avoiding sexually transmitted diseases, providing detailed information about contraception and its side effects; better management and training for nurses, so they can deal sympathetically with teenagers requiring contraception and provide the necessary information and education campaigns that take away the stigma of teenage sexuality, so that girls are not afraid to ask for contraception".
LoveLife's Harrison stressed the role of schools in curbing adolescent pregnancy: "Schoolgoing is protective. [Teenagers] not at school are more likely to fall pregnant than those at school; surveys show girls are 1.7 times more likely to use condoms when in school."
He said there was a need to determine whether teen pregnancies in Gauteng schools were "really spiraling out of control or whether the higher figures represented improvements in reporting, or [there was] less stigma associated with disclosing a pregnancy".
Keeping children in school was essential, Harrison said. "We need to do a better job in anticipating school leaving - that's when they [schoolgirls] become hugely vulnerable."