Teenage Fertility in Vhembe District in Limpopo Province, How High is that?

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1 Journal of Emerging Trends in Economics and Management Sciences (JETEMS) 3 (2): Scholarlink Research Institute Journals, 2012 (ISSN: ) Journal jetems.scholarlinkresearch.org of Emerging Trends Economics and Management Sciences (JETEMS) 3(2): (ISSN: ) Teenage Fertility in Vhembe District in Limpopo Province, How High is that? Kwabena A. Kyei Department of Statistics, University of Venda Private Bag X5050, Thohoyandou 0950, South Africa Abstract Teenage pregnancy is a very big issue globally, but its magnitude in South Africa poses a grave concern. Alarming figures released by the Gauteng provincial education department indicate that school pregnancies have doubled from 2005 to 2006, despite a decade of spending on sex education and AIDS awareness. The effects of unplanned pregnancy and HIV are a particular concern limiting girls future possibilities. In 2001, the Limpopo province had the highest fertility level in the country with an average of 5 children per woman. But the fertility level in Vhembe which is a district in Limpopo is low at 2.5 children. The study aims to determine the level of teenage fertility in the district and to recommend strategies to curb early pregnancies which turn to destroy the future of many young girls. Using a survey conducted in some municipalities in the district in 2010, this paper reveals that teenage fertility in Vhembe is rather higher. The proportion of teenage births in the district is far above 56 percent. Keywords: higher fertility, sex education, contraception, deep poverty, Vhembe district INTRODUCTION Teenage pregnancy is a disease mostly in Africa and has a lot of social problems. It results in overpopulation and a very high proportion of youthful population. Besides, there are most noticeable consequences related to teenage pregnancies which include: school drop-out or interrupted education; waywardness and criminal activities; abortion; and child neglect; poverty etc. Pregnant teenagers are less likely to complete high school and attend tertiary institutions (The Alan Guttmacher Institute, AGI). Besides overpopulation, teenage pregnancy results in high infant mortality rate, an increase in underprivileged families, high maternal mortality, and other deaths due to sexually related diseases. The number of pregnant schoolgirls in the Gauteng province in South African jumped from 1169 in 2005 to 2336 in 2006 despite a decade of spending on sex education and AIDS awareness. In spite of the increase in programs aimed at preventing teenage pregnancies, the rate of teenage births is still very high. One in three girls has had a baby by the age of 20 (Harrison, 2008). In a country where HIV prevalence is 18.8 percent, the high level of teenage pregnancy has heightened concerns. The latest national survey into HIV prevalence recorded that 16 percent of pregnant women under the age of 20 years tested HIV positive (MRC, 2008). In developed countries, teenage births are associated with many social issues, including lower educational levels, higher rates of poverty and other poorer life outcomes. Teenage pregnancy in developed countries is usually outside of marriage, and carries a social stigma in many communities and cultures. In 134 developing countries, however particularly in the Arab world teenage births are usually within marriage and does not involve social stigma ( In some societies, early marriage and traditional gender roles are important factors in the rate of teenage births. For example, in sub-saharan African countries, early birth is often seen as a blessing because it is a proof of the young woman s fertility. In the Indian subcontinent too, early marriage and births are more common in traditional rural communities compare to the rate in cities. BACKGROUND Teenage females have been underemphasized as a target group as far as fertility and socio-economic developments are concerned, even though pregnancy levels are high in this age group. The level of teenage fertility in South Africa is high, though has been declining over time (see table 1). Table 1: Percentage of teenage girls (15 19 years) who have ever been pregnant by province Province 1998 (%) 2003(%) Eastern Cape (EC) Free State (FS) Gauteng (G) Kwazulu Natal (KZN) Limpopo (L) Mpumalanga (MP) North West (NW) Northern Cape (NC) Western Cape (WC) Sources: Department of Health 1998, South Africa Demographic Survey, 2003 Pretoria: DoH.

2 In South Africa, there was a concern raised in 2003 by the Department of Basic Education that teenage pregnancy among school learners was quite high, and that learner pregnancy rates were higher in schools located in poor areas and schools that were poorly resourced. Some people felt that the rise in teenage births was due to child support grant (CSG). Other people alluded that the rise in learner pregnancy was more likely due to improved reporting than a real increase. According to the Demographic and Health Survey (SADHS) data 1998 and 2003, teenage pregnancy is well over 12 percent. In 1998, 16 percent of teenagers aged years had been pregnant or were pregnant at the time of the survey (SADHS). In 2003 however, the proportion of teenagers who had been pregnant or were pregnant at the time of the survey was 12 percent. In each case, the proportion of teenagers who had been pregnant rose from 2 percent at the age 15 years to about 27 percent at the age 19 years (Children s Institute, 2011). A survey was conducted by Human Science Research Council in 2003 (HSRC 2003 Status of Youth Survey); the data together with other data showed that an increase in education resulted in a decrease in pregnancies, and that pregnancies did not necessarily result in learners dropping out of school. This study aims not only to determine the level but also seeks to add its findings to the pool of knowledge found in literature about teenage fertility in the Vhembe district in the Limpopo province. METHODOLOGY The data were obtained through a survey (cluster type survey) conducted in five locations in the Vhembe district between March and July The locations covered were Vuwani: 643 houses (dwellings or visiting points), Malamulele town : 709 houses, Malamulele villages: 649 houses, Makwarela: 283 houses and Dzata (Mphephu): 379 houses. About 2660 women aged between 13 and 50 years were interviewed. The questionnaire used has items on social, economic and demographic variables of the participants such as age, marital status, level of education, employment status, number of years married, number of children born, use of contraception, oral rehydration therapy, immunization and other health as well as vital statistics questions. Basic statistical methods using Statistical Packages for Social Sciences (SPSS) programs have been employed to analyse the data and the results/statistics were adjusted for missing values, some of which are marginal (see, Kyei 2011a). RESULTS OF ANALYSIS Table 2 shows the proportion of teenage girls with children in Vhembe. Though the survey data have some minor discrepancies (see Kyei, 2011a) the results are plausible. The proportion of girls with children is as follows: those aged 13 years is 30 percent, aged 14 years is 10 percent, 15 years is 55 percent, aged 16 years is 35 percent, 17 years is 57 percent, 18 years is 78 percent and 19 years is 72 percent. These figures show some of the minor discrepancies mentioned above; for example, the proportion of girls aged 13 years with children is 30 percent while the proportion for girls aged 14 with children is 10 percent. However, it is evident that the fertility level of the teenage girls (aged years) in Vhembe is very high at 57 percent. The proportion cited for the Gauteng province is between percent and that cited for the KwaZulu-Natal province, is 32 percent (see Hallman, 2008); so teenage births in Vhembe is far higher than these two provinces and possibly higher than other provinces in the country. Table 2: Age Distribution of Teenage Girls with Children in Vhembe District Age of Women (years) Number of Women Total Number of Children Ever Born Total Source: Survey data 2010 Proportion of Teenagers Ever Given Birth Table 3 shows the proportion of young women aged between 20 and 24 years in Vhembe with children. For these young women (aged years), the proportion is more than 88 percent. Comparatively, this figure is not very high because in Limpopo the proportion is 86.3 percent, while in Mpumalanga it is 83.6 percent and Northern Cape, it is 79.5 percent (see table 4). The mean number of children born to a woman in Vhembe district is 2.5 while that of Limpopo is 5 (see Kyei, 2011a). Notwithstanding, the fertility level in Limpopo which is highest in the country at five children per woman, the teenage fertility level in the Limpopo province is not the highest in the country. It is the third highest coming after Mpumalanga (22.7%) and KwaZulu- Natal(19.2%), with Limpopo at 18.4 percent. Table 3: Age Distribution of Young Adult Women with Children in Vhembe District Age of Women (years) Number of Women Total number of Children Ever Born Total Proportion of Adolescent Ever Given Birth 135

3 The proportion of the teenage women, aged years, with at least one child were as follows: Mpumalanga, 22.7 percent, KwaZulu Natal, 19.2 percent; Limpopo, 18.4 percent; Northern Cape, 17.5 percent, Western Cape, 15.7 percent, Free State, 14.7, North West, 14.6 percent, Gauteng, 14.5 and Eastern Cape 14.0 percent (see table 4) (Kyei, 2011b). Figure 1 presents the parity progression ratios for women aged years. Parity progression ratio is the ratio of women who had given birth to at least k+1, (W k+1 ), children to those women who had given birth to at least k, (W k ), children, where k starts from zero. i.e. Parity progression ratio (PPR, a(k)) is defined as: a(k) = W k+1 /W k ; k= 0, 1, 2, (i) The ratio for these women with no child to having at least one child is highest in Mpumalanga followed by KwaZulu Natal and the lowest is in Eastern Cape. These figures show that adolescent fertility is highest in the Mpumalanga province and the potential to increase is also highest in that province with a parity progression ratio of that the fertility level in the district is very low at 2.5. So the contrast cannot be ignored. According to Kyei (2011a), even though teenage girls in the district start producing babies early, after the first child, they are, more often, thrown out of their partners homes and have to go back to school to continue their studies. This resumed schooling produces a very long birth interval between the first child and the second. And this is the more reason that the adult overall fertility is low. Table 4: Proportion of Teenage and Young Women with Children by Province (Ever given Birth) by age group Province years years EC FS G KZN L MP NW NC WC Vhembe Source: Kyei, 2011b A study by the Department of Social Development (DSD) in the Limpopo province arrived at similar results where teenage pregnancy in the province is seen to be high and that of Vhembe and Mopani districts appears more worrisome. The mean age of sexual debut in the province is found to be 16.3 years, and some of the teenage girls in Vhembe report that In our culture no use of condom irrespective of whether you are married or not as long as you are having sex (DSD, 2011: 100). Fig 1: Parity Progression ratio for Women Aged years Source: Census 2001 DISCUSSION AND SUMMARY Table 4 and figures 2 compare the teenage fertility in the Vhembe district with those of the nine provinces in the country. As mentioned earlier, though the Limpopo province from where Vhembe lies, the proportion of teenage births is just at 18.4 percent, the proportion of teenage births in Vhembe is surprisingly high at 57 percent. And for the young women aged years, the proportion of births is at 88 percent. It is true that the sample size particularly for the teenagers is small and that limits the study, however the same survey data establish 136 Figure 2: Proportion of Under Twenty-five Women with Children by Province and Vhembe District. Source: Census 2001 and Survey data 2010

4 It is clear from the table that teenage fertility in Vhembe is very high. The question now is what causes this observation? As said earlier some experts believe that the early child bearing practice has been promoted by the social grant that the government gives to mothers. They argue that because of this child- support grant many young teenage girls do not fear falling pregnant even while in school. But a survey conducted on 1500 girls aged between 15 and 24 years by Medical Research Council (MRC, 2008) indicated that only 2 percent cited the child-care grant as an incentive. In Limpopo, the DSD report shows that only the deeply poor families (37%) consider child grant as a reason for teenage pregnancy, 63% of the people do not consider child grant as a cause for teenage birth (DSD, 2011: 57). In another study, about 25 percent of the teenagers just said they wanted to have a baby, and another 20 percent cited social pressures and self-affirmation as reason for being pregnant ((IRIN, 2007). According to Harrison (2008) the problem of teenage pregnancy in South Africa is not uniform throughout the nine provinces. He remarks that, on the 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". He continued that in one school in Soweto, a huge township on the outskirts of Johannesburg about 71 percent of pupils fell pregnant. He suggests that this type of incidence is no doubt associated with things like gang activity, coercion and substance abuse. According to a MRC study on the 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, because they felt the teenagers should not be having sex. Their response to teenagers in the matter of contraception was highly judgmental and unhelpful. The teenage girls described it as 'harassment'" (MRC, 2008). In South Africa some parents in pursuit of getting children at home, will encourage their teenage girls to go and make babies. Some mothers will tell their teenage girls to make children for them because they want grandchildren and they cannot wait for many more years. Children born to teenage mothers are often left to the care of ageing family members. They may be exposed to the violence of family life in the townships and socialized into accepting violence as the only means to resolve conflict. The "abandoned children in African cities" referred to by Kulin (1988) and the growing numbers of "street children" in urban areas in developing countries cited by Kulin to be connected with teenage birth is not quite true. For in Africa, child neglect is not a function of teenage birth. Babies of teenage girls join all the members in the family to grow up and are therefore not isolated or neglected. Harrison (2008) stressed the role of schools in curbing adolescent pregnancy: "Schoolgoing is protective. Teenagers who are 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." The MRC study (2008) proposes "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". Although the overall rate of teenage births has been declining, rates have remained high for younger unmarried teenagers. Evaluation studies of pregnancy prevention programs indicate that many are ineffective or not well evaluated. Possible Factors Influencing Vhembe s Teenage Fertility Early sexual activity, lack of knowledge and non-use of contraception as well as poverty are some of the major factors that affect teenage fertility in Vhembe. From Tables 5a and 5b we see that cohabitation starts early in Vhembe district. By the age of 15 years, teenage girls are already cohabiting. The proportion of the cohabitation among teenage girls doubles from 15 years to 16 years then to17 years before slowing down. From age 17 years the proportion increases by 75 percent and from 18 years to 19 years the proportion increases marginally by 38 percent. Table 5a: Distribution of marital status by age of teenage mothers Age (in years) Total Married Living together Lived together previously Never lived and never pregnant Total Table 5b: Distribution of marital status by age of young adults with children Age (in years) Total Married Living together Lived together previously Never lived and never pregnant Total

5 Though the sample size for the teenagers is small, by comparing table 5a with table 6 we get some clue as to why teenage fertility is high in Vhembe district. We see from the tables that even though 3 teenagers aged 15 years, have either lived with a male partner or are still living with him, these teenagers have never used any form of contraception. For those teenage women aged 16 years, only one out of six has ever used pills. Five of them have never used any contraception. The other proportions are 8 out 12 aged 17 years, 14 out of 21 aged 18 years and 23 out of 29 aged 19 years have never used any contraception. We see clearly that sexually active teenage girls are not protecting themselves against pregnancy. The study by the Department of Social Development (DSD) supports the lack of use of contraceptive use in Limpopo. Some teenage learners were quoted as saying: We are afraid to go to a clinic because when someone you know or knows your parents sees you, we think they will tell our parents that we are doing family planning (DSD, 2011: 90). Table 6: Distribution of Non-Contraceptive use by age of teenage mothers Age (years) Pills IUD Injection Diaphragm Analysis of variance (ANOVA) test conducted, produced the following table. All the methods statistically show relationship with the exception of diaphragm where there appears no significant relationship between teenage pregnancy and the use of contraception. Taking pills, Injection, IUD and the use of condom, all have strong relationship with births. Teenagers who are sexually active without using contraception will definitely become pregnant. Table 7: ANOVA to test the relationship between teenage births and contraceptive use Sum of Squares df Mean Square F Sig. have you ever given birth Between Groups Within Groups Total take pills Between Groups Within Groups Total IUD Between Groups Within Groups Total diaphragm, foam, jelly women can Between Groups place a sponge or suppository or Within Groups diaphragm inside them before Total intercourse condom, men can use a rubber sheath during sexual intercourse Between Groups Within Groups Total Chi-square test performed to validate the relationship produces table 7. Though the sample sizes for some of the cells are too small, nonetheless, lack of knowledge about contraception and/or non-use of contraceptives will definitely produce unintended babies. Poverty and adverse life circumstances foster teenage pregnancy. Data from the American Academy of Pediatrics reveal that about 83 percent of adolescent come from poor homes (AGI). Economically poor countries such as Niger and Bangladesh have far more teenage mothers compared with economically rich countries such as Switzerland and Japan. Sociologist Mike A. Males noted that teenage birth rates closely mapped poverty rates in California, (http//ebookee.org). In the UK, around half of all pregnancies to under 18 years are concentrated among the 30% most deprived population, with only 14% occurring among the 30% least deprived. In Italy, the teenage birth rate in the well-off central regions is only 3.3 per 1,000, while that of the poorer Mezzogiorno is 10.0 per 1000, more than three times (http//ebookee.org). In Nigeria it has been reported in Abia state that dozens of teenage girls give birth in order to sell the babies for a price of between one hundred and sixty to one hundred and ninety US dollars (US $160 - $190). The organization/foundation that buys these babies, it is understood, in turn, sells the babies to some rich families for up to six thousand five hundred US dollars depending on the sex of the baby. Baby boys sell much higher because these rich families want boys to succeed them (THIS DAY, June 4, 2011). According to Dr Sackey (2011), Executive Director of Teamcare, a women s development and health oriented non-governmental organization (NGO), the increased rate of teenage pregnancy and bad lifestyles among the youth in Ghana, is due to poverty. She made the observation when she was launching TeamCare in the capital, and called for more family planning and sex education for youth in order for 138

6 them to take informed decisions on sexual issues (www. Myjoyonline.com). CONCLUSION Knowledge of the status of teenage pregnancy in South Africa is crucial to promote adolescent health. Factors that can contribute to the number of teenagers who fall pregnant are, for example, poverty and its concomitant gender power imbalances, (older and richer partners in particular), early sexual debut, barriers to contraceptive use (seldom used a sexual initiation), high value placed on children and misinformation on sexual health matters. Pregnancy at a very young age may result in pregnancy complications and can lead to the death of the young mother and/or her baby. Other associated consequences include increased risk of infant morbidity, as well as the possibility of emotional and financial strain for the mother. Fertility in Vhembe district, according to the survey data is 2.5 which is almost half of the provincial figure of 5 children, and equals to the national figure. However, teenage fertility is extremely high. Over 56 percent of teenagers have had at least a child. These are young women who are school-going. Thus, a considerable amount of schoolgirls drop out of school at least for a year to give birth before resuming. Though these teenagers are sexually active, their knowledge about contraception is very little therefore do not take any precautionary measures against becoming pregnant. Their parents, on the other hand, do not discourage their sexual behaviour, do not appear worried when these teenagers fall pregnant and at times encourage them (the girls) to make babies. RECOMMENDATIONS As a means of reducing teenage fertility in Vhembe district in particular, and the country or even the continent at large, this study recommends that the teenage girls be taught the following: the importance of completing high school before starting a family so that they can properly take care of their own children; the importance of getting some vocational training before starting a family in order to reduce poverty; healthy lifestyles with emphasis on the danger in early pregnancy. Besides, teenage girls should be given sex education, taught about the use of contraception and contraceptive devices be made available to them on demand. And nurses should be sympathetic to them, especially in the matter concerning access to contraceptive devices. Early cohabitation should be discouraged and in fact teenage pregnancy be frowned upon. And the teenage girls should rather be encouraged to look to the future with optimism. In so doing they will take their studies seriously and teenage fertility level will drop. REFERENCES Children s Institute, HIV & AIDS and STI Strategic Plan for South Africa (http//: Retrieved on 15 November, Department of Social Development Factors associated with Teenage Pregnancy in Limpopo Province. Report. DSD : Polokwane. Hallman, K Teenage Pregnancy in South Africa with a Specific Focus on School-going Learners. In: HSRC. Report submitted to Department of Education. Pretoria. Harrison, D Three ways to reduce teen Pregnancy in South Africa. Paper prepared for the HSRC Youth Policy Initiative Roundtable 5. Teenage Pregnancy. Reserve Bank: Pretoria. IRIN, Teenage Pregnancy figures cause alarm. Figures released on 6 March (http//: Retrieved on 10 June, Kulin, T Black Teenager Pregnancy in South Africa: Some consideration. (http//: co.za). Retrieved on 15 June, Kyei, K. A. 2011a. Some Socio Economic Indicators from Vhembe District in Limpopo Province in South Africa (JETEMS) 2 (5): Scholarlink Research Institute journals. Kyei, K. A. 2011b.Comparison of the Historical Fertility Levels among the Nine Provinces of South Africa. Journal of Human Ecology, J. Hum Ecol, 35 (2) Males, M. A. Teenage birth rates closely mapped poverty rates in California. (http//ebookee.org). Retrieved on 2 October Medical Research Council, South African National HIV Prevalence, Incidence, Behavior and Communication Survey Report: A Turning Tide among Teenagers. (http//: Retrieved on 5 July Sackey, S. (2011). Poverty is the root cause of rampant teenage pregnancy. My Joyonline Newspaper, April 16, Retrieved on 20 April 2011 from ( SADHS South African Demographic Survey. Pretoria: Department of Health. 139

7 SADHS South African Demographic Survey. Pretoria: Department of Health. The Alan Guttmacher Institute. Teenage Pregnancy Essays and articles at enotes ( Retrieved on 3 February THIS DAY. This Day Newspaper. Published on 4 June Nigeria. on 12 September Retrieved 140

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