Preg­nancy shoot up by 80%?

Mail & Guardian - - Health -

Al­most 2 000km from the Baloyi fam­ily, in a Khayelit­sha school, an HSRC re­searcher sits down with 14-yearold Dineo Tshobo*. “Do you think Noloy­iso should tell the po­lice when her boyfriend Xolani forces her to have sex?” the re­searcher asks.

Dineo replies: “No, no, that’s nor­mal. He gives her money for things she needs, so when Xolani wants some­thing [sex] she must give him. He de­serves it.”

This re­search is part of a five-year pilot project — called the Kwanele In­ter­ven­tion — that will chal­lenge harm­ful gen­der norms un­cov­ered among school­child­ren, in­clud­ing ideas that women should pro­vide sex in ex­change for ma­te­rial and emo­tional support and that those who decline sex are “just playing hard to get”.

Through role-playing, chil­dren from 20 schools in Khayelit­sha near Cape Town learn to re­think toxic no­tions about re­la­tion­ships, the pro­gramme man­ager at the youth non-profit Grass­root Soccer Mbulelo Malotana ex­plains. The or­gan­i­sa­tion is help­ing the HSRC to run the project with the health or­gan­i­sa­tion Soul City In­sti­tute for So­cial Jus­tice.

The early re­sults from the study are shock­ing.

Al­most half of pri­mary school pupils in Khayelit­sha have ex­pe­ri­enced sex­ual vi­o­lence. Chil­dren as young as 10-years-old re­ported, for in­stance, be­ing slapped or ver­bally threat­ened. A fifth of young­sters were forced to per­form hu­mil­i­at­ing acts or were raped.

Some said they were threat­ened with a weapon to have sex.

The study also re­vealed that pri­mary school­child­ren are at a higher risk of abuse than their older peers, but they were un­equipped to talk about it. Pri­mary school pupils were un­likely to un­der­stand that they had been raped and were in­stead quick to say that they “agreed in the end”, lead re­searcher In­grid Lynch told Bhek­i­sisa in Au­gust.

Back in Bush­buck­ridge, young girls aren’t taught about rape ei­ther. “My friends and I have never talked about rape. I had never heard of it be­fore [it hap­pened to me],” An­gela says.

As in An­gela’s case, chil­dren are mostly only warned about the dan­gers and dis­eases as­so­ci­ated with sex, says Benita Mool­man, who re­searches gen­der at the HSRC. These mes­sages are im­por­tant, but they can’t be taught with­out ex­plain­ing how re­la­tion­ships work in real life. “Young peo­ple are ex­plor­ing re­la­tion­ships whether adults tell them it’s dan­ger­ous or not,” she says.

Mool­man says teach­ing young ado­les­cents, and es­pe­cially young girls, about re­la­tion­ships can help them to avoid the dan­ger­ous si­t­u­a­tions their teach­ers warn them against. “In­stead of telling them not to go into re­la­tion­ships, teach them how to set goals and bound­aries.”

She con­cludes: “Such lessons could give girls the self-con­fi­dence to leave bad re­la­tion­ships.”

When Mpumalanga health MEC Sasekani Manzini re­vealed that more than 10 000 teenagers in the prov­ince had be­come moth­ers, it spurred a flurry of news ar­ti­cles.

But these num­bers could be mis­lead­ing. “Teen preg­nan­cies have not nec­es­sar­ily in­creased that much. We have just been get­ting bet­ter at de­tect­ing them,” Makoae ex­plains.

At just un­der 8%, Mpumalanga’s teen preg­nancy rate is higher than the na­tional av­er­age of 6.8%, data from the Health Sys­tems Trust re­vealed in 2017. But, in to­tal, the num­ber of teenagers giv­ing birth in hos­pi­tals in South Africa has dropped by 12% in the past five years.

With­out con­text, dra­matic sta­tis­tics can in­flame myths about teenage preg­nan­cies, Makoae says. “In re­al­ity, teenage preg­nan­cies are a symp­tom of so­ci­ety’s ig­no­rance of what young girls like An­gela need.”

For ex­am­ple, Makoae says, me­dia re­ports have al­leged that peo­ple get preg­nant for grant money.

But there’s no proof for that.

A 2015 PLOS ONE study found no ev­i­dence that ado­les­cent moth­ers were de­lib­er­ately get­ting preg­nant for child grants. In ad­di­tion, a 2012 house­hold sur­vey pub­lished in the jour­nal African Health Sciences re­vealed that most girls — al­most three-quar­ters — who had chil­dren in their ado­les­cence said their preg­nan­cies were un­in­tended. The sur­vey, which was con­ducted in the East­ern Cape, Gaut­eng, Kwazu­lunatal and Mpumalanga, re­vealed that 55.5% of fe­male re­spon­dents be­tween 18 and 24 got preg­nant the first time be­cause they did not un­der­stand the risks in­volved in what they were do­ing or did not un­der­stand how preg­nancy hap­pens.

On pa­per, South Africa’s sex­ual ed­u­ca­tion poli­cies are lead­ing the way on the con­ti­nent, Makoae says.

But teach­ers, who of­ten work in un­der-re­sourced schools, fre­quently don’t get the mes­sage across, she ex­plains. “Teach­ers are miss­ing the op­por­tu­nity to teach chil­dren about hu­man sex­u­al­ity be­cause it of­ten goes against their own be­liefs.”

In a ru­ral prov­ince like Mpumalanga, teach­ers are some­times the only ones talk­ing to chil­dren about sex, says the HSRC’S Roshin Es­sop. The South African Jour­nal of Child Health re­search showed that teach­ers in poorer com- mu­ni­ties lack the support they need to do this ef­fi­ciently.

When chil­dren go home, Es­sop says, they of­ten face stigma about sex that stops them from ask­ing their par­ents ques­tions. But there could be an easy way to make sure chil­dren get the in­for­ma­tion they need by using tools that al­ready ex­ist.

Makoae says the clinic book­lets par­ents get when their chil­dren are born could just as eas­ily be used for sex ed­u­ca­tion. These doc­u­ments make com­mu­ni­ca­tion be­tween homes and clin­ics eas­ier by telling par­ents what health ser­vices their child needs in early life. She says a sim­i­lar book­let with sex­ual health in­for­ma­tion for young ado­les­cents could help to bridge the gap be­tween class­rooms and clin­ics. And par­ents can keep track of what their chil­dren are learn­ing, she ex­plains.

Clin­ics could help to find out why young girls are fall­ing preg­nant by sim­ply ask­ing, Demo­cratic Al­liance spokesper­son for health in Mpumalanga Jane Sit­hole ar­gues. Health fa­cil­i­ties al­ready gather in­for­ma­tion about pa­tients when they come in. So, adding one or two ques­tions about the rea­sons the young women fall preg­nant could help us to track what in­for­ma­tion is still miss­ing, she says.

On the 10-minute drive to the hos­pi­tal, An­gela does not say a word. She’s gone into labour, but her face doesn’t be­tray a thing.

“She doesn’t talk much,” her sis­ter says. “But she’s strong.”

*Not their real names

This story was pro­duced by the M&G Cen­tre for Health Jour­nal­ism, Bhek­i­sisa www.bhek­i­sisa.org

(Un)safe spa­ces: Musa, Baloyi’s young brother, was forced to wait un­til his sis­ter’s armed at­tacker had fallen asleep to slip out and call for help

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