Cycles of vulnerability: A scoping review of teenage pregnancy, inequality, and intervention effectiveness in South Africa
Joseph Alabi Oluwatobi & Winnie Alinah Chauke
Abstract
Teenage pregnancy is a significant public health issue that affects the health and well-being of adolescents and their children. The development of effective strategies requires a thorough understanding of the factors influencing teenage pregnancy and existing interventions. This scoping review examines the current literature on teenage pregnancy, including its prevalence, associated factors, and the effectiveness of intervention strategies. An extensive search was conducted on EBSCOhost, Scopus, and Google Scholar, using keywords related to teenage pregnancy. Studies published between 2019 and 2024 were included in the review. An analysis of the data was conducted based on factors related to socioeconomic status, educational interventions, and health care services. The review included a total of 30 studies. The findings indicate that socioeconomic status, educational attainment, and access to health care are significant contributors to teenage pregnancy. The consequences of teenage pregnancy are multifaceted, ranging from mental health issues to educational setbacks and physical health risks, exacerbated by societal stigma and inadequate healthcare and educational support. While certain interventions, such as School-Based Contraceptive Services (SBCC) and Life Orientation (LO) education, show promise, implementing them can be challenging due to confidentiality concerns and undervaluation within the education system. This study recommends improving support systems, integrating comprehensive sexual education, increasing access to contraception and healthcare services, and promoting inclusive educational policies. Further, targeted community awareness campaigns are critical to destigmatise discussions regarding sexuality and reproductive health. Moreover, ongoing research is needed to monitor interventions' effectiveness and inform evidence-based policy improvements.
Keywords
adolescent health, intervention strategies, sexual and reproductive health, socio-economic factors
Author information & Contribution
Joseph Alabi Oluwatobi. Corresponding author. PhD. Research Fellow, School of Social Science, College of Humanities, University of KwaZulu-Natal. Email: damilarealabi40@yahoo.com
Winnie Alinah Chauke. MSc. Postgraduate researcher, School of Social Science, College of Humanities, University of KwaZulu-Natal. Email: winniemaluleke@gmail.com
“All authors equally contributed to the conception, design, preparation, data gathering and analysis, and writing of the manuscript. All authors read and approved the final manuscript.”
Disclosure statement
No potential conflict of interest was reported by the authors.
Funding
This work was not supported by any funding.
Institutional Review Board Statement
Not Applicable
Data and Materials Availability
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
AI Declaration
AI tools were not used in writing this paper.
Notes
Acknowledgement
References
Amod, Z., Halana, V., & Smith, N. (2019). School-going teenage mothers in an under-resourced community: Lived experiences and perceptions of support. Journal of Youth Studies, 22(9), 1255–1271. https://doi.org/10.1080/13676261.2019.1571177
Anakpo, G., & Kollamparambil, U. (2021). Teenage motherhood and child outcomes: Evidence from South Africa. South African Journal of Childhood Education, 11(1), a972. https://doi.org/10.4102/sajce.v11i1.972
Anyanwu, F. C., Akinsola, H. A., Tuglia, A. K., & Obisie-Nmehielle, N. (2020). A qualitative assessment of the influence of family dynamics on adolescents’ sexual risk behaviour in a migration-affected community. International Journal of Qualitative Studies on Health and Well-being, 15(1).
Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Baloyi, V., Kganakga, K., Madzhie, M., & Chueng, M. (2020). An exploration of the causes of student pregnancy and psychological stressors experienced by pregnant students at University of Venda, South Africa. Cogent Psychology, 7(1). https://doi.org/10.1080/23311908.2020.1863176
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
Coleman, J. N., Milford, C., Mosery, N., Choi, K. W., Greener, L. R., Matthews, L. T., & Psaros, C. (2021). “I did not plan… that is what hurts”: Pregnancy intentions and contraceptive use among pregnant young women in KwaZulu-Natal, South Africa. African Journal of AIDS Research, 20(2), 149–157. https://doi.org/10.2989/16085906.2021.1914693
Davids, E. L., Zembe, Y., De Vries, P. J., Mathews, C., & Swartz, A. (2021). Exploring condom use decision-making among adolescents: The synergistic role of affective and rational processes. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-11926-y
Department of Health & Department of Basic Education. (2012). Integrated school health policy.
Duby, Z., McClinton Appollis, T., Jonas, K., Maruping, K., Dietrich, J., Lovette, A., Kuo, C., Vanleeuw, L., & Mathews, C. (2020). “As a young pregnant girl… the challenges you face”: Exploring the intersection between mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa. AIDS and Behavior, 25(2), 344–356. https://doi.org/10.1007/s10461-020-02974-3
Gcelu, N. (2019). The effectiveness of stakeholder collaboration in preventing learner pregnancy in secondary schools in the Eastern Cape, South Africa: Implications for leadership. South African Journal of Education, 39(3), 1–8. https://doi.org/10.15700/saje.v39n3a1650
Gebrekristos, L. T., Groves, A. K., McNaughton Reyes, L., Maman, S., & Moodley, D. (2020). IPV victimisation in pregnancy increases postpartum STI incidence among adolescent mothers in Durban, South Africa. AIDS Care, 32(Suppl. 2), 193–198. https://doi.org/10.1080/09540121.2020.1742871
Gillespie, B., Allen, H., Pritchard, M., Soma-Pillay, P., Balen, J., & Anumba, D. (2021). Agency under constraint: Adolescent accounts of pregnancy and motherhood in informal settlements in South Africa. Global Public Health, 17(9). https://doi.org/10.1080/17441692.2021.1981974
Govender, D., Naidoo, S., & Taylor, M. (2019). Knowledge, attitudes and peer influences related to pregnancy, sexual and reproductive health among adolescents using maternal health services in Ugu, KwaZulu-Natal, South Africa. BMC Public Health, 19(1), 928. https://doi.org/10.1186/s12889-019-7242-y
Groves, A. K., Gebrekristos, L. T., McNaughton Reyes, L., Moodley, D., Raziano, V., & Maman, S. (2021). A mixed-methods study of resilience and return to school among adolescent mothers in South Africa. Global Public Health, 17(9), 2111–2125. https://doi.org/10.1080/17441692.2021.1970208
Jochim, J., Cluver, L., Sidloyi, L., Kelly, J., Ornellas, A., Mangqalaza, H., Coakley, C., Nogoduka, C., Pillay, M., Nokama, B., George, G., Toska, E., & Teen Advisory Group Eastern Cape. (2023). Improving educational and reproductive outcomes for adolescent mothers in South Africa: A cross-sectional analysis towards realising policy goals. Global Public Health, 18(1). https://doi.org/10.1080/17441692.2023.2206465
Jochim, J., Meinck, F., Toska, E., Roberts, K., Wittesaele, C., Langwenya, N., & Cluver, L. (2023). Who goes back to school after birth? Factors associated with postpartum school return among adolescent mothers in the Eastern Cape, South Africa. Global Public Health, 18(1), 1–15. https://doi.org/10.1080/17441692.2022.2049846
Khoza, N., Zulu, P., & Shung-King, M. (2019). Acceptability and feasibility of a school-based contraceptive clinic in a low-income community in South Africa. Primary Health Care Research & Development, 20. https://doi.org/10.1017/S1463423618000762
Koch, R., & Beyers, C. (2023). Teaching comprehensive sexuality education using a praxis co-created with adolescents. African Journal of Primary Health Care & Family Medicine, 15(1), e1–e8. https://doi.org/10.4102/phcfm.v15i1.3855
Koketso, M. F. (2020). Contributing factors of teenage fatherhood in South Africa. e-BANGI, 17(2), 156–165. https://www.proquest.com/openview/0fc46af3c7fac79a69488cee29c6ba35/1?pq-origsite=gscholar&cbl=616374
Kriel, Y., Milford, C., Cordero, J. P., Suleman, F., Steyn, P. S., & Smit, J. A. (2023). Access to public sector family planning services and modern contraceptive methods in South Africa: A qualitative evaluation from community and health care provider perspectives. PLoS ONE, 18(3). https://doi.org/10.1371/journal.pone.0282996
Makola, L., Mlangeni, L., Mabaso, M., Chibi, B., Sokhela, Z., Silimfe, Z., Seutlwadi, L., Naidoo, D., Khumalo, S., Mncadi, A., & Zuma, K. (2019). Predictors of contraceptive use among adolescent girls and young women (AGYW) aged 15 to 24 years in South Africa: Results from the 2012 national population-based household survey. BMC Women’s Health, 19(1), 1–7. https://doi.org/10.1186/s12905-019-0861-8
Malatji, H., Dube, N., Nkala-Dlamini, B., & Shumba, K. (2023). Coping strategies and support provided by educational centres to teenage mothers re-engaging with education post-pregnancy: A case of a township school in South Africa. E-Bangi Journal of Social Science and Humanities, 20(3). https://doi.org/10.17576/ebangi.2023.2003.20
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G., for the PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), Article e1000097. https://doi.org/10.1371/journal.pmed.1000097
Moodley, J., & Ngene, N. C. (2020). Maternal deaths due to eclampsia in teenagers: Lessons from assessment of maternal deaths in South Africa. African Journal of Primary Health Care & Family Medicine, 12(1). https://doi.org/10.4102/phcfm.v12i1.2305
Msipu Phiri, T., Nyamaruze, P., & Akintola, O. (2023). Perspectives about social support among unmarried pregnant university students in South Africa. PLoS ONE, 17(4), 1–20. https://doi.org/10.1371/journal.pone.0284906
Mturi, A. J., & Bechuke, A. L. (2019). Challenges of including sex education in the Life Orientation Programme offered by schools: The case of Mahikeng, Northwest Province, South Africa. African Journal of Reproductive Health, 23(3). https://doi.org/10.29063/ajrh2019/v23i3.12
Mukuna, R. K., & Aloka, P. J. O. (2021). Interpretative phenomenological analysis of teenage mothers’ resiliency in overcoming adversities in pregnancy and early motherhood in South Africa. Problems of Education in the 21st Century, 79(1), 104–116. https://doi.org/10.33225/pec/21.79.104
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18, Article 143. https://doi.org/10.1186/s12874-018-0611-x
Muthelo, L., Mbombi, M. O., Mphekgwana, P., Mabila, L. N., Dhau, I., Tlouyamma, J., Mashaba, R. G., Mothapo, K., Ntimane, C. B., Seakamela, K. P., Nemuramba, R., Maimela, E., & Sodi, T. (2024). Exploring mental health problems and support needs among pregnant and parenting teenagers in rural areas of Limpopo, South Africa. BMC Women’s Health, 24, Article 40. https://doi.org/10.1186/s12905-024-03040-z
Pillay, D., Naidoo, L., Swe-Han, K. S., & Mahabeer, Y. (2021). Neonatal sepsis in a tertiary unit in South Africa. BMC Infectious Diseases, 21, Article 225. https://doi.org/10.1186/s12879-021-05869-3
Ramalepa, T. N., Ramukumba, T. S., & Masala-Chokwe, M. (2021). Teenage pregnancies in Bapong schools, Madibeng Local Municipality: Teachers’ views. South African Journal of Education, 41(2). https://doi.org/10.15700/saje.v41n2a1646
Sepeng, N. V., Mulaudzi, F. M., Mathivha, P., Musie, M. R., & Seretlo, R. J. (2023). Strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province: Different stakeholders’ perspectives, a co-operative inquiry qualitative protocol paper. Reproductive Health, 20, Article 1. https://doi.org/10.1186/s12978-023-01669-x
Shange, L., & Maharaj, P. (2023). Contraceptive use among young mothers with repeat births: Evidence from a qualitative study in KwaZulu-Natal, South Africa. African Journal of Reproductive Health, 27(3), 64–70. https://doi.org/10.29063/ajrh2023/v27i3.8
Sogo, F., & Matlala, S. F. (2020). Concealed pregnancy among school-going adolescents in South Africa: A qualitative study on risks for maternal and child health. Bangladesh Journal of Medical Science, 19(4), 620–629. https://doi.org/10.3329/bjms.v19i4.46616
Statistics South Africa. (2022, March 28). The young and the restless – Adolescent health in South Africa. https://www.statssa.gov.za
Tolla, T., Bergh, K., Duby, Z., Gana, N., Mathews, C., & Jonas, K. (2024). Adolescent girls and young women’s (AGYW) access to and use of contraception services in Cape Town: Perspectives from AGYW and health care providers. BMC Health Services Research, 24, Article 1. https://doi.org/10.1186/s12913-024-11236-0
UNAIDS. (2019). Global AIDS update 2019—Communities at the centre. https://www.unaids.org/en/resources/documents/2019/2019-global-AIDS-update
Vickerman, P., Quaife, M., Kilbourne-Brook, M., Mvundura, M., Eakle, R., & Terris-Prestholt, F. (2020). HIV prevention is not all about HIV – Using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection. BMC Infectious Diseases, 20(1). https://doi.org/10.1186/s12879-020-05399-4
World Health Organization. (2023). Adolescent pregnancy. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
World Health Organization. (2023). Sexually transmitted infections (STIs). https://www.who.int/health-topics/sexually-transmitted-infections#tab=tab_1
Cite this article:
Oluwatobi, J.A. & Chauke, W.A. (2026). Cycles of vulnerability: A scoping review of teenage pregnancy, inequality, and intervention effectiveness in South Africa. International Review of Social Sciences Research, 6(4), 1-24. https://doi.org/10.53378/irssr.353386
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