by Janina Jochim, Franziska Meinck, Elona Toska, Kathryn Roberts, Camille Wittesaele, Nontokozo Langwenya, Lucie Cluver
Global Public Health, 7 April 2022 (Open access)
Umlazi Township
Umlazi District
Abstract
Early motherhood can negatively impact health, educational, and socio-economic outcomes for adolescent mothers and their children. Supporting adolescent mothers’ educational attainment, and timely return to school, may be key to interrupting intergenerational cycles of adversity. Yet, there remains a paucity of evidence on the factors that are associated with mothers’ postpartum return to school and the mediators of this process, particularly across sub-Saharan Africa where adolescent pregnancy rates remain high. This paper is based on interviews with 1,046 adolescent mothers from South Africa. Mothers who had returned to school after birth showed lower poverty, fewer repeated grades preceding the pregnancy, continued schooling during pregnancy, higher day-care/crèche use, more family childcare support, and lower engagement in exclusive breastfeeding within six months postpartum. Mediation analyses showed that lower poverty was directly associated with school return and via two indirect pathways: continued schooling during pregnancy and using day-care/crèche services. This study demonstrates that lacking childcare constitutes a major hurdle to mothers’ school return, which needs to be addressed in addition to socioeconomic and individual-level barriers. Policy makers and practitioners should consider supporting young mothers with combination interventions that include services supporting school retention during pregnancy and access to, and financial supplements for, day-care.
Introduction
Adolescent fertility remains high in many regions of the world, with particularly elevated rates across Africa where about one-fifth of adolescent girls become pregnant under the age of 19. Early pregnancies can have major health consequences for adolescent girls, and childbirth complications remain the leading cause of death among girls between 15–19 years globally. Across sub-Saharan Africa, adolescent pregnancies occur against the backdrop of the highest global maternal mortality rates, high levels of HIV, violence, deprivation, low service access, and limited support mechanisms – these conditions pose significant obstacles for adolescent mothers and their children to achieve good health and social outcomes.
A common concern related to adolescent pregnancy is impaired school outcomes of the young mother and, inter-generationally, even of her children. Education is a well-established social determinant of health, and supporting adolescent mothers’ continued schooling might provide opportunities to strengthen their long-term health and well-being.
In South Africa, about 20% of female school-going adolescents report having ever been pregnant and recent estimates show that approximately 125,000 adolescent girls give birth annually. Supporting these girls to return to school after childbirth is critical, especially because prolonged absence can increase the risk of a permanent school dropout. Like many countries across the African Union, which increasingly aim to provide an enabling policy-environment, the South African Department of Education established a national policy that supports young mothers’ school return. However, evidence shows that only between 30% and 50% of young mothers do manage to continue their education, highlighting a continued need to better understand barriers to school re-enrolment….
[Research has provided only] limited insights into the support that adolescent mothers require to navigate the dual-challenge of parenting whilst attending school. A recent mixed-methods study with 90 young mothers from Umlazi Township in KwaZulu-Natal corroborates the importance of instrumental support, showing associations between the return to school and family assistance with the re-enrolment process, provision of childcare from the family or support to organize external childcare, and financial support. These results align with a small pool of research from Zambia, Kenya and Mozambique, indicating that lacking financial means and the need for childcare are the main barriers to school return for young mothers. Yet, no study to date has been able to quantitatively explore the relationship between financial and childcare obstacles, nor interrogate different pathways towards girls’ school return….
Data for this study were collected as part of the HEY BABY (Helping Empower Youth Brought up in Adversity with their Babies and Young Children) cohort study of adolescent mothers (aged 10–24) and their children living in urban, peri-urban, and rural locations in the Eastern Cape province of South Africa (n=1,046). Building on previous evidence, the present study aimed to investigate further pre-and post-pregnancy variables hypothesized to affect the return to school….
PHOTO 1: Umlazi Township, KwaZulu Natal, by Ali Mahommed in Afro News, 24 August 2021
PHOTO 2: Umlazi District, by Photographer 695, Flickr, 1 November 2019