Teen Pregnancy Prevention Research Articles

Quality Improvement in Teen Pregnancy Prevention: Follow-Up to a “Focus on Fidelity”

In teen pregnancy prevention (TPP) evidence-based program replication, fidelity toolkits (FTKs) provide structure to ensure that essential curricular components are delivered as intended. The purpose of this project was to extend quality improvement efforts (Flinders, 2017) through analysis of FTKs from four years of TPP implementation. An evidence-based TPP program was delivered to females, 15-19 years of age (n = 1,658) from four suburban Ohio counties. Fidelity rates were calculated by agency staff and undergraduate nursing students. Grounded theory was used to identify themes from the narrative sections of the FTKs. Plan-Do-Study-Act methodology (Agency for Healthcare Research and Quality, 2008) guided this quality improvement work. Staff fidelity was reported as 98.38%. Student fidelity was reported at 99.05%. Key themes, identified as a result of the qualitative analysis, were categorized as participant factors, site factors, or presenter factors. Toolkits created an effective safeguard to ensure the replication of the evidence-based TPP program, with fidelity. Undergraduate students are capable of implementing evidence-based programming, with fidelity, to meet the educational needs of their communities. Analysis of narrative comments from toolkits can influence FTK revisions to improve program delivery.

Swimming Upstream: Addressing Racial Disparities in Teen Births in North Carolina.

Despite the stark decline in North Carolina's teen birth rates over the past three decades, rates remain disproportionately highest amongst Black, Latinx, and Native American teens in comparison to white teens. Numerous upstream factors continue to drive racial inequities, creating greater disparities in birth rates among teens of color.

Experiences of Seeking Antenatal Care and Delivery Among Teenagers in Kibuku District, Uganda

Background: Uganda is ranked 14 out of 54 countries in Africa with the highest level of teenage pregnancy. The teenage pregnancy rate in Kibuku District in 2016 was 35.8%, high above the average rate in Uganda (25%) and also above rural areas in Uganda (27%). Unfortunately, there is limited information on the experiences of seeking antenatal care and delivery among teenagers. This paper explored teenagers’ experiences seeking services at health facilities in the Kibuku district, Eastern Uganda. Methods: This study used a phenomenological design. Data were collected using in-depth interviews with 27 teenagers aged 14-19 years seeking antenatal care (ANC) or those who had delivered. The teenagers were purposively selected to participate in the study. Data collected was thematically and inductively analyzed through coding. Results: The study showed that most teenage mothers knew the importance of seeking ANC and delivery from a health facility. Unfortunately, few sought services early due to some experiences, including financial constraints, support from their caregivers (husbands and parents), medication, and health education. The teenagers were motivated to attend ANC and were treated well by health workers. However, most teenagers did not have the decision-making power to seek care. Conclusion: Teenage mothers knew the importance of seeking ANC and delivery at health facilities. Their experiences with the health facilities also contributed to the health-seeking behavior of the teenagers, including the comfort received by the girls at the facility, the medication administered, how they were treated by the health workers and the availability of utilities. Health and social workers could consider sensitizing teenagers and their caregivers about the delicate nature of their health when pregnant to make personal decisions.

Impacts of Healthy U: A cluster-randomized control trial of a sexual health education app developed for justice-involved male youth

PurposeDespite overall declines in teen pregnancy rates, teen pregnancies remain high among justice-involved youth. Justice-involved youth are disproportionately likely to engage in riskier sexual health behavior and simultaneously lack access to sexual health education programs. The study investigated the impact of Healthy U, a program specifically designed for male justice-involved youth. Healthy U is an app-based, self-paced fatherhood prevention program. MethodsThe study employed a cluster-randomized control trial among four, male-serving residential facilities operated by a state juvenile justice agency. Within the facilities, living units were randomly assigned to either receive Healthy U or participate in business-as-usual conditions. Male youth, ages 14–19, participated in baseline surveys prior to treatment group participation in Healthy U, and completed surveys six months post-baseline. ResultsResults indicated participation in Healthy U significantly and meaningfully increased positive attitudes toward condom use and negative attitudes toward sexual health behavior, as well as increased intentions to use condoms and birth control. No significant differences were found for knowledge about condom use. ConclusionsResults from this study indicate Healthy U, an app-based, self-paced program developed with and for male justice-involved youth, increased important non-behavioral sexual health-related outcomes. Currently, there is a noteworthy lack of sexual health programs developed specifically for justice-involved youth, regardless of gender. Thus, it is notable that Healthy U not only fills this gap but does so in an effective way.

Adaptation and Resilience: Lessons Learned From Implementing a Combination Health and Education Intervention for Adolescent Girls and Young Women in South Africa During the COVID-19 Pandemic.

The COVID-19 pandemic has been associated with reduced access to health services and worsening health outcomes for HIV and sexual and reproductive health (SRH). Through the analysis of data from an evaluation study of a combination intervention for adolescent girls and young women (AGYW) in South Africa, we sought to examine the way in which implementation and service provision were impacted by the COVID-19 pandemic and related restrictions, describing the adaptation implementers made to respond to this context. The intervention was implemented from 2019 in South African districts identified as high priority, given the high rates of HIV and teenage pregnancy amongst AGYW. The South African government introduced the first COVID-19 lockdown in March 2020. We conducted in-depth interviews with 38 intervention implementers in the period from November 2020 to March 2021. Respondents described various ways in which the COVID-19 pandemic and related restrictions had limited their ability to implement the intervention and provide services as planned. As a result, AGYW intervention beneficiary access to SRH and psychosocial services was disrupted. Implementers described several ways in which they attempted to adapt to the pandemic context, such as offering services remotely or door-to-door. Despite attempts to respond to the context and adapt services, overall COVID-19 negatively affected implementation and service provision, and heightened issues around community acceptability of the programs. Our findings can help to inform efforts to reduce health service disruption, increase health system resilience, and ensure continuous SRH service provision to AGYW in times of pandemics and other crises.

035 What to do when it fails? Teenage pregnancy in Europe

According to World Health Organization (WHO), adolescence is the period of human life from ages 10 to19. Worldwide adolescent pregnancies are mostly unplanned, with 12 million live births a year, of which 1 million from 12 to 15 agers. 5 million abortions a year must be added, of which 3 million unsafe. Obstetric complications are the second cause of death among 15–19 agers. 95% teenage pregnancies occur in poor countries, mostly in Asia and West Africa. In West Countries teen pregnancy rate is declining, with (7%) births in USA and 4% in Europe, the latter accounting for 200.000 live births and 160.000 abortions in 2011.

Prevalence of Teenage Pregnancy & Its Outcome at Shaikh Zaid Women Hospital Larkana

Background: Teenage adolescent pregnancy is an important community health issue globally. Research shows that mothers in teenage period are at a higher risk of maternal death and complications related with pregnancy in comparison to the mothers who are adult. Therefore, this research was directed to examine the sociodemographic profile and fetal and maternal outcomes related with teenage pregnancy and their comparison with mothers of 20-30 years of age. Study Design: A comparative cross-sectional study. Place and Duration: In the obstetrics and Gynecology department of Sheikh Zaid Women Hospital Larkana for one-year duration from March 2021 to February 2022. Methods: A total of 60 teenage mothers ≤19 and 60 mothers who were 20-30 years of age respectively, were nominated as controls and cases. Data on the obstetric complications, fetal outcomes and sociodemographic profile were collected through face-to-face interviews using a pre-tested, pre-designed, partially structured questionnaire. The statistics were analyzed by entering data in the excel sheet of Microsoft. Results: In this study, 18.1 years was the mean age in teenage pregnant females and 24.3 years in the control group. 17.8 years was the mean age at which teenage mothers were married and for adults it was 20.1 years. 66.7% of teenage mothers and 61.7% of the control group are of high-low socioeconomic status. 80% of teenage pregnant females and 75% of control group were from rural areas. The mainstream of teenage mothers (70%) and control mothers (58.3%) are housewives by profession. The consanguineous marriages were observed in 33.3% of adolescent pregnant females and 41.7% in the control group. In this study, 38.3% and 46.7% of the mothers in adolescent and control group respectively had ante-natal checks during their pregnancy. Stillbirth / miscarriage were reported in 13.3% of adolescent mothers and 25% in the control group. 63.3% of teenage mothers had mild anemia and 53.3% in controls. The incidence of malnutrition (40% vs 15%, p <0.05), PPH (25% vs 6.7%, p <0.05), PROM (20% vs 3.3%, p <0.05) was significant in teenage mothers in comparison to mothers who were adults. The incidence of PIH was lower significantly in mothers during adolescence in comparison to adult mothers (13.3% vs. 31.7%, p <0.05). Conclusions: Complications such as PROM, maternal malnutrition, premature delivery, PPH and low birth weight occurred more frequently in adolescent mothers than in mothers who were adults. The adult mother’s higher proportion of PIH than in teenage mothers. Keywords: Adult pregnancy, teenage pregnancy, sociodemographic factors, adverse fetal and maternal outcomes.

Teenage pregnancy and its consequences: Evidence from a South-eastern rural community of Nigeria

Abstract: Purpose: This paper aims to investigate the relationship between education and teenage pregnancy, and its grave consequences on vulnerable teenagers. Methodology: A systematic random sampling method was used to select a sample of two hundred young teenagers from the eight villages that make up the Ihuokpara community. Frequency tables and pie charts were used for the analysis and interpretation of data, while chi-square (x2) was used in testing the hypothesis. Results: The findings revealed that teenage pregnancies occur as a result of a lack of education (Ignorance) about sexuality and other reproductive health-related issues. However, the findings also revealed that there is a water-tight relationship existing between education and the tide of teen pregnancy so that the rate of awareness of sexuality determines the rate of teenage pregnancy. Limitations: This study only examines some factors such as the low level of education (ignorance) about sexuality, human reproduction, sexual health, and other reproductive health-related issues that may cause teenage pregnancy in Ihuokpara. The future researcher may find other factors that are not included in this study. Contribution: This study hopefully can give some things that are important for the individual, family, and communities to lend their support to others in their articulated efforts toward the teenage pregnancy cases. Keywords: 1. Adolescents 2. Educators 3. Nigeria 4. Teenagers 5. Teenage Pregnancy

The respecting the circle of life teen pregnancy prevention intervention: Its impact among different subgroups of Native American youth

PurposeThis study reports the differential impact of an evidence-based teen pregnancy prevention program among subgroups of participating Native American youth. MethodsThis randomized controlled trial included N = 534 Native Americans ages 11–19. Participants were randomly assigned 1:1 (intervention: 266; control: 268) to the Respecting the Circle of Life intervention (RCL) versus a control condition. Logistic and linear regression was used to examine intervention impact at 9- and 12- months post-intervention among the subgroups of males, females, younger (11–14 years) and older (15–19 years) youth. ResultsGirls and boys in the intervention group (RCL) had improved condom self-efficacy (Adjusted mean difference (AMD) and 95% CI girls: 0.56 (0.34–0.79); boys: 0.55 (0.32–0.77); both p < 0.0001) and contraceptive use self-efficacy at 9 months (AMD (95% CI) girls: 0.40 (0.16–0.63); boys: 0.40 (0.17–0.63); girls p = 0.001, boys p = 0.0009) compared to those in the control group. Study group differences were sustained for girls at 12 months but not for boys (condom use self-efficacy AMD (95% CI) girls: 0.54 (0.34–0.75); contraceptive use self-efficacy girls: 0.47 (0.24–0.70); both p < 0.0001). Boys in the RCL group had higher 12-month sexual/reproductive health knowledge (AMD (95% CI) boys: 2.15 (0.45–3.85); p = 0.01) compared to those in the control group, but girls did not. Girls in the RCL group had increased intention to use a condom at 12 months (OR (95 %CI): 1.69 (1.00–2.86); p = 0.05) compared to those in the control group, whereas boys in the RCL group had decreased intention to have sex in the next year at 9 months (OR (95% CI): 0.39 (0.21–0.73); p = 0.003) compared to boys in the control group. RCL Participants ages 11–14 had improved sexual/reproductive health knowledge at 12 months (AMD (95% CI): 1.96 (0.79–3.13); p = 0.001) compared to control participants of the same age. They also had improved condom and contraceptive use self-efficacy at 9 months (condom use self-efficacy AMD (95% CI): 0.65 (0.46–0.83); contraceptive use self-efficacy: 0.47 (0.28–0.65); both p < 0.0001) and 12-months (AMD (95% CI): 0.43 (0.25–0.61); 0.35 (0.16–0.54); p < 0.0001 and p = 0.0004, respectively) compared to control participants of the same age. There were no statistically significant impacts among participants ages 15–19. ConclusionThis is one of the first analyses of the differential impact of an evidence-based teen pregnancy prevention program conducted among subgroups of Native youth. Results guide dissemination and future research efforts, including that RCL is particularly effective among youth who are under the age of 15 at the time of participation, and that additional tailoring will optimize this program for older adolescents.

A Mixed-Methods Pilot Evaluation of Manhood 2.0, a Program to Reduce Unintended Pregnancy Among Young Men.

One promising though understudied approach to addressing race/ethnic disparities in teen pregnancy rates is through sexual and reproductive health (SRH) programming for young men. This pilot study assessed the feasibility, quality, and preliminary efficacy of Manhood 2.0—a group-based, after-school SRH program for young Black and Latino men, which examines gender norms. This mixed-methods study describes program attendance and quality; participant experiences and engagement in the program; and changes in participant gender norms, knowledge, attitudes, self-efficacy, and social support. Quantitative data from baseline and post-intervention surveys (n = 51) were analyzed using paired t-tests and McNemar’s tests. Qualitative data from five post-intervention focus groups (n = 27) were transcribed, coded, and analyzed for themes. At baseline, participants were ages 15 to18 years (M = 16.4 years), 30% were Latino, 66% were Black, 34% ever had sex, and 44% of sexually active participants had sex without any contraceptive method or condom. Quality ratings by program observers were high. The majority of participants (61%) attended at least 75% of sessions, and 96% rated Manhood 2.0 as “very good” or “excellent.” Pre–post comparisons showed increases in receipt of SRH information; contraception knowledge; positive attitudes about supporting partners in pregnancy prevention; self-efficacy in partner communication about sex; discussing program content with friends and family; and social competence and support. Focus group participants described benefits from the Manhood 2.0 content (i.e., full range of contraceptive methods, sexual consent, gender norms) and delivery (i.e., reflective discussion, nonjudgmental facilitators). Findings suggest that Manhood 2.0 is a promising SRH program for young men.

The determinants of pregnancy health literacy among youth in Bogalay Township, Ayeyarwaddy Region, Myanmar

Background: Focusing on adolescent reproductive health is very important, as 16% of the world's population is adolescents. This study aimed to identify the determinants of teenage pregnancy health literacy among youth and explore the perception of teenage pregnancy among youth and their guardians.Methods: We conducted a cross-sectional study with a mixed-method approach to identify the determinants and perception of pregnancy health literacy among youth in Bogale Township, Ayeyarwaddy region, Myanmar, between July and December 2020. We did the face-to-face personal interviews with guided self-administered questionnaires among 310 youth and individual depth interviews with 12 youth and 12 of their parents.Results: About 43% (95% CI 37.1%, 48.1%) were well-versed in pregnancy health literacy issues. This study discovered that youth with high school education and less had a 6.8 (95% CI =1.4, 34.7) fold increase in odds of having poor pregnancy health literacy compared to those with higher education. Moreover, youth who could not earn their income was approximately 5.7 times more likely to have poor pregnancy health literacy than those who could earn. The majority of youth requested to disseminate reproductive health information through various media and channels and that health facilities be well-equipped to provide reproductive health care services to teenagers.Conclusions: Sexual and reproductive health education/teaching programs and adolescents-friendly reproductive health services should be effectively implemented to prevent teenage pregnancy and ensure safer sex practices among teenagers. School-based sexual education programs must involve and assist parents and teachers in taking a more active role in SRH education in schools.

Neighborhood Land Uses as Predictors of the Upward Mobility of Poor Youth

Land uses within the neighborhood where poor youths reside have important effects on their development and therefore may predict their welfare as adults. Mean household incomes as adults and teenage birth rates of youth growing up in poor households are predicted based upon the land uses within the neighborhood they occupied as teenagers. Controlling for an extensive set of neighborhood socioeconomic and demographic variables, land uses are found to add to our understanding of the characteristics of places with upward mobility. Differences in land use between white and minority youth neighborhoods are also found to explain racial gaps in adult outcomes.

Emergency Medical Services Demand: An Analysis of County-Level Social Determinants.

Variations in the demand for Emergency Medical Services (EMS) exist when observed at a local level. This unspecified heterogeneity leads to an investigation of social factors contributing to EMS demand. Data for this study were collected from publicly available EMS reports from Florida and Oklahoma for 2009 - 2015. Health and social data were gathered from County health rankings and roadmap reports. Data were combined into a single dataset, and pooled ordinary-least-squares models with time-fixed effects were utilized for tests of inference. EMS call volume was log-transformed to derive a semi-elasticity function. A total of 874 county-year observations were analyzed. Increases in poor/fair health (95% CI: 0.6% - 3.9%), binge drinking (95% CI: 1.6% - 3.5%), teen birth rate (95% CI: 1.1% - 5.2%), unemployment rate (95% CI: 0.5% - 3.9%), and violent crime rate (95% CI: 1.0% - 3.0%) were associated with an increase in the EMS demand rate. The data supports the notion that some community measures have an effect on EMS demand as counties with higher levels of poor health, binge drinking, teen births, unemployment, and violent crime saw higher EMS demand. These factors may have been treated as spurious, or overlooked by policy makers and EMS leadership.

Using a Rapid Knowledge Translation Approach for Better Sexual and Reproductive Health and Rights in Bangladesh, Burundi, Indonesia, and Jordan.

Translation of knowledge into policy and practice is important to prevent sexual reproductive health and rights (SRHR)-related morbidity and mortality and ensure access to rights. Existing approaches to knowledge translation are often relatively rigid and implicitly assume linear processes, leading to time-consuming processes that are not tailored to countries' needs. SRHR knowledge platforms designed and implemented a collaborative rapid improvement model for knowledge translation (CRIM-KT) in Burundi, Bangladesh, Indonesia, and Jordan. The approach consisted of learning sessions and action periods aimed at improving policies and practices addressing the prevention of child marriage and teenage pregnancies. To evaluate the approach, a participatory action learning process took place throughout the implementation (September 2017 and January 2019). An end evaluation was conducted using a desk review of project documentation, in-depth interviews, and a focus group discussion to document the process, outcomes, and lessons learned. In Indonesia, a local government policy was changed that aims to prevent child marriage by avoiding misinterpretation of a local cultural practice. In Jordan, the cabinet endorsed a national action plan to prevent child marriage and changes in practice took place. In Burundi, no tangible changes in policy and practice in SRHR were observed. In Bangladesh, practice changed by strengthening coordination for collaboration and exchange among stakeholders to prevent child marriage. In all countries, the approach considerably strengthened participants' knowledge translation capacities. The CRIM-KT led to improvements in policy and practice in a relatively short time frame and different contexts. This can be explained by the systematic, structured, and participatory approach, allowing for contextual adaptation and involvement of stakeholders, as well as the cross-learning on 2 levels (international and country collaboration teams). The principles of the CRIM-KT may be further developed and applied in other fields in global health to strengthen knowledge translation processes.

Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women

BackgroundIn contexts where poverty and mental health stressors already interact to negatively impact the most vulnerable populations, COVID-19 is likely to have worsened these impacts. Before the COVID-19 pandemic, adolescent girls and young women (AGYW) in South Africa already faced intersecting mental health stressors and vulnerabilities. It is critical to understand how additional challenges brought on by COVID-19 have intersected with existing vulnerabilities and mental health risks AGYW faced, particularly given the intersections between psychological distress and increased risk behaviours that impact sexual and reproductive health. We aimed to examine socio-economic and mental health impacts of COVID-19 on South African AGYW in order to understand how additional challenges brought on by COVID-19 have intersected with existing challenges, compounding AGYW vulnerabilities.MethodsUsing qualitative and quantitative methods, framed by the syndemic theory, we examined the intersections between mental health and the COVID-19 epidemic amongst AGYW in six districts of South Africa characterised by high rates of HIV, teenage pregnancy and socio-economic hardship. Between November 2020 and March 2021 we conducted a cross-sectional telephone survey with 515 AGYW, and in-depth interviews with 50 AGYW, aged 15 to 24 years.ResultsOur findings reveal how COVID-19 restrictions led to increased experiences of stress and anxiety. Poor mental health was compounded by strained family relationships, increased fear of domestic violence, household unemployment, economic stress and food insecurity. Respondents described feelings of boredom, frustration, isolation, loneliness, fear and hopelessness. However, despite the multitude of challenges, some AGYW articulated emotional resilience, describing ways in which they coped and retained hope.ConclusionVarious psycho-social risk factors already disproportionally affect the mental health of AGYW in these communities; the COVID-19 pandemic intersects with these pre-existing social and environmental factors. Understanding strategies AGYW have used to positively cope with the uncertainty of COVID-19 amongst an array of pre-existing mental health stressors, is key in informing efforts to respond to their needs. Multisectoral interventions are needed to address the drivers of poor mental health among AGYW, and bolster healthy coping mechanisms; interventions seeking to mitigate the mental health impacts on this vulnerable population need to be responsive to the unpredictable pandemic environment.

School Disengagement, School-Age Births and High School Graduation: Evidence From Linked Administrative Records.

Failure to complete secondary education often results from a process of educational disengagement. Studies of teen childbearing and high school completion have not adequately accounted for the role of school disengagement prior to conception and may overestimate causal impacts of teen childbearing. We link New York City birth and school records to study a cohort of 22,484 Black and Latina public school students. We measure disengagement with monthly absences from age 12 until the month before conception and identify five preconception attendance trajectories using group-based trajectory modeling. Preconception absenteeism can account for as much as half the deficit in high school completion associated with a teen birth. This finding is robust to statistical approaches, such as school fixed effects and inverse-probability-weighted regression adjustment. Our results suggest that programs intending to increase educational attainment among young women should emphasize attendance and engagement, rather than primarily teenage pregnancy prevention.

97. Misinformation About Levonorgestrel Emergency Contraception in West Virginia Community Pharmacies

Levonorgestrel (LNG) emergency contraception (EC)—commonly known as Plan B®--became available in the United States (US) without a prescription in 2013, but barriers to access remain. One barrier is misinformation about the medication and who can obtain it. To assess the accuracy of information provided by community pharmacies in West Virginia (WV), a state with particularly low LNG EC access and high teen pregnancy rate, we conducted a mystery caller study to ask pharmacies questions about the requirements for purchasing LNG EC and when it should be taken for maximum effectiveness.

Improving communication between American Indian youth and caregivers to prevent teenage pregnancy.

American Indian (AI) youth are at increased risk for poor reproductive health outcomes. Parental communication and monitoring are established predictors of sexual risk-taking among adolescents. No program evaluations of sexual risk avoidance programs have focused exclusively on AI youth and parents. This study assesses the impact of the Respecting the Circle of Life (RCL) Teenage Pregnancy Prevention program on parent-youth communication and parental monitoring through a randomized controlled trial with AI youth ages 11-19 and their trusted adults (parents/caregivers) (N = 518). RCL consists of 8-peer group and one parent-youth session. Trusted adult participants completed the Parental Monitoring Scale and the Parent Adolescent Communication Scale at baseline and 3 and 9 months post-intervention via self-report. Intervention impact was evaluated using linear regression models, which included an indicator for study group. At 3 months post, trusted adults in the intervention reported significantly higher levels of sexual health communication (P = 0.042) and spoke to their child more often about how to get condoms (P = 0.001), get birth control (P = 0.014) and protect themselves from human immunodeficiency virus (P = 0.005) compared with trusted adults in the control condition. Program impact varied by age and sex. This study adds to literature and extends findings on RCL impact.

Diné (Navajo) Female Perspectives on Mother-Daughter Cultural Assets Around the Transition to Womanhood: A Qualitative Study.

American Indian (AI) people have protective factors embedded in cultural teachings that buffer against high-risk behaviors. This study applies a qualitative, grounded theory approach to identify cultural assets for a Diné (Navajo) mother-daughter intervention aimed at preventing substance abuse and teen pregnancy. Focus groups and in-depth interviews were conducted with 28 AI females' ages 8 years and older from the Navajo Nation. Key themes were (a) preserving the Diné way of life, (b) cultural assets related to being a healthy Diné woman, (c) matrilineal networks as a source of strength/pride, (d) historical trauma as a source of resilience, (e) male influences as protective health factors, (f) Western education as a measure of success, and (g) integrating different belief systems. Study findings may be applied as foundational elements for culturally grounded AI substance abuse and teen pregnancy prevention strategies, as well as culturally safe nursing practice.

Navigating Education in the Context of COVID-19 Lockdowns and School Closures: Challenges and Resilience Among Adolescent Girls and Young Women in South Africa

Gender related vulnerabilities and inequalities place female learners at high risk of school disengagement due to COVID-19 disruptions. Understanding the impacts of school closures and educational disruptions on female learners in South Africa is critical to inform appropriate, gender-sensitive policies, and programs, to mitigate further exacerbation of educational inequalities. We examined the effects that COVID-19 and lockdowns have had on the educational experiences of adolescent girls and young women (AGYW) aged 15–24, in six districts of South Africa characterized by high rates of HIV, teenage pregnancy and socio-economic hardship. Following a concurrent triangulation mixed-methods approach, we conducted a cross-sectional survey with 515 AGYW, and qualitative interviews with 50 AGYW. More than half of survey participants enrolled in education had been unable to continue with their studies. Factors associated with educational disruption included low socio-economic status, lack of cell phone access and household food insecurity. Qualitative narratives included challenges with online learning and studying at home in resource restricted settings, and insufficient support from schools and teachers. However, despite multiple barriers to continuing education, some AGYW demonstrated educational resilience, enabled by psychosocial and structural support, and resource access. Our findings lend support to an emerging evidence base showing that the closure of schools and tertiary institutions, combined with challenging home environments, and a lack of access to appropriate technology, has disproportionately impacted the most vulnerable AGYW, exacerbating pre-existing educational inequalities within the South African education system. Addressing structural barriers to educational equity, particularly in the pandemic context, including access of technology and the internet, is urgent.