Fifty years ago, it was hard for women to obtain contraception and relatively easy to die giving birth. Many women were unable to decide whom and when to marry, and when or whether to have children.
A worldwide movement to give women real choices in life culminated in the 1994 International Conference on Population and Development (ICPD), where a consensus was reached about the links between women’s empowerment, sexual and reproductive health, and rights and sustainable development.
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Not so long ago, most people had large families: five children, on average. Where once there was one global fertility rate, today there are many, with differences wider than at any point in human history.
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In terms of teenage and learner pregnancy, it is estimated that fertility in South Africa rises from a low of 2% among 15 year olds and peaks at 30.2% among 19 year olds (DOH, MRC & Measure DHS, 2002). Data from the 2003 Reproductive Health Research Unit (RHRU) survey also shows that teenagers aged 17-19 account for 93% of teenage fertility (Harrison, 2008b). It is evident therefore that female learners in their final years of schooling are especially vulnerable to unplanned pregnancy.
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Worldwide, more than a million young people between the ages of 15-24 are newly infected with HIV each year. In 2013, almost 60% of all new HIV infections occurred amongst adolescent girls and young women between the ages of 15 and 24. The HIV-incidence rate among female youth aged 15 to 24 in South Africa is more than four times higher than their male counterparts.
In 2012, KZN not only had the highest HIV prevalence in the country but the highest prevalence of 12% amongst young people in this age group. In developing countries there is a lack of research on what young people perceive to be important during the delivery of reproductive health services.
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Evidence has shown that comprehensive sexuality education that is age- appropriate, gender- sensitive and life skills- based, can provide young people with the knowledge, skills and efficacy to make informed decisions about their sewxuality and lifestyle. When young people are equipped with accurate and relevant information, when they have developed skills in decision- making, negotiation, communication and critical thinking, and have access to counselling and SRH/HIV services that are affordable, they are better able to take advantage of educational and other opportunities that will impact their lifelong well- being.
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The State of World Population report notes that of the 125 million 10-year-olds today, 60 million are girls who are systematically disadvantaged at the global level as they move through adolescence into adulthood. Girls are less likely than boys to complete formal schooling at the secondary and university levels, are more likely to be in poorer physical and mental health, and will find it harder to get paid jobs.
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The launch and implementation of this, the South African National Sex Worker HIV Plan, shows the comittment of combating new infections in this population. The plan provides for a standardised minimum package of services to be implemented by all sectors, both within and outside of government.
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KwaZulu-Natal province in South Africa has the largest population of children under the age of five and experiences the highest number of child births per annum in the country. Its population has also been ravaged by the dual epidemics of HIV and TB and it has struggled to meet targets for maternal and child mortality. In South Africa’s federal system, provinces have decision-making power on the prioritization and allocation of resources within their jurisdiction. As part of strategic planning for 2015–2019, KwaZulu-Natal provincial authorities requested an assessment of current mortality levels in the province and identification and costing of priority interventions for saving additional maternal, newborn and child lives, as well as preventing stillbirths in the province.
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