1,150
Views
0
CrossRef citations to date
0
Altmetric
Review Article

Key normative, legal, and policy considerations for supporting pregnant and postpartum adolescents in high HIV-burden settings: a critical analysis

ORCID Icon, , , , , , , , & show all

References

  • Ahinkorah BO, Kang M, Perry L, et al. Prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa: a multi-country analysis. PLOS ONE. 2021;16(2):e0246308.doi:10.1371/journal.pone.0246308
  • Kassa GM, Arowojolu AO, Odukogbe AA, et al. Prevalence and determinants of adolescent pregnancy in Africa: a systematic review and meta-analysis. Reprod Health. 2018;15(1):1–17. doi:10.1186/s12978-017-0439-6
  • UNFPA. Motherhood in childhood: the untold story; 2022.
  • Horwood C, Butler LM, Haskins L, et al. HIV-infected adolescent mothers and their infants: low coverage of HIV services and high risk of HIV transmission in KwaZulu-Natal, South Africa. PLoS One. 2013;8(9):e74568. doi:10.1371/journal.pone.0072586
  • Laurenzi CA, Gordon S, Abrahams N, et al. Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents: a systematic review. Reprod Health. 2020;17(1):1–15. doi:10.1186/s12978-019-0847-x
  • UNFPA. Seeing the unseen: the case for action in the neglected crisis of unintended pregnancy. New York, NY: State of the World Population; 2022.
  • Grønvik T, Fossgard Sandøy I. Complications associated with adolescent childbearing in Sub-Saharan Africa: a systematic literature review and meta-analysis. PLOS ONE. 2018;13(9):e0204327. doi:10.1371/journal.pone.0204327
  • Ganchimeg T, Ota E, Morisaki N, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG: Int J Obst Gynaecol. 2014;121:40–48.
  • Toska E, Cluver L, Laurenzi CA, et al. Reproductive aspirations, contraception use and dual protection among adolescent girls and young women: the effect of motherhood and HIV status. J Int AIDS Soc. 2020;23(Suppl 5):e25558. doi:10.1002/jia2.25558
  • Joint United Nations Programme on HIV/AIDS. Miles to go: closing gaps, breaking barriers, righting injustices. Geneva: UNAIDS; 2018, p. 4.
  • Noori N, Proctor JL, Efevbera Y, et al. The effect of adolescent pregnancy on child mortality in 46 low- and middle-income countries. medRxiv; 2022. doi:10.1101/2021.06.10.21258227.
  • Groves AK, Gebrekristos LT, Smith PD, et al. Adolescent mothers in eastern and Southern Africa: an overlooked and uniquely vulnerable subpopulation in the fight against HIV. J Adolesc Health. 2022;70(6):895–901. doi:10.1016/j.jadohealth.2021.12.012.
  • Hill LM, Maman S, Groves AK, et al. Social support among HIV-positive and HIV-negative adolescents in Umlazi, South Africa: changes in family and partner relationships during pregnancy and the postpartum period. BMC Pregnancy Childbirth. 2015;15(1):117. doi:10.1186/s12884-015-0542-z
  • Petroni S, Yates R, Siddiqi M, et al. Understanding the relationships between HIV and child marriage: conclusions from an expert consultation. J Adolesc Health. 2019;64(6):694–696. doi:10.1016/j.jadohealth.2019.02.001
  • Cluver LD, Orkin FM, Meinck F, et al. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents. J Int AIDS Soc. 2016;19(1):20646. doi:10.7448/IAS.19.1.20646
  • Govender D, Naidoo S, Taylor M. I have to provide for another life emotionally, physically and financially: understanding pregnancy, motherhood and the future aspirations of adolescent mothers in KwaZulu-Natal South, Africa. BMC Pregnancy Childbirth. 2020;20(1):620. doi:10.1186/s12884-020-03319-7
  • Erasmus MO, Knight L, Dutton J. Barriers to accessing maternal health care amongst pregnant adolescents in South Africa: a qualitative study. Int J Public Health. 2020;65(4):469–476. doi:10.1007/s00038-020-01374-7
  • Singer M. A dose of drugs, a touch of violence, a case of AIDS: conceptualizing the SAVA syndemic. Free Inq Creat Sociol. 2000;28(1):13–24.
  • Pillay Y, Pienaar S, Barron P, et al. Impact of COVID-19 on routine primary healthcare services in South Africa. S Afr Med J. 2021;111(8):714–719. doi:10.7196/SAMJ.2021.v111i8.15786
  • Zulaika G, Bulbarelli M, Nyothach E, et al. Impact of COVID-19 lockdowns on adolescent pregnancy and school dropout among secondary schoolgirls in Kenya. BMJ Global Health. 2022;7(1):e007666. doi:10.1136/bmjgh-2021-007666
  • Meherali S, Adewale B, Ali S, et al. Impact of the COVID-19 pandemic on adolescents: sexual and reproductive health in Low- and middle-income countries. Int J Environ Res Public Health. 2021;18(24). doi:10.3390/ijerph182413221
  • Presidential Policy and Strategy Unit. Population Council. Promises to keep: impact of COVID-19 on adolescents in Kenya; 2021.
  • Cousins S. COVID-19 has “devastating” effect on women and girls. Lancet. 2020;396(10247):301–302. doi:10.1016/S0140-6736(20)31679-2
  • Govender K, Cowden RG, Nyamaruze P, et al. Beyond the disease: contextualized implications of the COVID-19 pandemic for children and young people living in eastern and Southern Africa. Front Public Health. 2020;8:504–504. doi:10.3389/fpubh.2020.00504
  • Toska E, Laurenzi CA, Roberts KJ, et al. Adolescent mothers affected by HIV and their children: a scoping review of evidence and experiences from sub-Saharan Africa. Glob Public Health. 2020;15(11):1655–1673. doi:10.1080/17441692.2020.1775867
  • UNFPA. Harmonization of the legal environment on Adolescent Sexual and Reproductive Health and Rights in East and Southern Africa; 2019.
  • Atuyambe L, Mirembe F, Johansson A, et al. Experiences of pregnant adolescents-voices from Wakiso district, Uganda. Afr Health Sci. 2005;5(4):304–309.
  • Ministry of Labour and Social Protection of Kenya. Violence against children in Kenya: findings from a National Survey, 2019; 2019.
  • Botswana Ministry of Local Government and Rural Development. Report on violence against children survey (VACS)/ national survey on life experiences and risk of HIV infection among 13-24 year old males and females in Botswana; 2019.
  • Zimbabwe Ministry of Health and Child Care. Young adult survey of Zimbabwe: a violence against children survey, 2017; 2019.
  • Ajayi AI, Ezegbe HC. Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa. BMC Public Health. 2020;20(1):1370. doi:10.1186/s12889-020-09488-6
  • Kasonde ME, Bwalya BB, Nyirenda ET, et al. Association between sexual violence and unintended pregnancy among married women in Zambia. BMC Public Health. 2022;22(1):1491. doi:10.1186/s12889-022-13881-8
  • Toska E. HEY BABY Baseline (unpublished data); 2022.
  • Grose RG, Chen JS, Roof KA, et al. Sexual and reproductive health outcomes of violence against women and girls in lower-income countries: a review of reviews. J Sex Res. 2021;58(1):1–20. doi:10.1080/00224499.2019.1707466
  • Presler-Marshall E, Jones N, Dutton R, et al. Girls don’t shout if they are raped … that is taboo’: exploring barriers to Ethiopian adolescents’ freedom from age-and gender-based violence. Report. London: Gender and Adolescence: Global Evidence; 2020.
  • Kennedy AC, Prock KA. I still feel like i am not normal”: a review of the role of stigma and stigmatization among female survivors of child sexual abuse, sexual assault, and intimate partner violence. Trauma Violence Abuse. 2018;19(5):512–527. doi:10.1177/1524838016673601
  • UNICEF. Child marriage.
  • UNICEF. Child marriage around the world: Infographic. UNICEF; 2022.
  • Huda MM, Flaherty M, Finlay JE, et al. Partner’s characteristics and adolescent motherhood among married adolescent girls in 48 low-income and middle-income countries: a population-based study. BMJ Open. 2022;12(3):e055021. doi:10.1136/bmjopen-2021-055021
  • Efevbera Y, Bhabha J, Farmer P, et al. Girl child marriage, socioeconomic status, and undernutrition: evidence from 35 countries in Sub-Saharan Africa. BMC Med. 2019;17(1):55. doi:10.1186/s12916-019-1279-8
  • Burgess RA, Jeffery M, Odero SA, et al. Overlooked and unaddressed: a narrative review of mental health consequences of child marriages. PLOS Global Public Health. 2022;2(1):e0000131.
  • Raj A. When the mother is a child: the impact of child marriage on the health and human rights of girls. Arch Dis Child 2010;95(11):931–935. doi:10.1136/adc.2009.178707
  • Petroni S, Steinhaus M, Fenn NS, et al. New findings on child marriage in Sub-Saharan Africa. Ann Glob Health. 2017;83(5-6):781–790. doi:10.1016/j.aogh.2017.09.001
  • Stoner MCD, Nguyen N, Kilburn K, et al. Age-disparate partnerships and incident HIV infection in adolescent girls and young women in rural South Africa. AIDS. 2019;33(1):83–91. doi:10.1097/QAD.0000000000002037
  • Toska E, Cluver LD, Boyes M, et al. From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa. Sex Health. 2015;12(1):59–66. doi:10.1071/SH14089
  • Clark S. Early marriage and HIV risks in Sub-Saharan Africa. Stud Fam Plann. 2004;35(3):149–160. doi:10.1111/j.1728-4465.2004.00019.x
  • Yaya S, Odusina EK, Bishwajit G. Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries. BMC Int Health Hum Rights. 2019;19(1):33. doi:10.1186/s12914-019-0219-1
  • Tallarico R, Ozah K, Orievulu KS. Age of consent: A case for harmonizing laws and policies to advance, promote and protect adolescents’ sexual and reproductive health rights. Afr J Reprod Health. 2021;25(2):94–102.
  • Efevbera Y, Bhabha J. Defining and deconstructing girl child marriage and applications to global public health. BMC Public Health. 2020;20(1):1547. doi:10.1186/s12889-020-09545-0
  • Petroni S, Das M, Sawyer SM. Protection versus rights: age of marriage versus age of sexual consent. The Lancet Child Adolesc Health. 2019;3(4):274–280. doi:10.1016/S2352-4642(18)30336-5
  • Rembe S, Chabaya O, Wadesango N, et al. Child and forced marriage as violation of women's rights, and responses by member states in Southern African Development Community. Agenda. 2011;25(1):65–74. doi:10.1080/10130950.2011.575586
  • Austrian K, Soler-Hampejsek E, Duby Z, et al. When he asks for sex, you will never refuse: transactional sex and adolescent pregnancy in Zambia. Stud Fam Plann. 2019;50(3):243–256.
  • Groves AK, Gebrekristos LT, McNaughton Reyes L, Moodley D, Maman S. Describing relationship characteristics and postpartum HIV risk among adolescent, young adult, and adult women in South Africa. J Adolesc Health. 2020;67(1):123–126.
  • [Republic] of South Africa. Children’s Act 38 of 2005; 2005.
  • Republic of South Africa. Choice on Termination of Pregnancy Act; 1996.
  • [Republic] of South Africa. Criminal Law (Sexual Offences and Related Matters). Amendment Act; 2007.
  • Wood K, Jewkes R. Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa. Reprod Health Matters. 2006;14(27):109–118. doi:10.1016/S0968-8080(06)27231-8
  • Hall KS, Manu A, Morhe E, et al. Bad girl and unmet family planning need among Sub-Saharan African adolescents: the role of sexual and reproductive health stigma. Qual Res Med Healthc. 2018;2(1):55–64. doi:10.4081/qrmh.2018.7062
  • Kangudie DM, Guidigbi H, Mensah S, et al. Effective integration of sexual reproductive health and HIV prevention, treatment, and care services across sub-Saharan Africa: where is the evidence for program implementation? Reprod Health. 2019;16(1):56. doi:10.1186/s12978-019-0709-6
  • Akatukwasa C, Bajunirwe F, Nuwamanya S, et al. Integration of HIV-sexual reproductive health services for young people and the barriers at public health facilities in Mbarara municipality, southwestern Uganda: a qualitative assessment. Int J Reprod Med. 2019;2019:6725432–6725432. doi:10.1155/2019/6725432
  • Chandra-Mouli V, Svanemyr J, Amin A, et al. Twenty years after international conference on population and development: where are we with adolescent sexual and reproductive health and rights? Int Conf Populat Develop. 2015;56(1, Supplement):S1–S6. doi:10.1016/j.jadohealth.2014.09.015
  • Sam-Agudu NA, Folayan MO, Haire BG. Program implementation gaps and ethical issues in the prevention of HIV infection among infants, children, and adolescents in sub-Saharan Africa. Pediatr Res 2020;87(2):406–413. doi:10.1038/s41390-019-0645-8
  • The Kenya HIV testing services guidelines. National AIDS and STI Control Programme (NASCOP. Ministry of Health; 2016.
  • Chandra-Mouli V, McCarraher DR, Phillips SJ, et al. Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reprod Health. 2014;11(1):1. doi:10.1186/1742-4755-11-1
  • Müller A, Röhrs S, Hoffman-Wanderer Y, et al. You have to make a judgment call. – Morals, judgments and the provision of quality sexual and reproductive health services for adolescents in South Africa. Soc Sci Med. 2016;148:71–78. doi:10.1016/j.socscimed.2015.11.048.
  • Carbone NB, Njala J, Jackson DJ, et al. I would love if there was a young woman to encourage us, to ease our anxiety which we would have if we were alone: Adapting the Mothers2Mothers mentor mother model for adolescent mothers living with HIV in Malawi. PLOS ONE. 2019;14(6):e0217693. doi:10.1371/journal.pone.0217693
  • Cluver L, Pantelic M, Toska E, et al. STACK ing the odds for adolescent survival: health service factors associated with full retention in care and adherence amongst adolescents living with HIV in South Africa. J Int AIDS Soc. 2018;21(9):e25176. doi:10.1002/jia2.25176
  • Geary RS, Gómez-Olivé FX, Kahn K, et al. Barriers to and facilitators of the provision of a youth-friendly health services programme in rural South Africa. BMC Health Serv Res. 2014;14(1):259. doi:10.1186/1472-6963-14-259
  • World Health Organization. Adolescent friendly health services for adolescents living with HIV: from theory to practice, December 2019: technical brief; 2019.
  • Ninsiima LR, Chiumia IK, Ndejjo R. Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review. Reprod Health. 2021;18(1):135. doi:10.1186/s12978-021-01183-y
  • Bjerregaard A. Forced out: mandatory pregnancy testing and the expulsion of pregnant students in Tanzanian Schools; 2013, 2017.
  • Education Amendment Bill 2018. Ministry of Primary and Secondary Education 1-7; 2018.
  • Svanemyr J. Adolescent pregnancy and social norms in Zambia. Cult Health Sex. 2020;22(6):615–629. doi:10.1080/13691058.2019.1621379
  • Zuilkowski SS, Henning M, Zulu J, et al. Zambia’s school re-entry policy for adolescent mothers: examining impacts beyond re-enrollment. Int J Educ Dev. 2019;64:1–7. doi:10.1016/j.ijedudev.2018.11.001
  • UNESCO. Early and unintended pregnancy and the education sector: evidence review and recommendations; 2017.
  • Girls Not Brides. Girls’ education and child marriage: thematic brief; July 2021.
  • Chersich M, Luchters S, Blaauw D, et al. Safeguarding maternal and child health in South Africa by starting the Child Support Grant before birth: design lessons from pregnancy support programmes in 27 countries. S Afr Med J. 2016;106(12):1192–1210. doi:10.7196/SAMJ.2017.v106i12.12011
  • UNICEF Office of Research-Innocenti. Cash plus.
  • Hodes R, Toska E, Gittings L. Babies for bling: are teenage girls having children to access grants? HIV nursing matters; 2016. http://www.mzantsiwakho.org.za/wp-content/uploads/2016/07/Hodes_2016_HIVNursingMatters_BabiesforBling_Vol.7_No.9.22-25.pdf.
  • UNFPA East and Southern Africa. Technical brief: harmonization of minimum ages and adolescent sexual and reproductive health rights (Consent to sex, marriage, and access to sexual and reproductive health services in East and Southern Africa); 2020, p. 8.
  • Jochim J, Meinck F, Toska E, et al. Who goes back to school after birth? Factors associated with postpartum school return among adolescent mothers in the Eastern Cape, South Africa. Glob Public Health. 2022;18:1–15.
  • Groves AK, Gebrekristos LT, McNaughton Reyes L, et al. A mixed-methods study of resilience and return to school among adolescent mothers in South Africa. Glob Public Health. 2022;17:2111–2124. doi:10.1080/17441692.2021.1970208
  • Delany A, Jehoma S. Implementation of social grants: Improving delivery and increasing access. South African Child Gauge 2016/2017. Children’s Institute, University of Cape Town; 2016, p. 60.
  • Malhotra A, Elnakib S. 20 years of the evidence base on what works to prevent child marriage: a systematic review. J Adolesc Health. 2021;68(5):847–862. doi:10.1016/j.jadohealth.2020.11.017
  • Cluver LD, Rudgard WE, Toska E, et al. Violence prevention accelerators for children and adolescents in South Africa: a path analysis using two pooled cohorts. PLoS Med. Nov 2020;17(11):e1003383. doi:10.1371/journal.pmed.1003383
  • Natali L, Dake F, Peterman A. Exploring the potential of cash transfers to delay early marriage and pregnancy among youth in Malawi and Zambia; 2019.
  • Olson Z, Clark RG, Reynolds SA. Can a conditional cash transfer reduce teen fertility? The case of Brazil’s Bolsa Familia. J Health Econ. 2019;63:128–144. doi:10.1016/j.jhealeco.2018.10.006
  • Cluver LD, Orkin FM, Boyes ME, et al. Cash plus care: social protection cumulatively mitigates HIV-risk behaviour among adolescents in South Africa. AIDS. 2014;28(Suppl 3):S389–S397. doi:10.1097/QAD.0000000000000340
  • UNICEF. Ujana Salama: cash plus model on youth well-being and safe, healthy transitions - round 3 findings. Innocenti Research Briefs; 2020.
  • [van] der Wal R, Loutfi D, Hong QN, et al. HIV-sensitive social protection for vulnerable young women in East and Southern Africa: a systematic review. J Int AIDS Soc. 2021;24(9):e25787.
  • UNICEF. COVID-19: a threat to progress against child marriage. New York, NY: UNICEF; 2021.
  • Gittings L, Kelly J, Toska E, et al. Lockdown is a good thing, but there should be more access to health’: health service experiences of South African adolescents and healthcare workers during COVID-19; 2021.
  • [van] Staden Q, Laurenzi CA, Toska E. Two years after lockdown: reviewing the effects of COVID-19 on health services and support for adolescents living with HIV in South Africa. J Int AIDS Soc. 2022;25(4):e25904. doi:10.1002/jia2.25904
  • [International] Rescue Committee. What happened? How the humanitarian response to COVID-19 Failed to protect women and girls; October 2020.
  • George AS, Amin A, de Abreu Lopes CM, et al. Structural determinants of gender inequality: why they matter for adolescent girls’ sexual and reproductive health. Br Med J. 2020;368:6985. doi:10.1136/bmj.l6985