If not now, when? Time for the European Union to define a global health strategy

Speakman, E. M., McKee, M., & Coker, R. (2017). If not now, when? Time for the European Union to define a global health strategy. Lancet Global Health, 5(4), e392-e393. https://doi.org/10.1016/S2214-109X%2817%2930085-

The socio-structural analysis of teenage pregnancy in South Africa

A dissertation submitted to the School of Social Sciences, Faculty of Humanities, University of Witwatersrand in fulfilment of the requirements for the Degree of Doctor of Philosophy in Demography and Population Studies, October 2017Teenage pregnancy is noted as one of the key development challenges in sub-Saharan Africa and globally due to its adverse social, health and demographic consequences. An avalanche of studies has emerged to identify the predictors of teenage pregnancy in South Africa which indicate a persistently high prevalence of teenage pregnancy. This study intends to examine how social disorganisation contributes to the prevalence of teenage pregnancy in South Africa. Social disorganisation is defined here as family disruption, service delivery inaccessibility, community unemployment and residential mobility. The theoretical basis of the study is the social disorganisation theory propounded by Shaw and McKay (1942). The theory was deemed appropriate due to its ability to investigate unfavourable factors beyond the individual-level occurring within society. This theory has not been applied to any teenage pregnancy study in South Africa. The data source for the study is South Africa’s 2011 census. The target population includes females aged 12 to 19. The study uses multilevel logistic regression modelling allowing heterogeneity at the individual and community levels to test the applicability of the theory in explaining teenage pregnancy. Results indicate that teenage pregnancy remains at critical levels with 3.97% of teenage females having given birth in the preceding year yet incidence among 15-19 year olds is 15 times higher than that of 12-14 year olds. Family forms other than two-parented marriages and communities with high levels of family disruption increase the likelihood of teenage pregnancy. Similarly, increasing household service delivery inaccessibility predisposes teenage females to higher odds of pregnancy, as expected. However, higher community unemployment was negatively associated with teenage pregnancy as were higher levels of residential mobility, which is contrary to previous international research findings. To this end, the study provides empirical evidence of the social disorganisation determinants of teenage pregnancy in South Africa. Additionally, the study shows the contribution of certain household and community factors in pregnancy likelihood among young women locally. In light of these findings it becomes necessary for practitioners to create intervention strategies that target these factors to curb the levels and chances of teenage pregnancy nationally. Furthermore, it is vital that government and other stakeholders financially support investigation and prevention campaigns that intentionally address contextual factors to increase adolescent sexual and reproductive health. Consequently, this study contributes to the investigation of structural derivatives to determine pertinent factors in the quest to decrease teenage pregnancy in South Africa.XL201