Application of the PEN-3 Cultural Model in Assessing Factors affecting Adolescent Pregnancies in Rural Eastern Cape, South Africa

Early pregnancy and child birth increases the health risk for the mother and the baby. It is a public health concern in South Africa as it may affect the health; social and economic well-being of society at large. Although immediate determinants of teenage pregnancy in South Africa relate to behaviour, the fundamental drivers are more deeply rooted institutional problems of poverty, underdevelopment and gender based violence. In addition, government policies, socio-economic injustices, unequal power structures and culture contribute to the high rates of teenage pregnancies in South Africa. The aim of this study was to assess contributing to adolescent pregnancies with in three rural communities in Eastern Cape Province. Guided by the PEN-3 cultural model and Community-based participatory research principles, an explorative qualitative research design was undertaken with 14 community care workers from Glenmore, Ndwayana and Grahamstown. As phase one of an ongoing study, semi-structured interviews were carried out with the participants. The results were coded according to the domains of the PEN 3 model. The main findings indicated that adolescent pregnancies are a significant cause for concern in the communities under study. Perceptions (myths surrounding contraceptive use), enablers (availability of clinics), and nurturers (parents, peers and boyfriends) were found to be important in making decisions regarding contraceptive use and sexual activity amongst adolescents. These factors identified will inform the development of culturally sensitive and appropriate health promotion material during the next phase of the study.