Learner Pregnancies: Basic Education, Social Development, Health Departments briefing

Basic Education

14 November 2017
Chairperson: Ms N Gina (ANC)
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Meeting Summary

The Committee heard that there are varying statistics on learner pregnancies because departments source their information from different places. The General Household Survey is used by Stats South Africa. The Department of Health only collects data from the deliveries of young girls under the age of 18 in health facilities. Meanwhile, the Department of Basic Education (DBE) collects data from schools. Regardless of which data source is used, the numbers are very high for the country. However; the silver lining is that the trend overtime is coming down although it is not happening fast enough.

Despite progressive policies supporting pregnant learners’ rights, pregnant learners faced many challenges in school: 

  • Insufficient support from school and teachers. Only a few schools have formal or effective mechanisms in place to offer sufficient opportunities for girls to catch up on missed work.
  • Teenage mothers who had support from their mothers are most likely to return and remain in school.

The Child Support Grant (CSG) is a useful support to mothers, however uptake among teenage mothers is very low - 20% of teenage mothers access CSG (contrary to popular sentiment that girls fall pregnant to access the grant).

Key drivers of teenage pregnancy include early sexual debut, gender based violence, inter-generational and transactional relationships, multiple relationships and low use of contraceptives. There are an estimated 2 363 new HIV infections per week among young women aged 15-24 in South Africa. Teenage mothers do not take up the child support grant which is contrary to popular narratives that they fall pregnant in order to access grants. Learner pregnancies are higher among learners who are in older grades as the chances of being sexually active are higher as one grows older.

The prevention approaches to learner pregnancies includes the access to Comprehensive Pregnancy Prevention Methods through providing access to male and female condoms. It also includes the strengthening of the curriculum for Compulsory Comprehensive Sexuality Education through educator training and aligning with Life Orientation textbooks. Peer education and other co-curricular programmes are also part of the prevention approaches. They also create a supportive educational environment where the psychological and physical conditions of the learner is recognised and supported.

Comprehensive Sexuality Education (CSE) must be strengthened through educator training and support, availability of other teaching aides, the integration of pregnancy prevention, alcohol and drug use into the CSE.

The Department of Social Development said that the psycho-social aspect of teenage pregnancy has been significant in their studies. They have found that the young learners age 13-18 were looking for affirmation when they were asked why they were engaging in sexual activity. House hold and economic matters have been a contributing factor to teenage pregnancy.

The Department of Health said there is a significant number of gender based violence linked to teenage pregnancy and the transmission of HIV. The communities must be involved in working to reduce teenage pregnancies.

Members acknowledged the decrease in the trend in learner pregnancies but considered this matter an emergency. Members asked what assistance is given to parents to get them involved in discussing matters of sexuality. They expressed concern about underage children who are found in shebeens where a lot of these incidences occur and about the cultural and traditional practices which lead to young children being pregnant. Members stated that vetting is important for all the people who work with learners to guarantee their safety. Members emphasised the importance of the various departments collaborating to deal with the matter. .

Meeting report

Opening remarks
The Chairperson welcomed the Department of Basic Education (DBE), the Department of Health (DOH) and the Department of Social Development (DSD). She said that learner pregnancy is a huge challenge the country is facing. This topic is important in order to ask what can be done to decrease the number of learner pregnancies. Everyone must work together to win the battle. If this is not cared for, it is a cycle that will continue. She asked why the statistics on learner pregnancies from the three departments are not the same.  
 
Mr Granville Whittle, Educational Enrichment Services, DBE, apologised on behalf of the Minister and Deputy Minister of Basic Education who could not attend.
 
Dr Yogan Pillay, Deputy Director General: HIV‚ TB‚ and Maternal and Child Health Programmes, DOH, said that there are different numbers due to the different sources of information. The General Household Survey is used by Stats South Africa. DOH only collects data from the deliveries of young girls under the age of 18 in health facilities. Now it is under the age of 19. DBE collects data from schools. The two choices to address this are to either look at the range or to use one data source but to look at a trend. Regardless of which data source is used, the numbers are very high for the country. The silver lining is that the trend overtime is coming down although it is not happening fast enough.

Briefing on Learner Pregnancies
Dr Faith Khumalo, Chief Director: Care and Support in Schools, DBE, presented on the implementation of DBE policies to prevent and manage learner pregnancy.

In 2012, the Department released a desktop study conducted by Human Sciences Research Council (HSRC) to review and analyse literature on teenage pregnancy and its determinants, with a focus on learners. Overall, the study reported:

  • A decline in teenage fertility rates over the past 5 decades. This could be attributed to, among others, increased access to education facilities, and information on reproductive choices.
  • Despite the reported decline in teenage fertility rates, the study asserted that unintended teenage pregnancies had remained unacceptably high, posing serious health, socio-economic and educational challenges to pregnant learners.
  • School drop-out (e.g. due to poor academic performance) preceded pregnancy.

The Department reported that 16% of women aged 16-19 in South Africa have begun childbearing. Deliveries of under 18s were estimated at 72 272 in 2015.

The Department of Basic Education (DBE) Annual School Survey data reported an estimated 15 504 pregnant learners within the school. Provinces with the highest rate of learner pregnancy were:

  • Gauteng (5 246)
  • Western Cape (2 891)
  • Mpumalanga (2 770)
  • KZN (2 408)
  • Lowest Northern Cape (69)

In contrast, the General Household Survey (GHS) 2015 data reflected that:

  • Limpopo had highest (21 675)
  • KZN (18 347)
  • EC (14 980)
  • GP (10 045)
  • NC lowest at (1 311)

The same survey indicated that only a third of girls stay in school during their pregnancy and return following childbirth.

The 2013 Review of Teenage Pregnancy in SA study further highlighted:

Despite progressive policies supporting pregnant learners’ rights, pregnant learners faced many challenges in school: 

  • Insufficient support from school and teachers. Only a few schools have formal or effective mechanisms in place to offer sufficient opportunities for girls to catch up on missed work.
  • Teenage mothers who had support from their mothers are most likely to return and remain in school.

The Child Support Grant (CSG) is a useful support to mothers, however uptake among teenage mothers is very low - 20% of teenage mothers access CSG (contrary to popular sentiment that girls fall pregnant to access the grant).

Key drivers of teenage pregnancy include early sexual debut, gender based violence, inter-generational and transactional relationships, multiple relationships and low use of contraceptives. There are an estimated 2 363 new HIV infections per week among young women aged 15-24 in South Africa. Teenage mothers do not take up the child support grant which is contrary to popular narratives that they fall pregnant in order to access grants. Learner pregnancies are higher among learners who are in older grades as the chances of being sexually active are higher as one grows older.

Issues of teenage pregnancies are not unique to South Africa as similar trends are emerging internationally. The top five countries with the most teenage pregnancies are Sierra Leone, Nigeria, Ghana Philippines and Egypt. South Africa is not in the top ten countires with the highest teenage pregnancies worldwide.

Despite challenges, the sector is doing the following:

  • The DBE promulgated the National Policy on HIV, STIs and TB on 14 August 2017.
  • CEM approved the National Policy for the Prevention and Management of Learner Pregnancy in Schools on 20 March 2017.
  • Both Policies have been developed to mainstream the Department’s response to HIV and AIDS and teenage pregnancy, and to mitigate their negative impact on educational outcomes.
  • Both Policies make bold provisions that our schools become access points for much needed Comprehensive Sexuality Education (CSE) and Sexual Reproductive Health Services (SRHS) by DoH and other partners.

The DBE learner pregnancy policy is based on the following principles:

  • The right to Education
  • Access to Comprehensive Pregnancy Prevention
  • Access to Comprehensive Sexuality Education
  • Access to Comprehensive Sexual & Reproductive Health Services
  • Counselling, Care and Support
  • Stigma and Discrimination
  • Dignity, Privacy and Confidentiality
  • Reasonable Accommodation
  • Critical Partnerships

The prevention approaches to learner pregnancies includes the access to Comprehensive Pregnancy Prevention Methods through providing access to male and female condoms. It also includes the strengthening of the curriculum for Compulsory Comprehensive Sexuality Education through educator training and aligning with Life Orientation textbooks. Peer education and other co-curricular programmes are also part of the prevention approaches. They also create a supportive educational environment where the psychological and physical conditions of the learner is recognised and supported.
 
Comprehensive Sexuality Education (CSE) must be strengthened through educator training and support, availability of other teaching aides, the integration of pregnancy prevention, alcohol and drug use into the CSE.
 
With the Scripted Lesson Plans (SLPs), a total of 3 585 teacher guides and 216 623 learner workbooks were distributed in 1 186 schools in the eight activity districts. 1 399 educators were trained to use SLPs in the classroom and 58 006 learners have been reached through SLPs.
 
The Intervention programmes includes the project DREAMS. 1 272 educators were trained on CSE while 784 trained educators taught on CSE. With the Keeping Girls in School Programme, it provides a combination of a range of support activities for girls. In 2016, a total of 47 837 Grades 7-9 were reached. With the Young Women and Girls Programme, 48 000 out of 80 000 have been reached in 10 districts in the provinces.
 
Breaking the Silence is a programme which strengthens the provision of sexuality education through a 360 mass media television production. The project has 13 episodes developed which address topics such as sexual orientation, transactional sex, sex and diseases, and the prevention of teenage pregnancy. DBE will develop 6 million DVD copies of the MTV ‘Shuga’ series for distribution to learners to support HIV prevention and peer education activities in schools.
 
South Africa is one of the 21 countries that have endorsed the Eastern and Southern Africa (ESA) Commitment which calls on countries to strengthen the delivery and quality of CSE and sexual and reproductive health rights to young people.
 
In relation to the Northern Cape Learner Pregnancy Case, three educators from Bothitong High School were reported for alleged sexual harassment by learners in grade 10. Two of the accused were apprehended by the police and were granted bail. They were served with suspension letters and the investigation is underway.
 
In AB Xuma Primary school, a 54-year-old guard is alleged to have sexually assaulted 87 children. The school reported the case to the police and a transversal psycho-social support team was established to assist learners, parents and educators.

As a way forward, DBE intends to do the following:

  • Strengthen CSE Curriculum and its implementation;
  • Improve access to Adolescent friendly Sexual and Reproductive Health Services;
  • Implementation of programmes in schools complemented by other coordinated community/ partner interventions and services;
  • Strengthen partnership with development partners, NGOs and other key stakeholders;
  • Increased public awareness through parental involvement and community dialogues; and

Engage parents on their key role in the prevention of teenage pregnancy

Ms Linda van Staden, National Population and Development Unit, DSD, said that the psycho-social aspect of teenage pregnancy has been significant in their studies. They found that young learners aged 13-18 were looking for affirmation when they were asked why they were engaging in sexual activity. Economic needs in the households were also a contributing factor to teenage pregnancy. In the department’s studies, many learners came from poor homes. There is also the problem of large household sizes and poor supervision of the children. Parents state that they are so busy that they acknowledge their limitations in monitoring their children. Household and economic issues deserve attention as they contribute to teenage pregnancy.

Dr Pillay spoke on the ‘she conquers campaign’. In South Africa, young girls between the ages of 15 and 24 get infected with HIV at a rate of just under 2000 per week through sexual activity. There is a significant amount of sexual and gender-based violence linked to teenage pregnancies and transmission of HIV. A study was done in a few communities in the KwaZulu-Natal to try and find out how the virus circulates in communities. On average 28-year-old young women are sexually active and unaware of their HIV positive status and are not on treatment.  They are having sexual relations with men around the same age as them and the men that are infected have relationships with much younger women of an average age of 18 who get both impregnated and infected by HIV. In June 2016, the Deputy President launched the ‘She Conquers Campaign” aimed at:

  • reducing new HIV infections in girls between the age of 15 and 24
  • to reduce teenage pregnancy
  • to ensure young people stay in school after pregnancy
  • to reduce sexual and gender-based violence
  • to create employment opportunities for young people

Dr Pillay said that they have identified 22 sub districts in the country with the highest levels of teenagers with HIV and who are pregnant. No one solution is going to work in reducing teenage pregnancy as it has to be a comprehensive package of services in hospitals, schools, communities. Government departments must work together with the communities that use the services they provide.
 
Dr Nonhlanlha Dlamini, Chief Director: Child, Youth and School Health, DOH, said that the Integrated School House Programme (ISHP) was launched in 2012. The package of services is divided according to the school phase. What the school house nurses deliver to the younger children is different to what is delivered to the older children. In the younger ages the focus is on addressing health barriers to learning. They also look at the nutritional status of children and check their pyscho-social vulnerability. In the grade 8 and 10 age groups, they provide information on puberty, menstruation, pregnancy, gender-based violence, HIV counselling and sexuality. They also provide information on contraception and they promote dual protection.
 
Ms Dlamini said that when they refer learners, the health facilities must be youth friendly. Standards for these youth friendly services must be conducive, accessible and available. They must also provide Information, Education and Communication materials (IEC) materials. The services must be provided in a manner which has privacy and confidentiality. The happy hour in KwaZulu-Natal is an example of this. There is a young health care provider who can communicate with the young people. They are planning to change the ‘happy hour’ name to something more appropriate. They also have a mobisite called ‘Be Wise’ on social media where they provide information which young people can interact with.
 
Discussion
The Chairperson said that the main objective is to decrease the number of teenage pregnancies.
 
The Chairperson said that the trend of learner pregnancy decreasing is giving a positive outlook on the matter.
 
Mr H Khosa (ANC) was concerned that this is a serious problem worldwide. He referred to the policy of the DBE. It is talking to the rights of the learners. What are the measures to ensure learner pregnancy is stopped? Have these policies been sent for public comments? Are these policies clear on who the implementers are? To what extent are these implementers trained to ensure it is a success? What is the target of the Department with regards to the age of learners? To what extent are parents involved? If they are involved what type of assistance is given to them to ensure they get used to discussing matters of sexuality with the children? He said that it is a serious challenge speaking to children on matters of sexuality and HIV and Aids. He asked to what extent is the Department involving shareholders such as businesses and religious groups as this is a societal matter? He said that a lot of these incidences occur in shebeens. There is a challenge of by laws that are not implemented. Underage children are found in shebeens and when they are drunk they do not think of using protection.
 
Ms L James (DA) said the DOH has always had a challenge of a shortage of nurses. She asked how it is resolving this problem in schools.
 
Dr S Thembekwayo (ANC) referred to page 10 of the presentation: provision of a supportive environment for the continuation of learning. She said that the pregnant learners must be accompanied by a guardian to schools at all times in case of a medical emergency. She asked what role this plays in the supportive environment.
 
Dr Thembekwayo asked about the intervention programmes. She said that not all provinces are included. How are other provinces going to be involved in such intervention programmes? What guided them in choosing these particular provinces to take part in the programmes?
 
Ms N Mokoto (ANC) thanked the departments for the work they have done to deal with the matter. Integration is important for the implementation of the programmes. They must have a joint programme which will ensure everything is pulled together so that they are able to make an impact and get true value for the money they have implemented into the programmes.
 
Ms Mokoto spoke on the negative impact of other cultural activities. There has been no mention of traditional and cultural practices which affect young children who end up pregnant. When the Committee did oversight, there were communities in KwaZulu-Natal where there were reports of teachers stating that girls who are 20 years old are encouraged to be pregnant by their parents. Boys that are the same age become men and become uncontrollable. There must be mention on how that impacts on the dropout rates of learners. She observed that the rate of learner pregnancies is static in some provinces. She asked what strategies the Department is using in applying this to other provinces. She referred to a municipality in KwaZulu-Natal that used a programme to deter girls from being sexually active. This approach was seen as discriminatory, but the constitution gives the right to positive discriminate. She asked if the municipality can modify the approach so that it does not seem negative. She asked how far the Department is with the programme of ensuring that schools engage in sports as a way of reducing learner engagement in other activities.
 
Ms J Basson (ANC) asked for clarity from the DOH on the point of health care workers. She asked how they are going to distribute the ratio of healthcare workers per school. She asked about the happy hour policy which only speaks to those who are pregnant. She asked where the perpetrators who impregnate girls feature in the policies as they are also involved?
 
Ms Basson asked for clarity from the DBE who they monitor in the provinces. She asked about Bothithong High School, where it is alleged that after several pupils were impregnated, allegedly by their teachers. She said that the presentation showed that no educator was involved. In the presentation, the Committee learnt that educators were suspended. She asked where they are and if the educators return to the schools?
 
Ms H Boshoff (DA) asked what the progress is with the ISHP. She further asked how the Learner Unit Record Information and Tracking System (LURITS) assists in tracking a learner to ensure that they return to school? [LURITS aims to collect unit record data for each learner in South Africa, from grade R through to Grade 12. The system also tracks the movement of each learner from school to school, even inter-provincial movements of learners can be traced] The reason why a learner does not return to school could be because of the stigmatisation from that teacher still being at school. The South African Council for Educators (SACE) must be involved with regards to the vetting of the teachers.
 
Ms Boshoff asked the DOH about the fertility rate that has decreased. Is there a programme in place to determine how many learners are giving birth outside of hospitals? She asked why the young girls are not applying for the grant that is available to them. There is no uniformity in schools with regards to the learner pregnancy policy. Many schools ask the learners to bring money to pay in the event that a medical crisis could arise. She asked the department to explain what the plan is which was implemented to assist learners who have returned from maternity leave.
 
Ms Boshoff asked why there are no statistics for 2016 if the information was collected from the annual surveys. With regards to the sexual abuse cases, the Department did not mention the matter where a young girl was gang raped. She asked what happened to the educators involved in the matter.
 
Dr P Maesela (ANC) said that there is a serious problem which could be likened to an emergency. If they intellectualise on it and do not have a plan, they will find sections of the country being perpetual victims. The statistics do not show which section of the population are more prone to be victims. The ward based outreach teams should be trained to deal with the matters on how to prevent the spread of infections and pregnancies. If they can be trained to profile vulnerable girls who are likely to fall pregnant and prevent the situation, then the matter could be addressed. They must use these facilities that are there in order to combat these matters as though they are an emergency.
 
The Chairperson asked about the cases which involve educators who impregnate learners. When it comes to a teacher and an educator who has been proven to be involved, they must be stripped of their role as a teacher. The Committee has emphasised this and has not seen this being addressed.
 
The Chairperson asked about the insufficient support from the side of the school. She asked what kind of support to the learners they are speaking of. When looking at the topic of sexuality education, she asked what the appropriate age is. The statistics show that even the primary school learners are being impregnated. The topic is sensitive to some cultures. There must be a comprehensive approach to teach all the communities to educate each other on the topic. How do parents and members of the community change themselves to be youth friendly to speak to these matters?
 
Mr Hubert Mweli, Director General, DBE, said that although South Africa is not among the top 10 countries with a high learner pregnancy rate, it is a country associated with a number of risks. HIV and Aids is a huge challenge in the country. Even if it is one learner, it is one too many. It must be viewed and approached as a crisis. The three departments are working closely together to address the matter.
 
Mr Mweli said that parents are involved, but a lot needs to be done. The parents are involved through parent meetings at schools. The DBE has strengthened the Quality Learning Programme. It is a societal problem and the members must relate the gravity of the matter in their constituencies and other areas. Civil society is involved through School Governing Bodies (SGBs). The Department might have to develop programmes that are targeting businesses and specific sections of civil society to increase advocacy.
 
Mr Mweli responded to Ms James’ question on the shortage of nurses by stating that DBE largely depended on the DOH for access to nurses. Very few schools have the health practitioners. The shortage negatively impacts the services which need to be received. SGBs have been trained and they are expected to have a subcommittee on health promotion for each school. The expectation that pregnant learners must be accompanied by guardians to school is not part of the policy. This is what has been created by schools out of desperation. It emanated from Limpopo where some schools encouraged parents to accompany their children. It is not a provision of the policy. It is not practicable for parents especially those who are working.  The three departments must strengthen the collaboration between them.
 
Mr Mweli said that financial resources are never enough, but there is a tendency in the basic education sector to ensure there is a teacher in each classroom. This is why they do not have enough health practitioners as they would like to have. Traditional practices and taboos are a challenge. He appreciates that public representations are able to raise these matters. With regards to involvement in curriculum enrichment activities and sports, they are working with the Department of Sports and Recreation. Some communities have been able to get learners involved in extracurricular activities.
 
Mr Mweli said that in relation to Bothithong High School, it came from the media reports. The Department suspended teachers who were alleged to be involved and reported the matter to the police two were arrested and released on bail. They are awaiting internal disciplinary processes and criminal procedures to unfold. The alleged activities were perceived to have taken place in the community which is outside of the control of the school which would have been difficult for the principal and SGB to handle the matter. SACE and the Department of Justice have discussed how the child protection registry is not updated which makes it difficult to deal with the perpetrators.
 
Poverty is a contributing factor to teenage Pregnancy. Other variables include family dysfunctionality and moral decay. The DBE does do follow up cases involving educators. In some instances, the matters drag on till a teacher is employed elsewhere.
 
Dr Whittle addressed the question of teachers who raped a school child. They were all suspended including the school principal. The province is investigating the matter and criminal charges were laid against them. In terms of utilising LURITS to track learners returning to school after falling pregnant, it is a good idea which is something the DOH will do. On the importance of vetting through SACE, there must not be a situation where a teacher found guilty for rape or sexual harassment and resurfaces elsewhere.  They must also find mechanisms working with the Treasury to block those teachers from getting paid. He spoke to the importance of principals and teachers at a school in understanding their obligation to report abuse. In some cases, when the principal becomes aware they try to protect the reputation of the school and tell the teacher to resign so it does not get in to the media. This is where the departments must work with the Department of Justice so that the teachers and principals understand their obligation to report.
 
Dr Whittle said that DBE annually charges teachers for sexual relations with children.
 
Ms Busisiwe Mpini, Health Promotions, DBE, said that with regards to monitoring at provincial level, the directorate works with provincial life skills coordinators. They collaborate with district monitors and at the school level. They also work with their colleagues with regards to the life orientation and curriculum in schools.
 
Dr Khumalo spoke on the public sentiment of the policy. For a period of 5 years, they have been engaging on the matters of sexual and reproductive health with a range of stakeholders. They also had a public comment process. Largely the comments were supportive about the policies put in place but there was a small group that wanted to make a point on condom distribution within schools. In terms of age appropriateness, the DBE was not clear on the target. There was a realisation that in an informed manner the approach was a correct one that they were wanting to implement. DBE has been learning from the Department Social Development on imbizos in communities in order to engage parents and they are hosting engagements with parents. This makes the DBE understand the context of each area which they go.
 
Dr Khumalo said that the Northern Cape has been identified for extra support for a number of reasons. Many of the donors that work in South Africa do not work in the province as it is not one of the identified high priority districts with high levels of HIV prevalence. The Northern Cape and North West have the highest rate of teenage pregnancy. DBE has noted that poor academic performance from girls is a major risk factor for dropping out of school and for pregnancy. DBE must identify girls who are struggling and ensure they are supported through academic support and career guidance.
 
The Chairperson said that in every school, sexuality education must be covered in the programmes of.
 
Dr Khumalo said that the scripted lesson plans are finalised in the system and managed through their curricular interventions. DBE is bringing in learner support agents that come into the schools. These are young adults and community members who are identified by the school and are provided with training. They are expected to assist in identifying vulnerable learners and liaise and be the referral link between the learners, schools and the health and social services. The programme is not yet available everywhere but is a programme which is important and they are progressively increasing their capacity.
 
Ms Dlamini said that there is a shortage of nurses. The DOH designed the school health programme to have nurses working through the school phases. It targets grade 1 and grade R learners as the foundation phase, grade 4 is the intermediate phase, grade 8 is the senior phase, and grade 10 is the Set phase. They worked out the ratios for the school health team is 1 school health team to every 2000 learners. In terms of transport the teams share pool cars. With assistance from the European Union, the Department purchased 77 school health mobiles which comes in sets of three. They provide dental care, primary health care clinic and optometric treatment for eyes. She said that one social determinants of health is poverty. The school health teams must prioritise quintile 1 and 2 schools and within those, they must prioritise grades 1, R and 4. For the schools which are left out and targets were not reached, they held a school health week in October. KwaZulu-Natal uses its community services nurses to go out into schools to provide services.
 
Ms Dlamini said that at the end of the last financial year, the implementation of the programme, 3 250 522 learners had been seen. Out of those, 962 000 had been referred for different services. In the annual performance plan, their target was 324 000 and they screened 387 646 grade 1 learners. For grade 8, the target was 109 000 and they achieved 179 476. In relation to the question on what is age appropriate, they looked at the life orientation programme and what partners like Soul City are doing.
 
Dr Pillay said that prevention is better than cure. They have been struggling to get young people to delay sexual debut which is the first line of prevention. When looking at the number of women who die after delivering, there is a significant number of young people who die from pregnancy related hypertension. There is good reason for them to focus on maternal morality. It is also important to look at how they get condoms in to schools. They asked for guidance from the Committee on what the key issues of social and cultural sensitivities which are involved in this. The DOH is improving the health facilities not to be judgemental of young people accessing contraceptives.
 
Dr Pillay said that Dreams is a demonstration project which is not meant to be in every district. The idea is for government to take the lessons from there and scale it up, such as in the ‘she conquers campaign’. The DOH has given condoms to community health care workers in order for them to distribute in their communities. There must be consistently strong messages around the matters of teenage learner pregnancy. The Department would be happy to put together data on learner pregnancies in the constituencies of the Members. They have to involve young people more in the design of the programmes. They are still doing things for the young people rather than with them.
 
Dr Pillay spoke to the matter of immunisation. There have been large measles outbreaks in the country because many young people are under immunised. Working with the other departments, they are well placed in finding the under immunised children and immunising them. Failing to address this matter will lead to measles outbreak in addition to the challenge of learner pregnancies.
 
Ms van Staden said that DSD has engaged with community members and family through ward based dialogues. The dialogues speak of social reproductive health and rights and in particular teenage pregnancy. They take the comments seriously and they feed off of what the communities want. This is related to the Mikondzo Programme. In relation to the grants uptake, it is unclear why young people are not taking them. They will engage with their colleague from SASSA to find out why it is low. The grant has good developmental outcomes.
 
Mr S Jafta (AID) said that a lot has been said in dealing with the matter of learner pregnancies. What is missing from the presentation is the emphasis on the efforts the DBE is doing to guarantee the safety of learners within the school premises. There are incidents of victimisation which happen in the schools by the people who are supposed to be playing a parental role. A lot needs to be done to encourage the victims to come forward and report the incidents of abuse.
 
Ms Basson responded to the DOH and said that public representatives must do their part. She asked in which districts Soul Buddyz and Love Life are still active? We have a tendency when implementing a programme for it to become for only a few years then it is gone. She asked who is reporting to the Department from the province. She asked when the programme of learning agents is going to be implemented. She said that she has a problem of aligning a programme on a programme. If they are serious and want learners to be saved, why don’t they appoint a nurse and social worker per district that can have direct contact and monitor learners?
 
Dr Thembekwayo said that on the response of the exclusion of the provinces, the donor’s preference to exclude other provinces is unacceptable. The provinces are part of South Africa and are part of the high rates of pregnancies. The teachers need to be educated and follow the same programme. She asked if there is no way the donors can be influenced to include other provinces.
 
Ms James asked if the different departments have time to come together to focus on one matter. They must focus on employing more social workers at schools as one person per sub district cannot manage 2000 learners. She asked if they can look at how they can budget together to get more social workers.
 
The Chairperson said that the matter of cooperative government and inter departmental relations is highly emphasised. There are challenges which will never be addressed when working alone.
 
Ms Mokoto asked about condom distribution at schools and how it is proceeding. She asked about the contradictions that arise as the work is done in terms of the age of consent. How are they engaging the department of justice on this matter? When teachers get arrested for activities they commit with the learners and in particular those who are underage, it must still go to the justice system. She said that the departments have not mentioned the use of radio as a medium which cannot be deemed outdated.  
 
The Chairperson asked what the impact of the Community dialogues of the DSD has been and in particular the rural areas. She asked DOH about the statistics on the ages 15-24 on newly infected young women. She said that if the age is increased to 35, what are they looking at when speaking at newly infected young women per week?
 
Ms van Staden said that in terms of their dialogues, there is interest from community leaders, parents and faith leaders. Those showing interest are taken to a five-day training course where they impart more knowledge on sexual and reproductive health rights. In the course they also look at the necessary policies within the country. They are currently busy with the evaluation of the dialogues.
 
Dr Pillay responded to the question of donors and said that in order to coordinate, the deputy minister has a steering department which speaks on strategic decisions of where they should invest donor funding. Government must be funding operational things and donors should only be used for demonstration. He said that there are sole buddies clubs in every province. In 2014, there were 249 soul buddies clubs in the Northern Cape. The highest number is in KwaZulu-Natal because of the large numbers of pupils. He responded to the question about the youth beyond 24 by stating that almost 1 in 3 pregnant women in South Africa who attend anti natal classes in the public sector are HIV positive.
 
Dr Pillay said that with respect to the total number of new infections in the country, in 2016 there were 270 000 new infections. Their target is to reach no more than 88 000 by December 2020. Over the last years it is decreasing, although it is not fast enough. Women are infected earlier than men. They must focus on the boys and men who are impregnating and them.
 
Mr Mweli said that they must do a lot to ensure the safety of learners. All provinces have been directed to prioritise vetting of all the people who are working with children. They will strengthen the role of SACE. He said that it is important for the various departments to work together as it reaches more learners and educators.
 
Mr Mweli said that matter of learner pregnancies is an important matter. In terms of their laws, learners are deemed to be minors regardless of their age. This creates proems if in terms of the criminal procedures and the age of consent.
 
Dr Whittle said they intend to only distribute condoms to high schools. It is an ongoing process. There are a lot of schools which approach the department to work with them in distributing condoms. Their position is they will not force schools to render services.
 
The Chairperson thanked the departments for the discussion. She said that it will never be a conclusive discussion. The discussions have spoken to the real need of protecting the youth of the country. Finally, she advised the departments to plan together.
 
The meeting was adjourned.

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