Achieving the health and well-being sustainable development goals among adolescent mothers and their children in South Africa: Cross-sectional analyses of a community-based mixed HIV-status cohort

Toska, Elona; Saal, Wylene; Chen Charles, Jenny; Wittesaele, Camille; Langwenya, Nontokozo; Jochim, Janina; Steventon Roberts, Kathryn J.; Anquandah, Jason; Banougnin, Boladé Hamed; Laurenzi, Christina; Sherr, Lorraine; Cluver, Lucie

Abstract

The Sustainable Development Goals (SDGs) are a visionary and multi-sectoral agenda for human development. With less than a decade left to reach these targets, it is important to identify those at greatest risk of not meeting these ambitious targets. Adolescent mothers and their children are a highly vulnerable group. We mapped 35 SGD-related targets among 1,046 adolescent mothers and their oldest child (n = 1046). Questionnaires using validated scales were completed by 10- to 24-year-old adolescent girls and young women who had their first child before age 20 in an HIV-endemic district in the Eastern Cape province of South Africa. Maternal outcomes included 26 SDG-aligned indicators, while child-related outcomes included 9 indicators. Data was collected by trained researchers, following informed voluntary consent by the adolescent mothers and their caregivers. Frequencies and chi-square tests were conducted to compare progress along SDG-aligned indicators among adolescent mothers by HIV status. Overall, adolescent mothers reported low attainment of SDG-aligned indicators. While four in five adolescent mothers lived in poor households, nearly 93% accessed at least one social cash transfer and 80% accessed a child support grant for their children. Food security rates among adolescent mothers (71%) were lower than among their children (91%). Only two-thirds of adolescent mothers returned to school after childbirth, and only one-fifth were either studying or employed. Over half of adolescent mothers had experienced at least one type of violence (domestic, sexual or community). HIV-positive status was associated with higher rates of hunger and substance use, poorer school attendance, and higher rates of exposure to violence. Understanding progress and gaps in meeting the SDGs among highly vulnerable groups is critical, particularly for adolescent mothers and their children. These complex vulnerabilities suggest that programming for adolescent mothers must address their unique needs.

• Journal Article Type: Article
• Acceptance Date: Nov 11, 2022
• Publication Date: Dec 8, 2022
• Deposit Date: Jan 16, 2023
• Publicly Available Date: Jan 16, 2023
• Journal: PLoS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 17
• Issue: 12
• DOI: https://doi.org/10.1371/journal.pone.0278163
• Keywords: Adolescent mothers; South Africa; HIV, Health
• Public URL: https://uwe-repository.worktribe.com/output/10307920
• Publisher URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0278163
• Additional Information: Data Availability Statement: All research data will be made available on request subject to participant consent and having completed all necessary documentation. All data requests should be sent to [e-mail] or to the Principal Investigators (https://www.heybaby.org.za/contact).