Beliefs of grade six learners ’ regarding adolescent pregnancy and sex

Curationis 30(1): 32-40 Escalating adolescent pregnancy and risky sexual behaviour is becoming more common amongst young adolescents and especially amongst black adolescents in South Africa. Statistics confirm that South African adolescents as young as fourteen are already sexually active and become pregnant. The decision to become sexually active with resulting adolescent pregnancy whether planned or not, are directly influenced by the teenager’s beliefs. A person’s beliefs consist of a person’ own individual beliefs or attitude as well as what the individual subjective norm which the individual perceive as other people’s beliefs regarding the same object of reason. The aim of the study was to describe the attitude of black grade six learners under the age of fourteen, towards adolescent pregnancy and sex. A quantitative descriptive research design was used. Results were clustered according to demographic variables as well as beliefs that consist of attitude and subjective norm. Findings provided insight into the beliefs of grade six learners regarding sex and adulthood, the roll of peer pressure, relationships of adolescent parents, social interaction of teenage parents, ability of adolescent parent’s ability to provide in the needs of the baby, the adequacy of a child support grant to raise a baby as well as the levels of education of adolescent parents. This article provide a detailed reflection on these results and propose off a doll parenting intervention strategy as means of modification of attitude and subjective norms of grade six learners in order to alter sexual behaviour. Correspondence address: Rev. Cecilna Grobler School of Nursing Faculty of Health Sciences University of the Free State PO Box 339, Bloemfontein 9300 Tel: (051)401 3478 Fax:(051)4019139 E-mail: groblerc.md@mail.uovs.ac.za Introduction Heightened sexual awareness forms a normal part of adolescent development, yet it is often characterized by experimentation, which has the potential o f placing adolescents at risk o f unprotected sexual activity, unplanned pregnancy and sexually transmitted infections including HIV infection (A m erican Academy o f Child & Adolescent Pshchiatry, 2004: online). Statistics indicate escalating rates of teenage pregnancy as well as sexual activity at ages as young as thirteen years (The Sensible, Healthy And Responsible People (SHARP) programme n.d.: Online). Literature state that the teenage pregnancy rate amongst black teenage females has increased by almost 33% over the period 1991 -1998, despite a slight decrease of 1.4% in the national rate over the same period (Pelser 2004:208). According to Mlangeni (2003: online) girls under the age of sixteen years are


Introduction
Heightened sexual awareness forms a normal part of adolescent development, yet it is often characterized by experimentation, which has the potential o f placing ad o lescen ts at risk o f unprotected sexual activity, unplanned pregnancy and sexually transm itted infections including HIV infection (A m erican A cadem y o f C hild & Adolescent Pshchiatry, 2004: online).Statistics indicate escalating rates of teenage pregnancy as well as sexual activity at ages as young as thirteen years (The S ensible, H ealthy And Responsible People (SHARP) programme n.d.: Online).Literature state that the teenage pregnancy rate amongst black teenage females has increased by almost 33% over the period 1991 -1998, despite a slight decrease of 1.4% in the national rate over the sam e period (P elser 2004:208).five times as likely to die during childbirth as women in their twenties.Adolescents -and younger adolescents in particularfurthermore have the tendency to give birth to low birth-mass infants who are at risk for n eu ro lo g ical and other developmental deficiencies.Due to these high mortality rates amongst adolescent mothers as well as infants, sexual activity amongst adolescents and the resulting adolescent pregnancy has become a primary cause of concern.Adolescent parents are furthermore at a significant disad v an tag e o f becom ing a psy ch o so cially and econom ically contributing adult parent (De Villiers & Kekesi, n.d.: Online).
A dolescent exposure to the risk of pregnancy has attracted considerable research attention in different societies.Research has indicated that the situation in South Africa resembles that prevailing in developing societies in Africa and Latin America (Mfono, 1998: 180).A literature overview highlighted a number of factors playing a role in the incidence o f the high teenage pregnancy rate.L iteratu re state that a d o le sc e n t's decision to become sexually active and/ or becom e p regnant are usually influenced by one or more of the following factors: • Race and ethnicity; • Poverty, socio-economic status; • Curiosity; • Lack of parental guidance; • Peer pressure; • Attitudes towards contraception, condoms and pregnancy; • Safer-sex behavioural skills (Elorm, 2003: Online;Mfono, 1998:180;Kalmuss, Davidson, Cohall, Larque and Cassell 2003: Online).These factors will have a dual influence on the adolescence as it will influence the adolescent's individual beliefs or attitude as well as those the adolescent p erceiv e as o ther p e o p le 's beliefs describe by Ajzen and Fishbein as the learner's subjective norm.Reddy, et. al. (2002: 51-54) state that a significant smaller percentage of "white" learners (8.5%[3.5-13.5])reported having made som eone pregnant or having been pregnant than black learners (17%[ 14. 1 -19.8]).It is therefore recommended that "black" and "coloured" learners should especially be targeted through the implementation of programs addressing the problem o f adolescent's lenient attitude towards adolescent pregnancy and sex in order to change behaviour.

Problem statement
Sexual behaviour and the resulting adolescent pregnancy is determined by adolescent's attitude toward sex and adolescent pregnancy as well as the adolescent's beliefs that is held by specific individuals or groups with whom he/she stand in relationships.According to the theory o f Reasoned Action as postulated by Ajzen and Fishbein in 1980 the intention to perform behaviour is determined by the individual's attitude toward performing a particular behaviour and the subjective norms held by the individual (Shaikh, 2000: Online).

Aim of the study
The aim of the study was to describe the attitude and subjective norms that form the beliefs that grade six learners have regarding sexual activities and teenage pregnancy.This was done according to the theory o f reasoned action as postulated by A jzen and Fishbein (Shaikh, 2000: Online).

Terminology
The following terminology was used throughout the content of this article: Adolescent: A young person who has entered puberty but who has not reached full maturity; a teenager.For this study a adolescent is a person aged eleven to thirteen years.Adolescent pregnancy: Females aged fourteen to nineteen years who are mothers or who have ever been pregnant (South Africa Demographic andHealth Survey 1998,1999: Online).

Conceptual framework
The theory o f reasoned actio n as postulated by Ajzen and Fishbein state that behaviour is determ ined by the individual's attitude and subjective norms (Shaikh, 2000: Online).See Figure 1 for a schematic illustration of the Theory of Reasoned Action.
Attitude is an individual's positive or negative feeling asso ciated w ith performing a specific behaviour.An individual will hold a favourable attitude tow ard a given behaviour if he/she believes that the performance o f the behaviour will lead to mostly positive outcom es.Should the individual however believe that mostly negative outcomes will result from the behaviour, he/she will hold a negative attitude toward it (Mykytyn& Harrison, 1993:15-26).
Subjective norms is determined by an in d iv id u a l's norm ative beliefs that significant people in the individuals life, think he/she should or should not perform a specific behaviour, coupled with motivation to comply with referents.Significant others are individuals whose preferences about a person's behaviour in this domain are important to him/her (Easley &Chai ken, 1993: Online).
Intention is the likelihood o f doing something.An intention is a type of judgm ent about how, in the present context, an individual will behave toward a particular brand/ situation.Intention is the best predictor o f behaviour and attitude and subjective norms influence the intention (Shaikh, 2000: Online).Source : Ajzen and Fishbein (1980) According to the Theory o f Reasoned A ction a d o le sc e n t's a ttitu d e and subjective norms will determ ine the individual's intention towards sexual activity and teenage pregnancy which will thus result in subsequent behaviour.Beliefs that form the attitude as well as subjective norms o f grade 6 learners, w hich will resu lt in in ten tio n and su b seq u en t b eh aviour, had to be determined.

Research methodology
A quantitative descriptive survey design with a purposive sampling method was used (D e Vos, 2 0 0 2 :145-146).A questionnaire was used to determine the beliefs that form the attitude as well as su b jectiv e norm s to w ards sexual behaviour and teenage pregnancy.

Questionnaire
According to the Theory of Reasoned Action o f Ajzen and Fishbein (1980:26-32), behaviour is the result of the attitude and subjective norms which will result in intention.Behaviour is a direct result of a sp ecific in ten tio n .Two individual translators used a method of back-translation as the questionnaire was firstly translated to Sotho and then back to English.This was done to ensure content validity.The questionnaire was 34 thus translated to Sotho as the learners in this study were grade six learners from a d o m inantly S otho-speaking background aged between eleven and thirteen years of age.Back-translation contributed to the reliability o f the questionnaire.

Population and sampling
The population was eighteen traditional black primary schools in Botshabelo using the same life skills programme for grade six learners.The reason for preference of traditional black schools is the fact that the highest prevalence of teenage pregnancy is found under black adolescents (Reddy, et al. 2002: 51).
P urposeful selectio n w as used to establish a homogenous group within B otshabelo w here the study was conducted.
H om ogeneity was established on a basis o f schools using the same life skills curriculum, schools that have similar numbers of learners, a similar socio-economic background from which learners came and age younger than thirteen years.Lack o f written consent of parents or legal guardians and absentees on the day of the pre-test was set as exclusion criteria, which left a number of 94 learners included in the study.Two schools in B otshabelo w ere purposeful selected for the study.S chools with grade 6 learners in Bothshabelo were listed.The two schools with the largest population of grade 6 learners under the age of 13 were selected as the experiential and control scools.Only two schools in Botshabelo were selected due to the fact that it was cost as well as time effective.It was decided to use two schools as to be able to generalize findings of the study within a specific area.When initial selection was done age was not taken into consideration as the average age of a grade six learners is usually eleven years.When the fact that more than Fifty percent o f grade six learners were older than thirteen years came to the attention of the researchers through data gathered in the pilot study, age was set as exclusion criteria.This was done to ensure that children older than thirteen years, who might already be sexually active, did not influence the results o f the study.

Pilot study
A pilot study is commonly defined as a smaller version o f a proposed study conducted to refine the methodology.It is developed much like the proposed study, using similar subjects, the same setting, the same treatment and the same data collection and analysis techniques (Bums & Grove 2001:49-50).
A pilot study was conducted at a school in Botshabelo, similar to the two schools, which was included into the study.A total of 38 learners were included in the pilot study.The purpose of this pilot study was to determine if the learners understood the questions asked, whether the coding of the questionnaire is correct, and to establish the time necessary to complete the questionnaire.The only adaptation derived from the pilot study was the change of language from English to Sotho, as learners seem ed to misinterpret some of the questions.

Data gathering
The grade 6 learners whose parents gave consent and who gave accent themselves, at both schools on the same date and tim e com pleted the questionnaire.Learners included in the study were taken to a separate location in the school where the questionnaire was completed.Completion o f the questionnaire took no longer than 20 minutes at a time.The researchers were present at all tim es as to answ er questions that may derive.The teachers were present to translate any questions of the children as well as the answers of the researchers.The questionnaire was gathered as soon as it was completed.

Data analysis
Data analysis was done by a biostatistician from the Department B iostatistics, Faculty o f Health Sciences at the University of the Free State.Data was first coded where after it was captured.Data was there after defaulted and p rocessed into frequencies and correlated frequencies.For the purpose o f the study the assessment on the questionnaire was summarized as a single group (N=94).This was done to establish the parameters for the attitude and subjective norms of the group at large.

Results
The results gathered were clustered according to demographic variables and beliefs o f grade six learners regarding sexual activities.

Demographic variables
D em ographic variab les are characteristics or attributes o f the subject that are collected to describe the sample.Demographic variables examined in this study were gender and ethnicity as well as primary caregivers of learners included in the study.

Gender and ethnicity
The sample (N=94) included in the study consisted of more female (61%) than male (39%>) learners in both schools that contributed to homogeneousness of the two groups.These learners come from a mainly Sotho speaking community as indicated by the home languages of learners (See table 1).The age of the learners ranged between eleven and thirteen years, as age above thirteen years was an exclusion criteria (See Figure 2).When the project was in itially planned, the research ers discovered less than 50% of grade six learners in schools in Botshabelo were under the age of thirteen years with ages ranging up to 18 years.As indicated in Figure 2,32% of the learners of the group were already thirteen at the time of the study while the majority of learners (47% (n=44)) in the group was twelve years of age.In this study none of the learners has ever taken part in sexual activities or had sexual intercourse.

Primary caregivers
More than 84% of all primary caregivers are parents, with grandparents following suite while no sibling households were indicated (See  Parents being primary caregivers tend to make a difference in the sexual behaviour of adolescents.Kalmuss et al. (2003: O nline) state that adolescents who perceive that their mother disapprove of their having sexual activities or who talk with their mother about condom use before first intercourse, are less likely to become sexually active or to fail to use condom s than ad o lescen ts whose parents do not communicate with them about sex and sexual activities.Mfono (1998: 182) further state that adolescents in a South African study felt that parents ju st abandoned their responsibility regarding sexual education o f their children.In the light of the fact that boys from an African culture tend to become sexually active at a younger age than girls, due to the absence o f security and education given by fathers, it is alarming to notice the absence of father figures as prim ary care givers, as 41 prim ary caregivers indicate fem ale headed households (Reddy, et.al. 2002:51).As such, parents play an essential role in the forming of positive subjective norms regarding sexual behaviour and the prevention of teenage pregnancies.
In many black African cultures, children were historically not allowed to discuss sexual activities openly (Ampim 2003: Online).In the olden days however, these children received sex education through the performance of puberty rites.Due to urbanization and industrialization these rites are however seldom performed now adays.
Parents m ostly warn adolescents to refrain from sexual activities while the required guidance and d iscip lin e is relin q u ish ed to overburdened teachers (Elorm, 2003;Sharp, n.d.: Online).Although parents warn adolescents to refrain from sexual ac tiv ities, adultery, polygam y and promiscuity is often found within the sub-Saharan cultures (Dahlman & Jones, n.d.: Online).This behaviour perceived by ad o lescen ts as acceptable, lead to adolescents being misguided regarding cultural approved values and moral behaviour.
A nother factor that underlie absent parents is the socio-economic status that has a direct influence on the lives of children.
The racial and ethnic differences in sexual risk taking and pregnancy are partly attributable to d ifferen ces in socio-econom ic disadvantages.According to Elorm (2003: online) children are forced to go into prostitution because it is an easy and fast way of making money for themselves as well as their parents.Adolescents in low income community who have parents with a low educational attainment or are living in a single parent family are also more likely to develop risky sexual behaviours and to fall pregnant at a young age.These adolescent's own level of academic achievement is furthermore positively related to age at sexual debut (Kalmuss, etal. 2003).
According to Ampim (2003) five initiation rites can be distinguished in the African culture, o f which one is the rite of adulthood.These rites are usually done at the onset of puberty (around twelve to thirteen years of age in many African cultures) and they are to ensure the shaping o f productive, com m unityorientated responsible adults.The problem however is that mentors of the

Beliefs regarding the influence o f peer pressure on sexual behaviour
Acceptance by peers without being sexually active (N=94) 67 33

Beliefs regarding personal relationships after having a baby.
A baby will strengthen the relationship between the parents of the baby (N=94) 19 81 Boy/girlfriend will raise the baby (N=94) 27 73 Families will raise baby (N=94) 36 64 Beliefs regarding social interaction after having a baby.Realization of the negative influence adolescent parenting will have on normal adolescent social interaction (N=94) 48 52

Beliefs regarding ability to provide in the needs o f the baby.
Realization that they would not be able to provide in the needs of a baby (=73) 73 27 Realization o f the dependency o f a child on its parents or primary care giver (n=38) 48 53 The baby would really love its parent (n=91) 54 46 The baby would really need its parents (n=91) 58 42 Teenage parents are able to fulfil all the needs of a baby (n=92) 21 79

Beliefs regarding the adequacy o f a child support grant to raise a baby
Realization that the child support grand is / might be insufficient to raise a baby (N=94) 61 39 There are therefore less time for the couple to spend together and feelings of resentment to the new infant may even result due to lack of time for self or spouse.

Beliefs regarding education o f adolescent parents
After the birth o f an infant, couples have about one third as much time together alone as they had before the birth of the baby (Longo: n.d.: Online).
According to Davies (2005: Online) up to half of the boyfriends and partners are said to be unhappy with their girlfriend's pregnancy.The boyfriends or partners are how ever much less likely to be negative in their reaction than that o f the girls' parents.In the black community, the issue o f reparation im m ediately comes up which is a complicated process which sometimes results in eventual marriage.Young black fathers don't always produce the goods -some studies have found that very few actually pay the full reparation demanded by the girl's parents, although most will probably pay something.In western-oriented groups, g irls are m uch less likely to be encouraged to marry the father of their child, and marriage is definitely not the automatic solution that it once was.Yet it also appears that pregnancy in itself is not going to break up all relationships.
In Davies' study, nearly 75% of the girls said that the father of the child was still their current boyfriend.
In Van der Merwe (n.d.: Online) supports this by stating that the child support grant has a direct impact on the high incidence o f adolescent pregnancies.He further state that these children will not be able to look after their R170-worth babies and that the next generation will pay the price for the policy regarding the availability o f child support grants to adolescent parents.
According to Kaufman, De Wet and Stadler(2000: Online) about 65% of black girls aged nineteen and younger who had given birth at least once did not complete their school education.According to Shearer(2002:236-243) teenage mothers are likely to experience low educational and occupational achievement and as result live in poverty, as well as have children with behavioural problems, academic difficulties and developmental delays including mild mental retardation.Adolescent fathers are also at risk of school dropout which increases the risk for socioeconomic disadvantage.

Conclusion
The need o f gender aw areness 38 Curationis M arch 2007 program mes such as the Life Skills curricula is therefore strongly indicated to modify such cognitions and create a critical consciousness about these issues of save sexual behaviour and abstinence.
The concept of curriculum refers to more than the syllabus and include all planned learning activities and subject courses that take place inside and outside the classroom.According to Carl (2002:35) it is the sum total of the means by which a student is guided in attain in g the intellectual and moral requisite of an intellectual citizen.It is further crucial that curriculum planners of the Life Skills program take into consideration issues like social, econom ic and cultural backgrounds of learners when designing and revising the curriculum.
It is recommended that practical learning experiences such as "doll-parenting" projects be included in the life skills program.Learners o f both genders should be exposed to such doll-parenting projects in which a doll is placed into the care of each learner for a period of at least two weeks, twenty four hours a day.Dollp aren tin g expose learners to the necessary responsibility and social impact of having a baby while still an adolescent.A budget-compilation need to be included in the study to accent the financial impacts having a baby will have on adolescent parents and their families.
It is recom m ended a q u alitativ e methodology should be used for future research as to gain an understanding of the influence o f such doll parenting projects on grade six learners' attitude regarding sex and sexual behaviour.
The researchers would like to express appreciation to Ms. Moleme from the Free State, Department of Education who acted as mediator between the Department of Education and the schools involved in the project and who arranged the services rendered by the Free State D epartm ent o f E ducation.The researchers would also like to thank Visionary Mentors, Child Line and God bless A frica as well as com m unity members who volunteered to become involved in the project.
It was thus necessary to m easure the le a rn e r's attitu d e and su b jectiv e norm s to determine intention and the possible behaviour towards sex.A questionnaire was used with the purpose of defining attitude and subjective norms o f the research subjects to determining beliefs or intention regarding sex and sexual behaviour.In a study of Unger (2000: Online) the Perceived Consequences o f Teenage Childbearing (PCTC) scale was used with the objective to describe high school le a rn e r's attitu d e tow ards teenage pregnancy.The P C T C -scale was however developed for older adolescents and only measured the consequences of adolescent pregnancy and parenting in the United States.A study by Prinsloo (2000:132 ) used a q u estio n n aire m easuring attitu d e tow ards sexual activities.Again the instrument was aimed at high school learners A new q u estio n n aire had to be developed that would be suitable for use with children under the age o f thirteen years of age.The School o f Nursing of the U niversity o f the Free State co llab o rated w ith m em bers o f the D epartm ent o f E ducation, n o n government organizations, faith-based organizations and community members, in the compilation of the questionnaire.Relevant concepts as identified by means of a thorough study of literature.These concepts, as addressed in the above mentioned instruments were included in the compilation of the final questionnaire that would determine the beliefs that form the attitude and subjective norms o f teenagers towards sexual activities and teenage pregnancy.Literature based questions was used to formulate further relevant questions.The questionnaire existed of questions ad dressing the issues o f b eliefs regarding

Figure 2 :
Figure 2: Distribution of age group per school (N=94)

Table 1 : Home language of learners
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