Qualitative findings
The overall aim of the TMP was to address psychological and social consequences of out-of-wedlock pregnancy and motherhood among unmarried teenage mothers in the Manafwa district by increasing unmarried teenage mothers’ decision making capacity and autonomy (agency) and by creating a supportive environment (opportunity structure). An inductive analysis of the qualitative interview findings resulted in five result areas: social norms, agency, coping, education, and income generation of the unmarried teenage mothers. In general, the ARDI staff, community based volunteers and community leaders reported in a more common and more positive way about the project’s results than the former teenage mothers did. The ARDI staff members estimated that approximately 60-80% of the 1036 participants in the TMP had been able to benefit from the project through continued education, increased economic benefits, improved relationships, and/or effective coping. Even though it appears that quality of life of a large majority of participants had improved after joining the project, the interviews data suggest that they also still had to cope with challenges such as lack of resources for school fees to continue education or lack of employment after finishing a certain level of education.
Social norms
Based on the interview data it seems that community norms with regard to the unmarried teenage mothers and the project had changed between 2000 and 2012, whereas norms with regard to out-of-wedlock sex and pregnancy had remained unchanged. It appears that before the project started, parents and community members and leaders generally had a negative attitude towards unmarried teenage mothers, influenced by deeply embedded cultural and religious moral beliefs regarding out-of-wedlock pregnancy and sex. The interviews seem to indicate that these beliefs did not change in the course of the project. For example, a pastor of a Christian church refers to out-of-wedlock sex and pregnancies as mistakes:
When somebody [unmarried teenage mother] has gone back to school and realises “This is what caught me to be helped and go back”, it changes that person completely and they learn from the former mistakes. Because at times we learn by mistakes, we learn by the Spirit, we learn by the word of God. (Male pastor of a Christian church)
However, the response of the pastor also illustrates that despite the disapproval of teenage mothers’ out-of-wedlock sexual behaviour, the norms with regard to the position of and future possibilities for unmarried teenage mothers seem to have changed. The interview data suggest that these norms have become less stigmatising and more supportive for the teenage mothers. Instead of encouraging marriage and discontinuation of the girl’s education after out-of-wedlock pregnancy, it seems that parents had become increasingly supportive of delayed marriage and continued education. One of the former teenage mothers explained:
I used to feel that I am already second hand, why should I go back to school? Even my mother told me to get married. You know what happens in a polygamous family, when you get pregnant you get married. […] That project really helped me, even my mum got encouragement from it. Coz’ those people told her to take me back to school. Without, she had left me to go and get married because I was pregnant. (Former teenage mother, 23 years old, married)
However, the interview data also give the impression that not all community members, leaders, peer youth and parents had changed their opinion and behaviour. A school head master reported:
Then there are peer groups. Some have these insulting words: “You are married, what are you doing in school?” Because of that fear, some of them are abandoned. […] So they are pointing: “Look at that girl, she delivered, now what is she still doing?” […] It is believed that when she produces, her life has ended. So that societal attitude may again discourage those ones to continue to be in class. (Head master secondary school)
A first step towards change in social norms appeared to be the involvement and consultation of influential community leaders in finding solutions for problems in the community, out-of-wedlock pregnancies being one of them. This included awareness raising about the magnitude of the problem and convincing community leaders of the need to jointly support unmarried teenage mothers. Initially, the community leaders were resistant and it required considerable efforts to convince community leaders of the need of the project. The interviews indicated that the change of norms had been a lengthy process:
This particular project, the goats project, has opened people’s eyes. To really identify a problem that looked like it was hidden. People would not really come into realisation of this problem. […] And now, whatever the case, people are slowly, slowly coming to realisation, they are thinking ‘Eh, I think we have to do something about that’. (Male ARDI social worker)
The initiative of three governmental leaders to support teenage mothers support groups with a plot of land or a venue for their activities can be interpreted as an indication that attitudes of at least some of the governmental leaders had changed. Once influential community leaders were supportive to the project and its approach, they were increasingly involved in community sensitisation. The goats giving ceremonies appeared to be a significant strategy to sensitise the community. It seems that testimonies of parents of ‘successful’ unmarried teenage mothers about their own coping process were among the effective strategies to influence other parents. An ARDI staff member reported about a goats giving ceremony:
There was one of the mothers of the children who succeeded. She came and talked here, before the rest of the people, and gave testimony of how she has supported this girl and how she is now very proud of her daughter. She was given time to really talk and I was really very impressed with her speech. And everybody was really listening. And of course those were now new parents and new girls and they were really listening. […] And now the girl is really a hope for the entire family. And I feel that those stories are really inspiring. (Male ARDI social worker)
It was reported that in later phases in the project, community norms also seem to have changed because of the successes of various teenage mothers in education and income generation.
Agency
The interviews give the impression that decision making freedom of unmarried teenage mothers in the TMP has to certain extent improved. It seems that particularly as a result of changed social norms and increased social support, continued education, and income generation, teenage mothers gained more freedom to do whatever they needed to do to achieve their goals (agency). It seems that improved self-confidence and improved autonomy had contributed to increased agency. It appears that self-confidence of teenage mothers generally had been very low during pregnancy and early motherhood, but that this had improved as a result of counselling, participation in the teenage mothers’ support groups and a more supportive environment. The section about coping further describes how belonging to a group contributed to their level of coping and self-confidence. Confidence of teenage mothers was also reflected in their capacity and responsibility to be an example for other teenage mothers and their parents. A former teenage mother shared her vision:
You can see where I have reached: I am now in campus. And I can also advise others. I advise parents who have their girl who produce at an early age. I advise them to take them back to school. (Former teenage mother, 22 years old, unmarried)
On first sight it seems that teenage mothers’ autonomy had also increased, particularly as a result of continued education and income generation, providing them with financial resources and with knowledge and skills to take care of themselves. However, further analysis of the data suggests that teenage mothers also remained to be dependent on the decisions of their father or their husband. After asking whether she could take her own decisions, a former teenage mother reported:
I can. Though I still depend on my parents. But I can. […] Right now I take decisions myself, because I know what is good and what is bad. Generally I know what to do. (Former teenage mother, 22 years old, unmarried)
It seems that if teenage mothers’ goals correspond with the goals of their parents or husbands, there is no conflict. However, non-correspondence of goals can challenge teenage mothers to do what they need to do to achieve their goals. It appears that limited agency of teenage mothers strongly relates to the extent their social environment and other external factors were supportive. This is illustrated by an ARDI staff member:
In my view, there are limitations in these girls making decisions. Not because they can’t make decisions, but sometimes they are influenced by circumstances around them. For example, you may want to be a person of principle, but there are certain things that make you drop your principles. For example, hunger. Hunger can sometimes force someone change their principles. (Male ARDI social worker)
The general impression that agency of teenage mothers had increased as a result of the project, was reflected in stories about improved care for their child, marriage with ‘better’ husbands, continuation with education and prevention of early marriage and of transactional sex. Increased agency of teenage mothers seems to strongly relate to the extent they were able to generate their own income to care for their child, to pay their own school fees, and to purchase daily necessities. Increased agency also seemed to be related to the extent teenage mothers could decide when and whom they would marry. It appears that female teenagers who were better educated were more attractive for males, giving the teenage mothers more opportunities to choose a husband. The interviews indicated that this also increased the chance to get married to a husband who would care well for them and to a more equal relationship. One of the former teenage mothers reported:
I gave birth in 1999, but through counselling and sensitisation, I managed to stay without giving birth for a long time, until I gave birth to Rose in 2004. And out of that I have managed to look for a husband who can take good care of me. […] And out of that, I have been able to go back to school. And now I earn my own money. (Former teenage mother, 32 years old, married)
According to respondents (community leaders, community based volunteers and ARDI staff), the number of early marriages and first and secondary pregnancies among teenage girls had decreased. The interviewed former teenage mothers attributed these declining figures to a decrease in (transactional) sex, which in turn would be a result of increased economic autonomy. One of them reported how increased income generation can prevent transactional sex:
When you are employed somewhere, even if you get little amount of money, it can help you. You can be getting 200,000 shillings [i.e., US$ 78], you are able to buy clothes and take care of your child. But if you don’t have anything, you cannot be okay, because you will be overthinking about how to make life go on. Because it is through those challenges that someone can get problems in the process of making ends meet, like having sex to get some money. Yet, he will end up giving you only 1,000 – 2,000 shilling [i.e., US$ 0.38 – 0.78]. So it is better I get something to do for myself than depending on someone. (Former teenage mother, 27 years old, boyfriend)
Finally, it appears that the element of the TMP whereby individual, marginalised, teenage mothers were brought together into a visible group of connected people, had been a crucial factor. The teenage mothers had become visible in a positive way through registration of a majority of the 52 support groups as community based organisations, in media stories and during community gatherings such as the goats giving ceremonies. Their visibility as a group of generally successful community citizens seems to have contributed to more supportive social norms and to the collective power and in turn collective and individual agency of the teenage mothers. The community elder reported about this:
These child mothers, like some of them had lost hope, they had no future. But those few recently, who changed their minds and went back to school, and have completed their schools, they are leaders. And I think that is the most significant change that we have seen around […]. They decided to go back to school, they have completed their school. I think that is the biggest achievement. Because somebody who was, who would be useless, is now a leader (Community elder).
Coping
The interview data and lifeline histories give the impression that many unmarried teenage mothers had to cope with great emotional turmoil as they strived to cope with pregnancy, delivery and early motherhood, a changed future perspective, lack of support of the father of the child, stigma of community members and peers, and negative responses of their parents. The lifeline histories showed that the period between discovery of their pregnancy and their introduction to the TMP, had been among the most difficult periods in their lives. See for example the lifeline history in Figure
1. Between discovery of the pregnancy and enrolment in the TMP, the ARDI staff and community based volunteers provided emotional support and counselling to the a number of female adolescents and their parents. The monitoring data showed that the average time between delivery of the child and full participation in ARDI’s activities had been 10 months. This was partly a result of shame to become visible in their community as an unmarried teenage mother. One of the former teenage mothers reported in her lifeline history about the period just after her pregnancy:
I got that pregnancy in 1999. So that is when my life changed to be upside down. I wanted to abort but I had no advice about abortion. And my mother noticed it and told me ‘Don’t do anything’. But my life changed completely knowing that now I will not join school, I am now no longer still a girl. I am now a mother until I came to produce that girl. Now, the baby was sick and I had no help. Because the man, the pregnancy was just like accidentally. The man was not willing to help me. The man sometimes says that that baby is not his’ and he keeps on denying. (Former teenage mother, 29 years old, married)
The interviews give the impression that the TMP has contributed among a majority of teenage mothers to effectively cope with the abovementioned challenges. The ‘advice of ARDI’ (counselling by counsellors and volunteers) and the teenage mothers groups were mentioned as important contributions to their coping capacity. The interviews suggest that teenage mothers felt taken seriously, listened to and treated as a valuable person by the ARDI staff and volunteers. It appears that teenage mothers shared their feelings and experienced that they mattered to others, which seems to have increased their self-confidence. Before they joined the TMP, most teenage mothers did not belong to the group of adult women, nor to their fellow non-pregnant peers, whereas participation in the project resulted in belonging to a group of unmarried teenage mothers. One of the former teenage mothers reported:
Having this education, like counselling meetings and income generating activity meetings, have helped me change my life and I have learned a lot. (Former teenage mother, 32 years old, married)
It appears that the attitude and behaviour of parents had been an important determinant of teenage mothers’ emotional turmoil as well as in their effective coping. Parents either contributed to or inhibited teenage mothers’ well-being by either expelling them from home or allowing them back, by allowing them to delay their marriage, by giving them emotional support and forgiveness, and by providing them support in motherhood, income generation, and continued education. It appears that counselling of the parents as well as role model examples of other parents had been interventions that contributed to changed attitudes and behaviours of parents. One of the former teenage mothers reported:
I felt bad and I stayed home for a whole year. And even after delivery I did not feel the joy of having a child. It was not until the ARDI people started counselling me that I started feeling that life is a little fine. The counsellor from ARDI talked to me personally and I felt okay. I was given a goat from ARDI and they also talked to my parents to take me back to school. And my parents accepted and took me back for the nursing assistant course and I joined. So I was happy. (Former teenage mother, 24 years old, not married)
The father of a teenage mother explained how the TMP had encouraged him to change his behaviour:
As a parent I got annoyed, of course, I got shocked and decided to leave her for a full year at home as a punishment. […] And through ARDI programme I also got some guiding and counselling. […] In case it is a mistake, we should not regard them as mistreats or as wastage. But they are people. In case they listen to your advice as a parent and go back to school, you give them some support. (Father of a teenage mother)
However, it appears that a small proportion of teenage mothers found it difficult to cope with their new situation and applied ineffective coping strategies such as early marriage and transactional sex. Even though it appears that the number of early marriages gradually declined since the start of the TMP in 2000, ARDI staff members estimated that around 30-40% of the 1036 participants had married at an early age, some with the father of the child. Teenage mothers either decided themselves to get married or their parents encouraged them to get married. For example, one of the former teenage mothers reported:
It was difficult to take care of the child and I needed a helper. So I decided to get married. […] That child doesn’t belong to this man, that doesn’t help so much. But I decided to get married on my own. (Former teenage mother, married, 29 years old)
Despite the emphasis of the TMP on economic autonomy and on parental support, it appears that transactional sex has remained a coping strategy of a minority of teenage mothers who were in financial need. The social worker explained that some teenage mothers who were in boarding schools were sometimes not sufficiently financially supported by their parents and some of them used transactional sex to sustain their living.
Education
All respondents unanimously perceived teenage mothers’ continued education as the project’s most significant change, because of the large number of teenage mothers who returned to school, and its positive effects such as increased autonomy, self-confidence, and income generation. A school head mistress illustrated this change:
The Teenage Mothers Project has helped teenage mothers to go back to school. Which is very good, because prior to that you would find that once a child gets pregnant, that is the end of the education. So it has created that sensitisation in the community that even giving birth to a child is not the end of the education. […] I have seen girls that have dropped out of school, being able to come back to school. Which means that the environment, the mentality that they were having, has changed. (Head mistress secondary school)
The monitoring data indicated that up to March 2012, 65.4% of the 1036 participants in the TMP had returned either to primary or secondary school. The data showed that a large majority had completed at least primary education and that 94 teenage mothers (9.1%) had attended vocational skills training, such as tailoring or administrative courses. Table
2 provides an overview of teenage mothers’ highest level of education.
The interview data indicated that the extent to which teenage mothers had continued education, seemed to depend on teenage mothers’ motivation, support of their parents, social norms regarding education, and the school environment. It appears that a majority of teenage mothers was motivated to continue education, determined by their goal to take good care of the child, the observation of other teenage mothers who had succeeded in school, their level of self-confidence and self-efficacy, and their increased awareness of the value of education because of the experience being expelled from school. It appears that stigmatising behaviour of peer students in the schools was one of the factors hampering teenage mothers’ motivation to return to school (see the section ‘1. Social norms’). Various activities in the TMP seem to have contributed to their motivation, of which individual counselling (‘advice’) was most frequently mentioned. A community based volunteer reported:
The girls in my group that I have seen, have taken my advice and they have gone back to school. I feel I am very proud of them and I feel the work I have done is not a waste of time because they listen and yield to advice. The success of these girls has helped me reach out to other parents. My work is easy because they now believe that giving birth at home is not the end of every good thing, they can still achieve more if they are supported. (Female community based volunteer)
However, it appears that not all teenage mothers had been motivated to continue their education, as was illustrated by a school head mistress:
Okay, I have known of examples, like of recent, a girl was here in this school. She had reported back from school. The environment under which she was living is a privilege. The parents wanted her at school, but herself she has opted to go and marry; her own decision. Not that her parents were talking her out of home. (Head mistress secondary school)
Parental support seemed to be the most important factor determining teenage mothers’ continuation with education. Their support included financial support (school fees, school uniforms, school lunches, stationary) and childcare support when their daughter attended school. It appears that the level of support varied among parents, largely depending on their attitudes towards education of unmarried teenage mothers. Parents had to choose between marriage (and receiving dowry) and providing support for education, partly influenced by community norms. The respondents indicated that the attitudes and behaviours of parents had changed as a result of family counselling, follow up visits to their homes, changed community norms with regard to continued education, and good performance of teenage mothers in school. One of the former teenage mothers described how her parents responded when they found out she was pregnant, and how they had changed as a result of counselling and her own efforts:
Now, when they found out I was pregnant, my parents lost hope in me, especially my dad. He felt like sending me away from his home because he felt I was disobeying him and that I was not seeing the value of education. […] John is the one who came up to home and talked to my dad. […] They called me and asked me if I wanted to go to school. I said “Me, I want”. He said “It is ok, but now who will take care of the kid?” But still I said “Me, I will go”. And my mum said “I will take care of the kid”. When the results came back, I had passed and I was very happy. It also gave him the morale that I was serious there. (Former teenage mother, 22 years old, unmarried)
It appears that parents who did not support their daughter’s education either did not perceive this as a priority or lacked sufficient financial resources. The interviews provided numerous examples of teenage mothers who had not been able to continue education because their parents lacked resources to financially support them.
The interview data suggest that a supportive school environment has contributed to continued education of many teenage mothers. According to ARDI staff, awareness raising and persuasion of school administrators had changed their attitudes and allowed unmarried teenage mothers to return to school. A school head master reported about his changed attitude and behaviour:
So in the course, they asked at the school ‘Can you allow them to continue?’ So I said, ‘One, our problem is that these are the problem students, who are supposed to be in class. So now when they are mothers, it may be difficult’. But with the effort and their advice, we now allow them to become part of us, back to students’ life. But we caution them that once in school, they remember that we do not allow them to be a mother again. (Head master secondary school)
Income generation
The TMP also seems to have contributed to increased income generation by the teenage mothers, through individual and collective income generating activities. Individually, teenage mothers had generated income through goat keeping, business or employment. One of the former teenage mothers explained how effective goats’ management had enabled her to exchange goats for a cow:
The goat grew and it produced. Although it was in bad health, I tried with my small money. I treated it, it grew, it produced and I got my cow now. I exchanged that cow to a female cow and I got a calf. Yah, it has helped because I can now sell that calf. I can pay for my girl. […] This cow can produce milk and I sell. If it produces much and I sell and it remains, my child takes some of it, also to support their health. (Former teenage mother, 29 years old, married)
It appears that parental support was conditional for the success of goats rearing as they were co-responsible for the goat, often located at their property. Parents and teenage mothers with goats’ management knowledge and skills appeared to be more successful in goat management and income generation. A community based volunteer illustrated this:
Some parents are generally good and when the girls get the goat they protect it. And even when the girl has gone to school they feed the goats. While other parents are bad. Immediately the girl gets that goat, they sell it and use it for personal reason. And some do not feed the goats when the girls are in school. So you find that those with support are more successful than those without support. (Female community based volunteer)
It was estimated that approximately 15% of all the provided goats had died or was sold because of (urgent) expenditures such as health care or medicines. However, according to ARDI staff members, these numbers had gradually declined in the course of the project as a result of more intensive monitoring, a Farm Africa goats management training to ARDI staff and volunteers, and goats management contracts between ARDI, each new project participant, her parents and the respective village leader.
Collective income was generated through a variety of activities by the teenage mothers support groups, including pharmacy management, bee, poultry, cattle and pig farming, sale of local snacks or coffee plant seedlings, and cultivation and sale of tomatoes, maize and onions. Out of the 52 support groups, 13 groups had been actively involved in income generation and generated approximately 200,000 shillings (US$ 76) per year. The groups had independently initiated these activities by a small financial investment by each of the group members. Once the activities were successful, ARDI reinforced this by providing in kind support such as seedlings. A community based volunteer reported:
Whenever we plant onions we get money, in fact good money, out of it. And we buy maize and currently we have stocked it in here in our store. Now after some time we sell, if we get a girl who has failed to raise enough for school. And we make our contribution and we equally help their young ones in terms of treatment when the mothers are away for school. (Female community based volunteer)
The interviews seem to suggest that the success of the income generating activities mainly depended on the leadership of the community based volunteers, on the commitment of the teenage mothers, and the support of the community members and leaders by providing groups with a piece of land or venue.