EASTERN CAPE – The Eastern Cape Department of Health has recorded a sustained decline in teenage and child pregnancies and births across the province, but child protection experts warn that the figures may conceal a far more complex and troubling reality of abuse, inequality and underreporting.

According to provincial data for the 2025/26 financial year, births among girls aged 10–14 dropped significantly, falling from 553 in 2022/23 to 292 in 2025/26.

In the latest quarter, 54 births were recorded, below the target of 75. A similar downward trend is reflected among adolescents aged 15–19, with total births decreasing from 17,064 to 13,916 over the same period.

Health MEC Ntandokazi Capa has attributed the decline to strengthened multi-sectoral interventions involving the Departments of Health, Education and Social Development, alongside community partners.

These include expanded youth-friendly services, prevention programmes, and improved access to reproductive health support.

Experts warn decline may mask deeper crisis

However, child protection organisation Childline SA says the decline in numbers does not necessarily reflect a simple success story.

According to Okuhle Mdodana, Director at Childline SA in the Eastern Cape, teenage and child pregnancies remain driven by deep structural and social challenges, particularly in high-risk communities.

“Sexual abuse and statutory rape remain major drivers, with many pregnancies in girls under 16 resulting from coercion, grooming, or abuse by older men, relatives, or community members,” she shared.

Poverty, she added, increases vulnerability to transactional relationships and “blessers”.

Mdodana also pointed to broken family structures, absent parenting, alcohol abuse, and overcrowded households as key risk factors that reduce supervision and protection. In many communities, cultural silence and stigma continue to prevent disclosure of abuse.

“Poverty, unemployment, and limited opportunities push some girls into relationships for financial support, especially in rural areas like the Eastern Cape,” she said, adding that inadequate sexual and reproductive health education further compounds the problem.

While the department has described the decline as progress, Childline cautions against celebrating what it calls “reductions from crisis levels”.

“Thousands of children are still becoming pregnant every year, often as a result of rape or coercion. A decline in numbers does not equal success when the underlying drivers remain unchanged,” Mdodana said.

She noted that many cases still result in school dropout, trauma and long-term poverty, and that Childline SA continues to see high volumes of cases through its helplines.

Concerns have also been raised about whether the decline reflects real behavioural change or underreporting.

Concerns over systemic failures

Mdodana said official data often reflects only public health facility births, excluding home deliveries, private care, miscarriages, unsafe abortions or unreported cases due to stigma.

“In rural Eastern Cape communities, stigma often leads families to conceal pregnancies or avoid facilities,” she said. “The decline may reflect some real gains in awareness or services, but it likely underestimates the true scale of the problem.”

The organisation also raised concerns about gaps in statutory rape reporting and referral systems, despite legal obligations under the Children’s Act and Sexual Offences Act.

Mdodana said implementation remains inconsistent due to confusion among professionals, fear of stigma, and weak follow-up systems.

“Cases are often reported, but investigations stall due to shortages of social workers, overburdened courts, and limited SAPS capacity,” she said. “In many instances, pregnancies in minors are not automatically followed by robust child protection responses.”

Childline says it frequently encounters cases where abuse is suspected but not properly escalated, particularly in rural areas where services are limited.

Key systemic gaps, according to the organisation, include shortages of social workers, poor coordination between government departments, weak school-based prevention programmes, and limited mental health support for survivors. Persistent poverty and community silence further deepen vulnerability.

To address these challenges, Childline SA is calling for stronger enforcement of mandatory reporting laws, expanded prevention education in schools, and increased investment in child protection services.

The organisation also wants faster, coordinated multi-sectoral response teams for abuse cases, expanded youth-friendly clinics, and greater economic and parenting support for vulnerable families.

“Every child pregnancy, especially among young girls, reflects a failure of protection,” Mdodana said. “This must be treated as a national emergency, not just a health statistic.”

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