Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South Africa

Background Fathers are intricately bound to the experience of adolescent mothers and their children. Yet, fathers of children born to adolescent mothers, particularly within the context of HIV, remain neglected in the literature. These exploratory analyses provide insight into the characteristics of...

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Main Authors: Colette Smith, Lorraine Sherr, Marguerite Marlow, Jane Kelly, Elona Toska, Lucie Dale Cluver, Janke Tolmay, Kathryn Steventon Roberts, Angelique Thomas
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e092723.full
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author Colette Smith
Lorraine Sherr
Marguerite Marlow
Jane Kelly
Elona Toska
Lucie Dale Cluver
Janke Tolmay
Kathryn Steventon Roberts
Angelique Thomas
author_facet Colette Smith
Lorraine Sherr
Marguerite Marlow
Jane Kelly
Elona Toska
Lucie Dale Cluver
Janke Tolmay
Kathryn Steventon Roberts
Angelique Thomas
author_sort Colette Smith
collection DOAJ
description Background Fathers are intricately bound to the experience of adolescent mothers and their children. Yet, fathers of children born to adolescent mothers, particularly within the context of HIV, remain neglected in the literature. These exploratory analyses provide insight into the characteristics of fathers of children born to adolescent mothers affected by HIV in South Africa.Setting Eastern Cape Province, South Africa.Design Cross-sectional data from a prospective cohort study.Participants Young mothers (10–24 years of age) and their children (0–68 months). All mothers completed detailed study questionnaires, including standardised and study-specific measures, relating to their self, their children and the fathers of their children. Summary statistics are presented based on maternal self-report of father characteristics. χ2 tests and t-tests (Fisher’s exact/Kruskal-Wallis tests, where appropriate) were additionally used to explore sample characteristics (including father characteristics, maternal experience and child characteristics) according to paternal age and father involvement in childcare (defined by responses to four maternal self-report questions). Father characteristics were also explored according to maternal HIV status and maternal mental health status.Results 40% of fathers were adolescents (10–19 years) at the birth of their children. Overall, father involvement was low (19.5%). Compared with noninvolved fathers, involved fathers were more likely to be older when their child was born (21 years vs 20 years, t=4.30, p=0.04), to be in a relationship with the mothers of their children (74.8% vs 47.2%, χ2=40.8, p≤0.0001), to reside with their children and their mothers (14.7% vs 3.7%, χ2=49.3, p≤0.0001) and to attend the first antenatal appointment (4.3% vs 1.5%, χ2=5.21, p=0.02). A quarter (25.4%; 227/894) of the adolescent mothers in the sample were living with HIV. The prevalence of maternal HIV was found to be higher among adolescent mothers of children born to older fathers compared with adolescent fathers (31.7% vs 15.9%, χ2=28.3, p≤0.001). Likewise, depressive symptoms were more prevalent among adolescent mothers of children born to older fathers compared with adolescent fathers (9.9% vs 5.3%, χ2=6.08, p=0.01). Adolescent mothers reporting poor mental health were less likely to be in a relationship with the fathers of their children (41.8% vs 54.1%, χ2=7.32, p=0.03) and more likely to experience domestic violence perpetrated by the fathers of their children (8.2% vs 3.3%, χ2=6.07, p=0.01) and to engage in arguments about finances with the fathers of their children (30.0% vs 17.0%, χ2=10.8, p=0.001). While some differences in individual subscales were identified, overall composite scores of child cognitive development did not differ according to father age or father involvement.Conclusions Analyses provide the first preliminary description of the fathers of children born to adolescent mothers affected by HIV in South Africa. Fathers are inherently tied to the experiences of adolescent mothers and their children. Father involvement with their children was low. Further research is required to explore the potential barriers to father involvement and pathways to overcome these. Efforts to bolster father engagement, such as the inclusion of fathers within maternal and child service provision, may have benefits for fathers, adolescent mothers and their children. There was a high prevalence of adolescent fatherhood in the study. Adolescent fathers may have specific needs requiring tailored intervention for adolescent parent families. The need for the inclusion of fathers within policy, programming and research remains.
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spelling doaj-art-7fb2ab3f30e5416da01a4ecf0c6f80f42025-08-20T03:15:42ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-092723Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South AfricaColette Smith0Lorraine Sherr1Marguerite Marlow2Jane Kelly3Elona Toska4Lucie Dale Cluver5Janke Tolmay6Kathryn Steventon Roberts7Angelique Thomas8Institute for Global Health, University College London, London, England, UKInstitute for Global Health, University College London, London, England, UKInstitute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, Stellenbosch, Western Cape, South AfricaCentre for Social Science Research, University of Cape Town Faculty of Humanities, Rondebosch, South AfricaDepartment of Social Policy and Intervention, University of Oxford, Oxford, England, UKDepartment of Social Policy and Intervention, University of Oxford, Oxford, England, UKDepartment of Social Policy and Intervention, University of Oxford, Oxford, England, UKDepartment of Social Policy and Intervention, University of Oxford, Oxford, England, UKCentre for Social Science Research, University of Cape Town Faculty of Humanities, Rondebosch, South AfricaBackground Fathers are intricately bound to the experience of adolescent mothers and their children. Yet, fathers of children born to adolescent mothers, particularly within the context of HIV, remain neglected in the literature. These exploratory analyses provide insight into the characteristics of fathers of children born to adolescent mothers affected by HIV in South Africa.Setting Eastern Cape Province, South Africa.Design Cross-sectional data from a prospective cohort study.Participants Young mothers (10–24 years of age) and their children (0–68 months). All mothers completed detailed study questionnaires, including standardised and study-specific measures, relating to their self, their children and the fathers of their children. Summary statistics are presented based on maternal self-report of father characteristics. χ2 tests and t-tests (Fisher’s exact/Kruskal-Wallis tests, where appropriate) were additionally used to explore sample characteristics (including father characteristics, maternal experience and child characteristics) according to paternal age and father involvement in childcare (defined by responses to four maternal self-report questions). Father characteristics were also explored according to maternal HIV status and maternal mental health status.Results 40% of fathers were adolescents (10–19 years) at the birth of their children. Overall, father involvement was low (19.5%). Compared with noninvolved fathers, involved fathers were more likely to be older when their child was born (21 years vs 20 years, t=4.30, p=0.04), to be in a relationship with the mothers of their children (74.8% vs 47.2%, χ2=40.8, p≤0.0001), to reside with their children and their mothers (14.7% vs 3.7%, χ2=49.3, p≤0.0001) and to attend the first antenatal appointment (4.3% vs 1.5%, χ2=5.21, p=0.02). A quarter (25.4%; 227/894) of the adolescent mothers in the sample were living with HIV. The prevalence of maternal HIV was found to be higher among adolescent mothers of children born to older fathers compared with adolescent fathers (31.7% vs 15.9%, χ2=28.3, p≤0.001). Likewise, depressive symptoms were more prevalent among adolescent mothers of children born to older fathers compared with adolescent fathers (9.9% vs 5.3%, χ2=6.08, p=0.01). Adolescent mothers reporting poor mental health were less likely to be in a relationship with the fathers of their children (41.8% vs 54.1%, χ2=7.32, p=0.03) and more likely to experience domestic violence perpetrated by the fathers of their children (8.2% vs 3.3%, χ2=6.07, p=0.01) and to engage in arguments about finances with the fathers of their children (30.0% vs 17.0%, χ2=10.8, p=0.001). While some differences in individual subscales were identified, overall composite scores of child cognitive development did not differ according to father age or father involvement.Conclusions Analyses provide the first preliminary description of the fathers of children born to adolescent mothers affected by HIV in South Africa. Fathers are inherently tied to the experiences of adolescent mothers and their children. Father involvement with their children was low. Further research is required to explore the potential barriers to father involvement and pathways to overcome these. Efforts to bolster father engagement, such as the inclusion of fathers within maternal and child service provision, may have benefits for fathers, adolescent mothers and their children. There was a high prevalence of adolescent fatherhood in the study. Adolescent fathers may have specific needs requiring tailored intervention for adolescent parent families. The need for the inclusion of fathers within policy, programming and research remains.https://bmjopen.bmj.com/content/15/7/e092723.full
spellingShingle Colette Smith
Lorraine Sherr
Marguerite Marlow
Jane Kelly
Elona Toska
Lucie Dale Cluver
Janke Tolmay
Kathryn Steventon Roberts
Angelique Thomas
Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South Africa
BMJ Open
title Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South Africa
title_full Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South Africa
title_fullStr Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South Africa
title_full_unstemmed Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South Africa
title_short Men matter: a cross-sectional exploration of the forgotten fathers of children born to adolescent mothers in South Africa
title_sort men matter a cross sectional exploration of the forgotten fathers of children born to adolescent mothers in south africa
url https://bmjopen.bmj.com/content/15/7/e092723.full
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