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By Anastasia Moloney SAN SALVADOR, May 2 (Thomson Reuters Foundation) - Rape at the hands of relatives and a lack of sex education are driving pregnancies among girls in El Salvador, which is struggling to stem one of the highest rates of teenage pregnancy in Latin America, according to a top health official.

More than a third of all pregnancies in the Central American nation are among girls aged 10 to 19, and girls as young as 9 have become pregnant, said Deputy Health Minister Eduardo Espinoza.

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"But the issue is before teenagers get pregnant and that's to do with school." He defended the government's record, however, saying access to health services has been expanded nationwide since 2009, including free contraception.

El Salvador's waves of emigration also has played a role, the minister said.

Around three million Salvadorans live abroad, mainly in the United States, many of whom fled the country's 1980-92 civil war and more recently gang violence.

This has left broken families and untended children, Espinoza said.

Espinoza said stepped-up efforts to stem teen pregnancies need to be taken by the ministry of education.