Adolescent girls’ experiences and health care workers’ perspectives on sexual and reproductive health services at urban public health care facilities in the Western Cape,South Africa

Abstract

Adolescent pregnancy is a pressing public health concern. In South Africa (SA), rates of unplanned pregnancy among adolescent girls are high and exacerbate social and economic challenges. Adolescents’ experiences of sexual and reproductive health services (SRHSs) may provide significant insights into the factors that affect access to these services. In this study, we explored factors influencing access to SRHS at two public health care clinics in urban areas of SA from the perspectives of adolescents and health care workers (HCWs). Participants were 11 adolescent girls (aged 15–17 years) and 5 HCWs. Data were collected between July 2019 and February 2020, using face-to-face semi-structured interviews. Interviews were conducted in English and transcribed verbatim. The data were thematically analysed using ATLAS.ti v8. Our findings suggest that some HCWs held firm views against premarital sex. However, these beliefs did not necessarily impact the care that they provided to adolescents. We found that adolescents demonstrate agency towards their sexual and reproductive health (SRH) education and service utilisation when supported by enabling factors, such as positive peer influence, parent–adolescent communication, and adolescent-friendly SRHS. Adolescents are thus motivated to access SRHS if the clinic environment fosters comfort and respect. While HCWs play a crucial role in shaping these experiences and ultimately influence whether adolescents return to access SRHS, multi-level interventions are needed to optimally support adolescents’ access to SRHS within the country.