Using cellphilm-making as advocacy: adolescent girls’ access to reproductive health services in primary health care facilities in rural northern KwaZulu-Natal

Abstract

This paper reports on a qualitative study that employed participatory visual methods to understand how adolescents access contraception in a rural community of northern KwaZulu-Natal. We focus on a cellphilm, a short film recorded with a cellphone, produced by a group of adolescent girls to share their perspectives regarding the challenges they encounter when seeking reproductive health services at primary health care facilities. Harsh health care worker attitudes, sub-standard communication and the lack of confidentiality were significant barriers to adolescents accessing youth-friendly sexual and reproductive health services in this community. Entrenched socio-cultural beliefs on adolescent female sexuality underpinned judgement and victimisation of girls seeking contraception and antenatal care services. In efforts to contest health care providers’ moralistic attitudes and illuminate the consequences thereof, adolescent girls exercise their agency by creating a cellphilm for health authorities.

ACKNOWLEDGEMENTS

The authors deeply appreciate: (1) the participants who shared their views on this project; (2) Discovery Foundation (Reference: 038206) and University of KwaZulu-Natal UCDP fund for financial support; and (3) research assistant, Ms Zama Khanyile, for her incredible contribution during data generation. No financial interest or benefits have arisen from this research or the application thereof.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

SUPPLEMENTAL DATA

Supplemental data for this article can be accessed online at https://doi.org/10.1080/1472586X.2024.2307329.

Notes

1 The first author, aided by a female isiZulu-speaking research assistant, was responsible for data generation and interactions with participants. The co-authors were involved in the third phase of data analysis and editing the manuscript.

Additional information

Funding

This work was supported by Discovery Foundation and University of KwaZulu-Natal Capacity Development Programme (UCDP) Fund.

Notes on contributors

Nompumelelo Gloria Mfeka-Nkabinde

Dr. Nompumelelo Gloria Mfeka-Nkabinde is a dedicated professional with a wealth of experience in Family Medicine, actively contributing to medical education, research, and community development. Her research interests include adolescent sexual and reproductive health and health care systems.

Relebohile Moletsane

Professor Relebohile Moletsane J.L. Dube Chair in Rural Education, University of KwaZulu-Natal Professor Moletsane has extensive experience in educational development, curriculum studies, and other issues at the intersection of gender and education. She acted as the director of the Gender and Development Unit at the Human Sciences Research Council until 2010. She has authored several articles and books, with her publications concentrating on the applicability of digital technologies to quality education, developmental strategies, gender issues and poverty alleviation within rural contexts. Professor Moletsane received her Ph.D. and M.S. in Education from Indiana University Bloomington, and her B.Ed. from the University of Fort Hare.

Anna Silvia Voce

Professor Anna Silvia Voce has made several substantive contributions to the development and implementation of the District Health Management Training Programme and health system strengthening interventions. As an educator she has contributed to the development and subsequent revisions of the postgraduate programmes offered in the Discipline of Public Health, specifically to the Master of Public Health and to the doctoral programme. Her special expertise is in qualitative research methodologies and has ensured that qualitative research competencies are core for public health graduates. Professor Anna Voce has served in several academic leadership roles: as Assistant Dean for Postgraduate Affairs, Academic Leader of Teaching and Learning, Academic Leader of Research, and now as Dean of the School of Nursing and Public Health.