Conflict and care in sexual and reproductive health services for young mothers in urban South Africa

Abstract

In South Africa, sexual and reproductive health services aim to facilitate access to and utilisation of care to young people. We draw on narrative interviews with 45 young mothers and six health care providers delivering sexual and reproductive health services at an urban health centre, to understand how young mothers experienced services in relation to ante- and post-natal care, including termination services. Although health care providers emphasised what they considered young women’s ‘ignorance’ and ‘irresponsibility’ as central to early and unintended pregnancy; they also expressed their sympathy and concern. In a resource-limited health care setting, with health system inefficiencies and lack of specialised training, there was little opportunity to deliver high-quality care to young women. We draw attention to the need to prioritise the training of health care providers to expand early pregnancy testing and termination services and to deliver patient-centred family planning services to young women.

Keywords:

• Early motherhood
• termination of pregnancy
• youth-friendly services
• South Africa

Acknowledgements

We thank all the participants in the study, particularly the young women who shared their stories. Health care providers at the community health centre supported recruitment for this study, provided the space for interviews in the crowded health centre and shared their personal experiences during their busy and demanding work schedules. We also thank the Gauteng Province Health Research Committee and the Johannesburg Health District Research Committee for permission to conduct this study.

Disclosure statement

No potential conflict of interest was reported by authors.

Additional information

Funding

This work is based on the research supported in part by the South African National Research Foundation [Grant Number: APDS 170526233617] and a Centre of Excellence in Human Development NRF Accelerator Grant. ‘Changing Family Structures and Care in South Africa’ (PI: Lenore Manderson).