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South Africa: A New Chapter For Sexual Health Services is Needed



In rural South Africa, how do we ensure inclusive and equitable quality sexual education that promotes lifelong health and support?

Join The Conversation

Padlet is a platform that allows people to have real- time conversation about a topic before, during or after the conference. I am using Padlet to encourage viewers to ask questions, share ideas or give comments.

The main question of this Padlet is: Why is sexual health education important for young adults? Feel free to add any other ideas, questions or comments.

HERE is the link to the conversation and the code is: mj6hzcetayfj

To access this padlet from your tablet or phone, scan this code from the padlet mobile app.


About the Sustainable Development Goals

SDG 1: End poverty in all its forms everywhere

Ending poverty requires several universal protection and support systems which aim to provide security for all individuals throughout all stages of life. The social issue that I’ll be addressing for this Catalyst Conference requires targeted measures to reduce vulnerability of getting sexually transmitted infections (STI). Providing quality sexual health education to young adults in South Africa requires educators to specifically address the risks of sexually transmitted infections (STI) and specific actions and tools that can reduce this risk. In order to eradicate the burden of STIs and HIV in South Africa, programs need to target underserved areas and issue within the country. For my project I focus on KwaZulu Natal, the province with the third highest poverty measure in South Africa.

SDG 3: Ensure healthy lives and promote well-being for all at all ages

In South Africa many young adults are still suffering needlessly from preventable diseases. Far too many infants are born with curable STIs and other preventable infections. Overcoming these diseases and ill health will require concerted and sustained efforts from the whole country, focusing on the young adult population group and the rural region of Kwazulu Natal who have been neglected.

SDG 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all

Many young women in South Africa lack the information needed to make informed decisions about their sexual and reproductive health and rights. Refocused efforts are needed to improve their quality of education. Disparities in education still run deep in rural areas of South Africa, and more investments in sexual health education infrastructure are required.

SDG 10: Reduce inequality within and among countries

Many girls in South Africa are kept out of school because of the patriarchal nature of South Africa society. Women occupy a lower social status than men and are socialized to work at home and be mothers. Progress will need to accelerate to reduce the growing disparities within South Africa and eliminate young women’s struggle in attaining quality education, especially when it comes to their sexual and reproductive rights.


Nearly 1 in 5 people living with HIV globally call South Africa home.

In South Africa, young women contact STIs and HIV at rates twice as high as young men.


The PROBLEM

South Africa’s burden of STIs is often neglected, especially among young people. In rural South Africa, there is an increasingly high burden of sexually transmitted infections and bacterial vaginosis. According to a study led by researchers from the London School of Hygiene & Tropical Medicine, “young women were more than twice as likely to be infected with chlamydia, and nearly twice as likely to be infected with genital herpes”.

Left untreated, STIs can cause lifelong health complications and permanent damage. Chlamydia, a curable STI, is a major cause of pelvic inflammatory disease, chronic pelvic pain and infertility. During the delivery of their baby, pregnant women can pass on this infection to the newborn, causing pneumonia and eye infections. In rural KwaZulu-Natal (KZN) where people’s’ health is often neglected due to impoverished conditions, these newborns are at risk for serious health problems.

KwaZulu Natal, South Africa

In KwaZulu-Natal, South Africa, school-attending women, ages 16-20, are at high risk of adverse reproductive health outcomes such at teen pregnancy, HIV, sexually transmitted infections (STIs) and female genital schistosomiasis (FGS). Various social and behavioural factors play a role in acquiring adverse reproductive health outcomes. Early sexual debut, multiple partners, and limited health education are associated with sexual health complications. One in three women aged 15-24 experienced an unintended pregnancy before the age of 20 and among females aged 15 to 24, HIV incidence is more than four times higher than the incidence of males in the same group.

The CAUSE

According to a report from Avert, “poverty, the low status of women and gender-based violence (GBV) have been cited as reasons for the disparity in HIV prevalence between gender”. Many young women in South Africa lack the information and resources needed to make informed decisions about their sexual and reproductive health and rights. In many areas in South Africa, talking about sex is very hard. Teachers, especially those in rural school, find it very difficult to talk about health because of cultural ideas of who has the right to speak about sex. Anthropologist, Nolwazi Mkhwanazi says, “It’s very different to teach sex education, including ideas around contraception. They [children] can’t get this information from nurses and hospitals either because of the same ideas.”

In KZN, pregnancy among school-attending women is very common, and about one third of young women have had a child by the age of 20. This impacts the mothers’ schooling, employment, earning and subsequently it also affect the child, who is born into poverty. In the absence of financial stability and parental care, young women are more prone to involve themselves in transactional sex or a sexual relationship with an older male partner. Transactional sex increases their risk of obtaining a sexually transmitted infection.

Intervention BEFORE transmission, not after

In rural schools in KZN, overall contraceptive use among young women remains low, which indicates that teenagers do not seek or receive this type of service from their local clinics. Even though contraceptives are available free of charge at public health care clinics, women living in rural areas may either not have a clinic nearby nor the funds to get to the nearest clinic. Vuyiseka Dubula, general secretary of Treatment Action Campaign says, “sex education has been greatly improved in recent years, but schools must go further by making condoms and health advice available on site”. Young women have to wait until after school to access health services but by that time, clinics are shut. If girls take time off school to go to the clinic, they may be turned away because of lack of resources or overcrowding. Implementing educational and health literacy programs, in addition to making health care facilities accessible may improve the health of young women.



“Implementing educational and health literacy programs, in addition to making health care facilities accessible may improve the health of young women”.

Hashini Nilushika Galappaththi-Arachchige

CALL TO ACTION!

There are two aspects to helping young men and women learn and seek treatment for safer sex. The first aspect involves action from the health service clinics and the second aspect involves school based programs.

In South Africa, there is a lack of interaction between the young women and health clinics. Many young women and men are either not able to reach health clinics or are turned away because of a problem with the staff ignoring government policy because it contradicts their own beliefs. Many teachers and nurses have strong cultural norms and therefore some refuse to supply birth control or STI treatment. Creating youth-friendly health services that are easily accessible to young people is an important factor to improve the health of young women.

Secondly, educational programs should be implemented to inform students about safer sexual practices prior to sexual debut. The average age of sexual debut in rural KZN is 16 years of age therefore, educational programs should be implemented before grade 10. Because of the non accessibility of health services to those living in rural areas, schools must become the bridge that connects young women and men to sexual health information and treatment. These adverse reproductive health outcomes can be prevented by early initiation of educational programs on puberty, sex and sexual risk behaviours prior to sexual debut (e.g. promote contraceptive use).

The need for sexual health services in schools is clear and urgent but implementation has been held back by a combination of policy gaps and resistance to these services on the local level. This means that the opportunity to protect the young school children from sexually transmitted infections and HIV has been missed.

My approach to catalyzing change focuses on the urgent need to reeducate and clear common misconceptions among parents, principles and teachers around what services should be offered in schools and why it is in the best interests of the children of South Africa that they support the access of these services. With parents, principle and teacher aboard, schools can go further by making condoms and health advice available on site, providing young adults, especially young women, with the information and resources necessary to make informed decisions.  

Children have the right to education and they have to right to health care services. By denying to give SRH services, we are robbing them of their rights. Youths should be educated and be able to access contraceptives without fear of being rejected or discriminated against.

Some people are against the idea of making contraceptives and SRH services more available to young adults but preventing teenagers from these resources won’t stop them from having sex. It will just drive them further away from services they need to protect themselves, leading to higher rates of sexually transmitted infections and unintended pregnancies.


Current programs in South Africa that are CATALYZING CHANGE

The Desmond Tutu HIV foundation has began a trail of the use of vaginal rings. These vaginal rings can be used for birth control by adding PrEP to the rings to reduce the risk of contracting HIV. Dr. Katherine Gill, a medical professional leading the trails at the Desmond Tutu HIV Foundation in Cape Town writes, “It’s a silicone ring and it’s impregnated with antiretroviral. If proven safe, it could avert at least a million HIV infections over the next 20 years”.

CLICK HERE to hear the story of Ziyanda Kamte!


Since 2013 the South African Department of Health will make condoms and health advice available on site at the schools. Through the introduction of eleven mobile health clinics, students will be able to test for HIV and other sexually transmitted infections. Vuyiseka Dubula says, “the plan is for everyone to know their status. We hope that this will change behaviour”. Mobile health clinics focuses on the delivery of world class health services to all underserves areas where there is a need for health care.

CLICK HERE to learn more about MHC vehicles.


Ibis Reproductive Health is an organization that strives to create a world where high-equality and reproductive health information and services are easy to access and affordable. In South Africa they aim to build a framework for evaluation and communication of sexual and reproductive health. In collaboration with the Ford Foundation, they address the socio-cultural norms underlying SRHR and HIV in order to “strengthen the agency of girls and young women”. Additionally, they provide opportunities that links SRHR and livelihoods of young women in order to strengthen both their sexual health resilience and their economic independence.

CLICK HERE to learn more about Ibis Reproductive Health

Take Action Now!

Global Citizen is a movement where people all around the world can publicly commit to taking action on various global issues. You can publicly commit to talking action by signing these petitions and urging world leaders to act.

Click here to learn more about Global Citizen.

Not One More: Help Global Citizen End Female Genital Mutilation

Sign the petition to urge world leaders to #LeveltheLaw by enacting and supporting the implementation of laws that protect girls and criminalize FGM. Help end this harmful practice for good.

SIGN HERE

Sign the She Decides Manifesto

By signing the SheDecides manifesto, you will join the thousands of people, companies, organizations and countries standing up to say we want a new normal: where every girl and woman, everywhere, can decide. Without question.

SIGN HERE

Tell World Leaders to Redouble Their Efforts By Amending Laws to Prevent Sexual Violence

Sign the petition urging governments to comprehensively look at their laws relating to rape, sexual violence and abuse.

SIGN HERE

Flipgrid QUESTION

Flipgrid is a platform where students can answer questions about a topic in video form. Once you post your response you can watch other people’s submission and make comments. Here is the class code: 186266c4

TOPIC QUESTION: Is school an appropriate environment for sex education?

HERE is the Flipgrid link

Join The Conversation!

Padlet is a platform that allows people to have real- time conversation about a topic, before, during or after the conference. I am using Padlet to encourage viewers to ask questions, share ideas or give comments to others’ posts.

The main question of this Padlet is: Why is sexual health education important for young adults? But feel free to add any other ideas, questions or comments.

HERE is the link to the conversation and the code is: mj6hzcetayfj

To access this padlet from your tablet or phone, scan this code from the padlet mobile app.


Meet the AUTHOR of this page!

Hello!

My name is Andoré Lategan and it should come to no surprise to someone that has read this article that I am from South Africa. I was born in Pretoria and lived there until I was 8 years old. In 2008 my family and I moved to Accra, Ghana and two years later, I moved to Dakar, Senegal. Africa will always be my home and I’ve found my passion for helping my community back in South Africa. I’m currently a senior at Singapore American School but I’ll be returning to South Africa in a couple months to continue my passion for medicine.

Please feel free to contact me with any questions or concerns!


MLA Citations

Through the making of my Catalyst Conference page I used a variety of resources such as news articles, research journals, videos and NGOs based in South Africa.

Here is the link to my MLA works cited document.

CONTACT ME!

lategan48356@sas.edu.sg

@andoreanna

Andoré Lategan

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COMMENTS: 2
  1. April 26, 2019 by Laura.Reysz Reply

    Andore, your passion for this topic shines through. I appreciate all the information you give and the many ways we can become involved. Well done!

  2. April 28, 2019 by Lauren.Elvrum Reply

    Andore, the resources, interactive pieces, and information that you have laid out in this project are all amazing! Great job!

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