Teenage Contraceptive Needs in Urban South Africa: A Case Study

This study explored qualitatively the needs of urban teenagers for sexuality education and contraceptive services in South Africa and problems encountered in accessing family planning (FP) services. Data were obtained from adolescents who used 4 FP service delivery points (SDPs) in urban Gauteng province and from providers in 1995. Information was collected from direct observations informal discussions focus groups and administrative records. Findings indicate that 3 of 4 clinics were suitable for serving teenage clients. Service at the first visit included a medical and reproductive history intake physical examination determination of needs sexuality and contraceptive education and counseling. Contraceptives were distributed at all sites. Nurses discussed side effects. All SDPs posted literature on FP sexually transmitted diseases and AIDS. Two centers had more complete walk-in services. The other 2 centers were more formal. One site was at a university where contraceptive choice was limited. All SDPs had adequate equipment. Clients expressed interest in facts. All but 1 SDP viewed clients favorably. Most teenagers were unmarried students and preferred hormonal methods especially injectables. Focus groups revealed communication difficulties with parents. Boys assigned responsibility for contraception to girls. Males were more regular clients. Most visited clinics after sexual relations began. Teenagers preferred separate services for youth. Most viewed teenage pregnancy as a disaster. Policy toward FP and teenagers changed after this study was conducted.