Harmonizing protection and rights: A review of age of consent policies in Eastern and Southern Africa

Introduction: Adolescents in Eastern and Southern Africa (ESA) remain disproportionately affected by HIV, early pregnancy, and gender-based violence. Age-of-consent laws critically shape access to sexual and reproductive health and rights (SRHR) services, yet regional legal frameworks are often inconsistent, restrictive, and discriminatory. Understanding these frameworks is essential for guiding rights-based policy reform. Methods: A narrative desk review was conducted between March and July 2025, synthesizing peer-reviewed studies, policy documents, and regional reports. The review examined age-of-consent laws governing sexual activity, HIV services, contraception, and abortion, identifying legal gaps, enforcement challenges, and areas of reform. Results: Significant heterogeneity was found across ESA. Many countries retain restrictive laws or parental consent requirements that deter adolescents from accessing SRHR services. South Africa has among the most progressive abortion laws, while Zimbabwe’s adoption of WHO-aligned guidelines signals emerging reform. However, barriers such as stigma, misinformation, and provider bias persist, limiting service utilization even in supportive contexts. Few countries include close-in-age exemptions, and weak enforcement further undermines adolescent rights. Conclusion: ESA’s fragmented legal frameworks continue to constrain adolescent SRHR. Reforms must balance protection with recognition of adolescents’ evolving autonomy. Policy implications: Policymakers should harmonize age-of-consent laws, lower thresholds for HIV services, introduce close-in-age exemptions, and ensure confidential access to contraception and abortion. Strengthening comprehensive sexuality education, combating stigma, and aligning laws with human rights standards are crucial to reducing HIV infections, early pregnancies, and maternal mortality across the region.