Breaking Barriers: Adolescent SRHR in SADC

Johannesburg, 27 March: Adolescent Sexual and Reproductive Health and Rights (ASRHR) remain a critical yet often neglected area in public health, particularly in the Southern African Development Community (SADC) region. While progress has been made, systemic challenges, including supply chain gaps, cultural resistance, and funding constraints, continue to hinder access to essential services for young people. The COVID-19 pandemic and emerging global health threats have further strained weak health systems, exacerbating inequalities.

South Africa’s launch of a cutting-edge mobile app to deliver adolescent and youth-friendly health services (AYFHS) marks a significant leap forward. Such digital tools bridge gaps in access by providing discreet, accurate information on contraception, sexually transmitted infections (STIs), and pregnancy prevention. This innovation aligns with global trends, leveraging technology to reach underserved populations, especially in remote areas.

Comprehensive Sexuality Education (CSE) empowers adolescents with knowledge to make informed health decisions. Despite resistance, some SADC countries have integrated CSE into their school curricula, equipping young people to navigate relationships and health risks. These efforts are vital to reducing adolescent fertility rates (AFR) and early marriages. In other countries, however, deep-seated cultural norms and political hesitancy hinder the implementation of Comprehensive Sexuality Education (CSE). Myths linking CSE to “promoting promiscuity” persist, despite evidence that CSE delays sexual debut and reduces risky behaviours. Resistance or ineffective approaches to CSE often perpetuate cycles of early pregnancy and child marriage, and a sluggish decline of adolescent birth rates.

Unmet needs for contraceptives persist in the region. According to data published in 2024 by Track 20, which assesses opportunities for family planning programming among adolescents and youth in Comoros, adolescents or youths in Comoros who use a modern method of contraception are 2% of all women, while adolescents or youth who have an unmet need for modern contraceptives are 7.3% of all women. This disparity highlights the need for targeted interventions to improve access to and education about modern contraceptives, addressing both supply and demand issues to meet better the reproductive health needs of young women in the region.

In South Africa, the Stop Stockouts Project (SSP) findings reveal that contraceptives are the most stockout-prone commodities in South Africa, leaving 31% of girls aged 15–19 and 28% of women aged 20–24 without access. Stockouts stem from supply chain inefficiencies, inadequate funding, and poor forecasting. Regional advocacy efforts are necessary to draw attention to contraceptive stockouts and promote accountability in supply chain management.

Emerging viruses and pandemic threats overwhelm underfunded health systems. Adolescents, already marginalised, face heightened barriers, clinics lack youth-friendly services, and providers may stigmatise young seekers of SRHR care.

Donor fatigue and shifting priorities, such as climate change and regional conflicts, pose a threat to ASRHR funding. The Global Gag Rule and anti-gender movements further restrict resources, leaving SADC governments to fill gaps with limited budgets.

Call to action for SADC Member States. 

To safeguard ASRHR gains and address challenges, SADC governments and stakeholders must act decisively by focusing on several key areas. First, it is essential to strengthen health systems. This can be achieved by investing in supply chains and adopting technology-driven solutions, such as AI for stock monitoring, to prevent stockouts of contraceptives. Additionally, training healthcare providers to deliver non-judgmental and youth-friendly services is crucial to ensure that all individuals receive the care and support they need.

Scaling up CSE and advocacy efforts is another vital step. This involves challenging misinformation by partnering with traditional leaders and the media to dispel myths surrounding CSE. Furthermore, it is essential to enact protections, such as enforcing laws against child marriage and mandating CSE in schools, to foster safe environments for young people.

In the wake of cuts in USAID funding, leveraging partnerships and innovation is also essential for advancing ASRHR. Mobilising domestic funding by allocating national budgets to ASRHR initiatives can reduce reliance on donor funding. Additionally, expanding digital tools, such as replicating South Africa’s app model across SADC and tailoring content to local contexts, can enhance access to valuable information and resources. Amid global health crises and funding cuts, SADC governments must champion ASRHR as a non-negotiable priority. By investing in youth today, the region can secure a healthier, more equitable future for all. The time to act is now.

(Kevin Chiramba is the Author of the ASRHR chapter in the 2024 Voice and Choice Barometer. This article is written in his personal capacity.)