Research

Meeting the sexual and reproductive health needs of high-school students in South Africa: Experiences from rural KwaZulu-Natal

Janet A Frohlich, Nolunthando Mkhize, Rachael C Dellar, Gethwana Mahlase, Carl T Montague, Quarraisha Abdool Karim

Abstract


Background. Adolescents in South Africa (SA) have a huge unmet need for sexual and reproductive health (SRH) services. Integrating such services into schools may overcome many of the current barriers to access.

Objectives. We describe an SRH service model developed for high-school students and its implementation in 14 high schools in rural SA.

Methods. Following consultation with community and other key stakeholders about the demand for and acceptability of adolescent-targeted SRH services, a three-tier school-based model was developed that included: (i) in-school group SRH information and awareness sessions; (ii) in-school individual SRH counselling and customised HIV counselling and testing (CCT); and (iii) referrals to in-school fixed, in-school mobile or public sector primary SRH clinics.

Results. From October 2011 to June 2012, 70 consultative meetings were held. There was overwhelming support for the pilot founded on concerns about the high HIV prevalence and teenage pregnancy rates among adolescents in the community. SRH information was provided to 8 867 high-school students, 4 171 (47.0%) of whom accessed on-site CCT services for HIV. The gender-specific prevalence of HIV in these students was 3.3% (64/1 962) and 1.1% (24/2 209) for females and males, respectively. Two hundred and thirty-nine students (5.7%) were referred for clinical services at in-school fixed, in-school mobile or public sector primary SRH clinics.

Conclusions. The SRH service provision pilot was acceptable in the community and seems feasible for scale-up. Further work is required to understand inter-school variability in uptake, identify additional service needs of students, and characterise SRH demand dynamics.

Authors' affiliations

Janet A Frohlich, Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

Nolunthando Mkhize, Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

Rachael C Dellar, Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

Gethwana Mahlase, Zimnandi Zonke, 69 West Street, Pietermaritzburg, South Africa

Carl T Montague, Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

Quarraisha Abdool Karim, Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, USA

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Keywords

HIV; Sexual and reproductive health; Adolescents; High schools; Epidemiology

Cite this article

South African Medical Journal 2014;104(10):687-690. DOI:10.7196/SAMJ.7841

Article History

Date submitted: 2013-12-09
Date published: 2014-05-16

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