Abstract
BackgroundWe use the ‘candidacy framework’ to describe adolescents’ and young people’s (AYP) experiences of health services in a rural KwaZulu-Natal district, South Africa.MethodsA qualitative approach was used including group discussions, in-depth and key informant interviews with a purposive sample of AYP (n = 70), community leaders (n = 15), school health teams (n = 10), and health service providers (n = 6).ResultsFindings indicate tacit understanding among AYP that they are candidates for general health services. However, HIV stigma, apprehensions and misconceptions about sexual and reproductive health, and socio-cultural views which disapprove of AYP pre-marital sex undermine their candidacy for sexual and reproductive services.ConclusionConsideration and understanding of the vulnerabilities and reasons AYP exclude themselves will inform interventions to address their health needs. AYP’s participation in the design of health services will increase their acceptability and encourage uptake of services.
Highlights
We use the ‘candidacy framework’ to describe adolescents’ and young people’s (AYP) experiences of health services in a rural KwaZulu-Natal district, South Africa
We found that the socio-cultural perspectives and moral dimensions which are more pronounced in Human immune-deficiency virus (HIV) and Sexual and Reproductive Health (SRH) services with the younger unmarried AYP, make them feel embarrassed and discouraged them from utilising these services [10, 13, 19, 31]
Our findings suggest that integrating HIV and SRH into primary health care services has the potential to encourage the uptake of HIV and SRH services in settings where stigma and socio-cultural norms undermine AYP’s candidacy to seek health services
Summary
We use the ‘candidacy framework’ to describe adolescents’ and young people’s (AYP) experiences of health services in a rural KwaZulu-Natal district, South Africa. In many African countries, challenges in persuading adolescents and young people aged 10–24 years (AYP) to engage with health services have been reported [1,2,3]. In South African studies on health service utilisation among AYP, the potential for HIV stigmatization at the point of delivery, and other health system factors, continue to pose challenges and limit AYP’s uptake of health services. These factors, which include distance to health facilities and long waiting times, are compounded by staff shortages and negative healthcare provider attitudes [3, 10,11,12]. Improving our understanding of the vulnerabilities and likely points of exclusion for AYP who are in contact with the health system will inform improvements in healthcare provision and should lead to improved health outcomes
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