Abstract
BackgroundThe South African legal and policy framework for sexual and reproductive healthcare provision for teenagers is complex.ObjectiveThe article outlines the dilemmas emanating from the legal and policy framework, summarises issues with implementation of the legal and policy framework in practice, and summarises recent changes to the law.MethodsIn-depth analysis of the legal and policy framework. Training workshops with a purposive sample of nurses and other healthcare providers in the Western Cape.FindingsTensions between consent and confidentiality imposed by the Termination of Pregnancy Act, the Children’s Act, the National Health Act and the Criminal Law (Sexual Offences and Related Matters) Amendment Act render conflicting obligations on healthcare providers. Healthcare providers’ experiences with service provision in this context show that the conflicting roles they inhabit render their service provision to teenagers more challenging.ConclusionHealthcare providers need to learn about their legal obligations surrounding adolescent sexual and reproductive health services.
Highlights
In October 2013, the Constitutional Court delivered judgement in the so-called Teddy Bear Clinic Case, which challenged the constitutionality of provisions of the Sexual Offences Act (Criminal Law [Sexual Offences and Related Matters] Amendment Act 32 of 2007) relating to adolescents
The provisions in question directly implicated sexual and reproductive health (SRH) care providers because they criminalised a very wide range of consensual sexual activity between adolescents aged 12–15 years, including kissing on the mouth, hugging, sexual touching and sexual intercourse. These provisions created mandatory requirements for ‘anyone’ with knowledge of consensual sexual activity to report this to the police, who were required to refer the case to the National Prosecuting Authority for a decision on how to proceed
This means that, when faced with a teenager who wants to access contraception or other SRH services, healthcare providers are faced with a tricky choice between providing services and reporting the teen
Summary
In October 2013, the Constitutional Court delivered judgement in the so-called Teddy Bear Clinic Case, which challenged the constitutionality of provisions of the Sexual Offences Act (Criminal Law [Sexual Offences and Related Matters] Amendment Act 32 of 2007) relating to adolescents. As well as the Sexual Offences Act 32 of 2007 (Republic of South Africa 2007), which says that children may only freely consent to sex at 16 years of age, regulate aspects of teenagers’ access to health care and sexual and reproductive rights and specify obligations and responsibilities of healthcare workers who provide SRH services to teenagers.
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