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SAMRC UHC/NHI Forum: Power and policy-making process in a health system

The SAMRC UHC/NHI Forum is an open meeting for those interested in developments, learning and plans related to the Universal Health Coverage and the National Health Insurance in South Africa and globally.

This webinar covered policy-making processes within a health system and how policy actors use their power within context to influence policy change. We will discuss empirical evidence of how various policy actors used their sources of power to effect change within a health system.

Quarterly Outputs Report

The HERStory Series: “We can’t share things with our teachers”: narratives of mistrust and disconnect between South African female learners and their teachers

Summary  

  • Teacher connectedness – the level of connectedness between students and their teachers – can have a strong impact on the learning experience, and the health of students
  • The support that teachers can provide is not only academic, but can also be psychosocial or emotional support, with positive effects on students’ self-confidence and self-esteem, educational attainment, mental health and wellbeing.
  • Student-teacher relationships and connectedness can also impact the sexual and reproductive health (SRH) of adolescent girls and young wome

Resource Materials

The HERStory Series: Access, use, and perceptions of contraception services among adolescent girls and young women in South Africa

Summary

  • Adolescent girls and young women (AGYW) have high unmet need for contraceptives, particularly in sub-Saharan Africa (SSA).
  • In South Africa, about one in five women of reproductive age (15–49 years) have an unmet need for contraception, and among AGYW, there is an even higher unmet need (31%among adolescent girls aged 15-19 and 28% among young women aged 20–24 years).
  • The high unmet need for contraception among AGYW contributes to teenage pregnancy rates which are decreasing at a slower rate in South Africa compared to other developing countries.

The HERStory Series: Lessons learned from implementing a PrEP programme for adolescent girls and young women in South Africa

Summary

  • Daily oral pre-exposure prophylaxis (PrEP) is highly efficacious for HIV prevention.
  • Adolescent girls and young women (AGYW)  are regarded as a priority population in South Africa’s National Strategic Plan (NSP) for curbing HIV, TB and STIs: 2017–2022 and they have been prioritised for PrEP delivery in South Africa.
  • Numerous sociocultural, behavioural, structural and physiological factors contribute to the disproportionate HIV risk that AGYW in South Africa face.
  • There is an urgent need for effective female-initiated HIV prevention

The HERStory Series: Relationship Dynamics, Gendered Power, and Motivations for Condomless Sex Amongst Adolescents and Young People in South Africa

Summary

  • South Africa has high rates of HIV and teenage pregnancy amongst adolescent girls and young women (AGYW).
  • Condom use amongst adolescents and young people in South Africa is sub-optimal; only half of sexually active AGYW
  • 15-24 years old who participated in the survey reported using a condom at last sex.
  • Amongst South African adolescents and young people motivations for the use or non-use of condoms are gendered; sexual norms and masculinities influence condom use.
    • AGYW’s motivations for non-condom use include relationship sec

The HERStory Series: Addressing the intersecting vulnerabilities in mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa

Summary

  • Adolescent girls and young women (AGYW) in South Africa face substantial social adversities and related mental health challenges due to a range of sexual and reproductive health (SRH), social, economic, environmental, physiological and interpersonal factors
  • AGYW vulnerability towards early pregnancy, HIV infection and poor mental health are bidirectional and interconnected
  • The social context in which South African AGYW are situated is characterised by a lack of social support, economic insecurity, and stigma - exacerbating gendered and age-relate

The HERStory Series: Safe Spaces for adolescent girls and young women (AGYW) as part of combination HIV prevention programmes in South Africa: how accessible, feasible and acceptable are they?

Summary

  • Adolescent girls and young women (AGYW) often experience services provided in health facilities as unfriendly and unresponsive to their needs, and this is especially the case for HIV sexual and reproductive health (SRH) care, where they have substantial unmet needs.
  • Hundreds of Safe Spaces have been set up in sub-Saharan Africa including South Africa to provide HIV, SRH and social protection services to AGYW, especially those who are more vulnerable, and to overcome the barriers that limit access to HIV and SRH care.
  • Based on a survey among AGYW

The HERStory series: COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women

Summary

  • Prior to the COVID-19 pandemic, adolescent girls and young women (AGYW) in South Africa already faced a range of socio-economic, structural and environmental mental health stressors.
  • COVID-19 has increased household financial strain and food insecurity, which have in turn contributed to increased depression, anxiety and mental health issues.
  • Poorer communities in South Africa have borne the brunt of the burden of lockdowns, with restrictions disproportionately affecting those families and individuals already living in poverty, increasing unemploy
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