The right to health is enshrined in South Africa’s constitution. Specifically, Section 27 of the Constitution is titled, “Health care, food, water and social security” which states that –

Everyone has the right to have access to:

1. health care services, including reproductive health care;
2. sufficient food and water; and
3. social security, including, if they are unable to support themselves and their dependants, appropriate social assistance.

The constitution also states that, ‘The state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of each of these rights and that no one may be refused emergency medical treatment’.

The National Health Insurance (NHI) Bill is set to be debated in parliament soon, the NHI aims to ensure that all South Africans receive access to healthcare, for adolescents (teen health), the country is also guided by the 2017 National Adolescent and Youth Policy. Other policies which focus on youth health include the South Africa’s National Strategic Plan for HIV, TB and STIs, 2017-2022.

Despite key legislation and policies, the good intent has not translated to better quality healthcare for all South Africans including the youth. The healthcare system is in tatters, there are reports of alleged food shortages, water shortages and even long queues. The government prioritises adolescent health through, 1) school health services and 2) adolescent and youth-friendly services (AYFS). Across the world and in South Africa, at the ground level, teenagers may be afraid to seek healthcare in cases of teenage pregnancy and to access contraception for fear of their parents, communities and friends finding out. Other common issues are that youth are shouted at and youth are often at the receiving end of negative attitudes from health workers (e.g., nurses, and doctors) including being stigmatized. Often health facilities are far away, youth require transport money to access health facilities, or these health facilities are open during school hours.

The public health care system does not offer a full package of services which teenagers need, we tend to find services such as contraception, HIV, and TB but it’s tough to find mental health services or even sanitary pads or menstrual cups. The public health care system is outdated, you are unable to find the information you need online, to book an appointment, ask questions or even complain when you suffer discrimination in the system. At school if there is a nurse or a health care provider, they may not always be available, medications may not be available, and you may not know how to make an appointment or are even worried that your friends may find out that you’re trying to access healthcare services. The private sector in South Africa is more modern, for those who are able to afford it, you are able to visit a gym, earn points for being healthy, and buy your medication at pharmacies, but all of this is quite expensive and out-of-reach for most teenagers in the country.

These are all some of the main issues we need to rally around, we as young people cannot accept the poor quality of health care services, not when the constitution of this country points to the right to health, not when our youth health services are underfunded and of poor quality. We need a better health system, one that serves all populations including young people.

About the author: Dr Shakira Choonara is an award-winning public health practitioner and the 2017 Woman of the Year in Health in South Africa, she is also a Youth Commissioner for the Lancet Commission on Adolescent Health and Wellbeing. Tweet @ChoonaraShakira

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