Abstract
Healthcare service provision for young people in South Africa is a complex landscape—balancing youth and human rights, numerous laws, legally and professionally mandated obligations, and a tenuous and resource-strained implementation context, all set against the backdrop of a highly charged and morally contested area of state-based service provision. Sexual and reproductive health services (SRH) are therefore a far-from-settled arena—either for the healthcare workers who provide services, or for the young people who need to access them. In straddling the divide between official policies and client claims, front-line service providers, so-called street-level bureaucrats, often become disdainful of the ‘ungrounded’ directives from lawmakers and politicians who are perceived as out of touch with implementation realities (Maynard-Moody and Musheno 2003). These conflicts are compounded in neo-Liberal environments of limited infrastructure and resources, such as the South African public health system.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsNotes
- 1.
Afrikaans is one of South Africa’s 11 official languages, and is widely spoken in the Province in which the fieldwork was undertaken.
References
Abrahams, N., S. Matthews, L. Martin, C. Lombard, and R. Jewkes. 2013. Intimate Partner Femicide in South Africa in 1999 and 2009. PLoS Med 10(4): e1001412. doi:10.1371/journal.pmed.1001412.
Anon. 1991. Regulations Relating to the Scope of Practice of Persons Who are Registered or Enrolled under the Nursing Act, Pretoria.
Borrow, S., A. Munns, and S. Henderson. 2011. Community-based child health nurses: An exploration of current practice. Contemporary Nurse 40(1): 71–86.
Breier, M. 2008. Medical Doctors. In Skills shortage in South Africa: Case studies of key professions, eds. J. Erasmus and M. Breier. Cape Town: HSRC Press.
Coovadia, H., et al. 2009. The health and health system of South Africa: Historical roots of current public health challenges. Lancet 374(9692): 817–834. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19709728. Accessed 1 May 2014.
Department of Health & the Reproductive Health Research Unit (WITS). 2001. National Contraception Policy Guidelines. Johannesburg: University of the Witwatersrand.
Department of Social Development. 2015. National Adolescent Sexual and Reproductive Health Rights Framework Strategy. Pretoria: Department for Social Development.
Ehlers, V. 2003. Adolescent mothers’ utilization of contraceptive services in South Africa. International Nursing Review 50(4): 229–241.
Fonn, S., and M. Xaba. 2001. Health Workers for Change: Developing the initiative. Health Policy and Planning 16(Suppl. 1): 13–18.
Harvey, D. 2005. A Brief History of Neoliberalism. Oxford: Oxford University Press.
Hoffman-Wanderer, Y., L. Carmody, J. Chai, and S. Röhrs. 2013. Condoms? Yes! Sex? No! Conflicting Responsibilities for Healthcare Professionals Under South Africa’s Framework on Reproductive Rights. Cape Town: Gender, Health and Justice Research Unit, University of Cape Town. Available from http://www.ghjru.uct.ac.za/sites/default/files/image_tool/images/242/documents/Condoms_Yes_Sex_No.pdf. Accessed 13 Dec 2015.
Joyner, K. 2009. Health Care for Intimate Partner Violence: Current Standard of Care and Development of Protocol Management, Ph.D Dissertation. University of Stellenbosch.
Lipsky, M. 1980. Street-level bureaucracy: Dilemmas of the Individual in Public Service. New York: Russell Sage Foundation.
Maynard-Moody, S., and M. Musheno. 2003. Cops, Teachers, Counsellors: Stories from the Front Lines of Public Service. Ann Arbor: University of Michigan Press.
Mayosi, B.M., and S.R. Benatar. 2014. Health and health care in South Africa—20 years after Mandela. The New England journal of medicine 371(14): 1344–1353. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25265493. Accessed 19 Mar 2015.
Milatovic, M., and L. Wånggren. 2014. Spaces of possibility: Pedagogy and politics in a changing institution. In The Para-Academic Handbook: A toolkit for making-learning-creating-acting, eds. A. Wardrop and D.M. Withers. Bristol: HammerOn Press.
Müller, A., S. Röhrs, Y. Hoffman-Wanderer, and K. Moult. 2016. “You have to make a judgment call”—Morals, judgments and the provision of quality sexual and reproductive health services for adolescents in South Africa. Social Science & Medicine 148: 71–78.
National Department of Health. 2011. Policy Paper for National Health Insurance. Available from http://www.gov.za/sites/www.gov.za/files/nationalhealthinsurance_2.pdf. Accessed 19 Mar 2015.
Ongaro, E., F. Ferré, and G. Fattore. 2015. The fiscal crisis in the health sector: Patterns of cutback management across Europe. Health Policy 119: 954–963.
Onya, H. 2007. Health Promotion in South Africa. Promotion & Education 14(4): 233–237.
Quaglio, G., T. Karapiperis, L. van Woensel, E. Arnold, and D. Mcdaid. 2013. Austerity and Health in Europe. Health Policy 113(1): 13–19.
Reid, S.J., L. Mantanga, C. Nkabinde, N. Mhlongo, and N. Mankahla. 2006. The community involvement of nursing and medical practitioners in KwaZulu-Natal. South African Family Practice 48(8): 16–16e.
Republic of South Africa. 2015. Budget Highlights 2015. Pretoria: National Treasury. Available from http://www.treasury.gov.za/documents/national%20budget/default.aspx#. Accessed 19 Aug 2015.
Sistrom, M.G., and P.J. Hale. 2006. Outbreak investigations: Community participation and role of community and public health nurses. Public Health Nursing 23(3): 256–263.
Von Holdt, K., and M. Murphy. 2007. Public hospitals in South Africa: stressed institutions, disempowered management. In State of the Nation: South Africa 2007, eds. S. Buhlungu, J. Daniel, and R. Southall. Cape Town: HSRC Press.
Vlassoff, C., and S. Fonn. 2001. Health Workers for Change as a health systems management and development tool. Health Policy and Planning 16(Suppl. 1): 47–52.
Watson, J., L. Vetten, P. Parenzee, T. Madonko, and S. Bornman. 2014. Eye on the Money: Women and government priorities in South Africa. Cape Town: Women’s Legal Centre. Available from https://za.boell.org/sites/default/files/wlc_eye_on_the_money_2014.pdf. Accessed 14 Jan 2016.
Wood, K., and R. Jewkes. 2006. Blood blockages and scolding nurses: Barriers to adolescent contraceptive use in South Africa. Reproductive Health Matters 14(27): 109–118. Available from http://www.ncbi.nlm.nih.gov/pubmed/16713885. Accessed 26 Nov 2014.
Legislation and Policy Documents
Children’s Act 38 of 2005.
Criminal Law [Sexual Offences and Related Matters] Amendment Act 32 of 2007.
Criminal Law [Sexual Offences and Related Matters] Amendment Act Amendment Act 5 of 2015.
Choice on Termination of Pregnancy Act 92 of 1996.
National Health Act 61 of 2003.
The South African Nursing Council Regulations Relating to the Scope of Practice of Persons Who are Registered or Enrolled under the Nursing Act, 1978, Government Notice No. R. 2598, 30 November 1984 as amended by: No. R. 146 10 July 1987; No. R. 2676 16 November 1990; No. R. 26015 February 1991.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Copyright information
© 2017 The Author(s)
About this chapter
Cite this chapter
Moult, K., Müller, A. (2017). 11 Morality, Austerity and the Complexities of Sexual and Reproductive Health Services for Young People in South Africa. In: Kelly, P., Pike, J. (eds) Neo-Liberalism and Austerity. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-58266-9_12
Download citation
DOI: https://doi.org/10.1057/978-1-137-58266-9_12
Published:
Publisher Name: Palgrave Macmillan, London
Print ISBN: 978-1-137-58265-2
Online ISBN: 978-1-137-58266-9
eBook Packages: Political Science and International StudiesPolitical Science and International Studies (R0)