The City of Cape Town’s Health Directorate continues to face a number of challenges relating to youth health – some more serious than others.
The Directorate has made strides in the last decade to attract more young people to primary healthcare facilities and the results are evident, in particular around reproductive health.
Between 2006 and 2015, the number of babies born to mothers under the age of 18 dropped from 5,3% to 3,87% of all births recorded. Other successes include the high uptake of contraceptive methods, including male and female condoms, and an enthusiasm for the youth-specific facilities and sessions set aside by City Health (such as the Site B youth clinic pictured above).‘I am satisfied with the apparent consciousness around sexual health. In fact, some of our young clients are very picky about the choice of condom they want to use, which is good because it means they’re using them. However, there is more to health. Young people are not immune to HIV and other sexually transmitted infections, or to tuberculosis (TB) and lifestyle diseases like diabetes. So we need to broaden their understanding of health by increasing education on all fronts,’ said the City’s Mayoral Committee Member for Health, Councillor Siyabulela Mamkeli.
One of the biggest concerns is that young people are known to underestimate their risk exposure. This is in spite of the fact that diseases like HIV and TB are easily transmitted in an environment where there is already a high burden of disease. This is compounded by the prolonged time duration between being infected and showing signs and symptoms of the disease. Both diseases have stigma, contributing to a delay in accessing care. A sense of being invincible (‘this will not happen to me’) also has an impact on young people not taking sufficient precautions. Factors such as peri-urban living conditions, alcohol and recreational drugs, poverty, and a desire to belong all promote early sexual debut as well as transactional sex.
Other challenges include external safety concerns (e.g. gangsterism) that keep young people away from clinics and personal health and hygiene related to menstruation and puberty.
City Health’s Eastern and Northern sub-districts have in the last year participated in pilot projects to distribute reusable sanitary pads to young girls at schools. The latter had materials sponsored by Rotary Oostenberg and then had women in the community sew the pads. The sub-district’s health promotion officer was able to distribute 210 packs to girls at four primary schools, while 175 packs containing facecloths and soap were handed out to girls who had not yet started menstruating.
The Directorate is also working to address challenges relating to the attitudes of staff towards young people.
‘We have heard stories that young people are opting to seek help from private healthcare providers because of attitudes and perceptions, both from the community and also clinic staff. This is not on, because the services they need are freely available at our clinics. So we are constantly engaging with our staff to make sure that they treat young clients with dignity. It is not our job to judge anyone’s life choices, but we can keep them healthy and happy by providing guidance, support and a welcoming environment,’ added Councillor Mamkeli.