Short Report
School-based healthcare services in Cape Town, South Africa: When there’s a will, there’s a way
Submitted: 28 June 2023 | Published: 27 October 2023
About the author(s)
Nadia Ahmed, Mortimer Market Centre, Central North West London NHS Trust, London, United Kingdom; and, Desmond Tutu HIV Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South AfricaCarey Pike, Desmond Tutu HIV Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Jessica Lee, Desmond Tutu HIV Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, United States of America
Colleen Wagner, Desmond Tutu HIV Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and, Networking HIV and AIDS Community of South Africa (NACOSA), Cape Town, South Africa
Linda-Gail Bekker, Desmond Tutu HIV Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Abstract
South African secondary schools do not deliver school-based healthcare services despite high rates of human immunodeficiency virus (HIV) infection, sexually transmitted infections, and unplanned pregnancies among adolescents, ongoing sub-optimal uptake of healthcare services from public healthcare facilities by adolescents, and national policy support for such services. A pilot school health nursing programme (SHNP) was offered to 44 secondary schools in a single health sub-district within the Western Cape, South Africa. The programme included fortnightly nurse visits that offered a standard package of healthcare services, including sexual and reproductive health services tailored according to school preference.
Of the 44 schools, 42 gave permission for the SHNP to operate, with the majority of schools selecting the full comprehensive package of services. Programme implementation was truncated such that delivery only occurred over two school terms (20 weeks); however, 344 students attended the service. The majority of service users were female with a median age of 16 years, and over a half attended the service for sexual and reproductive health services.
Contribution: A key challenge to school-based health service delivery arose from inadequate stakeholder support and differential views of adolescent healthcare needs among government officials, parents, guardians, school staff and governing bodies. These findings motivate for ongoing multi-level stakeholder engagement around the reality of adolescent healthcare needs and further opportunities to deliver school health services for longer time periods such that their feasibility, acceptability, and potential to impact healthcare outcomes can be assessed in this setting.
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Crossref Citations
1. Realising agency: insights from participatory research with learners in a South African sexual and reproductive health programme
Chelsea Coakley, Devyn Lee, Carey Pike, Laura Myers, Miriam Hartmann, Asantewa Oduro, Noluthando Ntlapo, Linda-Gail Bekker
Frontiers in Public Health vol: 12 year: 2024
doi: 10.3389/fpubh.2024.1329425