When 17-year-old Olwethu Hlatshwayo stopped her family planning appointments in October 2025, it wasn’t because she no longer wanted to prevent another pregnancy.

Before each clinic visit, the Orange Farm teenager, who had an 18-month-old baby, struggled to sleep, dreading facing the nurses at Embalenhle Clinic.

On clinic days, Hlatshwayo would walk almost an hour to school to mark the attendance register before making her way to the clinic.

“When I tried to explain that I am going to lose more school hours, the nurses told me that adolescent girls are in school. That I started with what I should have finished with, young girls like me like frustrating themselves with adult stuff.”

When youth-friendly services feel hostile 

According to the Gauteng health department, the government is implementing the Adolescent and Youth-Friendly Services (AYFS), or Youth Zones, where learners wearing school uniforms are fast-tracked and assisted by peer educators. But this has not been Hlatshwayo’s experience. 

“Usually I’d arrive at 8h00 and finish around 10h30, standing in a long queue, while the nurses go on a tea break. Then I still had to rush back to school,” she says. 

Gauteng health spokesperson Steve Mabona says the Youth Zone policy specifies hours scheduled around school-going youth: “the time that is most convenient for school-going youth to ensure they access the services without missing school (e.g. 14h00–16h00)”

Hlatshwayo eventually changed to the Mountain View Clinic, hoping to find a facility that’s more youth-friendly.  

“I couldn’t lose more school time, my clinic appointments clashed with my classes,  it was challenging to honour my family planning appointments,” says Hlatshwayo, who was on the Depo Provera contraceptive injection that’s given every three months. 

At Mountain View, she asked about getting a long-term contraceptive method like the implant. “But the nurses told me that I am overweight, so the method would not work, and I have health complications that will make both contraceptive methods fail me. The explanation was brief,” she says. 

After this encounter, Hlatshwayo decided to stop taking contraceptives altogether. 

The teenager says the long queues, missed school hours, and judgemental comments from nurses became too much to bear.

“Coming back from the clinic from my family planning appointments, I felt like I had failed. I was always sad, demotivated. It was getting too much. My mental health was affected.”

Sixteen-year-old Nohlanhla Mbatha* from Meriting says health promoters regularly visit her school, encouraging learners to take up family planning services. But after seeing her mom being humiliated by nurses at Finetown clinic, Mbatha is hesitant.  

“My mum took me with her to attend her appointment for family planning. The nurse scolded my mom like a child in front of me and other patients,” she recalls. “I will never set foot again at the facility. My fear comes from the scolding and rudeness I experienced; I am also scared that nurses may judge me.” 

Mbatha says she avoids going to the clinic, even when she is sick. 

“If the nurse could be so harsh and rude to my mum as an adult, what about me as a teenager?”

Health department acknowledges gaps

Mabona says patients should use the appropriate channels to file a complaint, including “suggestion boxes, patient experience surveys, and district complaint management systems.”

He says there are “occasional lapses in adherence to the principles of person-centred care” for many reasons, including “staff attrition, staff shortages, high patient volumes, resource constraints, and varying levels of staff training”. 

Youth want solutions

Hlatshwayo and Mbatha are two teenagers in a province with the lowest rate of contraceptive use. According to the latest District Health Barometer, Gauteng’s uptake of contraceptives is 50%, far lower than the national average of 60.6%.

Hlengiwe Khomo, director of the Orange Farm-based community organisation IsiGgu so Mama, says stronger collaboration between health facilities and community organisations could help bridge the gap between young women and healthcare workers.

“Local health facilities need strong collaborations with community organisations because young girls spend more time in community organisations,” she says.

“Facilities need to create programmes that can be delivered through community organisations and help young girls feel comfortable seeking help and staying in care. Community organisations can help bridge the gap between young girls and healthcare workers, while also easing the burden on burnt-out nurses.”

Hlatshwayo would like to resume family planning, and is clear about what would work for her and her peers.

“If we can be provided with a mobile clinic or tent that comes to our community regularly on Saturdays, to give service to school girls where we know we can attend, receive detailed education on family planning and all available methods, it will save us time and the emotional burden of going to the clinic.” -Health-e News

*Not her real name