Reflecting on adolescents' evolving sexual and reproductive health rights: canvassing the opinion of social workers in KwaZulu-Natal, South Africa.

In South Africa children under the age of 18 are legal minors and considered not fully capable of acting independently. However, in certain defined circumstances the law has granted minors the capacity to act independently, including regarding their sexual and reproductive health (SRH). This study explored the perspectives and practices of 17 social workers from KwaZulu-Natal on legislation relevant to adolescents' evolving sexual and reproductive health and rights and the decriminalisation of consensual underage sex. A key finding was that many social workers have conservative views about adolescent access to SRH advice and services and many were critical of the recent decriminalisation of underage consensual sex. In the main, social workers were concerned that adolescents lack the capacity to make SRH care decisions and that liberal laws promote underage sex rather than protect adolescents. Despite antagonistic views of SRH laws related to adolescents, many social workers felt that they are able to uphold their professional rather than personal views in their work. These findings are important given that a key barrier to adolescent access and uptake of SRH advice and services relates to concerns that they will be judged. Therefore service providers need to be regularly updated on adolescent SRH issues (including rights, laws, and policies) and be engaged in critical thinking about conflicting cultural, moral and personal judgements around adolescent sexuality. Such training should include counselling and communication skills that address issues on confidentiality, adolescents' dignity, privacy and best interests.