Behind youth month celebrations, rural youth face a daily struggle for healthcare
As South Africa commemorates youth month, the stark realities of rural health inequality demand urgent attention. Behind the celebrations and historical reflections lies a painful truth: for many rural youth, access to even the most basic healthcare remains a daily struggle and a violation of their rights.
Katlego Rammala*, a 27-year-old from rural Limpopo, still remembers the day she walked more than 15 kilometres to her local clinic to ask for contraceptives, only to be told they were out of stock. A few months later, Katlego discovered she was pregnant. It was unplanned, and at the time, she was still in school.
Her story is not unique.
Katlego’s story highlights a common rural reality: Young people being denied access to contraceptives due to stockouts, distance, or provider bias.
The latest RHAP policy brief titled Putting the youth first: prioritising contraception and antenatal care for adolescent girls in rural areas, shows that South Africa still shows some of the highest adolescent pregnancy rates globally, with almost one in four girls falling pregnant before the age of 20.
The policy brief outlines the need for contraceptive services and antenatal care to be prioritised for rural adolescent girls and notes six steps that can be taken to change the status quo.
According to the policy brief, the national delivery rate among adolescent girls has increased from 13.9% to 14.1% between 2022/23 and 2023/24. And this pattern is more severe in rural provinces like Eastern Cape (18.0%), Northern Cape (17.2%) and Mpumalanga (16.6%).
In RHAP’s 2023 Contraceptives Fact Sheet, it noted that over 30% of rural clinics regularly experience stockouts of key contraceptives. Often, young women are offered limited options based on availability, not what suits their lives or bodies.
Young people, especially teenage girls, struggle across rural South Africa to find timely, courteous, high-quality healthcare. From early pregnancies and mental health issues to menstrual agony, the system still ignores their needs.
According to RHAP’s 2024 Policy Brief on Early Pregnancy, rural girls are more vulnerable to early and unintended pregnancies due to limited access to contraception, lack of youth-friendly services, and harmful gender norms. In some districts, nearly 1 in 4 girls aged 15–19 has been pregnant at least once, a statistic that speaks volumes about structural neglect, not personal failure.
This is a rights issue as much as a healthcare one. Young rural people have rights to decent treatment, nonjudgmental care, and well informed decisions.
*The name used in this story has been changed for privacy reasons*