Hivos, through the Regional SRHR Fund program, and the SADC Parliamentary Forum recently convened a high-level dialogue in Harare, Zimbabwe, during the Joint Meeting of SADC Ministers of Finance and Health. The aim was to strengthen parliamentary leadership on legal reform and sustainable financing for adolescent sexual and reproductive health and rights (SRHR).
Along with policymakers, legal experts, civil society organizations, and development partners, the dialogue examined how contradictory age of consent laws and chronic lack of health financing are preventing adolescents’ access to sometimes lifesaving SRHR services across the SADC region.
Underinvestment restricting young people
The discussions zeroed in on a critical legal inconsistency affecting young people in many Member States. While adolescents may legally consent to sexual activity at ages 16 or 18, they are often prohibited from accessing HIV testing, contraceptives, information, and other essential SRHR services without parental or guardian consent. This creates uncertainty for healthcare providers and discourages adolescents from seeking care, which exposes them to preventable health risks.
In addition, the lack of funding has resulted in limited youth-friendly services, inadequate healthcare provider training, shortages of SRHR products, and too few outreach programs. Together, these legal and financial barriers leave many adolescents without the support they need.
Prevention is still better than treatment
Participants emphasized that adolescent SRHR should be viewed not only as a human rights obligation but also as a smart domestic health investment.
One participant neatly summed up the argument for investing in adolescent SRHR:
“If we invest in ensuring access to SRHR services and appropriate information by age 16, it’s far more cost-effective than bearing the human and financial costs later on, including early and unintended pregnancies, HIV infections, unsafe abortions, and school dropouts.”
The dialogue called for regional governments to devote national budget lines for adolescent SRHR, strengthen primary healthcare systems, and invest in training healthcare providers to deliver confidential, non-discriminatory services.
Legal reform necessary for change
The discussions included encouraging examples of legal, policy, and financing reform from across the region. In Malawi, the HIV and AIDS Prevention and Management Act allows young people from 13 on to independently consent to HIV testing and related services.
Similarly, South Africa’s Children’s Act applies the principle of the “mature minor” doctrine, enabling children aged 12 years and older who demonstrate sufficient maturity to independently access contraceptives and other SRHR services.
Experiences from Malawi and Zambia show that parliamentary engagement and multisectoral dialogue can help increase national health budgets, strengthen oversight of public expenditure, and improve accountability for health financing.
Parliamentary support the defining step
The role of parliamentarians was recognized as critical for reform. Beyond passing legislation, Members of Parliament can scrutinize national budgets, advocate for increased funding, and ensure that adequate resources are allocated to adolescent health programs.
The meeting also put forward several innovative financing options for parliamentarians to pursue, including expanding national health insurance schemes, improving efficiency in public expenditure, and dedicating revenues from health-promoting taxes to preventive healthcare services.
But participants stressed that legal reform without sufficient resources for implementation would leave adolescents facing the same practical barriers. Equally, increased financing without supportive legal frameworks would fail to guarantee equitable access to services.
Towards a future of equal access
The dialogue concluded with several important commitments, including:
- Holding national dialogues between Ministries of Health and Justice, parliamentarians, civil society organizations, and young people to address legal barriers.
- Developing regional SADC guidelines and model legislative provisions that distinguish the age of consent to sexual activity from the age of consent to access health services.
- Promoting legal frameworks that include “mature minor” approaches.
- Strengthening parliamentary oversight of health budgets.
- Expanding youth-friendly health services and investing in healthcare provider training.
What the Regional SRHR Fund aims to achieve
With initiatives like this high-level dialogue, the Fund works towards a stronger and more coordinated youth-led civil society in East and Southern Africa that can promote, address and advance SRHR and its intersections with HIV and gender inequalities at the regional level, focusing on a highly vulnerable and underserved young population.
