Sexual and Reproductive Health Rights and Information and Communications Technologies: A Policy Review and Case Study from South Africa

Despite impressive legal provisions addressing sexual and reproductive health and rights, South Africa experiences very high levels of adolescent pregnancy and women and girls are often negatively affected by uneven gender relations, poor access to health services and a lack of knowledge about SRHR. Teenage sexual health is not uniform throughout South Africa, with poverty and place of residence strongly affecting outcomes. In particular, women and adolescents in rural and peri-urban (informal settlement or township) contexts experience neglect and exclusion from health-care services. In addition, poor South African women have inadequate knowledge about SRHR and thus struggle to make informed decisions.

At the same time, there is considerable excitement about the potential for ICT to provide solutions to health system challenges, with a receptive policy environment embracing e-health and m-health, and innovative examples of ICT-based health delivery.

This policy research examines three inter-related aspects of SRH for women and girls in South Africa, namely:

• To what extent are policymakers and other stakeholders aware of the peri-urban as a particular place which shapes the SRH of women and girls?
• Who are the core actors advocating for ICT inclusion, and what are the key framings around SRH, ICT and the peri-urban?
• What factors are enabling or challenging the incorporation of ICT as a driver of policy change for SRH? To what extent are policymakers using ICT as a mechanism for addressing the challenges of women’s and girls’ SRHR?

Recommendations from the report include:

• Pay careful attention, coupled with impartial research, to the role of the private sector when partnering with government; with particular consideration of regulation, vested interests, technical expertise, framing content and political influence
• The legal parameters of privacy, ethics and safety of personal information need ongoing consideration as ICT innovate and new health system initiatives emerge
• Given the inequity of access in relation to cost, place and uneven data services borne by poor women and adolescent girls, develop incentives that encourage donors, NGOs, the private sector and civil society to address government development objectives
• Government health messaging needs to be developed by health and South African content experts with appropriate timeframes to allow for testing and with attention to the unintended effects of messaging
• Donors can enhance their impact by investing in projects that reinforce progressive legal provisions within the country – for example, underscoring the recognition that maternal health will be better improved if not isolated from SRHR and reproductive justice
• Methodologies of testing and refining messaging need to be funded, developed, and adopted as best practices for ICT content
• Encourage ICT for health integration into existing health systems and programmes, rather than stand-alone projects and innovations
• ICT innovators need to work with the principle of medicine to do no harm and be accountable to all partners as well as the poor communities they serve
• Online safety is paramount and more needs to be done by governments, donors, NGOs and researchers to explore possible protections (moderated online spaces, legal provisions, protection of personal data etc.) so that women and adolescent girls, whether seeking or providing information online, can be secure and safe.