Youth friendly clinics make inroads in reducing unintended teen births in South Africa

Despite widespread, freely available contraception and progressive reproductive health laws, most teen mothers report their last pregnancy as unintended or unplanned. This begs the question: Why are many sexually active teens failing to use contraceptives when they are widely available for free? In response, loveLife rolled out the National Adolescent Friendly Clinic Initiative (NAFCI) starting in the early 2000s. NAFCI aimed to remove barriers that youth faces in accessing reproductive health services, and to provide youth-focused sexual health education. We find that the program increased contraception usage and decreased sexually transmitted diseases and early teen births. The program effectively encouraged women to delay childbearing by over a year, with a significant reduction in births to mothers under 17. Children born to mothers with NAFCI access were also in better health and more connected to the health system. In light of these positive findings, and the negative effects that teen childbearing has on both the mother and child, we recommend that youth-friendly initiatives be implemented in all public health facilities. ; We acknowledge the support provided by Hewlett/PRB Global Teams of Research Excellence in Population, Reproductive Health, and Economic Development and Hewlett Foundation/Institute of International Education Dissertation Fellowship in Population, Reproductive Health and Economic Development.