A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Bioethics and Health Law Johannesburg, 2015 / Generally, consensual adolescent sexual intercourse is fraught with a number of negative outcomes such as socio-economically, where unplanned pregnancies occur, and medically with the spread of sexually transmitted diseases that require treatment. The Sexual Offences and Related Matters Amendment Act 32 of 2007, hereunder referred to as the Sexual Offences Act (“SOA”), criminalised consensual sexual intercourse between adolescents aged from 12 to less than16 years. Since the inception of the SOA in 2007, there seemed to have been relatively little evaluation of the practical effect of sections 15 and 16 of the SOA on society. This changed in 2011 when two non-profit organisations, The Teddy Bear Clinic for Abused Children and RAPCAN (Resources Aimed at the Prevention of Child Abuse and Neglect) who were the first and second applicants respectively, challenged the constitutionality of certain sections of the SOA. These sections are: - section 15 – entitled “Acts of consensual sexual penetration with certain children (statutory rape)”; - section 16 – entitled “Acts of consensual sexual violation with certain children (statutory sexual assault); and - section 56(2) – which deals with defences in respect of sections 15 and 16. In October 2013, the Constitutional Court declared sections 15 and 16 inconsistent with the Constitution. That declaration was suspended for a period of 18 months to enable Parliament to correct the defects in the statute. It is widely known that adolescents still engage in consensual sex with each other regardless of the law. The issues invite an evaluation of the current legislation in the context of the health and social issues that surround them. In addition, the impact of the current applicable legislation on the present realism needs to be scrutinised. It is essential for alternative interventions to be established which will aid in reducing the negative impact of consensual adolescent sexual intercourse. This research report looks at interventions that could be introduced to prevent adolescent sexual intercourse and alleviate the negativity of outcomes. Furthermore, the report aims to suggest an ethical, structured approach to reduce the current negative outcomes of adolescent sexual intercourse. In order to accomplish this I first describe the legislation that applies to consensual adolescent sexual intercourse of children between the ages of 12 and 16 years old. This brought to the fore the health practitioner’s practical experiences of problems associated with this legislation. In addition, I identify and discuss some ethical problems that health practitioners are confronted with in relation to consensual adolescent intercourse, in terms of having to balance their professional legal and ethical obligations. Finally, I propose some recommendations that will inform educational organisations on the relevant information to be included in sexual and reproductive health education campaigns. Furthermore, recommendations are made to relevant national policy-making departments to make strategic decisions regarding health and social interventions for adolescent sexual and reproductive health services. / MT2016

Diss. (sammanfattning) Stockholm : Karol. inst., 2000. / Härtill 6 uppsatser.

Thesis (Ph. D.)--University of Virginia, 1997. / Includes bibliographical references (157-196). Also available online through Digital Dissertations.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 191-208).

Introduction The most tragic outcome of a teenage pregnancy is a teenage maternal death. Research from African countries has shown that pregnant teenagers are at increased risk for maternal death when compared with older women, chiefly from complications of hypertension in pregnancy and pregnancy-related sepsis. The objectives of this study were to determine the proportion of maternal deaths accounted for by teenagers, and to describe associated obstetric factors, causes of death and avoidable factors. Setting and methods This was a descriptive retrospective study, using records of all maternal deaths at Chris Hani Baragwanath Hospital (CHBH) from 1997 to 2011. All maternal deaths at CHBH are notified to the national government, and complete patient records have been kept since 1997. All teenage (age less than 20 years) maternal deaths were found by hand-searching all maternal death files for the study period. Demographic and obstetric details were recorded, as well as the primary cause of death and avoidable factors in each case, using the methodology of the Confidential Enquiries into Maternal Deaths in South Africa. Results There were 33 teenage maternal deaths out of a total of 562 deaths (6.1%). Eighteen (54.5%) of the teenagers were 18 or 19 years old. Nine died without having booked for antenatal care.Twenty-six (78.8%) were 28 weeks or more pregnant or postpartum when they died. The most frequent causes of death were hypertensive disorders of pregnancy (n=10; 30.3%), including 9 cases of eclampsia, and non-pregnancy-related infections (n=10; 30.3%), including 6 cases of lower respiratory tract infection and 2 foreign nationals who died of malaria. Among the teenagers who died from non-pregnancy-related infections, 3 were HIV infected, 4 were HIV negative and 3 did not have HIV results. Infrequent causes of death included pregnancy-related sepsis (n=2; 6.1%), and postpartum haemorrhage (n=1; 3.0%). The most frequent avoidable factors were failure to book for antenatal clinic (n=5; 15.2%) and delay in seeking medical help (n=8; 24.2%). Conclusion Maternal deaths in teenagers were infrequent and occurred in a lower proportion of all maternal deaths (6.1%) than expected, based on data suggesting a 13% teenage pregnancy proportion from a study done in 1999 to 2001. This finding differs from those in other African countries. The high frequency of eclampsia is similar to data from other countries, but pregnancy-related sepsis was not frequent. Development and maintenance of adolescent community resources and health services, including improving access to foreign teenagers, may improve health care utilisation by teenagers. Utilisation indicators would include use of contraception, uptake of termination of pregnancy services, and antenatal care attendance for ongoing pregnancies.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri--Columbia, 2003. / "May 2003." Typescript. Vita. Includes bibliographical references (leaves 285-308).

Thesis (Ph. D.)--University of Missouri--Columbia, 2000. / "May 2000." Typescript. Vita. Includes bibliographical references (leaves 56-72, 152-166). Also available on the Internet.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2010. / Härtill 4 uppsatser.