Understanding Church-Led Adolescent and Youth Sexual Reproductive Health (AYSRH) Interventions Within the Framework of Church Beliefs and Practices in South Africa: A Qualitative Study.

Background: The existing literature often oversimplifies the complex relationship between religion and Adolescent and Youth Sexual and Reproductive Health (AYSRH), particularly regarding church-based interventions. This study aimed to investigate the nature and implementation strategies of church AYSRH programmes within their belief systems to inform effective programme development. Methodology: An interpretive descriptive design was employed. Data were collected in the Vaal Triangle region of South Africa (Vanderbijlpark, Vereeniging, and Sasolburg) between August 2019 and February 2020. In-depth interviews were conducted with pastors, government officials, and school principals. Focus group discussions were held with parent and youth church groups alongside youth groups from Technical and Vocational Education and Training (TVET) colleges. Data were analyzed using Atlas.ti v.23. Results: Church-based AYSRH interventions primarily emphasize information provision and abstinence until marriage, aligned with prevailing moral values. These interventions are delivered through integration into existing church programmes and collaborations with external stakeholders for specialized areas like contraception. Limitations identified included ineffectiveness, superficiality, impracticality, tensions between religious doctrine and lived realities, a reductionist focus, a singular information-sharing approach, and limited pastor understanding and openness regarding AYSRH. Conclusions: Churches possess valuable communication platforms and partnerships that could be leveraged for AYSRH interventions. However, this study highlights a one-sided focus on church teachings and significant tensions between idealized approaches and practical implementation, raising critical questions about the overall efficacy of church-led AYSRH projects. This research validates prior findings on church-based AYSRH interventions while offering nuanced insights and heuristic perspectives for a more comprehensive and less simplistic understanding of church-driven AYSRH services.