Changes to the law on consent in South Africa: implications for school-based adolescent sexual and reproductive health research

BACKGROUND:The National Health Act, No 61, 2003 in South Africa is the first effort made by the government to protect health-related research participants under law. Implemented on March 1, 2012, the law mandates active consent from a parent or legal guardian for all research conducted with research participants under the age of 18 years. This paper focuses on the Act's implications for school-based adolescent sexual and reproductive health research.DISCUSSION:Although well intentioned, the added legal protections in the National Health Act may have the unintended consequence of reducing participation rates in school-based adolescent sexual and reproductive health research, thereby excluding the most at-risk students. The Act may also compromise adolescents' right to dignity and privacy, especially considering the personal nature of research on sex and sexuality. Devolved, discretionary decision-making, which empowers local human research ethics committees to permit a wider range of protective measures, including passive consent, independent adolescent consent or community consultation ought to be considered. The continued and direct involvement of young people in their sexual and reproductive health and well-being is an important principle to uphold.SUMMARY:This paper calls for a re-examination of section 71's ethical guidelines relating to informed consent in the National Health Act, No 61, 2003 in South Africa in order to better serve the interests of South African adolescents in sexual and reproductive health research

Recollections of parental style and perceptions of current family functioning at age 50

It is hypothesized that recollections of an individual's parental behaviour towards them is associated with their view of their current family functioning. This hypothesis was tested for using data provided by 213 men and 270 women drawn at age 50 from the Newcastle Thousand Families Study. Relationships between retrospective reports of parental behaviour during childhood and perceptions of current family functioning at age 50 were investigated using a univariate regression analysis in order to explore the relationship between scores on the Parental Bonding Instrument (PBI) and the McMaster Family Assessment Device (FAD). Where a significant association was observed the relationship between subscale scores was further examined using a multivariate regression analysis including gender and self-reported psychological well-being (as measured by the General Health Questionnaire- GHQ) as covariates. Several statistically significant associations between PBI and FAD subscale scores were observed. Four of these remained statistically significant once gender and self-reported psychological well-being were adjusted for. In this population sample, aspects of recalled parental behaviour were associated with the health of current family functioning in several domains as reported by the FAD. These associations appear to be partly mediated by current psychological well-being

The Impact of Socio-economic Status and Mobility on Perceived Family Functioning

Perceptions of current family functioning in relation to current household income level, educational status, social-class at birth and social mobility over the lifecourse were investigated in a group of 483 individuals at age 50. Subjective report of family functioning was assessed using the McMaster Family Assessment Device (FAD) with socio-economic information obtained from a self-report Health and Lifestyle Questionnaire. Results indicated significant relationships between household income, social mobility and FAD scores for men but not for women in this sample. For men, lower current income and downward social mobility over the lifecourse were associated with a more negative perception of family functioning. Further research is required to understand the gender differences observed and delineate cause versus effect mechanisms