Illegal abortion remains a significant public health challenge globally, particularly among adolescent girls who often lack adequate reproductive health information, access to healthcare services, and social support. Despite South Africa’s progressive abortion legislation, teenage girls in rural communities like Lusikisiki still face barriers to accessing safe reproductive health services due to socio-cultural stigma, misinformation, and limited youth-friendly services, increasing the risk of unsafe abortion and related health complications. This paper outlines a protocol for a proposed qualitative case study that aims to assess the awareness of teenage girls in Lusikisiki regarding the health risks associated with illegal abortion, explore their sources of information, identify factors influencing their awareness, and propose strategies to reduce unsafe abortion. A qualitative case study design guided by an interpretive paradigm will be used to explore the perceptions and experiences of teenage girls. A purposive sample of 25 participants aged 13–19 years will be recruited from Village Clinic, Bambisana Hospital, and St Elizabeth Regional Hospital. Data will be collected through semi-structured interviews and analysed using thematic analysis supported by NVivo software. The anticipated findings are expected to provide context-specific insights to support improved reproductive health education and adolescent-friendly healthcare services in rural communities.

This scoping review mapped the barriers to safe abortion and reproductive health services among youth between 15 and 24 years in low- and middle-income countries. Young people in low- and middle-income countries face persistent challenges due to sociocultural barriers. These challenges are worsened by structural barriers, leading many adolescents to unsafe methods that increase preventable health risks. This review focused on barriers to safe abortion and reproductive health services among youth between 15 and 24 years in low- and middle-income countries. A scoping review was conducted following the Arksey and O’Malley framework from the relevant literature, using academic databases and repositories, in diverse regions. Sixty-nine articles were initially identified; 11 studies that met the eligibility criteria were included in the final analysis. Five themes emerged: stigma and social norms, provider attitudes and values, legal and policy uncertainty, financial and geographic barriers, and limited information and services, which hinder access to reproductive health services. The findings show that unsafe abortion among youth in low- and middle-income countries is driven by interconnected sociocultural and structural barriers that limit access to effective reproductive health services. This study provides insights to help policymakers and healthcare providers improve access to safe abortion and reproductive health services in low- and middle-income countries.