PPASA is also involved in provincial, national and international advocacy and lobbying for the greater recognition of reproductive and sexual health rights, as well as improved sexual and reproductive health.

During the last 22 years, PPASA as an organisation has undergone significant changes. Between 1980 to 1985, the focus of the organisation seemed to have been on providing family planning services, with the main target group being the underserved communities (mainly the black community).

During the next five years, 1986 to 1990, PPASA experienced internal political transformation. As was happening throughout the country, the organization began going through a period of racial integration and cultural diversity. There was increased interest to better serve the underserved communities. Thus in addition to the community-based distribution (house-to-house approach), youth clinics to serve the black community were established in the urban areas.

In the nineties significant changes were made with the nationalisation of PPASA. This period coincided with a worldwide transformation in the reproductive health sphere with the 1994 International Conference on Population and Development (ICPD). A major outcome of the ICPD Programme of Action was the need for a paradigm shift from family planning to a more comprehensive approach to sexual and reproductive health (SRH). PPASA was one of the organisations in sub-Saharan Africa that embraced this paradigm shift almost immediately. Some of the new initiatives included: pioneering a youth sexual and reproductive health programme, using young people as peer educators; advocating for sexual rights for the young people; initiation of the first youth friendly centre in the country; involving men as an integral part to the advancement of SRH rights and services; and launching of a major the community-based programme.

The 1996 to 2000 period was characterized by rapid expansion of the PPASA SRH programme and a focus on strengthening of the organization. New provincial offices/ branches were established and new sites were integrated. In addition, several projects/programmes such as the Teacher Training programme, the loveLife programme and several Youth Centres were established. In addition to this, PPASA increased its involvement in the development of the Adolescent Health Policy. During this period, in 1997, PPASA developed a Strategic Plan, which the organization used for its operation. In order to conform to accommodate the expansion of the program, PPASA implemented a restructuring of the organization. The rapid expansion, which began in the nineties, has continued into millennium. By the end of 2002, PPASA had a national coverage providing services in all nine provinces of the country.

PPASA has engaged on a programme to challenge the attitudes and behaviours held by men that compromise their own health and safety as well as the health and safety of women and children; and to encourage men to become actively involved in responding to gender based violence and the HIV/AIDS epidemic. Since 1997 the MAP programme has worked with men’s groups in communities, prisons and the military.

PPASA’s CBD programme, known as the Community-Based Reproductive Health Service (CBRHS), has been running since 1996, and was initiated as a response to a high unmet need for contraceptive services. The PPASA programme has targeted underserved communities in rural and peri-urban areas, including work in informal settlements CBRHS was the sole provision source, as the nearest clinics, hospitals or NGO’s are some distance away. South Africa now has what is considered to be a high contraceptive prevalence, and it is recognized that, although useful, contraception distribution by lay people is controversial and is not a priority for the Department of Health in the face of the HIV epidemic. Nevertheless, PPASA’s CBRHS programme has demonstrated that the model of community based service delivery by community members, for community members, is a viable, effective and flexible vehicle for health information and service delivery. It is well positioned to be applied to broader development interventions. There are a number of opportunities for this model to positively impact on current challenges in South Africa, such as HIV/AIDS and gender violence. This has warranted a new approach to the CBRHS programme. PPASA is now in the process of redesigning the programme. The focus will shift to a more comprehensive community based life skills that will have a community developmental approach. Agents will be drawn from a vast pool of the unemployed. Initially they will be contracted for a period of 3 years and receive a stipend. Because of its two pronged developmental approach, PPASA will seek buy-in from the Department of Social services whose focus is poverty alleviation and HIV/AIDS prevention.
The leadership in the design and management of Adolescent Reproductive Health Services (ARHS) has earned PPASA a major role in the launch of loveLife. loveLife is recognised as the most innovative and largest campaign working with young people worldwide. PPASA as a consortium partner manages the most programmes under the loveLife banner.

However, while PPASA has made inroads in various SRH components, the SRH challenges in South Africa, as in other parts of sub-Saharan Africa have increased tremendously. Thus, there is increased demand for SRH services. Of significance also, is the fact that PPASA, as an organisation has not focused on marketing itself, and unfortunately over the last few years has lost its image as a leader in SRH, despite all the work that it has done. This loss of visibility could have serious implications on the future of the organisation.