The implementation of the Choice on Termination of Pregnancy Act: some empirical findings

The Choice on Termination of Pregnancy Act of 1996 substantially liberalised abortion law. Whilst a substantial number of terminations of pregnancies (TOPs) have already been performed in terms of the new Act, it has also surfaced that an array of factors of various kinds may impede its further implementation and operation. A study was undertaken to determine the nature and extent of any such impediments to the implementation of the Choice on Termination of Pregnancy Act. More specifically a survey was conducted amongst a sample of 75 women who had undergone a TOP since the implementation of the Act; health professionals and social workers who provide TOP services (n = 16); and health professionals and social workers who are in a position to refer women to TOP facilities (n = 63). Overall, the clients were well treated at the TOP facilities, and were satisfied with the service given to them. However, post-counselling and to a lesser extent pre-counselling, is lacking. Counselling is important as a considerable proportion of the clients suffered from emotional feelings usually associated with depression and/or self-reproach before and after the termination procedure. Furthermore these clients did not usually discuss their termination with family members. TOP service providers were dissatisfied with the TOP facilities, especially the insufficient number of consultation and counselling rooms. Health care workers in a position to refer clients to TOP facilities were not always willing to do so, thereby obstructing the referral system. In the main, it is recommended that the entire TOP procedure should be done at clinics/hospitals so that clients will not have to do inductions at home, more trained staff should be available, facilities should be adequate and accessible, and there should be psychological support for staff.

Policy-making for real: politics and progress in South African health care

Problems have been accumulating in South African health care for well over three centuries yet when it comes to resolving the crisis by means of appropriate policy measures, one becomes aware of the powers at play and the interests at stake in maintaining the status quo, thus obstructing much initiative in the process of reform.

Privatisation of South African health care: in whose interest?

In this article, essentially a critique on the privatisation of health care delivery in South Africa, the concept and social phenomenon of privatisation is analysed and evaluated, and the detrimental side-effects and latent consequences thereof dismantled. It is argued that the privatisation of South African health care is a reflection of narrow economistic thinking that will neither contribute to the more efficient functioning of the existing health care system nor alleviate the prevailing problems of shortages of resources and deficiencies in organisation. Privatisation of South African health care is in the last instance and in many respectse not in the interest of the patient population in all its diversity.