Women’s reproductive health and rights: Department of Health progress report

Meeting report

Women’s Health and Rights: Department of Health (DOH) Briefing
Ms Nthari Matsau, Deputy Director General, Department of Health, briefed the Committee on the Department’s work on women’s maternal and reproductive health issues. She stated that South Africa was a signatory to several conventions that promoted the rights of women. Protection of women’s health and reproductive health was a focus area, and there were several programmes implemented to promote women’s health. Women must recognize their sexual reproductive rights which enabled them to determine their sexuality and the number of children they wished to have. She stated that research was conducted on policy matters and that the Department kept its commitments in the national strategic plan. All provinces were presently implementing guidelines that aimed to provide access to health services for women, mainly in the areas of contraception and family planning services.

Ms Matsau noted that the local policies and commitments included the medical termination of pregnancy guidelines, the policy on conscientious objection to Choice on Termination of Pregnancy, a draft policy document on fertility options, including for the HIV positive, a policy on sexual assault care, cervical cancer screening policy, family planning training manual and policy and other policy issues.

The programmes covered included contraception and family planning services, choice on the termination of pregnancy, gender based violence at ten Thuthuzela Centres, and peri and post natal care. She set out that the top five causes of maternal deaths were non-pregnancy related infections (often AIDS), complications of hypertension, obstetric haemorrhage, sepsis related to pregnancy and pre-existing conditions. Most were attributable to avoidable factors, missed opportunities and substandard care, despite the fact that 84% of women were delivering their babies in a facility with skilled birth attendants. The Department was implementing the recommendations of the National Committee on Confidential Enquiry into Maternal Deaths to try to reduce the number of maternal deaths. Further programmes included prevention of mother to child transmission (PMTCT), intra-partum care for HIV infected mothers, and post-partum care. The Department also offered youth friendly services and upliftment of the right to informed decision making.
Ms Matsau said she was concerned about the decline in the use of contraceptives and an increased demand for termination of pregnancies. She noted that there was progress in dealing with gender-based violence as places of safety had been set up for victims. She added that there was a need for male involvement so that men could get an understanding of women’s issues.

Discussion
The Chairperson asked if the budget was sufficient for the Department’s programmes.

Ms Matsau responded that funds were insufficient in many cases. She added that the administration of HIV/AIDS and maternal health were in different clusters and that sometimes led to a conflict of where to spend. However, HIV/AIDS had attracted a lot of funding and the department accessed resources where the need arose.

The Chairperson asked about operationalisation of women’s rights. She said that not much was mentioned about reproductive health and asked if gender focused people were fully utilised to disseminate information.

Ms Matsau said there was some structural failure within the government, due to dual obligations. Gender focal points were extensions of other government programmes. She said that more needed to be done for relevant departments to deal with some of the issues.

The Chairperson asked how long it was going to take for the distribution of the policy document on sexual assault.

Ms Matsau responded that the document was completed three years back. She also added that the department’s gender officer was involved in training of nurses to help them deal better with sexual assault victims.

Ms N Ngele (ANC) asked if women were sterilised voluntarily, or if it was forced on them by illness.

Ms Matsau said it was voluntary and that women would tend to be sterilised when they were satisfied with the number of children they had, as well as to reduce the risk of cancer. She added that women over the age of forty were encouraged not to have more children as that carried health risk implications. Ms Matsau said the Department’s cancer programme had forums through which it conducted campaigns and rallies. She also stated that traditional leaders were involved as they interacted amongst themselves and with the Department to work against HIV/AIDS.

Ms Ngele asked if the department had any interaction with religious leaders, especially with regards to abortion.

Ms Matsau said the Department approached religious leaders cautiously, and that in general they tended to interact with the Ministers and not the individual congregation.

The Chairperson asked about any HIV/AIDS research in which the Department was involved.

Ms Matsau said the Department had held a discussion about research three weeks before. She noted that the research efforts had not been successful, and there was difficulty as using humans in research would put them at risk of getting HIV/AIDS.

Ms C Dudley (ACDP) asked about the age group that was seeking termination of pregnancies.

Ms Matsau said most females seeking terminations fell into the 15 to 24 age group. The latest health survey wanted to find out why contraception was not being used and why it was apparently being substituted with terminations.

Ms M Nxumalo (ANC) said that young women were faced with problems in accessibility as they were familiar with the officials from whom they were to access contraceptives.

Dr S Amos, Chief Director, Department of Health said that she did not believe that accessibility was any longer a factor. Young females got pregnant on the spur of the moment. She said young females were encouraged to carry condoms, but they did not. The problem was not accessibility to services but their attitude to life. Ms Amos also noted that there was always a high demand for abortions after holidays and music festivals.

Ms Nxumalo asked if the Department had any family planning programmes, noting that teenage pregnancy came about owing to lack of family planning. She said that there would not be so many terminations of pregnancies if family planning was practised.

Ms Matsau said the Department did not have a family planning programme, and that in the past it was a priority, although it was not any longer due to the need to increase population. She said there was need for campaigns to raise awareness on sexual reproductive health.

The meeting was adjourned.