Question NW2089 to the Minister of Health

Reply:

(a) There is no specific budget allocated for termination of pregnancy services, however the services are covered under Equitable Share

(b) There is no specific budget calculation for termination of pregnancy, the service/program is not a stand-alone programme it falls within the Women, Maternal and Reproductive Health at all level of care, therefore the calculation is done under Equitable share budget.

(c) The clinic cannot turn away the clients however; clinic can only refer clients on the following basis:

• 1. If there is no one trained and providing the termination of pregnancy services in a facility; the health care workers, don’t turn them away BUT refer clients where services are rendered
  2. If the client is above 12 weeks, and there is no Doctor who can provide the above 12 weeks’ cases in a facility as stipulated in the Choice on Termination of Pregnancy Act, 92 of 1996, then the client can be referred to next level of care where second trimester termination of pregnancy is offered;
  3. If the client is above 20 weeks, however the client can be counselled on pregnancy resolutions e.g. adoption etc.

(d) The National Department of Health did not receive reports from provinces indicating challenges related to backlog on termination of pregnancy

(e) The National Department of Health has developed the Sexual and Reproductive Health and Rights Training Package/Curriculum consisting of 14 modules.

1. Module one is compulsory and covers value clarification and mind transformation and

2. Module 7 is a specific module for termination of pregnancy (theory and practical session).

(f)-(g) Staff vacancy rate. The Department do not have the vacancy rate specific for termination of pregnancy however the service is being rendered under Women, Maternal and Reproductive Health programme. There is no breakdown of vacancies because termination of pregnancy is not a standalone programme it is offered under the Women, Maternal and Reproductive Health programme.

(h) The Department Conduct Value Clarification and mind transformation workshop to address unwillingness and negative attitude of the health care workers at all levels of care. Choice on termination of pregnancy guidelines (2019) provides guidance to managers, frontline workers and service users to respond to issues on conscientious objection which is described as blocking access to care .

(i)-(j) The following table reflects the details in this regard.

	Year	Total number of TOP’s performed in the last five years per province and National
		Province (i)	South Africa (National) (j)
		Eastern Cape	Free State	Gauteng	KwaZulu-Natal	Limpopo	Mpuma-langa	Northern Cape	North West	Western Cape
	2017	9,905	5,397	11,929	17,700	6,703	3,080	1,149	4,859	15,415	76,137
	2018	14,130	7,404	18,827	27,032	11,297	5,738	1,671	7,840	18,785	112,724
	2019	13,342	7,666	19,881	28,344	14,323	7,584	1,533	9,557	18,831	121,061
	2020	10,922	7,242	23,338	22,399	14,494	4,449	1,337	8,325	17,209	109,715
	2021	12,118	7,617	25,827	23,688	13,828	5,014	1,705	9,002	16,129	114,928
Source DHIS

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