The evaluation of the termination of pregnancy programme in Mpumalanga Province

Abstract

The purpose of the study was to evaluate the impact of the Termination of Pregnancy (TOP) programme in South Africa, using Mpumalanga as focal area, with the view of developing guidelines to assist service providers in the implementation of the Choice on Termination of Pregnancy (CTOP), Act 92 of 1996. The study was conducted in two phases. In phase 1, a qualitative, quantitative, contextual, explorative, descriptive and case study research design was utilised. The purpose was to explore and describe TOP service providers and facility managers’ knowledge regarding the CTOP Act, as well as their experiences and feelings regarding TOP provision, and the feelings and experiences of health care consumers utilising TOP services. Records of attendance regarding the utilisation of the services were also reviewed. Data was collected using unstructured and semi-structured interviews. Phase 2 of the study focused on the development of guidelines to assist in the translation of the CTOP Act to action at service level. The findings revealed that although the TOP programme was operating within the reproductive health for women initiative, TOP service providers and facility managers were not knowledgeable on other legislation that supports the CTOP Act to integrate its implementation. All the participants experienced emotional, physical and psychological discomfort in providing TOP services. Lack of support of the programme also posed a major challenge. These findings formed the basis for the development of the guidelines.