Picture: Oupa Mokoena/African News Agency (ANA)
South Africa’s current healthcare landscape is a system directly bequeathed as a result of apartheid and is typically characterised by inequities between those who have adequate, quality access versus those who do not have efficient and satisfactory access. This has a profoundly negative knock-on effect on the average individual, particularly those living in marginalised communities.

Although 25 years of democracy have yielded significant strides, structural and psychosocial barriers remain a hindrance to under-resourced communities.

There is a socio-economic disadvantage in accessing quality sexual and reproductive health (SRH) services in rural locations, as well as for migrants and adolescents.

Women and young girls in these categories are faced with increased odds of unintended pregnancy and unsafe abortions.

The Choice on Termination of Pregnancy Act of 1996 marks South Africa’s objective to advance women’s right to reproductive health.

But despite the fact the law allows women access to safe and legal abortion, many of them continue to opt for illegal abortions.

For those of us at the coalface of SRH work, a lack of resources remains the reality under which we operate.

Nurses in most, if not all, government hospitals are overburdened by patient load and a lack of sufficient resources to perform abortions.

As a result this also impacts on the patient. The unavoidable waiting period often pushes patients to request second-trimester abortions, which places an additional burden on the system as few medical practitioners are willing to perform surgical abortions while facilities that perform surgically are equally unavailable.

It’s widely known in the health sector that the lack of psycho-social services for abortion providers in the form of targeted training, debriefing and counselling, is another hindrance to the quality of SRH and abortion services.

Efforts to integrate safe abortion care into the broader maternal and SRH agenda need to be strengthened along with the provision of quality access.

Structured values-clarification training programmes for both healthcare practitioners and managers would contribute to more effective and timeous decision-making.

Fiscal resources should be prioritised to improve the availability and quality of abortion infrastructure and service delivery across all provinces.

The government should also ensure that the mandated public health facilities are adequately staffed with trained and willing abortion service providers.

Beyond government measures and efforts, healthcare providers are also obligated to offer compassionate, comprehensive and youth-friendly SRH services.

Those working in the healthcare system but who are not abortion providers should also be trained in how to treat women seeking such services.

Moreover, policies and guidelines should be expedited to provide systematic guidance on timeous referrals to the relevant facilities.

We need to level the playing field by ensuring equitable access to healthcare for all South Africans.

Women and young girls in rural communities and migrants must equally benefit from the policy redress of a post-apartheid, democratic South Africa, while healthcare workers must be enabled and supported in their work through the provision of conducive working environments.

It’s time for our policies to translate into action in the corridors of healthcare facilities. Until that is the reality, the work is far from over.

* Dlamini is the founder of Precious Women’s Reproductive Health Clinic in Durban.

** The views expressed here are not necessarily those of Independent Media.