Challenges Related to the Structure of the Choice on Termination of Pregnancy Services in Public Health Facilities in the Tshwane District of Gauteng

Abstract

In 1997 South Africa legalised termination of pregnancy services for all women living within the country. It is now more than a decade since Choice on Termination of Pregnancy (CTOP) services have been implemented however, the state of the infrastructure of CTOP services in public health facilities is a cause for concern. The assessment of the quality of CTOP services in public health facilities has been seriously neglected. The objectives of the study were to assess, determine and evaluate the challenges related to the quality of the infrastructure of CTOP services in public health facilities. A quantitative, nonexperimental cross-sectional survey design was used. The population comprised of facility/quality managers, registered
professional nurses and midwives. A universal sampling method was used. Data was collected from healthcare professionals who were involved in procuring CTOP services. The public health facilities were assessed in terms of space adequacy, provision of privacy, availability of ablution facilities, rest room as well as human and material resources using the Donabedian model. It was found that insufficient provision was made to the  infrastructure of public health facilities to accommodate the high demand for CTOP services. Structural challenges remain a barrier in meeting the objectives of the CTOP services. There is evidence of significant differences between the facility/quality managers versus the professional nurses regarding their response to space provided for rendering CTOP services. The study recommends the revitalisation of the structure of CTOP services to improve the quality rendered.

Keywords: Challenges, structure, CTOP, public health facilities