ArticleGlobal health action2017
'I am all alone': factors influencing the provision of termination of pregnancy services in two South African provinces.
Article in Global health action, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Implementation of safe abortion care policy in africa: a scoping review of readiness and outcomes.BMC public health · 2026Article
- Knowledge, practices, and emotional experiences of Italian midwives and healthcare professionals in termination of pregnancy for fetal anomaly: The RESPeC-ToP Study.European journal of midwifery · 2026Article
- Socio-ecological analysis of nurses' roles and challenges in choice on termination of pregnancy services in South Africa: A scoping review.Journal of public health in Africa · 2026Review
- Sub-national analysis of intimate partner violence and termination of pregnancy among ever-in-union women in South Africa.Scientific reports · 2025Article
- Exploring Emotional Well-Being and Support of Midwives Who Provide Termination of Pregnancy Care: An International Survey.Journal of advanced nursing · 2025Article
- A qualitative exploration of the reasons and influencing factors for pregnancy termination among young women in Soweto, South Africa: a Socio-ecological perspective.Reproductive health · 2024Article
- Providers' experiences with abortion care: A scoping review.PloS one · 2024Article
- Article
- Perinatal palliative care in sub-Saharan Africa: recommendations for practice, future research, and guideline development.Frontiers in pediatrics · 2023Review
- Willingness to perform induced abortion and associated factors among graduating midwifery, medical, nursing, and public health officer students of University of Gondar, Northwest Ethiopia: institution based cross sectional study.BMC pregnancy and childbirth · 2020Article
- Trends in and predictors of pregnancy termination among 15-24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003-2018.BMC pregnancy and childbirth · 2020Article
- Factors Influencing Abortion Decision-Making Processes among Young Women.International journal of environmental research and public health · 2018Article
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2 authors.
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Abstract
backgroundGlobally, universal access to sexual and reproductive health care services has been re-emphasised. One-third of maternal deaths could be averted by improving access to safe abortion services. Anecdotal evidence suggests that the implementation of the Choice of Termination of Pregnancy Act has been suboptimal in South Africa.
objectivesIn two South African provinces, determine: the proportion of designated termination of pregnancy (TOP) facilities that provide these services; explore the factors that influence the provision of TOP services; and explore the work experiences of health care providers at designated TOP facilities.
methodsDuring 2014 and 2015, we conducted a cross-sectional study at designated TOP facilities in Gauteng and North West provinces. A combination of methods was used, consisting of: site visits to, and observation of, each of the designated facilities using a checklist, and in-depth interviews with a sub-set of 30 TOP service providers, using a semi-structured interview schedule. The interview questions focused on the factors influencing TOP service provision, and the work experiences of TOP service providers. We used interpretative phenomenological analysis to analyse the data from the interviews.
resultsOverall, 77% (47/61) of designated facilities were providing TOP services, with 87.5% (28/32) in Gauteng Province, compared with 65.5% (19/29) in North West Province. Service provision was influenced by health system deficiencies, human resource challenges, lack of prioritisation and lack of management support. Study participants reported a heavy burden of care provision and expressed an overwhelming feeling of loneliness, courtesy stigma and lack of support from other nurses and doctors, which further influence TOP service provision.
conclusionsSouth Africa has an enabling legal environment for the provision of TOP services. Supportive management, prioritisation of TOP services and employee wellness programmes to address the psychosocial issues experienced by providers are critical elements of an enabling health policy environment.
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