You are here

TERMS OF REFERENCE FOR COMPREHENSIVE ABORTION CARE IN LIMPOPO

Termination of pregnancy (TOP) remains one of the most controversial sexual health issues, and yet despite the long-standing stigmas and opposition to its practice; termination of pregnancy remains a common experience for some women around the world.  The UN International Conference on Human Rights, held in Tehran in 1968, proclaimed reproductive rights as a subset of human rights: “Parents have a basic human right to determine freely and responsibly the number and spacing of their children.” Later UN conferences, conventions and resolutions have strengthened the case for reproductive rights and for the right to safe termination of pregnancy.

In 1999, the UN General Assembly agreed upon a set of Key actions for the further implementation of the Programme of Action of ICPD and stated: “In recognizing and implementing the above, and in circumstances where termination of pregnancy is not against the law, health systems should train and equip health-service providers and should take other measures to ensure that such termination is safe and accessible. Additional measures should be taken to safeguard women’s health”. Studies suggest that legal access to TOP services improves sexual and reproductive health – it could reduce unintended pregnancies, births, maternal ill-health and mortality as well as reduce HIV infections in infants. In terms of national legality and legislature, termination of pregnancy was legalized in South Africa with the Choice on Termination of Pregnancy Act in 1996 which gave women rights to request termination of pregnancy up to and including the 12th week of pregnancy and under certain circumstances between the 13th and 20th week of pregnancy by a certified nurse practitioner or medical doctor. In 2004, an amendment was added in order to make termination of pregnancy services more available for women.

This amendment allowed for any health facility that has a 24-hour maternity service to offer first trimester abortion services. It also allowed registered nurses that have completed a TOP training course to provide first trimester terminations, expanding the base of providers for abortions. As a result of this legislation studies suggest that there has been a reduction in maternal deaths from unsafe abortions, although they are still occurring2 . Primarily, the continuing high rate of unsafe termination of pregnancies is due to a variety of interconnected factors such as women lacking awareness of the availability of safe abortions; the knowledge of the time for abortion on request is not widely known, resulting in delays to seek abortion to a time beyond the limit set by the law. Not only are women unaware of the abortion legislation, a study done in KwaZulu Natal found that 68% of participants were not aware of any existing facility for termination of pregnancy. In addition, there is often confusion over the fee status of abortion in South Africa as women are unaware that the service is provided for free in public facilities. But even with TOP services being free of charge, poverty still limits access to healthcare, never mind sexual reproductive health and family planning. Further, termination of pregnancy is something that is not often talked about in communities, within families, or even among friends as it is still socially unacceptable. There are serious social consequences for having an abortion because of the stigma attached to the act, with women facing being outcast from their communities In Limpopo, the findings of the Sustainable Abortion Ecosystem workshops conducted by Ipas indicate that Limpopo has challenges with training and retainment of termination of pregnancy providers, which is exacerbated by a limited number of TOP facilities providing either 1st of 2nd trimester abortion services. Due to the above mentioned reasons, women do not discuss let alone seek termination of pregnancy and resort to seeking alternative methods, which perpetuates the cycle of unsafe and illegal methods. 2.

The purpose of this assignment is to scale up the Capacity enhancement on Comprehensive Abortion Care (CAC) in Limpopo to ensure safe access to SRHR services including Safe Abortion and Post Abortion care.

Interested applicants are requested to submit the following to zaf.admin@unfpa.org

 The closing date for proposal submissions is 22 October, 2021