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Only 40% of public clinics provide abortions: Study

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Only about four out of every 10 public clinics that should be offering abortion services actually do, according to a new survey conducted by the Bhekisisa Mail & Guardian Centre for Health Journalism.

Bhekisisa launched South Africa’s first online, searchable map of free, safe abortion providers, #SizaMap.

#SizaMap maps out free government abortion services on Friday.

Users can search for providers in the area where they live. The map also lists clinics’ contact details and addresses as well as the days on which abortions are provided and what other family planning options are available.

#SizaMap specifies what kind of abortions is offered at each clinic or hospital.

Non-surgical, or medical abortions, can be performed for pregnancies 12 weeks or earlier at facilities like community health centres by midwives, trained nurses or doctors.

Surgical terminations for pregnancies between 13 and 20 weeks require hospital admission and can only be done by a doctor.

South Africa legalised abortion more than 20 years ago but a lack of information still comes between many people and accessing safe, legal terminations.

Just over half of women who had used illegal providers said they did so because they “did not know about the law,” reveals a 2005 study published in the International Journal of Gynecology & Obstetrics.

An additional 15% of women in the 50-person study said they knew their rights but didn’t know where to get a legal abortion.

To construct #SizaMap, Bhekisisa began by requesting a list of facilities designated to provide abortions from the national health department and was provided with a register of 450 clinics and hospitals but the department admitted this was out of date.

From February to mid-March, Bhekisisa worked with provincial health departments to determine which facilities actually provided abortions.

Following these consultations, Bhekisisa phoned each of the 246 facilities that had been confirmed by provincial health department spokespeople to confirm services were being offered. Of these facilities, 236 could be reached by phone. A facility was deemed unreachable after not responding to five phone calls over a period of two days.

Ultimately, 197 facilities reported actually providing terminations.

“Our #SizaMap consultants presented themselves as pregnant women seeking abortions when calling clinics so that they were also able to record nurses’ attitudes.”

“Some healthcare workers provided surprisingly discriminatory responses such as “We don’t provide abortions here, this is a child-friendly hospital. Your child could be the next president.” Others refused to give information over the phone, potentially forcing abortion seekers to spend money on transport to the clinic only to risk being turned away.”

“We know that globally and here at home, access to safe abortions save women’s lives because it ensures the procedure takes place in a regulated environment. A lack of information shouldn’t stand in the way of that,” says Bhekisisa Editor, Mia Malan.

“We’ve been encouraged that the map has already helped quite a few women find government-approved services when they needed them. Now, we hope that #SizaMap will put the same information in the hands of many more.”

Bhekisisa is the largest specialist desk at the Mail & Guardian and specialises in long-form, narrative writing and analysis on health in South Africa and from around the continent.

M&G editor-in-chief Khadija Patel says #SizaMap demonstrates the power that sustained and solid reporting can have on the lives of the citizens it serves.

Patel says, “Bhekisisa worked for months to meticulously check and re-check data on this project to empower people to demand their rights and save lives. #SizaMap remains a powerful example of service-orientated journalism.”

#SizaMap can be embedded into any website using the following code:

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