South Africa: 'Break the Silence on Sexual and Reproductive Health Issues'

(file photo).
28 June 2019

Johannesburg — For about two year now, South African public hospitals have been experiencing the shortage of contraceptives like Depo-provera, Nuristate and the pill with no clear explanation. The shortages come at at time when women and activists are calling for more contraceptive choices. These shortages result in increased unwanted pregnancies which result in the boom of illegal abortion businesses as women do not seek abortion services from public health facilities because they fear how the response to their requests.

allAfrica's Sethi Ncube spoke to Dr Manala Makua, who is responsible for the development of Sexual and Reproductive Health (SRH) policies and monitoring of implementation at national level. Makua focuses on women's health, which includes women's reproductive cancers, fertility planning and safe conceptions, contraceptive services, terminations of pregnancies, human genetics, maternal health, neonatal health and preventing HIV transmission from of mother to child.

Why are health facilities failing to provide women with much-needed comprehensive family planning services?

It takes 30 to 45 minutes to complete the proper counseling, examination and provision of the contraceptive method for the first-time user. There are 8 hours per day which means that a nurse will have to see only 8 new users per day. You are well aware that in a clinic there are more than 40 to 50 clients waiting for a nurse. If it will be acceptable to the clients to come by appointment and not report it as being sent back that may improve the quality of service to some extent.

How is the Department of Health mitigating shortfalls and developing policies to prevent this in future?

We are negotiating with private doctors and pharmacies to provide the service at the nominal fee for those who can afford. We are working with Department of Education to include comprehensive sexuality education in schools.

Why are women still the focus of the manufacturing of contraceptives, with so much advancement in science? A man can make lots of women pregnant while a woman can only carry one baby at a time, why not focus on men?

This is where we require activism by women, like women in 1976 who changed the apartheid law, for the benefit of all. The global world requires mobilisation to change the SRH agenda.

Why are contraceptives not advancing the same way as other drugs, e.g. HIV drugs? Women are still stuck with old contraceptive methods.

Organizations such as Bill and Melinda Gates and FP2020 are trying to mobilise the scientists to develop better technology on contraceptives but not all political governments are supportive of the initiatives. More work still needs to be done.

Most young women get to know about contraception after the birth of their first baby. What can be done about this?

If comprehensive sexuality education is taught explicitly in school and not later than grade 5, then information levels will improve and young people will be more knowledgeable to make proper decisions.

Women/activists are calling for broader choices of contraceptives. What's stopping this from happening?

This I can assure you that it will happen soon. In the next two to three years we will introduce 5 more methods.

What do you wish to see us as the media do to make the amazing work you do easier?

Break the silence about the SRH issues. Not to report it when it has adverse events such as rape or violence but weekly dedication to educate the community. Correct the myths and give facts of life.

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