Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study

 

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dc.contributor.author Harries, Jane
dc.contributor.author Cooper, Diane
dc.contributor.author Strebel, Anna
dc.contributor.author Colvin, Christopher J
dc.date.accessioned 2015-07-30T03:53:59Z
dc.date.available 2015-07-30T03:53:59Z
dc.date.issued 2014-02-26
dc.identifier.citation Harries, J., Cooper, D., Strebel, A., & Colvin, C. J. (2014). Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study. Reproductive health, 11(1), 16.
dc.identifier.uri http://hdl.handle.net/11427/13584
dc.identifier.uri http://dx.doi.org/10.1186/1742-4755-11-16
dc.description.abstract Abstract Background Despite abortion being legally available in South Africa after a change in legislation in 1996, barriers to accessing safe abortion services continue to exist. These barriers include provider opposition to abortion often on the grounds of religious or moral beliefs including the unregulated practice of conscientious objection. Few studies have explored how providers in South Africa make sense of, or understand, conscientious objection in terms of refusing to provide abortion care services and the consequent impact on abortion access. Methods A qualitative approach was used which included 48 in-depth interviews with a purposively selected population of abortion related health service providers, managers and policy influentials in the Western Cape Province, South Africa. Data were analyzed using a thematic analysis approach. Results The ways in which conscientious objection was interpreted and practiced, and its impact on abortion service provision was explored. In most public sector facilities there was a general lack of understanding concerning the circumstances in which health care providers were entitled to invoke their right to refuse to provide, or assist in abortion services. Providers seemed to have poor understandings of how conscientious objection was to be implemented, but were also constrained in that there were few guidelines or systems in place to guide them in the process. Conclusions Exploring the ways in which conscientious objection was interpreted and applied by differing levels of health care workers in relation to abortion provision raised multiple and contradictory issues. From providers’ accounts it was often difficult to distinguish what constituted confusion with regards to the specifics of how conscientious objection was to be implemented in terms of the Choice on Termination of Pregnancy Act, and what was refusal of abortion care based on opposition to abortion in general. In order to disentangle what is resistance to abortion provision in general, and what is conscientious objection on religious or moral grounds, clear guidelines need to be provided including what measures need to be undertaken in order to lodge one’s right to conscientious objection. This would facilitate long term contingency plans for overall abortion service provision.
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License *
dc.rights.uri http://creativecommons.org/licenses/by/2.0 *
dc.source Reproductive Health en_ZA
dc.source.uri http://www.reproductive-health-journal.com/
dc.subject.other Reproductive Rights en_ZA
dc.title Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study
dc.type Journal Article en_ZA
dc.date.updated 2015-05-01T18:11:08Z
dc.language.rfc3066 en
dc.rights.holder Harries et al.; licensee BioMed Central Ltd.
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Women's Health Research Unit en_ZA
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uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Harries, J., Cooper, D., Strebel, A., & Colvin, C. J. (2014). Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study. <i>Reproductive Health</i>, http://hdl.handle.net/11427/13584 en_ZA
dc.identifier.chicagocitation Harries, Jane, Diane Cooper, Anna Strebel, and Christopher J Colvin "Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study." <i>Reproductive Health</i> (2014) http://hdl.handle.net/11427/13584 en_ZA
dc.identifier.vancouvercitation Harries J, Cooper D, Strebel A, Colvin CJ. Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study. Reproductive Health. 2014; http://hdl.handle.net/11427/13584. en_ZA
dc.identifier.ris TY - Journal Article AU - Harries, Jane AU - Cooper, Diane AU - Strebel, Anna AU - Colvin, Christopher J AB - Abstract Background Despite abortion being legally available in South Africa after a change in legislation in 1996, barriers to accessing safe abortion services continue to exist. These barriers include provider opposition to abortion often on the grounds of religious or moral beliefs including the unregulated practice of conscientious objection. Few studies have explored how providers in South Africa make sense of, or understand, conscientious objection in terms of refusing to provide abortion care services and the consequent impact on abortion access. Methods A qualitative approach was used which included 48 in-depth interviews with a purposively selected population of abortion related health service providers, managers and policy influentials in the Western Cape Province, South Africa. Data were analyzed using a thematic analysis approach. Results The ways in which conscientious objection was interpreted and practiced, and its impact on abortion service provision was explored. In most public sector facilities there was a general lack of understanding concerning the circumstances in which health care providers were entitled to invoke their right to refuse to provide, or assist in abortion services. Providers seemed to have poor understandings of how conscientious objection was to be implemented, but were also constrained in that there were few guidelines or systems in place to guide them in the process. Conclusions Exploring the ways in which conscientious objection was interpreted and applied by differing levels of health care workers in relation to abortion provision raised multiple and contradictory issues. From providers’ accounts it was often difficult to distinguish what constituted confusion with regards to the specifics of how conscientious objection was to be implemented in terms of the Choice on Termination of Pregnancy Act, and what was refusal of abortion care based on opposition to abortion in general. In order to disentangle what is resistance to abortion provision in general, and what is conscientious objection on religious or moral grounds, clear guidelines need to be provided including what measures need to be undertaken in order to lodge one’s right to conscientious objection. This would facilitate long term contingency plans for overall abortion service provision. DA - 2014-02-26 DB - OpenUCT DO - 10.1186/1742-4755-11-16 DP - University of Cape Town J1 - Reproductive Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study TI - Conscientious objection and its impact on abortion service provision in South Africa: a qualitative study UR - http://hdl.handle.net/11427/13584 ER - en_ZA


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This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License