1. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Entrenching democracy - giving meaning to reproductive choice in South Africa National Coucil of Provinces Meeting National Parliament, Cape Town 25 September 2001 REPRODUCTIVE RIGHTS ALLIANCE

2. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Structure of presentation Introduction to the Reproductive Rights Alliance Historical Overview - law Oversight Hearing Report- June 2000 TEWS Analysis Recommendations Questions and Discussion

3. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Reproductive Rights Alliance National structure committed to the realization of reproductive choice for all human beings, particularly women. Core business- a cohesive voice for a pro-choice perspective. Cross range of health, reproductive health, women’s rights and community based structures. Established in 1995 - specifically to lobby for passing of the Choice on Termination of Pregnancy Act. Advocacy work- specifically in relation to access: –advance –inform –defend –empower

4. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Why the need for the law Constitutional Framework - Bill of Rights. Women’s health. International obligations Democratization process.

5. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Questions to think about Why is access to safe, legal termination of pregnancy critical for the entrenchment of democracy in South Africa? Based on your provincial experience, what are the key questions you would like answered?

6. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 National Abortion Strategic Plan Partnership between National DOH and IPAS. Process through which to address historic challenges to effective implementation of the Choice on Termination of Pregnancy Act. Consultative workshop - ongoing consultative process with respective stakeholders.

7. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Vision articulated in Strategic Plan Recognising the values of human dignity, the achievement of equality, the security of the person, non-racialism and non-sexism, and the advancement of human rights and freedoms which underlie a democratic South Africa, we believe that no woman should risk her life, her health, her future fertility, her well being or the well being of her family because of unwanted pregnancy and lack of reproductive health choices. In pursuit of our vision, an integrated, holistic approach takes into consideration the political, social and economic contexts within which women seek and are provided with TOP services. Our vision is that every woman in South Africa shall have access to good quality termination of pregnancy services when faced with an unwanted pregnancy as well as access to other reproductive health services.

8. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Goal as articulated by the plan To provide acceptable, accessible, affordable, cost effective and user -friendly termination of pregnancy services for women with unwanted pregnancies as part of the reproductive health service programme and integrated into comprehensive health services, eventually reducing the number of unwanted pregnancies and the need for pregnancy termination.

9. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Threats to effective TOP service delivery Social - cultural religious context - leads to stigmization of service and health care providers involved in service provision. Macro economic framework - cuts in social spending. National Priorities - segmented approach to development. Challenges to legislation. Unequl gender power relations.

10. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Enablers for effective TOP service delivery Enabling legal framework: –Constitution –Choice on Termination of Pregnancy Act. Free of charge service. Vibrant pro-choice civil society. Strong relationships between respective stakeholders. Committed health care providers and management. Support initiatives for health care providers. Midwife training - decentralization

11. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Weaknesses Inadequate resource provision. Lack of visible TOP, national leadership. Weak management systems and processes. Unsupportive, disabling institutional environments.

12. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Strengths Committed national and provincial management. Committed service deliverers. Government- civil society partnerships: –monitoring –defense of legislation –IEC Models of good practise.

13. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Recommendations (1) Provide an enabling supportive environment and infrastructure to ensure the availability, equitable access and appropriate delivery of a good quality TOP service. Decentralize TOP service provision. Provide adequate resources to meet nation wide demand for TOP services. Defend the Act through meticulous practice and strategic partnerships.

14. Reproductive Rights Alliance presentation to Health Portfolio Committe - 25/09/01 Recommendations (2) Support health care providers to provide quality TOP services. Provide client-friendly quality TOP services. Mainstream current and future TOP training for all health care providers into all existing clinical training programmes. Forge visible leadership on TOP nationally. Provide an enabling environment for minors’ access to TOP and related reproductive health services.