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South Africa

Goal: Increasing the number of health providers willing and able to routinely deliver postpartum family planning and comprehensive abortion care services

Duration: 3 years (with 1 year extension)

Partner: The Health Foundation, Department of Health: Western Cape

Funder: Large Anonymous Donor

Download our impact statement of the Leading Safe Choices programme in South Africa 

Our impact

  • 366 healthcare providers trained in postpartum family planning
  • 378 healthcare providers trained in postpartum family planning counselling
  • 91 healthcare providers trained in comprehensive abortion care (CAC)
  • 264 healthcare providers attended values clarification workshops
  • 20 abortion services reopened across the Western Cape province

Provided postpartum family planning services to nearly 50,000 women during the programme, one quarter of whom received family planning for the first time.

Introduced PPIUD insertion within 10 facilities, increasing post partum family planning options available to women.

  • Helped to strengthen and tackle resistance towards abortion services
  • Reduced referral and waiting times for abortion services
  • Encouraged staff to talk more openly and confidently about abortion, including on issues of legality and women's rights


The RCOG partnered with the Health Foundation to improve postpartum family planning and comprehensive abortion care services in the Western Cape, South Africa. The Leading Safe Choices programme adopted a systems approach, working through existing Department of Health structures in country and with local programme and clinical teams, to better ensure sustainability of impact.

The programme was implemented across 10 facilities: Mitchell’s Plain District Hospital, Mitchell’s Plain MOU and CHC, Tygerberg Hospital, Mowbray Maternity Hospital, Michael Mapongwana and Khayelitsha District Hospital, and expansion sites New Somerset Hospital, Karl Bremer Hospital, Kraaifontein CHC and Retreat CHC.

The programme comprised of short, interactive training courses addressing the knowledge, skills and attitudes essential for the provision of high quality postpartum family planning and comprehensive abortion care. Training was followed by a mentorship programme to provide on-the-job support, and strategies to tackle systems barriers, such as close liaison with facility and district management.

The LSC programme has increased the number CAC providers in the Western Cape, and together with the Western Cape District of Health created and implemented a CAC Optimisation Strategy for the district. The strategy included Values Clarification Workshops, hiring dedicated CAC mentors to support newly trained providers and engagement with all levels of management to guide and support the roll out of services. As a result of these efforts, 20 new Termination of Pregnancy Clinics have opened in the Western Cape.

"I know that LSC training has made a huge impact on the community. We make such a huge impact on staff, that the staff are already taking ownership. We have buy-in from stakeholders, the facility manager, operational manager, and the pharmacy. Everything is there and they are doing an amazing job."

Sister Mandy Saambou, Leading Safe Choices Mentor in postpartum family planning