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Leading Safe Choices: 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

Banner for Leading Safe Choices: South Africa


  • Over 830 health care providers trained
  • Increased LARC uptake from 10% in July 2016 to 29% in December 2017 among postpartum women
  • 20 new termination of pregnancy clinics opened in Western Cape since the start of the LSC programme


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


Read more case studies from the Leading Safe Choices programme

Read the LSC blog on Values Clarification and Attitude Transformation Workshops in South Africa