In South Africa, the complex relationship between progressive laws and unmet need offers unique opportunities and challenges. South African law guarantees access to sexual and reproductive health (SRH) services and death from unsafe abortion has declined by more than 90% since the Choice on Termination of Pregnancy Act was passed in 1996. However, the country’s maternal mortality rate remains unacceptably high, and many women face obstacles to getting a safe, legal abortion. South Africa still has high rates of HIV and unintended pregnancy, and young women face particular challenges to protecting their health and exercising their rights: One in three women aged 15-24 experiences an unintended pregnancy before the age of 20 and among females aged 15 to 24, HIV incidence is more than four times higher than the incidence of males in the same group.
Ibis opened its Johannesburg office in 2003 and we have an established network of NGO, university, and government partners throughout South Africa. We have built a rich body of work on South African young women’s SRH that has included participatory research with young women and community members in urban and rural settings, trainings for health care providers, and the development of SRH curricula. We now lead a national forum to address teenage pregnancy comprised of NGOs, government agencies, and researchers. We also conduct clinical research focused on improving abortion access and quality of care. Our research on medication abortion helped pave the way to the roll-out of medication abortion in public sector clinics in the country. We have led a number of completed and ongoing studies focused on improving second-trimester abortion care.