South African womens experiences of contraception and contraceptive services.

The impact of apartheid on South African womens experiences of contraception and contraceptive services was assessed through focus group discussions involving 86 White and Black women from the largely urban Gauteng province. The findings contradicted the widely held assumption that White women who obtain care through the private sector receive substantially better services than Black women in the public sector. Women who attended clinics in the public sector reported hostility from providers and were subjected to sterilization procedures without their full knowledge or consent. In the private sector financial considerations were often a major motivator of services provided. Service in both sectors was characterized by long waiting periods limited information and choice of methods and inadequate provider competence. Widespread regardless of the race of the client was an assumption on the part of health providers that they should make decisions on behalf of their clients and a failure to encourage women to take control of their own fertility. Recommended on the basis of these findings are better education about sexuality and contraception in the schools and community improvements in the training of health care workers and research on the dynamics of health worker-client interactions.