Understanding the Impact of Decentralisation on Reproductive Health Services in Africa (RHD) - South Africa Report

The provision of appropriate reproductive health care remains one of the main health care challenges in developing countries. The development of the delivery of reproductive health services is continually confronted by challenges from a changing environment, an important element of which is health sector reform, in particular decentralisation, which is being undertaken by most governments in Africa.

The general objective of this research is to make health sector decentralisation more effective in the development of appropriate reproductive health services. The general research question is: How does decentralisation affect reproductive health services? The overall research project compares different forms of decentralisation in two anglophone (South Africa and Uganda) and two francophone (Burkina Faso and Mali) countries in Africa to assess the impact of decentralisation on, and importance for, the development of reproductive health services.

This report is one of the deliverables of the European Union funded research project, led by The Nuffield Centre for International Health and Development (Contract: CA4-CT-2002-10028), Understanding the Impact of Decentralisation on Reproductive Health Services in Africa (RHD) and reports on the findings of the research in South Africa. The findings of this research have been used for the comparative study of the two anglophone countries (South Africa and Uganda) and for the comparison of the anglophone and francophone countries. The final product of the research project are the guidelines for policy makers which have been published by Nuffield Centre for International Health and Development.