NCOP
FOR WRITTEN REPLY
QUESTION NO. 4
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 February 2012
(INTERNAL QUESTION PAPER NO. 01)
Mr D A Worth (DA-FS) to ask the Minister of Health:
Whether his department has a comprehensive health sector policy in place
which deals with domestic violence; if not, (a) why not and (b) when will
such a policy be implemented; if so, (i) when was this policy implemented,
(ii) how was it implemented and (iii) how is the success of the policy (aa)
measured and (bb) evaluated?
CW4E
REPLY:
My department has identified and prioritised Violence as one of the leading
causes of disability and mortality in South Africa adding to the burden of
diseases and public health care spending on preventable diseases. Domestic
Violence is a public health concern and an act of human rights violation
that contributes to reversing the health sector gains in reducing infant
and maternal morbidity and mortality.
Life expectancy in South Africa is adversely affected by communicable
diseases such as HIV, TB, Malaria, Respiratory Infections and Diarrheal
Diseases; high Maternal and Child Mortality; increasing levels of non-
communicable diseases, which contributed to 28% of the total burden of
disease measured by disability-adjusted life years(DALY) 2004; as well as
Violence and Trauma related injuries (NSDA 2010-2013). In this context,
Domestic Violence falls under Violence and Trauma and is mainly experienced
as a form of Gender-Based Violence (GBV).
The following measures are in place:
i) The national Primary Health Care Package for South Africa (Department
of Health, 2000) sets forth a number of responsibilities with regard
to domestic violence and sexual assault. The document recognises the
need for inter-departmental and intersectoral collaboration in
delivering services;
ii) A draft "Strategic Framework for the Prevention of Injury and
Violence in South Africa" has been drafted and this includes sections
on prevention of domestic violence. This is a comprehensive document
that covers activities to be conducted by a range of government
departments and we are currently collating inputs from all relevant
departments prior to the document being considered and accepted as a
formal government strategy. Specific health responsibilities and
activities will be finalized once the inter-sectoral framework has
been finalized;
iii) The department has developed relevant policies and tools to assist
health care workers on how to care for victims of Domestic Violence.
The examples of such tools and measures include the Facilitatorsâ
Manual for: Caring for survivors of Sexual Assault and Rape (2008);
Sexual Assault Policy and Management Guidelines for Sexual Assault;
Strategic Plan for Injury Prevention; A Booklet of Services provided
by the department for Victim Support (Crisis Centres and Post Exposure
Prophylaxis) across the country; A Guide for Survivors of Rape and
Sexual Assault, the Victimsâ Rights and Patientsâ Rights Charter; the
Gender Policy Guidelines for the Public Health Sector and the Gender
Audit;
iv) The Patientsâ Rights Charter, National Department of Health,
(Department of Health, 2002b) directly upholds and promotes the right
of access to health care. Choice on Termination of Pregnancy Act, 1996
(Act No. 92 of 1996) (Government Gazette, 1996b) âpromotes
reproductive rights and extends freedom of choice by affording every
woman the right to choose whether to have an early, safe and legal
termination of pregnancy according to her beliefsâ;
v) The NDOH is conducting continuous training in all provinces using
these manuals. During the period 2008-2010 all health professionals
that are working in the designated public facilities were trained;
vi) A National Directory 2011: Reference booklet on Clinical Forensic
Medicine Services for Communities was developed in 2011 that contains
a list of health facilities in each Province by District to guide
communities on where to access these services;
vii) To ensure continuity of care through proper health screening and
referral across the health care system and beyond thus preventing
missed opportunities for victims and their family, the department
collaborates closely with other key departments through multisectoral
response teams in structures such as the National Gender-Based
Violence Council ( Department for Women, Children and People with
Disabilities), the Inter-departmental Management Team (NPA) on Sexual
Offenses (Thuthuzela Care Centres and One Stop Centres(DSD), the
Intedepartmental Committee on Victim Empowerment (DSD), Domestic
Violence Task Team and the Child Justice Intersectoral Team (DoJ&CD).
This is in line with the Health Sector implementation of the
Negotiated Service Agreement (NSDA);
viii) Sexual assault and post rape care services forms part of clinical
forensic medicine services and can be provided by registered forensic
pathologists, medical officers/practitioners or nurses trained to
perform the examination and collect evidence in a manner suitable for
use in a court of law (Government Gazette, 2011). A comprehensive PHC
service package is in place for the health sector prevention, response
and support to domestic violence through interventions such as:
â Provision of health care after sexual assault or rape
â Providing Medico-legal services through reporting and
collection of forensic evidence
â Providing proper treatment of injuries
â Preventing unwanted pregnancy
â Managing an unwanted pregnancy
â Providing post-exposure prophylaxis for HIV
â Preventing and treating other infections including STIs and
hepatitis B
â Preventing and treating psychological distress
â Providing access to psycho-social/psychological/psychiatric care.
â Follow up care
â Provision of information to the patient
â Public awareness and education
â Appropriate and complete documentation of injuries
END.